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Counseling and Therapy
Methods of Treatment
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Below are brief descriptions of the methods health professionals use and/or recommend in working with teens and their families.
Behavioral Therapy / Behavior Modification
As the name implies, this approach focuses on behavior — changing unwanted behaviors through rewards, reinforcements, and desensitization. Desensitization is a process of confronting something that arouses anxiety, discomfort, or fear and overcoming the unwanted responses. Someone whose fear of germs leads to excessive washing, for example, may be trained to relax and not wash his or her hands after touching a public doorknob. Behavioral therapy often involves the cooperation of others, especially family and close friends, to reinforce a desired behavior.
Medication alone, or in combination with psychotherapy, can be an effective treatment for a number of emotional, behavioral, and mental disorders. The kind of medication a psychiatrist prescribes varies with the disorder and the individual being treated. For example, some people who suffer from anxiety, bipolar disorder, major depression, obsessive compulsive disorder, panic disorders, and schizophrenia find their symptoms improve dramatically through careful monitoring of appropriate medication.
Client-centered counseling is a well-established helping approach for a wide range of problems. Based on the teachings of Carl Rogers, it assumes that the individual is the authority of his or her life and that human nature is inherently constructive and social. The client-centered counselor believes the individual is an expert on his or her own life, even if that person sometimes can't quite believe he or she is. Without diagnoses or treatment plans, the counselor enables the individual to sort through thoughts, feelings, ideas, and choices creatively with the help of attentive, nonjudgmental, and honest listening. This atmosphere of unconditional positive regard, empathy, and trust offered by the counselor fosters clarity, self-directed growth, and genuine change. Client-centered therapy is also used in conjunction with other treatment as a way for the individual to organize and integrate his or her experiences.
This method aims to identify and correct distorted thinking patterns that can lead to feelings and behaviors that may be troublesome, self-defeating, or even self-destructive. The goal is to replace such thinking with a more balanced view that, in turn, leads to more fulfilling and productive behavior. Consider the person who will not apply for a promotion on the assumption that it is beyond reach, for example. With cognitive therapy, the next time a promotion comes up that person might still initially think, “I won’t get that position…” but then immediately add, “unless I show my boss what a good job I would do.”
A combination of cognitive and behavioral therapies, this approach helps people change negative thought patterns, beliefs, and behaviors so they can manage symptoms and enjoy more productive, less stressful lives.
Couples Counseling and Family Therapy
These two similar approaches to therapy involve discussions and problem-solving sessions facilitated by a therapist — sometimes with the couple or entire family group, sometimes with individuals. Such therapy can help couples and family members improve their understanding of, and the way they respond to, one another. This type of therapy can resolve patterns of behavior that might lead to more severe mental illness. Family therapy may be very useful with children and adolescents who are experiencing problems.
Coping with serious mental illness is hard on marriages and families. Family therapy can help educate the individuals about the nature of the disorder and teach them skills to cope better with the effects of having a family member with a mental illness — such as how to deal with feelings of anger or guilt. In addition, family therapy can help members identify and reduce factors that may trigger or worsen the disorder.
Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) is a combination of behavioral and cognitive therapy originally designed for the treatment of borderline personality disorder. It is increasingly being used with adolescents and adults who exhibit impulsive and inappropriate acting-out behaviors (e.g., self-injury, eating disorders, suicidal tendencies, drug dependence). The approach integrates individual and group therapies to focus on the seemingly opposite ideas of (1) the need to accept oneself as one is and the need to change, (2) getting what one needs and giving it up to become more competent, and (3) accepting one's experience and suffering, yet gaining skills to reduce the suffering.
Also known as ECT, this highly controversial technique uses low voltage electrical stimulation of the brain to treat some forms of major depression, acute mania, and some forms of schizophrenia. This potentially life-saving technique is considered only when other therapies have failed, when a person is seriously medically ill and/or unable to take medication, or when a person is very likely to commit suicide. Substantial improvements in the equipment, dosing guidelines, and anesthesia have significantly reduced the possibility of side effects.
