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This article originally appeared in Macaroni Kid on April 29, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I recently found out my 17-year-old is smoking marijuana. He said he does it to help with anxiety and that he finds a lot of relief in it. I don’t love the idea at all, but I also feel powerless to stop him. How can I talk to him about the risks but also be supportive if I lose this battle?

Answer: This is a difficult time for parents. At 17, your son is on the cusp of becoming a legal adult. This can give teens a feeling of not needing guidance or permission. Passing the milestone of 18 will not suddenly make him mature enough to all make decisions that are in his best interest. However, if your son is just starting to use at 17, studies show he is less at risk than a teen who starts at a young age, who smokes/vapes for years. A University of Montreal study says that the more teenagers delay smoking marijuana (cannabis) until they are older, the better it is for their brains, but there may be little ill effect if they start after age 17. That may give you some comfort. However, the human brain takes 26 years to reach full development so introducing substances does have risks when it comes to full potential.

That being said, I find a troubling issue in your question. What is causing the anxiety at age 17 for him to self-medicate with marijuana to relieve it? Many people have found cannabis calming, yet at seventeen or any age really, understanding the underlying cause of the anxiety is key. There are many non-drug ways of treating anxiety worth exploring.

Teens have lots of reasons to feel anxious and the pandemic has increased this anxiety. Life looks uncertain, relationships and future plans may be on hold, decreased social activity can add to general unsettledness and hopelessness. Under normal times, this age is challenging—adult responsibilities and major life decisions loom and teens question themselves. They are also developmentally pulling away from parental influences which can sometimes cause problems at home.

I commend you for wanting to address his marijuana use, but an overall conversation needs to include healthy coping and understanding of what is contributing to his anxiety. Living with anxiety can be a lifelong struggle and he should seek help at an early age to prevent this. Assure him that he does not have to talk to you about it, but a counselor might be a great help to him. Cognitive Behavioral Therapy (CBT) is an evidence-based successful treatment for anxiety which many therapists use in their work.

I urge you to do more research to give you what you need for the discussion. For parents with younger children, talking about marijuana and substance abuse needs to happen before they start using and should be an ongoing conversation. Here are some talking points (taken from the references below) for you and other parents to begin a conversation about marijuana use.

Marijuana can affect driving. It is extremely important that teens who drive understand how dangerous driving under the influence of marijuana can be. Reaction time and judgment can be impaired coupled with inexperience behind the wheel.

Importantly, marijuana is illegal. The fact that many states have legalized recreational marijuana has given a lot of young people the idea that it is legal and okay for them to use. It is not. Recreational marijuana is only legal for adults age 21 and older. Legal trouble can be incurred by a teen for possession and/or dealing.

Marijuana is not good for teen brains. Studies have shown that early marijuana use (16 and younger) causes problems with judgment, planning, and decision-making that may lead to risky behaviors. Some studies show problems with memory, motivation, and academic performance. Not the best situation with which to step into adulthood. The teens who may have a predisposition (possible family history) to mental illness and/or addiction may find themselves struggling with depression, psychosis, or further substance use.

There are very real health reasons not to smoke/vape cannabis. A 2017 study in the American Journal of Respiratory and Critical Care Medicine states that teens who vape are twice as likely to experience respiratory problems along with coughs, bronchitis, congestion, and phlegm than peers who do not vape.

Lastly, I like that you want to have a conversation with your son about marijuana. This is hard for parents who are often confused themselves or have mixed messages on the subject. I also like that you want to be supportive no matter the outcome. It is a conversation worth having and it will show your love for him.

Here is further information about cannabis use in teens and about anxiety:

https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Anxiety-Disorders.aspx
https://www.verywellmind.com/marijuana-use-by-teens-statistics-2610207
https://www.sciencedaily.com/releases/2017/01/170125214606.htm#:~:text=2,Delaying%20marijuana%20smoking%20to%20age%2017%20cuts,teens’%20brains%2C%20new%20study%20suggests&text=Summary%3A,they’re%20less%20at%20risk.

