Archive for 'Articles'

Feb 03

In order to aid in the treatment of several mental health disorders, the American Psychological Association has defined the best first lines of treatment. We at The Academy at Sisters understand the importance of a consistent philosophical approach to changing at-risk behaviors and use a cognitive behavioral therapy model which follows evidence-based validated best practices. A case manager guides each student through their own individualized treatment plan.

Although we believe short-term use of medication to control behavior may be necessary, it is not a healthy long-term solution to behavioral problems. In our programs, we include the services of a clinical psychologist, board certified psychiatrist, doctor of counseling and autism specialist, as well as other specialists as needed.

ADHD, Attention Deficit / Hyperactivity Disorder:
Behavioral treatments have the most favorable risk-benefit ratios, suggesting they be the first line interventions. Combining behavior based treatment with medication can yield better short-term outcomes than either intervention alone. Combining both medication and behavioral treatments enables lower doses of medication to be used.

Conduct Disorder Oppositional Defiant:
Evidence shows psychosocial cognitive behavior interventions should be first line of treatment and tried before psychotropic.

Obsessive Compulsive Disorder:
Cognitive behavior treatment is the first line of intervention. Health Topics Medication should be added only if necessary.

Anxiety Disorders:
Strong evidence to support cognitive behavior treatment as a first line treatment and does not pose health risks as medications do.

Depression:
First line treatment strategy designed to minimize risks would involve sequential use of psychosocial interventions and close monitoring followed by medication if necessary. (Fluoxetine is the only medication approved by FDA for treating depression in children.)

Bipolar:
The limited research suggests psychosocial treatments are beneficial and do not present adverse side effects. Short and long-term medication trials are needed to clarify the risk-benefit ratios for medications used to treat bipolar.

Anorexia/Bulimia:
For bulimia, cognitive behavior treatment appears to have the most scientific support and a more favorable risk-benefit ratio. For anorexia there is a general lack of evidence of effectiveness for both psychological and pharmacological.

Jan 31

Often people choose not to offer feedback even though it would be useful in communicating with others. Instead, they avoid or overlook confrontations. They don’t want to make waves, or out of a lack of concern, don’t want to get involved.

Even though we may not be aware of it, we are all capable of harming people we care for. If a person is being irresponsible, it is your responsibility to confront that person. Tell the person about the behavior you observed and give the person an opportunity to recognize it. It takes a lot of practice to make a confrontation that is fair, accurate and shows concern. It is important to practice offering this feedback as well as accepting it.

Offering Feedback:

1. Offer the person feedback out of genuine concern for the situation instead of complaining or looking for support from others. Rely on an outside observer only if a conflict develops.

2. Confront the person quietly, so as not to attract an audience, unless it is necessary at the time to prevent further hurtful behavior.

3. Don’t compare the person’s behavior with anyone else’s. Nobody wants to hear that they are inferior to others. This makes people not want to listen even if the feedback is meaningful.

4. Offer your feedback as soon as you can. Putting it off or not doing it makes the situation more difficult. Waiting allow you to build up feelings of resentment and insecurity.

5. Don’t repeat a point once you have made it and the other person has carefully considered it. Pushing a point will probably make the other person defensive and unwilling to listen.

6. Don’t put the other person down or on the defensive.

7. Object only to actions that the other person can change. Ask only what you have a right to ask for. You may ask the person not to shout, but if you ask them not to be angry with you, you’re probably asking too much.

8. Offer feedback about only one issue at a time. More than one is difficult for anyone to handle. Pick one behavior and stick to the point.

9. After offering your feedback out of concern, don’t apologize for it. Apology will only minimize what you have done. In other words, this will only lessen the effectiveness of what you had tried to do.
10. Don’t ‘soft-soap’ what you have to say. Get to the point, but remain caring in your behavior.

11. Don’t use sarcasm. It will only cause the other person to become angry or fearful. It will also cause you to feel more inadequate and fearful.

12. Avoid words like ‘always’ and ‘never’. The use of these words may prevent you from being accurate and truthful.

13. If you never compliment the person, don’t expect them to remain open to your criticism.

Accepting Feedback:

1. Remain silent while you are receiving feedback. Whether you agree or not is not an issue. This can be discussed later. Interrupting or voicing disapproval only complicates the matter and causes defensiveness.

2. Look directly at the person who is confronting you. Maintaining eye contact shows respect and indicates you’re listening to what is being said.

3. Under no condition find fault with the person offering you feedback. If they have made a mistake in grammar, or are using a bad approach, wait and tell the person after the confrontation has been made. Doing it at the time creates insecurities in the other person and keeps you from listening to what is being said and how it is being said.

4. Don’t create the impression that the other person is offending you. The hardest people to deal with are those who are defensive at first and who then, when cornered, act as though they are at the edge of despair. Acknowledge the confrontation and accept ownership.