Drawing, painting, and sculpting help many people to reconcile inner conflicts, release deeply repressed emotions, and foster self-awareness as well as personal growth. Some mental health providers use art therapy as both a diagnostic tool and to help treat disorders such as depression, abuse-related trauma, and schizophrenia.
For example, in Coloring Therapy, the activity of coloring itself is used as a way to begin to quiet the mind, listen inwardly and open up to higher knowledge, healing, and creativity. This alternative to formal meditation practices can help people of all ages in recovery improve coping and awareness skills through an enjoyable activity.
Those who are recovering from physical, sexual, or emotional abuse may find these techniques especially helpful for gaining a sense of ease with their own bodies. The underlying premise to dance/movement therapy is that it can help a person integrate the emotional, physical, and cognitive facets of “self.”
Research suggests music stimulates the body’s natural “feel good” chemicals (opiates and endorphins). This results in improved blood flow, blood pressure, pulse rate, breathing, and posture changes. Music/sound therapy has been used to treat disorders such as stress, grief, depression, schizophrenia, autism in children, and to diagnose mental health needs.
Eye Movement Desensitization Reprocessing
EMDR creates eye movements that mimic those of REM sleep to create the same brain waves present during REM sleep while the individual is awake. During this period, traumatic and other issues are processed more efficiently than at normal levels of brain functioning. EMDR has shown effective results for individuals with ADD/ADHD.
Group therapy focuses on learning from the experiences of others and involves groups of usually 4 to 12 people who have similar problems and who meet regularly with a therapist. The therapist uses the emotional interactions of the group’s members to help them get relief from distress and possibly modify their behavior.
Holistic medicine is the art and science of healing that addresses the whole person - body, mind, and spirit. The practice of holistic medicine integrates conventional and alternative therapies (such as acupressure, yoga, gi gong, and energy medicine) to prevent and treat disease, and most importantly, to promote optimal health. This condition of holistic health is defined as the unlimited and unimpeded free flow of life force energy through body, mind, and spirit.
Holistic medicine encompasses all safe and appropriate modalities of diagnosis and treatment. It includes analysis of physical, nutritional, environmental, emotional, spiritual and lifestyle elements. Holistic medicine focuses upon patient education and participation in the healing process.
Through one-on-one conversations, this approach focuses on the patient’s current life and relationships within the family, social, and work environments. The goal is to identify and resolve problems with insight, as well as build on strengths.
Seasonal affective disorder (SAD) is a form of depression that appears related to fluctuations in the exposure to natural light. It usually strikes during autumn and often continues through the winter when natural light is reduced. Researchers have found that people who have SAD can be helped with the symptoms of their illness if they spend blocks of time bathed in light from a special full-spectrum light source, called a “light box.”
Some people prefer to seek help for mental health problems from their pastor, rabbi, or priest rather than from therapists who are not affiliated with a religious community. Counselors working within traditional faith communities increasingly are recognizing the need to incorporate psychotherapy and/or medication, along with prayer and spirituality, to effectively help some people with mental disorders.
Geared toward young children, this technique uses a variety of activities — such as painting, puppets, and dioramas — to establish communication with the therapist and resolve problems. Play allows the child to express emotions and problems that would be too difficult to discuss with another person.
This approach focuses on past conflicts as the underpinnings to current emotional and behavioral problems. In this long-term and intensive therapy, an individual meets with a psychoanalyst three to five times a week, using “free association” to explore unconscious motivations and earlier, unproductive patterns of resolving issues.
Based on the principles of psychoanalysis, this therapy is less intense, tends to occur once or twice a week, and spans a shorter time. It is based on the premise that human behavior is determined by one’s past experiences, genetic factors, and current situation. This approach recognizes the significant influence that emotions and unconscious motivation can have on human behavior.
Rational Emotive Behavior Therapy
Rational Emotive Behavior Therapy (REBT) is a humanistic, action-oriented approach to emotional growth, first articulated by Dr. Albert Ellis in 1955, which emphasizes individuals' capacity for creating their emotions; the ability to change and overcome the past by focusing on the present; and the power to choose and implement satisfying alternatives to current patterns.