Click to access evidence-brief-youth-13-17-e.pdf

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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If you are asking this question, you are probably not alone. In fact, 18 million Americans struggle with misusing alcohol or with the symptoms of Alcohol Use Disorders (AUD). If you feel as though your relationship with alcohol is a problem or could become a problem, it is important to know that you are not alone. There are resources that can provide help and guide you through a recovery journey. Arming yourself with information is a good first step.

What is Alcohol Use Disorder (alcohol addiction)?

There are hereditary and environmental factors to addiction, but many times the cause is not known. The following are some of the symptoms that characterize AUD.

The individual:

  • drinks more or longer than they initially intended to
  • has tried to moderate or stop drinking in the past, but has been unable to
  • spends a lot of time drinking or recovering from the effects of drinking
  • experiences cravings, or strong desires to drink
  • drinks even though it interferes with home, family, work, or school responsibilities
  • drinks even though it causes trouble in their personal life
  • gives up activities or obligations that were once important, in order to drink
  • gets into situations while drinking that may be risky or cause harm
  • continues to drink even if it causes depression, anxiety, or other health problems
  • has to drink more to produce the desired effects
  • has withdrawal symptoms when not drinking

NOTE: According to the DSM-5 Diagnostic and Statistical Manual for Mental Disorders, showing two-three of these symptoms in the last year may indicate a mild alcohol use disorder, while showing four-five symptoms indicates a moderate AUD. Displaying six or more symptoms signifies a severe alcohol use disorder.

Who is at risk for alcohol use disorders?

Drinking alcohol in moderation can be okay for some people. This means that while they may feel the effects of alcohol consumption, they do not feel compelled to keep drinking. Moderate drinking is classified as no more than one or two drinks per day for men and women.

Using alcohol when bored, stressed, lonely, depressed, or if there is a genetic predisposition to addiction (family members with AUD), can lead to further serious problems. If you or someone you care about is drinking to get through the day, it may be time to reach out for help.

How does alcohol affect physical health?

Like any substance consumed in excess, there will likely be side effects. Alcohol may also interact negatively with prescription medications and make it difficult to diagnose other health concerns.

When drinking to excess there can be problems with:

  • Alcohol poisoning
  • Sexual dysfunction
  • Reduced inhibitions or risky behaviors
  • Inability to focus, impaired memory
  • Affected vision, reflexes, and coordination

Long-term effects of active addiction:

  • Impaired learning and/or brain development
  • Increased depression and anxiety
  • Major organ damage; increased risk for heart disease
  • Cirrhosis (chronic liver disease)
  • Cancer

How does alcohol affect mental health?

Alcohol is a depressant. Therefore, it slows down your brain and alters its chemistry. There are many effects including changes to mood, energy levels, memory, concentration, and sleep patterns.

Alcohol may also impact decision making. While drinking, a person may “do things without thinking” or say or do things they would not do or say while sober such as pushing away or hurting the people who care most about them. It can give a person courage to engage in risky situations like unsafe sexual encounters, trouble with law enforcement or getting into fights. Alcohol can contribute to life falling apart, causing withdrawal from important relationships and social situations, and even self-harm. A combination of factors along with intoxication has led to many dying by suicide.

Where do I go for help with AUD?

Talk with your primary care practitioner. There are multiple treatment options ranging from hospitalization for detox if needed, to outpatient therapy with a counselor or group, to rehabilitation or participation in an intensive outpatient program (IOP). There is also residential treatment. There are even medications that can provide support for building a sober life.

