| Depression: Although
many people become depressed at some point during their life span,
there is a distinction between feeling sad for a given period of
time and a clinical depression. Those experiencing a severe depression
may experience a depressed mood for most of the day, every day,
markedly diminished pleasure in activities, sleeping problems, fatigue,
diminished ability to think, feelings of worthlessness and recurrent
thoughts of death. These symptoms continue for over 2 months and
are not better accounted for by bereavement. The lifetime risk for
Major Depressive Disorder varies from 10% to 25% for women and 5%
to 12% for men. Episodes of Major Depressive Disorder often follow
a severe psychosocial stressor, such as the death of a loved one
or divorce. In therapy we work to understand the origin of the current
problems and work to find viable solutions. Therapy can also be
useful in helping people identify problems early on, so as to address
them before they become overwhelming. The ultimate goal of therapy
is to help people resolve their concerns and to learn more effective
coping skills.
Anxiety: Everyone experiences anxiety at
certain points in their lives, and this, in many cases, is a natural
response to the uncertainties of life. However, if an individual
experiences anxiety that significantly impairs their ability to
function, it is important to try to resolve that impairment. There
are a variety of Anxiety Disorders (e.g. Panic Disorder, Agoraphobia,
Specific Phobia, Social Phobia, Obsessive Compulsive Disorder, Posttraumatic
Stress Disorder, Acute Stress Disorder, and Generalized Anxiety
Disorder). One goal of therapy in treating anxiety is to identify
the "triggers" that elicit anxiety. Another goal is to
learn and practice relaxation techniques that the individual can
implement when faced with the triggers for anxiety. For those individuals
who have a long-standing history of anxiety, it is also helpful
to identify and come to terms with the origins of their fears in
order to reduce and effectively manage their responses to stressful
situations.
Relationship Issues: We all face times in
our lives when we have difficulty in our interactions with others,
whether they are family, friends or co-workers. Oftentimes these
roadblocks can be examined and addressed within therapy. Sometimes
it may be as simple as improving communication skills while other
times it may require a deeper examination of the underlying conflict
involved in those problematic relationships.
Life Transitions: As we move through life
we all face periods in our lives where we move out of one role into
another (e.g., leaving home, getting married or divorced, children
leaving home, job changes, death of a loved one, retirement, etc.).
Anytime we encounter transitions we are likely to feel somewhat
uncomfortable and it may elicit questions about how we will bring
meaning to our new role in life. One goal of therapy in addressing
these transitions is to clarify these meanings and learn to cope
with the ambiguities that go along with the move from one role to
another.
Post-Traumatic Stress Disorder (PTSD): The
essential feature of PTSD is the development of characteristic symptoms
following exposure to an extreme traumatic stressor involving direct
personal experience of an event that involves actual or threatened
death or serious injury to oneself, an acquaintance or a close family
member. In response to such stressors the individual experiences,
intense fear, helplessness or horror, a heightened arousal and recurrent
intrusive thoughts that cause significant impairment. The lifetime
prevalence rate ranges from 1% to 14%. Because individuals who have
experienced a severe trauma often have had their sense of trust
of the world betrayed, a key component of therapy for PTSD is the
re-establishment of trust within the context of the therapeutic
relationship. Another key component of therapy is to develop relaxation
skills and self-care. Within this context, the therapist and the
client can begin to resolve the trauma and regain a sense of well
being in the world.
Obsessive-Compulsive Disorder (OCD): The
essential features of OCD are recurrent obsessions or compulsions
that are severe enough to be time consuming (i.e., they take more
than 1 hour a day) or cause marked distress or significant impairment.
At some point during the course of the disorder the person has recognized
that the obsessions or compulsions are excessive or unreasonable.
Obsessions are persistent ideas, thoughts or impulses that are experienced
as intrusive and cause anxiety or distress. Compulsions are repetitive
behaviors (e.g., hand washing, ordering, and checking) or mental
acts (e.g., praying, counting, repeating words) the goal of which
is to prevent or reduce anxiety or distress. The lifetime prevalence
rate is 2.5%, and usually begins in adolescence or early adulthood.
Therapy usually addresses the obsessions and compulsions, and helps
the individual find more adaptive ways of coping. Furthermore, if
this is a long-standing problem, the relationship between a compassionate
and trustworthy therapist and the client can help the client resolve
the personal issues that are associated with the disorder.
Assertiveness Skills: Assertiveness is an
essential skill in adult communications, yet many of us have not
been taught appropriate ways of asserting ourselves. Instead, we
may respond to situations by being passive (i.e., "I don’t
have any needs"), aggressive (i.e., "You must fulfill
my needs, or else") or passive-aggressive (i.e., "I’m
not going to tell you what I need, but if you don’t fulfill
my needs you’re going to pay"). During my internship at
the Veterans Medical Center in Gainesville, Florida I taught assertiveness
skills classes. Assertiveness skills teach the individual methods
of asserting themselves in such a way that they can clearly articulate
their needs without being aggressive with another person. An interesting
outcome of these classes was that, after 10 weeks of assertiveness
training, there was a statistically significant decrease in the
levels of depression of the participants. Participants indicated
that they felt a sense of increased empowerment because they had
developed better communication skills. These skills are developed
through practice and receiving feedback in therapy.
Women's Issues: There are a number of socio-cultural
issues that women must face that are unique to them. It is helpful
for women to be able to identify and articulate some obstacles that
they face in life. After identifying those issues, I assist women
in developing useful strategies for facing those issues.
Parenting Issues: Parenting is one of the
most challenging and important jobs we have. Oftentimes we parent
as we were parented, simply because we aren't aware of options.
Based on Rudolph Dreikur's book: Children: The Challenge I help
parents examine the roadblocks they encounter in parenting. One
ultimate goal of this work is to help the child and parent understand
the idea that there are logical consequences for our actions. Once
this concept has been integrated into parenting, the child learns
a valuable lesson that should last a lifetime.
Psychological Evaluations for the Texas Commission
on Law Enforcement Officer Standards and Education (TCLEOSE).
These evaluations are conducted to verify that the law officer is
in satisfactory psychological and emotional health to perform the
duties, accept the responsibilities and meet the qualifications
established by the appointing agency.
Health and Medical Psychology: is
another major area in which I provide services. Those services assist
individuals and their families in coping with physical illness associated
with such things as heart disease, cancer, AIDS, liver disease,
geriatrics, and pre-and post-surgical support and the psychological
issues (e.g., anxiety, depression, and grief) that frequently accompany
illness. |