The fundamental idea of Reality Therapy is that no matter what has happened in the past, our future is ours and success is based on the behaviors we choose. Developed by William Glasser in the 1960's, Reality Therapy is based on Choice Theory which states that almost all behavior is chosen and that we are driven to satisfy five basic needs -- survival, love and belonging, power, freedom, and fun. The most important need is love and belonging, as closeness and connectedness with others is necessary for satisfying all of the needs. This counseling method emphasizes personal responsibility. It focuses on the present to empower the client to satisfy his or her needs and wants in the present and in the future.
Relaxation and Stress Reduction Techniques
Learning to control muscle tension and “involuntary” body functioning, such as heart rate and skin temperature, can be a path to mastering one’s fears. It is used in combination with, or as an alternative to, medication to treat disorders such as anxiety, panic, and phobias. For example, a person can learn to “retrain” his or her breathing habits in stressful situations to induce relaxation and decrease hyperventilation. Some preliminary research indicates it may offer an additional tool for treating attentional disorders (ADD/ADHD), mood disorders, personality disorders, and schizophrenia.
Guided Imagery or Visualization:
This process involves going into a state of deep relaxation and creating a mental image of recovery and wellness. Physicians, nurses, and mental health providers occasionally use this approach to treat alcohol and drug addictions, depression, panic disorders, phobias, and stress.
The underlying principle of this approach is that rubbing, kneading, brushing, and tapping a person’s muscles can help release tension and pent emotions. It has been used to treat trauma-related depression and stress.
Self-help has become an integral part of treatment for mental health problems. Many people with mental illnesses find that self-help groups are an invaluable resource for recovery and for empowerment. Self-help generally refers to groups or meetings that:
Transpersonal psychologists are concerned with the development of a healthy individuality and its extension to include aspects of the higher self. This viewpoint acknowledges that behind the masks, roles and melodramas of one's conditioned personality lies a deeper state of being that transcends individual identity. As the transpersonal perspective unites the spiritual with the psychological aspects of human experience, it addresses the integration of the whole person — body, mind, emotion and spirit. In doing so, transpersonal psychology draws on the world's spiritual traditions; mythology, anthropology and the arts; research on consciousness; and Western psychological theory.
Practical Help, Real Answers
for Adoptive & Foster Parents
by John Eldredge
by Michael Gurian
Contact these organizations for further information and for referrals to mental health professionals in your area.
(formerly Institute for Rational-Emotive Therapy)
45 East 65th Street
New York, New York 10021
3615 Wisconsin Avenue NW
1202 Allanson Road
P. O. Box 739
Forest, Virginia 24551
Phone: 434-525-9470 or
Association of Marriage and Family Therapy
9504-A Lee Highway
Fairfax, Virginia 22031
Century Plaza, Suite 108
Holistic Medical Association
820 Davis Street, Suite 100
Evanston, Illinois 60201
4601 North Park Avenue, Suite 101
Chevy Chase, Maryland 20815
1951 W. Camelback Rd. Ste. 445
Phoenix, Arizona 85015
(formerly Association for Advancement of Behavior Therapy)
305 - 7th Avenue, 16th Fl.
New York, New York 10001
P. O. Box 3876
Chicago, Illinois 60690
45 Franklin Street, Suite 313
San Francisco, California 94102
6728 Old McLean Village Drive
McLean, VA 22101
151 Slater Street, Suite 205
Ottawa, Ontario K1P 5H3 Canada
1150 Silverado, Suite 112
La Jolla, California 92037
101 East State Street, PMB 112
Ithaca, New York 14850
11E-900 Greenbank Road, Suite 527
Nepean (Ottawa), Ontario
102 Gilson Avenue
Weirton, West Virginia 26062
Ventura Boulevard, Suite 1340
4340 East West Highway, Suite 402
Bethesda, Maryland 20814
National Association of
Richard Shulman, Director
7 South Main Street
West Hartford, Connecticut 06107
22024 Lassen Street, Suite 118
Chatsworth, California 91311
© Focus Adolescent Services