Lastly, there are many recovery communities like AA, Smart Recovery, and Women for Sobriety that provide support and assistance in learning how to live a healthy, sober life.

sources: healthline.com, headspace.org, recoverycentersofamerica.com, cdc.org, apibhs.com

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This article originally appeared in Macaroni Kid on March 25, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I am absolutely fed up with my mother-in-law. She has spent pretty much my entire marriage to her son criticizing me as a wife and mother. My husband used to defend me more but has given up saying his mom won’t change her ways so it’s not worth the fight. Recently she called me a “lazy mom” in front of our ten-year-old. Our daughter cried on the way home and said she doesn’t want to see grandma anymore. My husband brushed it off. I’m furious as my daughter deserves to see him stick up for me (and her) and should not be exposed to that. I want to have a discussion with my husband but see red every time I start to gear up for it. How can I discuss this without making matters worse?

Answer: This is an important question to which so many can relate. You would like to not be criticized by your mother-in-law. You would like to be supported by your husband when there are problems between your mother-in-law and yourself. And you want healthy behavior about relationships and respect, to be modeled for your daughter.

Relationships with in-laws and parents are so significant. When troubled, they can be like a tormenting drip, drip, drip of a faucet or they may be like walking through a field with dangerous mines all around, always waiting for an explosion. The criticism can be at the table for every family gathering. When good, however, they can add richness to your life and the lives of your children. All your family relationships can be impacted by this difficulty with your mother-in-law. It can be helpful to see a counselor, a neutral party, to help you sort it out.

“Seeing red” when you want to talk with your husband is not getting the problem solved. Keep in mind that your goal is to help him understand what you need from him. If you go about this angrily or in an accusatory fashion, he will stop listening. Also, remember that he is in the middle. His mother may have been critical all his life, and he may feel powerless to think she can change. He will need some tools to be able to help and counseling may help the two of you stand together to resolve this.

Learning about setting boundaries is one way of making improvements. I encourage you to get a book or do an internet study on how to set boundaries or ask the counselor to help you with this. Learning to set boundaries helps you know what to do when you are not respected. The result of healthy boundaries is that slowly you will begin to gain respect. One of my favorite sayings about boundaries is “people use the people they can use and respect the people they cannot use.” If your mother-in-law can get you upset, cause you to storm out, and leave you hurting then she is the one who is in control. You can say to your mother-in-law, “I value our relationship and your time with your granddaughter, but I cannot allow you to speak to me in that way especially in front of her. Please speak to me with respect or we will need to leave.” If she continues and you allow it, she remains in control. Instead, quietly gather your things and your daughter and let her know you are leaving. No drama, no tears, just leave.

This learning process also includes evaluating those areas in which you may be contributing to the discord between the two of you. You cannot ask to be spoken to with respect unless you also speak and treat her with respect. Most often in these situations, everyone needs to do better.

Lastly, it may sound odd, but try to ignite feelings of love and kindness towards her. You can do this by looking at her life. Is she lonely, hurt, depressed; does she have needs that are not met, or were never met? People often push away the people they need most by the things they say and the things they do. Creating kind thoughts for her may help you connect with her in a more meaningful way. This takes practice, but modeling this for your daughter can have a big payoff for everyone.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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This article originally appeared in Macaroni Kid on February 23, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: My son has battled depression and anxiety since late elementary school. He is 16 now. We have tried multiple medications for him, and he sees a therapist regularly. He seems to have gotten worse in the last six months which is no surprise given the difficulties of the past year. I am frustrated because I don’t feel like the meds he is on do enough. It feels like we have tried them all. Any advice would be appreciated.

Answer: Whatever you do, keep trying. I can just imagine how frustrated and hopeless you and he feel—you are doing the right things, and you are not seeing any change. Do not give up.

I hope I can give you some things to think about that might provide ways to further explore and treat his depression. Some people have what is called “treatment-resistant depression.” It means they are not responding as expected to the usual methods of treatment. That means it is necessary for everyone, both professionals and family, to look at other interventions. These are things which need to be considered:

Is the diagnosis correct? There are different kinds of depression which require different kinds of treatment. Since your son’s depression has gone on for this long, he should be treated by a psychiatrist and not a primary care physician.

Is the dose correct? Many psychiatrists are like artists and chemists, in a sense, adding some of this and tweaking some of that, until they get just the right combination. It can take time to find just the right formula of medications. Every person is unique and responds to medications differently.

