Archives for February, 2010
Recently, radio host Michael Dresser made a very apt comparison. He said that it seems that therapy can be approached at least somewhat starting like a business. Having a business plan certainly helps and in terms of assessing goals, addressing budgetary concerns, and so on, the comparison holds. But what about in terms of time-frame projections, that is, target dates for progress? I contend that the business-plan model can work. In therapy, as in business, one should set target dates for achieving goals and schedule regular check-ins to make sure that things are on the right track.
It is a beloved Jewish teaching that when it comes to spiritual service and growth, one can learn lessons from every person. For example, the 18th century mystic Reb Zusha said that from a child, one can learn to never sit still and to keep striving for what he wants. From a thief, one can learn to keep trying to attain the “treasure” (that is, spiritual growth)—if a thief fails one night, he will try the next night, and so on. The same holds true for the path of one’s psycho-emotional growth. When it comes to recovery, whether it is recovery from a mental illness or an addiction, one can learn a lot from all kinds of people. Even from a rather violent (though compelling), figure currently in the public’s eye, the ancient gladiator, Spartacus.
Some patients say that psychotherapy (without medication) is helpful less than half the time! Though this percentage varies depending on diagnosis and much of the reporting is anecdotal, there is at a detailed and well-done 2003-2004 study that focuses on depression and its treatment. SAMHSA, the federal Substance Abuse and Mental Health Services Administration, reports that:
On Wednesday, we featured the first part of our interview with Dr. David Sack, psychiatrist and CEO of Promises Treatment Centers. Today, we continue our conversation about co-occurring mental illness and addiction, also known as dual-diagnosis, with Dr. Sack. RZ: Today, more and more addiction and mental health treatment providers are recognizing that co-occurring disorders are quite common. It used to be that addiction treatment programs didn't always recognize that large percentages of their clients were mentally ill chemical abusers (MICAs), unless their mental illness was very apparent. Now mental health care providers are getting on the bandwagon and beginning to recognize that many of their patients are medicating themselves with everything from wine to prescription pain killers to illicit drugs—leading to potentially serious chemical abuse problems. Do you have any suggestions about how to motivate mental health care patients to be more upfront about substance abuse?
In the past few years, more and more states as well as the federal government have begun to examine the complex relationship between substance abuse and mental illness. Having been involved in both addiction and mental health treatment for over two decades, I can attest to the fact that though plenty of people struggle with both issues simultaneously, many of them don’t get correctly diagnosed. Frequently, patients are diagnosed with either a mental health problem or an addiction. This means that an important part of their treatment is missing. Dr. David Sack, a psychiatrist who is certified in psychiatry, addiction psychiatry, and addiction medicine and is the CEO of Promises Treatment Centers, a California-based treatment program, has generously agreed to discuss co-occurring mental illness and addiction, also known as dual-diagnosis.
To give our readers a better sense of what an effective mental health treatment plan looks like, I have been recreating a treatment plan here through a series of blog posts. To see other posts in this series, please click here. If your therapist is the GPS, you are the driver. Ultimately, you have control over where you are going emotionally.* Therefore, outlining courses of action that you will take is as vital to your success as are your therapist’s courses of action, which we discussed in our blog post Your Therapist's "To Do" List. The next section of the mental health treatment plan I use is called the Patient’s Objectives—in a nutshell, your own “to do” list. These objectives are the actual courses of action you will take to help you reach your goals. They will usually be a reflection of your therapist’s objectives.
What can you do to get the most out of your therapy sessions? What basic communication and relationship skills (see videos, below), can you learn in order to improve all your relationships, not just your relationship with your therapist? One day a few months ago, I was doing a weekly training for therapists and one of them said, "I wish my patients could sit in on this training—it would be really beneficial to them." Bingo! It occurred to me that if I could distill some of the information about communication skills that I impart to therapists and patients—keep the content simple and the explanations brief—it might help patients get more from therapy.
On Friday, we featured the first part of our conversation with psychotherapist and Is God Pink? author Mary Jo Rapini, MeD, LPC, who told us about her near-death experience after suffering a cerebral aneurysm. Today, Mary Jo’s story continues with her return to this world. “Suddenly I was back in this place. My husband Ron was shaking me and crying—he was really the one who suffered during my illness. He told me I might not be able to run or walk and asked me if I understood what this meant. He then told me that he wanted me to be strong. He said, ‘You are so strong, Mary, please don't die.’” “I told him, ‘I'm not going to die, Ron. I just talked to God and he won't take me.’”
To give our readers a better sense of what an effective mental health treatment plan looks like, I have been recreating a treatment plan here through a series of blog posts. To see other posts in this series, please click here. The next section of the mental health treatment plan I like to use is number three—the Therapist’s Objectives—in a nutshell, your therapist’s “to do” list. These objectives are the actual courses of action that your therapist will take to help you reach your goals. They may be very specific, and describe the methods and techniques (also known as interventions), that your therapist will be using. Or, they may be more general.
Parents, beware! According to a University of British Columbia study led by Jelena Obradović, presently an assistant professor in the School of Education at Stanford University, kids who are sensitive to stress, despite being prone to behavior and health problems, are likely to do extremely...