Therapy for Managing Depression, Anger and Aggression

Classic Cognitive-Behavioral Therapy models are based on the assumption that thoughts(cognitive processes) dictate feelings.  Those feelings then dictate behaviors (or actions).

450px-Fire-lite-bg-10Here is a basic example:
A fire alarm goes off in a hotel at night

Person A thinks:  some kids pulled the alarm and now I am awake!
Person A feelsanger at the kids andannoyance about being awake.

Person B thinks: there must be a fire, I must get out!
Person B feelsfear of being trapped in the fire, worry about how to escape

Person C thinks: I remember when my friends and I liked to pull the fire alarm.
Person C feelsunderstanding of kids having fun and comfortable to go back to sleep.

You CAN control you thoughts, which leads to the ability to have more positive feelings.

Christy Motta, MA summarizes a Cognitive-Behavioral approach to dealing with aggression below:

In the case of aggression, the individual must change the perceptions and beliefs that contribute to increased anger. In order to do this, the individual must: 1. Cope with arousal. The first step is to identify (observe) what is happening. The individual must become aware of when they are angry and notice the physical sensations and thoughts that accompany it.

2. Replace problem thoughts with thoughts that are helpful in dealing with PROVOCATION. “This could be rough, but I can deal with it” “easy does it” “Live and let live” “Stick to the issues. Don’t take it personally.”

3. Modify problem thoughts to those that are helpful in dealing with CONFRONTATION. “keep my cool, walk away, take a time out” “I don’t need to prove myself” “There’s no point in getting mad”

4. Change appraisals and reflections AFTER A CONFRONTATION.

a. Unresolved: “They don’t have to agree” “let it go” “don’t take it personally”
b. Resolved. Label (Describe) what happened. Praise self.

People frequently need some external limits in order to identify their aggression as a problem and begin actively working on modifying their thoughts. Probation, the risk of losing housing and the risk of losing important valued relationships are common consequences that get people thinking about their aggression.

How to YOU choose your therapist?

women smilingOnce you make the decision to pursue counseling, you must then decide WHICH therapist to call.  Many people ask friends or family members for recommendations, others search the internet, and still others use the old-fashioned yellow pages.  No matter how you choose, that first session is your opportunity to see if you have found a therapist who will meet your needs.

Dr. John Grohol, CEO of PsychCentral, writes 
The four most important attributes of a good therapist are:
1. A good therapist is positive and empathetic.
2. A good therapist is professional, courteous, and respectful.
3. A good therapist recognizes her strengths and limitations.
4. A good therapist is genuine.

As you meet and talk with your therapist the first time, look for these characteristics. Here are some suggestions of questions you could ask as you are determining if your therapist has the four key criteria listed above:

  1. How are you licensed? What are your training credentials? Do you belong to any professional groups?
  2. How would you describe your treatment style? Many different treatment styles exist. Different approaches may be more or less appropriate for you depending on your situation and needs.
  3. What kind of evaluation process do you use to recommend a treatment plan?
  4. What are the measurable criteria you use to assess how well treatment is working? Can you give me a few examples?
  5. Do you use published clinical practice guidelines to guide your treatment planning? How?
  6. What psychotherapeutic approaches and tools do you use?
  7. How do you decide which approach is best for the patient? Do you ever use more than one approach? When?
  8. How will you work with other medical providers, such as psychiatrist, who may also provide care?
  9. How often will we meet?  How long will treatment last?  How do I know when treatment is complete?

Think about how well you will be able to relate to the therapist as she answers these questions.  You want to achieve the best possible match in order to have the greatest chance of meeting your goals.

If you would like to ask me any of the above questions, or learn more about my practice.  Please contact me.

Five ways you can help your teen with PEER pressure

How does Peer Pressure affect your teenager?counseling-adolescents

Adolescents often have several groups and layers of friendships.  They may have a couple of close friends, different larger groups of friends with common interests, and friends who come in and out of their lives.  Friendships during the teenage years tend to be fluid and changing over time.  Teens most often choose to spend time with others of the same age and background and select friends from the same ethnicity, gender, and socioeconomic status.

Peer friendships can provide some of the most healthy and happy experiences for a teenager.  Strong peer-to-peer relationships help teens develop important skills of communication and compromise.  In a positive environment, adolescent friendships can be one of the most important developmental experiences in your child’s life.

Unfortunately, situations exist where peer influence and peer pressure can lead a teenager to choose unhealthy and unsafe behaviors.  In these cases, parents want to help guide their child to make positive choices.  Some effective strategies recommended by adolescent development experts Dr. B. Bradford Brown and Dr. Laurence Steinberg are:

1.     Nurture your child’s self-esteem.  An adolescent with a positive self-concept and strong since of self worth is less likely to be influenced by outside influences.

2.     Encourage your child to form positive relationships with other adults.  These relationships can help a teen learn good models for healthy relationships.  Encourage your child to spend time with a teacher, counselor, or relative who you believe who be a positive mentor to your child.

3.     Encourage diverse relationships.  Parents who model diverse friend relationships in their own lives help teens learn to do the same.  Encourage your child to create friendships across ethnic, gender, and socio-economic or religious lines.

4.     Teach your child specific skills to make good decisions and resist negative behaviors.  Adolescents need to be taught methods to properly analyze a situation first, and then make a decision.  The most basic concept is the cost vs. benefits analysis.  Teach your child to evaluate the positive outcomes with the negative outcomes of several possible scenarios.  Be specific with respect to consequences for behaviors.

5.     Teach your teen exit strategies and ways to say “no” to negative pressures.  Preparing your teen in advance for ways to deal with specific circumstances will help when they are faced with a “real life” situation.  Role-play examples of common peer pressure moments such as being offered alcohol or drugs.  Help your child prepare positive responses that are comfortable for them.

Remember, peer relationships can be one of the best experiences for your child’s healthy development.  Following the above recommendations will put your child in the best possible position to avoid negative influence and make positive choices.

For more detailed information on the above, consult the following sources:

Brown, B. B. (2004). Adolescents’ relationships with peers. In R. M. Lerner & L. Steinberg (Eds.), Handbook of Adolescent Psychology, 2nd edition (pp. 363-394). New York: Wiley.

Friendships, cliques, and crowds. In G. R. Steinberg, L. (2005). Adolescence. New York, NY: McGraw-Hill.