Are there other mental health conditions complicating treatment? For example, if your son has Attention Deficit Hyperactivity Disorder (ADHD), he could be having trouble both socially and academically, which may contribute to him feeling bad about himself. Treating the ADHD could help with this.

Are there other medical conditions complicating treatment? Medical conditions such as thyroid disorders, mononucleosis, iron deficiency anemia and other vitamin deficiencies like Vitamin D, B2, B6, or folate (Treatment-Resistant Depression in Adolescents, David Brent, MD) can all contribute to depression. Lab work can help assess for these.

How well is your son sleeping? Adolescents are known to spend late night hours on screens and devices; this can interfere with a normal sleep cycle and greatly impact his mood. Medication is not a substitute for lifestyle deficits. Sleep, exercise, good nutrition, and social interactions make life better.

Is your son taking his medication regularly and as prescribed? Missing doses, for example, greatly reduces a medication’s effectiveness.

Is there depression in the family? Is there a family member’s depression, particularly a parent’s, which is not being treated or fully treated? This has a significant influence on how a child views the world.

Is your son currently experiencing bullying, or does he have a history of trauma or abuse? Medication does not treat these issues; however, they have a profound effect on mood. If he has these issues, is he working on them in therapy? Does he need additional assistance from parents, school officials or other professionals with these situations?

Is your son struggling with his sexuality or gender identity? Sexuality and gender identity are big and confusing to adolescents. Could his sexuality or gender identity lead him to family rejection or bullying by peers?

Is your son using substances like alcohol, marijuana or other drugs? Is there alcohol or drug abuse in the family? Using these substances or being affected by someone else’s use of substances alters normal emotional coping.

Is your son thinking about suicide or self-harm? This is so important. Ask him. Educate him that these choices are sometimes the result of feeling very depressed and hopeless. Help him know that there is hope, that as a family you will keep trying to help him feel better. Do not hesitate to take him to the hospital if he is doing things or saying things that make you think he is suicidal. He may be angry, but it is the safest thing to do. If you need help getting him there, do not hesitate to call 911.

Does he have a good relationship with his therapist? Not every therapist is right for every person. Check-in and make sure that he feels connected with and heard by his therapist.

It is very hard to have a child with prolonged depression. Parents feel hopeless and lost. Sometimes parents of depressed children need to talk to someone about it. Call a counselor to help you. Thank you for asking this question. You are not alone.

This and other helpful information on Treatment-Resistant Depression in Adolescents can be found here.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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Bipolar disorder is thought to be a rare condition consisting of “mood swings” but it’s much more common and complex than that. Bipolar disorder affects 60 million people worldwide and approximately 5.7 million Americans. Of these, an estimated 51% will go untreated or misdiagnosed.

Bipolar disorder, sometimes known as manic-depressive illness or manic depression, is a mental disorder that causes an unusual shift in mood, energy, activity level, concentration, judgement, or ability to perform day-to-day tasks. The “unusual” shifts refer to uncharacteristic changes in an individual lasting days or weeks. This is known as an “episode.” A manic episode is an emotional “high,” while a depressive episode is an emotional “low.”

Manic and hypomanic episodes include three or more of the following signs:

  • Unusually upbeat, jumpy, or wired; increased activity, energy
  • Exaggerated sense of well-being or self-confidence
  • Distractibility, racing thoughts
  • Decreased need for sleep
  • Unusual talkativeness
  • Poor decision making such as excessive shopping, risky sexual behavior, etc.

Depressive episodes include five or more of the following signs:

  • Depressed mood; sad, empty, hopeless, irritable feelings
  • Insomnia or sleeping too much
  • Fatigue/loss of energy
  • Restlessness or slowed actions
  • Apathy
  • Abrupt change in weight and/or appetite
  • Decreased ability to think/concentrate
  • Feelings of worthlessness or excessive guilt
  • Thinking about or attempting suicide

Those with bipolar disorder may not recognize the changes in their behavior. Some may also enjoy the feelings of euphoria that accompany a manic episode, but an emotional crash will always follow. The signs described above are not normal or typical of young children, adolescents or adults, and should be taken seriously.