5. Don’t exaggerate the feedback that you are being offered. If a person tells you that you were thoughtless, don’t blow it out of proportion by telling the person that you were vicious and then defend yourself against something you weren’t confronted about.

6. Don’t use negative jokes. It is hurtful behavior to someone who is trying to show you concern and creates bad feelings.

7. Don’t change the subject. Use your knowledge and understanding to help clarify the situation, not to cloud the issue. Deal only with the behavior at hand.

Jan 27

The Teen-age years are a time for erratic behaviors, making mistakes and what some call ‘impulsive’ behaviors. Some of these decisions show up as uncontrolled energy, distractions (lack of concentration) and moment by moment changing ideas about what we want, where will we go today, with whom, etc. It is also associated with frequent irritability and confusion about decisions; therefore, some days may seem ‘impulsive’ because it is easier to follow the group than to be responsible for your own decision- making.

“Impulsive behavior” is defined as, ‘acting suddenly, while ignoring the consequences of the behavior’.It would seem that the word impulsive has been over used and in many cases used as an excuse for behaviors, especially for adolescents. That is why it is important to stress that you are responsible for their decisions and actions. There is never an excuse for harmful impulses!

Here is a list of examples of impulsive actions:

Punching something or being verbally aggressive
Stealing
‘Borrowing’ without asking
Running away
Spending more money than you have (going in debt)
Unprotected sex, acting out sexually
Drug use
Being dishonest
Breaking the rules
Drinking alcohol
Cutting yourself (self-destruction)
Driving under the influence of an illegal substance or getting into a car with irresponsible peers
Tantrums (slamming doors, throwing things, hitting walls
Destroying property when angry
Being mean, cruel or ‘putting others down’
Smoking cigarettes
Overeating
Trying to commit suicide
Doing bizarre things with your hair (shave it, color it, etc.)
Driving without a license

We also know we have choices. Some decisions may seem impulsive but we decide on things all the time without even realizing it. The truth is we always think about everything we do even if it doesn’t seem like it at the time. How often have you responded, “Wow, I didn’t even think about it, I just did it.” You did think, it just went by really fast and it may have seemed unimportant; therefore, you could ignore the consequences.

It is important to learn that sudden decisions (or impulsive behaviors which may be harmful) are never an excuse for our actions and you always have a choice! Listen to those things you say to yourself before you act! Learn to hear the justifications and excuses you make to yourself when you ignore what you know is right and wrong.

Jan 20

What is your most valuable possession? No, it’s not your stereo, your bicycle, your stamp collection or anything else that money can buy. It is your SELF – your good opinion about yourself. SELF is the feeling inside that says, “I really like myself!” Developing self helps you face whatever life throws at you. Many adults are constantly bothered by self doubts because they never learned to like themselves.

Don’t concentrate on the frightening unknowns; jump in and give it a try. You’ll survive. And with each success, you bolster your self-image and inspire yourself to go further. When you don’t succeed, however, don’t punish yourself. You can’t be perfect; you can’t do everything well. What’s important is that you don’t allow your fears to prevent you from trying new experiences. Look around you. You’ll notice a distinct shortage of perfect people! So do your best but don’t get hung up on being the best all the time. Try hard and have faith in yourself. That’s what matters.

Another obstacle is ENVY. Being jealous of others is a waste of time and energy. Every person’s life has both good and bad qualities. Your assets outshine the other person’s in some areas. Be thankful for your blessings; don’t begrudge the other person theirs. When you make a big mistake, make it right, forgive yourself, and get on with your life. Don’t wallow in a zero state.

Never overlook the advantages of reaching out to others. Reaching out is a sure-fire way to feel better about yourself. Caring about others is a measure of strength of character and enhances personal power and self-esteem.

One last piece of advice: Learn to “talk” to yourself (rationally). Congratulate yourself for everything you do right. And when you fail or make a mistake encourage yourself to keep trying. With that kind of attitude you shouldn’t find it difficult to become your own BEST FRIEND.

“Things work out best for those who make the best of how things work.”
Anonymous

Jan 13

Self-talk is that “little voice inside your head”. It is what you tell yourself about yourself, or about a situation. Self-talk can be positive, like when you tell yourself “I can do this” to help you get through something you’re nervous about. Or, it can be negative, like when you tell yourself “I’m so stupid” and beat yourself up about a mistake you’ve made.

What does self-talk have to do with anger management?

A lot! Self-talk has a huge influence on your feelings and can make you feel better or worse about any given situation. If your self-talk tends to be negative, you probably spend a lot more time feeling angry (at yourself or at others) than someone whose self-talk tends to be positive.

Example:
Situation: John is in a movie theatre on his way back to his seat from the concession stand. Someone bumps into him and knocks half of his super-sized bucket of popcorn onto the floor. The guy who bumped into him just kept walking.

Negative Self-Talk: “That jerk probably bumped into me on purpose. He’s trying to make me look like a fool. Embarrassing me in front of all these other people, they are probably all thinking I’m a punk if I don’t do something about it. I can’t let him disrespect me like that.”

