Anxiety
Our staff staff provide tailored cognitive-behavioral therapies (CBT) for anxiety such as:
- Cognitive Therapy
- Metacognitive Therapy, or
- Acceptance and Commitment Therapy.
The course of individual therapy will vary based upon each client’s needs, but most of the time there is a focus on developing new skills to identify and change thought and behavior patterns and find alternative ways to cope with stressors. Clients are often given “assignments” to perform between sessions to enhance their personal development.
Substance Issues
The best type of treatment (or combination of treatments) will vary depending upon the person’s unique situation. One of the most important parts of any treatment is creating a commitment to change. Specialized counseling focused on understanding the problem and increasing motivation is often a starting point that leads to other treatments.
Several psychosocial treatment approaches have been shown to be effective including motivational interviewing, cognitive-behavioral therapy, community reinforcement, and others. In addition, many people find self-help groups to be beneficial such as Alcoholics Anonymous or Moderation Management. Medications can be useful additions to psychosocial treatments for certain substances, but medications alone are very limited in their effectiveness.
Most treatment approaches can be done on an outpatient basis, but hospitalization may be needed for initial stabilization or to deal with medical complications.
Our staff offer individual evaluation and psychotherapy, family consultation, and consultation with other health care professionals for the treatment of substance abuse and dependence. The components of individual psychotherapy will vary based upon the type of substance problem and whether other issues are involved. Most often, individual psychotherapy will involve strategies from motivational interviewing, cognitive-behavioral therapy, and community reinforcement. In some cases, we will see a client who is already in a treatment program and doing well, but not getting the help needed for insomnia, depression, anxiety, or other co-morbid issues.
We do NOT provide urine toxicity screenings, medically controlled withdrawal commonly referred to as “detoxification”), or substitution medication therapies. If the severity of a client’s substance use problems are severe, we will refer the client to a multidisciplinary treatment program.
Depression
Our staff offers individualized counseling sessions for depression. The course of individual therapy will vary based upon each client’s needs, but most of the time there is a focus on identifying and changing behavioral and thought patterns using a cognitive-behavioral therapy (CBT) framework. The client is asked to keep thought records and complete other tasks in between sessions to learn and internalize new skills. Individual therapy for depression usually lasts from 15 to 20 sessions.
Bright light therapy can be added as an adjunctive treatment for certain types of depression. We highly recommend getting a professional evaluation to determine if light therapy is a good option for any client. Although it can be an effective treatment, it requires a time commitment on behalf of the client of about 1/2 hour each day. The most serious risk associated with light therapy is the emergence of hypomania or mania. So persons with a history (or family history) of mania should be carefully monitored by a professional in case medication treatments are also needed. Click here for information about The Brighter Side specialty package.
The group entitled Optimism in Everyday Life focuses on preventing and overcoming depression by learning to be more optimistic. The group process generally follows three phases. In the first phase, members learn about how to use cognitive therapy and learned optimism to analyze life situations. In the second phase, members analyze each other’s life situations and give feedback with guidance from the group leader. In the third phase, participants are expected to analyze their own life situations and solicit feedback from others about how to be more optimistic. All participants in this group must have an evaluation or screening before joining and may be asked to participate in individual therapy if appropriate.
Insomnia
The best type of treatment (or combination of treatments) will depend one each person’s unique situation. I strongly advise people to get a physical health evaluation from their primary care physician to rule out any medical problems. In addition, if there are indications of a sleep disorder other than insomnia, I advise a ‘sleep study’ using polysomnography.
For occasional or short-term insomnia, many people respond favorably to a combination of:
- Occasional use of sleep medications
- Relaxation exercises
- Supportive counseling to discuss stress
- Physical exercise
- Improvements in sleep environment
- Reduction or elimination of substances
- Bright light therapy
For long-term or chronic insomnia, I recommend a more structured and comprehensive approach. Cognitive behavioral therapy (CBT) that specifically targets insomnia appears to be the most effective treatment for chronic insomnia. Research studies comparing cognitive behavioral therapy (CBT) to sedative medication treatment for long-term insomnia have shown that people who received CBT tended to get more improvements in sleep and the improvements were longer lasting. In many cases, medications can be used effectively in combination with CBT.
Our staff offer brief relaxation training, individual cognitive-behavioral treatment (CBT), group CBT, and bright light therapy. Both the individual and group CBT sessions are structured treatments specifically targeted to manage insomnia. An initial evaluation is required before starting any form of treatment. Individual treatment has the benefits of increased privacy and the flexibility to spend more time on particular areas that may be of concern such as managing anxiety contributing to the insomnia. Group treatment has the advantages of maintaining a set schedule and being very cost efficient. Clients may decide to utilize the Insomnia Group for a majority of the treatment and add a few individual sessions to trouble-shoot or discuss personal issues not covered in the group. Light therapy can added to any of the above treatments.