There are three different types of bipolar disorder diagnoses:

Bipolar I Disorder: Manic episodes lasting at least 7 days or manic episodes so severe that immediate hospitalization is required and depressive episodes lasting at least two weeks. Mixed features may be possible (manic and depressive episodes occurring simultaneously). Bipolar I disorder is the most severe.

Bipolar II Disorder: A pattern of depressive and hypomanic episodes (less severe mania) that last for longer periods but are less severe than bipolar I disorder.

Cyclothymia: Periods of hypomanic and depressive symptoms lasting at least 2 years. Symptoms are less severe than Bipolar I and II disorders and individuals are usually able to function in their daily life.

Bipolar disorder is commonly misdiagnosed, the main reason being that those with the disorder may also have a co-occurring disorder. These can include anxiety disorder, attention-deficit/hyperactivity disorder, substance use disorder, eating disorders, or other mental health disorders. A mental health professional will diagnose bipolar disorder by observing signs and symptoms, life experiences of the individual, and the family health history of the individual. A diagnosis typically occurs in late adolescence with the average age being 25, but those in their later adult years can also be diagnosed.

It’s important that those with bipolar disorder or those with undiagnosed symptoms to attain treatment. If left untreated, an individual’s manic and depressive episodes will not improve. Additionally, they may be at risk for drug and alcohol abuse, legal or financial troubles, impaired performance at work and school, difficulty maintaining relationships and suicide attempts. In fact, 30% of individuals diagnosed with bipolar disorder will attempt suicide at least once in their life. A diagnosis and ongoing treatment are vital.

Individuals with bipolar disorder are at higher risk of thyroid disease, migraine headaches, heart disease, diabetes and more. Treatment is highly individualized, especially when it comes to correct medication, often an antipsychotic and/or anti-depressant. Primary care visits are also important in ongoing treatment.

Treatment can include psychotherapy sessions (talk therapy) and medication taken consistently, regular exercise that benefits brain and heart health, sticking to daily routines, avoiding misuse of substances, as well as journaling for symptom tracking are recommended. Individuals with bipolar disorder can lead wonderfully healthy, functioning lives with the assistance of lifelong treatment.

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Are you feeling busy, distracted and exhausted? Even after the emotionally overwhelming year we’ve all just experienced, we haven’t slowed down and taken time for ourselves. Further, our society doesn’t value the practice of introspection, the observation of one’s own mental and emotional processes. Introspection, or self-reflection, is the willingness to recognize and determine your “old programming” that no longer serves you so that you can build new “programming.” How this can be done? With a calm mind to start.

How do I calm my mind?
Having a calm mind will allow you to concentrate and feel more relaxed. This practice will vary person to person, but here are some suggestions:

  • Take a few deep breaths; practice breath work
  • Stretch your body
  • Go for a walk; move your body
  • Journal, meditate, pray

How do I practice self-reflection?
When your mind is calm, allow yourself to draw inward and think deeply on the issue, emotion or memory at hand. To help, ask yourself:

  • What does this make me think?
  • How does it make me feel?
  • How does it hold me back?

It’s important not to judge yourself. Be honest with yourself so that you’re not tempted to imagine how you should feel. Don’t be afraid to dig deeper! You’re trying to access the root of the issue and you will most likely come across resistance. This is your ego/mind trying to protect you from uncomfortable and harmful emotions.

Additionally, you can ask yourself questions in order to get to know yourself better whether or not you’re currently working through an issue. Start with these:

  • What am I really scared of?
  • Am I holding on to something that I can let go of?
  • When did I last push passed my comfort zone?
  • What do I want most in life?
  • When was the last time I made someone smile?

