Marin Family Counseling

New treatment for anxiety disorders

In this article by author Katherine Harmon in Scientific America titled, Observations:Nonexpert treatment shown to be more effective than primary care describes a protocol that allows patients the flexibility of using a combination of pharmacological based treatment and/ or computer assisted cognitive behavioral therapy.

In reading the study, the purpose of it was to develop a short term treatment method  for those patients suffering from anxiety who may be reluctant to receive treatment. One of the features of anxiety is often an inability to demonstrate self efficacy and get the resources needed to help manage symptoms. Additionally the researchers also wanted to lower the demands on the primary care physician, psychiatrists, and psychologists within the managed care system, which most likely translates into the desire to find ways of  lowering delivery  costs.

While the Scientific America article is titled and references "nonexpert  treatment"; it appears to be inaccurate. The treatment protocol utilizes a nurse or masters level therapist  with some training in anxiety disorders, to perform an intake, inform the patient on treatment options, provide psychoeducation on anxiety disorders, and instruct patients on how to use the computer guided treatment program. All of which take place in person.  Psychiatrists prescribe and oversee those using medications. Psychologists monitor the patient's attendance and self reports in order to determine if other more in-depth interventions are needed.

The novelty of this program is  not the absence of mental health professionals or "experts", but rather the additional use of  a computer assisted anxiety reduction tool. This allows both the patient and those monitoring the outcome data, a method  of  treatment that is both convenient and more cost effective than providing more traditional talk therapy.

Autism does not equal divorce

Parents of children with Autism have often feared that along with their child's diagnoses comes an inevitable divorce.  It has often been reported that families with a child with Autism have an 80% divorce rate. Brian Freedman, Clinical Director of the Kennedy Krieger Institute of Autism and Related Disorders had doubts that those statistics were accurate, and looked for more concrete evidence.

Freedman found after looking at the 2007 National Children's Health Survey, that a diagnose of Autism had no effect on whether on not a family stayed intact. Often similar statistics have been said of parents whose  child dies. Over the years it has been determined that divorce increases in those cases when the parents already had marital discord prior to their child's illness and death and not because of it. Perhaps the same might be found in later studies of families with an Autistic child.

While there is no doubt that there are increased stressors associated with families in either of these scenarios, it is important for parents to hear that divorce is not a foregone conclusion.

For more on this story go to: http://www.npr.org/blogs/health/2010/05/19/126976857/autism_diagnosis_children_divorce

For ideas  on family stress reduction go to:  http://www.autism-society.org/site/PageServer?pagename=life_fam_stress

Latest research on cyberbullying

Parents have concerns about their teens use of online media, cyberbullying, and privacy issues. The latest research by Pew/Internet ,released earlier this month, gives us an interesting look at the habits of teens ages 12-17.  In  their studies conducted through interviews of parent/child pairs from 2006-2009, they found that "bullying still happens more offline at school than online.... the impulse behind behaviors hasn't changed - just the vehicle."

Some interesting key findings about media use are:

• 63% of online teens go online daily.
• 89% go online from home.
• 94% go online for research for school projects.
• 81% go online for go online for information regarding entertainment information -movies, TV,Music and sports.
• 73% use an online network. (social media) 37% use it daily.
• 64% have created their own content online.
• 31% have looked online for issues related to health and weight.
• 17% have looked online for sensitive health issues.

What is interesting about teens online habits are  that  teens use  the internet as their preferred source of obtaining research for both personal and educational purposes. Because 31% of teens show an interest in health issues, it could be  useful for parents and educators to  begin to help teens discern what health sources are reliable and how best to interpret the vast amount of information available. Those seeking "sensitive health issue" advice are most likely looking for information around sexual issues  and parents may especially want to make sure that information is accurate. Since 89% use online resources from home, it might provide an opportunity for  parents and teens and to talk about the resources they are using and possibly explore ways to monitor appropriate use.

Some key findings regarding harassment:

• Older girls report more online harassment -38%
• 39% of social media users were harassed.
• 32% have experienced online harassment.
• 15% reported private material forwarded without permission( from phone and internet )
• 6% had embarrassing pictures distributed.
• 15% received a sext -4% sent. (sext - sexual pictures of text sent via email or phone)
• Those users with unlimited texting plan increased receipt of sexts.

The researchers stated that a significant portion of teens were not bothered by the various forms of harassment and 1/3 or 34% were distressed. High internet users were more likely to be distressed.

What questions researchers could further explore from these findings, and parents and educators can begin to discuss directly with teens, are the following:

• Are teens under reporting their distress? It would be developmentally appropriate.
• Are high internet users more distressed because they are more isolated and use the internet or social media tools more than those who are more socially active? Or, is it because "higher use" may support engaging in that type of behavior? Is there  more opportunity for harassment to flow in both directions with frequent use?
• Does sexts feel more removed and anonymous and therefore "safer?"

Parents and educators can support youth by providing outside interests, better relationship skills and  tolerance; which are just a few ways to hopefully combat harassment. Because teens really want their privacy, helping youth better understand how easily they set themselves up to be exploited, could be the first step in helping teens become more savvy users of media.

Some thoughts about Mother's Day challenges

  

Mother's day can be a wonderful time to celebrate your mother, or your own experience of being a mother. But what can you do if your mother relationships are complicated?   Here are some thoughts for when things become more difficult. 

Scenario #1 : Your mother-in-law and your mother don't want to share you, your spouse/partner, or the grandchildren, but you are tired of  trying to be in three places at once.

• You might want to acknowledge that sharing the attention may be hard on the moms, but it is even harder on the children when they have to make multiple visits on one day. Your solution might be to host a party for everyone to meet together on the same day and at the same time.
• You might choose to have a weekend event that allows meeting with everyone separately. This can be helpful if you are in a blended family situation.
• You might try and celebrate mother's day with your children and not the grandparents too. Although you know that your mother and/or mother-in- law might be disappointed, you can express your desire to experience mother's day as a mother and not also as an adult child. You could suggest that you will make alternative arrangements to celebrate as a family on a different day.

Scenario #2: You have been trying to become a mother and this day is another reminder that your body isn't performing the way you want.

• Be honest with your loved ones and let them know what you can and cannot tolerate right now.
• Make event times manageable so that overwhelm and disappointment are less likely. The longer you have to endure relatives, well meaning or intrusive questions, or environments that are uncomfortable, the harder it is to set limits and stay appropriate.

Scenario #3: You are grieving the loss of your mother.

• Be around others that you can share your loss with.
• Honor your mother on that day with a ritual that honors her and your relationship with her.
• Spend the day with a mother who might not have her own children around.

Scenario#4: You have a taxing relationship with your mother, but feel you must see her on that day.

• Invite other supportive people to participate, if appropriate, to serve as a buffer.
• Put clear limits ahead of time on the duration of the event so that everyone knows what to expect.
• Pick neutral cards, gifts, or activities, that feel comfortable to participate in.

Scenario #5:  You may want to be a mother, but for a variety of reasons that may not be possible right now.There are different ways women  "mother" their friends, loved ones, and children they know.

• Share the day with other women who are in a similar situation and celebrate the way in which you support one another.
• Share the day with those who you may serve as a mother, aunt, or grandmother figure to.
• Create pet mom's day. Some people view their pets as children. It can be comforting  to honor those relationships as well.

Holidays can be stressful when there are multiple needs to attend to. Often people get "charged" around special events. Even if your mother relationships are not complicated or stressful, it doesn't hurt to plan ahead and communicate everyone's expectations clearly to help fully enjoy your time together and avoid misunderstandings.