Positive Self-Talk: “The guy is probably oblivious – doesn’t even realize what he just did. Either that or he’s got some serious issues going on. Everyone who saw this is probably thinking what a jerk he is. I’m not going to let it ruin my night. Anyway, he just cut my calorie intake for the night in half.”

Clearly, our own self talk influences how we react to situations that might make us angry. To illustrate how this happens, let’s take a look at the anger cycle.

Anger Cycle:

Stage 1: ‘Conflict Occurs’
Conflict occurs when there are two or more opposing attitudes, values or beliefs. The conflict can be internal (a conflict within yourself, such as when you have two opposing beliefs), or interpersonal (between two or more people).

Stage 2: ‘Response’
How people respond to conflict can determine the consequences of the conflict. Your response to conflict is the easiest part of the cycle to control.

Stage 3: ‘Consequences’
There are consequences to every conflict, but it is important to remember that the consequences can be negative or positive.

Stage 4: ‘Reinforcement’ or ‘Change’
As a result for the consequences, the conflict cycle can be reinforced so it continues in the same old way. Or, the consequences can lead to change, so that the parties involved either exit the cycle altogether or continue but change the patterns in the cycle.

Ask Yourself: At what part of the anger cycle is self-talk important? How does self-talk effect the cycle, in either positive or negative ways?

What different outcome might positive self-talk have on the anger cycle compared to negative self-talk?

Jan 04

Motivational Interviewing: is a directive, client centered counseling style for eliciting behavior change by helping clients explore and resolve ambivalence.

• Motivation to change is elicited from the client and not imposed from without. You can’t give someone motivation much like you can’t give them self-esteem. This relies upon identifying and utilizing the client’s intrinsic values to stimulate behavior change.

• It’s the clients task (not the counselors) to articulate and resolve ambivalence. Each course of action has perceived benefits and costs associated with it.
Example: If I stop smoking I’ll feel better about myself, but I’ll gain weight which will make me unattractive and unhappy. The counselor’s job is to facilitate expression of this seeming impasse to how the ambivalence may be resolved.
Example: If I drop my demanding behavior I’ll feel weak and vulnerable.

• Direct persuasion is not an effective method for resolving ambivalence.
Urgent persuading increase client resistance.

• The counseling tone is a quiet and eliciting one.
Direct persuasion, aggressive confrontation and argumentation are the conceptual opposites of MI.

• The counselor is directive in helping the client examine and resolve ambivalence.
The operational assumption in MI is that ambivalence or lack of resolve or choice is the principal obstacle to be overcome in triggering change.

• Readiness to change is not a client trait but a fluctuating product of interaction with the counselor.
The counselor then must be responsive to signs of motivation. Resistance and denial are feedback on how the counselor is doing and may be a cue to modify the approach.

• The counselor/client relationship is a partnership or collaboration.

Dec 08

There are only ten things in your life that you can control:

1. What you do. You cannot control others. Let them go and give them back to themselves.

2. What you say. You cannot control what others say to you. Let what they say go and give their words back to them.

3. What you think. You cannot control how others think about you. Let what they think about you go and give their thoughts back to them.

4. Your work. You cannot control others performance. Let their performance go and give it back to them.

5. The people you associate with. You cannot control who will and will not be your friend. Let negative influences go and give their negativity back to them.

6. Your basic physical health. You cannot control others personal health. Let their issues go and give it back to them.

7. The environment you live in. You cannot control others choices. Let their choices go and give their choices back to them.

8. Your finances. You cannot control others finances. Let their finance issues go and give it back to them.

9. Your time. You cannot control how others wish to spend their time. Let it go and give their life back to them.

10. You cannot control what others wish to do with their lives. Let it go and give their life back to them.

Letting go is about getting rid of the need to control anything and everything that is not on the above list. If it is not within your power to change it, control it, or alter it, then let go of it! Period. Try it right now, and feel the tranquility that comes with releasing those which we cannot control, and the peace in giving them back to themselves.

Dec 07

“Whoever I decide to be depends on who I am with.”
Pet Shop Boys

“Peer pressure” is defined as the ability of adolescents to impact the behaviors, feelings, and thoughts of one another. This happens because of the intense need for a feeling of belonging and acceptance adolescents have and their willingness to conform to peer expectations. Adolescents can have either a negative or a positive influence on one another.

“Negative pressure” means to convince someone to go along with negative or illegal activities. It also means to do things that are negative in order to be accepted by others.

“Positive pressure” means to influence someone to change or grow by role modeling or by having expectations of them.

“Tattling” means to tell on someone for your own personal gain. An example would be to “bust” someone for breaking a rule as revenge for something else.

“Responsible concern” means to confront someone to benefit them. This means putting aside your own feelings or discomfort in order to meet someone else’s needs. An example would be to not condone an act by someone which is harmful to them or others. Here is the online cake delivery service for more details https://www.expresscake.com/