Why should I practice self-reflection?
With self-reflection comes self-awareness. You’ll begin to see your thoughts, behaviors, emotions and reactions in real time as you experience them. You can determine which ones bother you, don’t serve you or harm you and learn to let them go. By slowing down, calming your mind, and asking yourself substantial questions to draw on old issues, you can then learn to shift your behaviors, thoughts and reactions to ones that better represent you, your values and beliefs.

The more you reflect, the easier you’ll be able to hold yourself accountable. This not only benefits you directly, but it also benefits those you surround yourself with. You may even inspire them to be more introspective!

What are benefits to introspection?
A self-aware person can expect myriad of benefits, but here are some that may be true for you:

  • Clarity
  • Self-control
  • Less stress and anxiety
  • Higher self-esteem and pride
  • Increased emotional intelligence
  • Easier time coping with challenges
  • Appropriate reactions to situations
  • Realize their potential and become more aligned

Remember, slowing down, calming your mind and regular self-reflection may come with resistance­­­­ from your mind, your family, even your job. Stay strong­­–this time is essential for your mental health. It’s okay to start small and always be gracious and patient with yourself. You’re in the process of changing how you think, feel, and behave. You’re changing your life!

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This article originally appeared in Macaroni Kid on January 20, 2021, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I am a new mom and COVID has been very difficult. My husband works out of the home and I feel very isolated. We are not seeing my parents right now even though they live close because they are high risk. I so appreciate Macaroni Kid as a resource but am missing in-person events and the ability to mingle with other moms. Can you share ideas for trying to stay connected and beat the heavy feeling of isolation? I am particularly worried with winter here that it will just get worse.

Answer: I can just imagine how badly you are missing in-person events and the ability to mingle with family and other moms. You are missing the fun of showing off your new baby to the world, and especially enjoying seeing your parents with their grandchild. This pandemic has really emphasized for all of us what really matters and the things we took for granted. New parenting should be a well-supported endeavor, and it’s not meant to be done alone.  

There are many things to do to take care of a new baby. I am going to add one more important job to your list and that is to take care of yourself. This is so important when you are feeling isolated. You will have to work to stay connected and fight the feelings of sadness that can often do just the reverse—cause you to withdraw.  

Not knowing your parents’ conditions, I am not sure if this can apply to your circumstance, but as long as you wear a mask and stay six feet apart, there are some activities you can do together. Outdoor activities are best. 

Here are a few ways to stay connected with loved ones, other parents, and your community: 

  • Bundle up the baby for brief porch visits. Let folks know you are coming so they can bundle up, too!
  • Try “car talk.” Park next to each other in opposite directions and talk for as long as you can handle the open window temperatures. Enjoy a hot drink while you chat.
  • Text pictures of the little one daily to your parents and in-laws. They will love it since they are probably feeling isolated and alone, too. Everyone will feel more engaged. 
  • Should baby nap long enough, bake something for your parents and make a delivery so they can get a quick peek at the little one.
  • There are many online groups. Try one on Facebook specifically for those who welcomed a baby during COVID called “COVID-19 Baby Parents Group.” These types of groups are just a chat forum to support one another and share ideas and resources.
  • Make sure you are letting your husband know how isolated you feel. He may be doing it already, but if not, ask that your husband check in on you during his work breaks.
  • Make a list of those friends and family for whom you can have regular contact whether by phone, Skype, Facetime, email, or car talk. Ask them for regular virtual or phone visits. Most importantly, let them know how you are feeling. You will find others feel as you do. 
  • Don’t let cold weather keep you from attending outdoor events. Most town recreation centers have developed “safe” family or kid activities to do which can connect and get families out of the house. Some are ongoing weekly events like skating, snowshoeing, or winter walks. One mom told me that she has enjoyed this so much. She bundles up her daughter and puts her in the sled at the event. It is a great place to meet other moms. The fresh, cool air can invigorate both mom and baby, giving you energy.
  • Some local farms are allowing families to visit the animals in the barns. Call ahead and ask. The sights, sounds, and smells of the working farm can make for a wonderful adventure.
  • Reach out to other new moms you may know. Share with them how you are feeling.  
  • Think of someone in your circle of acquaintances who might also be feeling isolated. In helping others, we often help ourselves.
  • Connect to a counselor via teletherapy. Most insurances will pay for this. There are many uncertainties in being a new mom even in times when accessing regular supports is easy. It is common for new parents to experience stress, anxiety, and some experience postpartum depression. The challenges of new parenting are emphasized during a pandemic. Asking for help is the act of a healthy person. 

Stay hopeful! Try something on this list each day. Dwell on thoughts when the pandemic will end and of all things you will want to do and explore with your child. Do not hesitate to reach out for help. We will get through this.

 

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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Katelyn Baxter-Musser

Working Successfully with Personality Disorders in Therapy

Deepen your knowledge of personality disorders with this one-day virtual training. We’ll discuss diagnosis, myths, biases, tools, and more.

About this Event

Working Successfully with Personality Disorders in Therapy: Decreasing Myths, Increasing Clinical Effectiveness and Tools to Use in Your Practice

Clients who present with personality disorders can be some of the most difficult and challenging clients that mental health providers engage with. These clients present with disrupted interpersonal relationships, self-harming and suicidal crises, difficulties regulating their emotions and an unstable sense of self. Without the right skills and support clinicians often find themselves feeling exhausted and frustrated when working with these diagnoses. Through this training clinicians will deepen their knowledge of personality disorders and discuss differential diagnoses. Clinicians will be able to challenge their preconceived notions and myths regarding this population. Clinicians will be provided with tools to enhance and freshen their skills set when working with personality disorders in a therapeutic setting.

Objectives

  • Understand myths, biases and judgments related to personality disorders
  • Review diagnostic criteria, differential diagnosis and co-occurring disorders
  • Learn therapeutic interventions to use in clinical practice to increase therapeutic effectiveness and client engagement
  • Develop an understanding of healthy and effective boundaries to set in an effort to decrease therapist burn-out

Outline

8:30 What do we know about personality disorders: Exploring biases and myths
9:00 Understanding personality disorders in clinical practice
10:15 Break
10:30 Evidence-based treatments and personality disorders
11:15 Exploring ways to implement clinical interventions
12:00 Lunch Break
1:00 Exploring ways to implement clinical interventions
2:15 Break
2:30 Case Conceptualization
3:00 Maintaining professional boundaries: decreasing therapist burnout and practicing self-care
4:00 Conclusion

About the Presenter

Katelyn Baxter-Musser is a Licensed Clinical Social Worker in private practice in Gorham. There she provides individual therapy, couples and family therapy and consultation to mental health professionals.

Katelyn has been in the field for over ten years and has worked in a variety of different roles including as a case manager, child and family therapist, trauma therapist and clinical coordinator. Prior to being in private practice Katelyn has worked for several agencies as well as Native American reservations.

In her private practice Katelyn specializes in working with domestic violence, abuse, trauma, PTSD, depression, anxiety, grief and relationship issues, dissociative disorders and personality disorders. Katelyn is a Certified Dialectical Behavior Therapist and a Certified EMDR therapist. Katelyn is trained in a variety of therapeutic modalities including DBT, EMDR, CBT, mindfulness and motivational interviewing.

She sits on the EMDRIA Standards and Training Committee and is the co-regional coordinator for the EMDR Southern Maine Regional Network.

Register Online:
Fri, March 12, 2021 – 8:30am – 4:00pm
Fri, March 19, 2021 – 8:30am – 4:00pm

 

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Have you found yourself at the beginning of a new year with good intentions and hefty resolutions, but ended up falling off track? We’ve all been there! Although it can seem discouraging, it is possible to make changes for the better. By having a growth mindset, you know that with time and effort you can stay on track with your goals and grow mentally and emotionally. Use these simple affirmations to start 2021 off confidently.

I failed vs. I learn from my mistakes. When we change the narrative from failure to growth, we’re more receptive to learning from our mistakes rather than fearing making them in the first place.

I can do it alone vs. I ask for help when I need it. There is a difference between independence and being self-sufficient and knowing when you need support. The key is learning when and to whom you should ask for help.

I’m not as good/successful/purposeful as they are vs. I focus on my own progress. Comparison has its place, but it can also be very dangerous to your mental health and your personal growth. When you focus on your progress, you learn more about yourself and what you need and want in your journey.

I’m not smart enough for that vs. I can do hard things. Strong, confident, and mentally healthy people know that a challenge can be a good thing. When you overcome difficult situations, you become more confident and resilient—and ready for the next challenge.

I’ll never understand it vs. I haven’t figured it out yet. When we have limiting thoughts, we are indeed limiting ourselves. It’s okay if something is taking you time to figure out or work through. Life is full of those situations! Giving yourself the empathy and understanding that certain things take time to work through will be beneficial in your growth.

I’m just not meant for this vs. I am on the right track. When you focus on yourself, learn from mistakes, and give yourself time to work through things, you’ll come to know yourself better on a deeper level. Your intuition is powerful and can guide you through many of life’s uncertainties especially if you’re equipped to learn to listen to it. It’s just as important to realize when you’re not on the right track and to change course until you know that you are.

It’s important to recognize that the way you communicate with yourself is just as important as the rest of your emotional and mental health. With societal pressures, family pressures, and internal pressures, it’s crucial that we heal the relationship we have with ourselves in order for us to truly progress and thrive.

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This article originally appeared in Macaroni Kid on December 17, 2020, by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine.  

Question: I am a bi-sexual woman married to a woman. My daughter will be starting school next year and we hope to do some preschool programs this year if possible. My daughter has a biological dad she doesn’t see often. I know questions will arise for her during the school years on having two moms. My wife and I have open conversations with our daughter and want to help prepare her for questions and how she can best handle them. Do you have suggestions on where to start?

Answer: It is so good that you are thinking ahead to help your daughter with complicated moments. We can’t be there all the time, but sometimes we can give our children tools to help them navigate. 

Like all the kinds of diversity that she will experience, your family situation of having two moms sets her apart. Diversity is about differences. The place to start is by helping her embrace all the beauty of diversity, the positive benefits diversity brings to our world. Has she tried foods like Chinese, Thai, or Italian? Does she know anyone whose family immigrated to our country? Does she have questions about how Somali women dress? Does she have questions about disabled (I like “otherly-abled”) people? Talking openly about these groups as well as gay and lesbian families will provide comfort, confidence, and information when these subjects come up at school.

Here is an example of just one of the many conversations to broaden her world of acceptance. When you enter a store together with automatic doors, explain that the doors were made that way so someone using a wheelchair can roll in easily and that the slopes at the end of a sidewalk mean everyone can get around easily. This normalizes these differences and shows how everyone is important. 

Having toys and books that celebrate differences, including having two moms, can be helpful and can provide opportunities for larger conversations. I’ve included some examples and urge you to explore the many fine options:

  • Matching Game: I Never Forget a Face by the EEBOO Corporation
  • Crayons: People Color Crayons by Lake Shore Learning
  • Book: Mommy, Mama and Me by Leslea Newman
  • Book: My Two Moms and Me by Michael Joosten
  • Book: Love Makes a Family by Sophia Beer

In your open conversations with her, talk about why she has two moms. Without knowing what questions will arise, increasing her knowledge and understanding of your relationship may give her the words she needs. In language, a child will understand, explain about love (“People are like peanut butter and jelly, meant to be together”). Let her know that sometimes people might not understand because they’ve never seen it before, and sometimes people are unkind about things they don’t understand. Invite her to always bring their questions to you and to talk about how she’s feeling.

Some families have two parents of different races. Some only have one parent, while some are being raised by grandparents. Your daughter is different. Your daughter is special—she has two moms.  

 

 

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine.

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