Eating Disorders Triggered by the Holidays

by Janine Vlassakis Tuesday, December 24, 2013

Believe you can and you're halfway there.                                   

Theodore Roosevelt 

The “most wonderful time of the year” can be tough for those suffering from an eating disorder. The holidays can be overwhelming and stressful with so much focus placed on food in social environments.  As a result many, and especially those with eating disorders, become anxious, upset or engage in disordered eating behaviors to attempt to mitigate their anxiety.  Here are suggestions to get through the holidays:

·          Remind yourself or your clients of common self-soothing practices and avoid dangerous coping mechanisms. 

·           Identify or encourage yourself or your client to identify what is “happy” about the holidays.  That simple reminder can help focus on the positive aspects of the season.

·          Families can play an integral part in helping the holidays be joyful. Remind your family or your clients’ family what a trying time this may be.  While food is an inherent part of most events during the holidays, families can help diffuse the focus by planning activities such as a craft or family game to focus on as a distraction. 

·          Remind your family or your client’s family that discussing your appearance may do more harm than good.  Help close family understand that statements such as, “you look so much better!” can translate to “I look fat” in your or your client’s mind.  Ask family to make other family members aware as well, so time with family can be remembered as positive rather than triggering negative emotions. 

·          If you or your client is taking a break from treatment over the holidays, be sure to address any concerns about being away and social situations.  Be sure to strategize and discuss skills to continue recovery. 

·          Arrange a time to start back into therapy after the holiday to continue treatment in the New Year.

·          Be mindful and encourage clients to be mindful of the positives of this time of year.  Focus on time spent with people supportive in recovery, and to create new happy memories to reflect upon next year.

Janine Vlassakis, M.Ed. is the Mid-Atlantic Professional Relations Coordinator for the Cambridge Eating Disorder Center.  Her role at CEDC is to provide clinicians and other professionals with information about the levels of care which CEDC offers.  In addition, with her background in counseling and education, she speaks regarding various topics relating to the complexity and treatment of Eating Disorders.  

 

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relationships, friendships | Self-Care | Social Work | Treatment Modalities

Suicide Prevention Blog Series: Clinical Tip #5

by Staff and Faculty of the QPR Institute Sunday, November 24, 2013

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.  

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc, says eighteen veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers.  According to the Centers for Disease Control and Prevention, in just one day, more then 101 of our fellow Americans will die by suicide.  Perhaps this clinical tip will save just one.

Clinical tip #5 -- Communicating Suicide Risk

The nature of modern clinical care by multiple providers requires clear communication to assure consumer safety.  Not only do prescriptions need to be clearly written, but progress notes must be legible to all providers of care.  In the root cause analysis of 400 consumers in active care who attempted or died by suicide while inpatients, communication failures ranked at the top of the list of contributory causes (National Center for Patient Safety, 2006).

To improve communications between clinicians regarding suicide risk, there is little consensus about a) how to assess immediate risk or b) how to determine its severity.  Still, risk stratification decisions and clinical judgments must be made every day as these assessments necessarily guide our interventions, monitoring levels, and frequency of contact. For a variety of reasons, suicidal consumers may not be entirely helpful in disclosing their suicidal intent, desire and plans.  If, after an assessment, you are not confident of your conclusions, it may be helpful to others on your team to add a chart note to this effect.

An explanatory note of “low confidence” would be warranted when the consumer:

·      Has been uncooperative and refused to collaborate in the assessment process

·      Has or may have psychotic symptoms, especially paranoia

·      Is or has been recently intoxicated

·      Has a history of impulsivity

·      Is faced with an uncontrollable external event, such as the serving of divorce papers or an arrest warrant 

In sum, a note of low confidence in the assessment suggests higher risk and that reassessment is indicated in the near term (not more than 24 hours), as well as the need for a second opinion, greater vigilance, and more frequent observation.

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals including: Mental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers. For more information please visit our full library of advanced courses!

Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRInstitute.com

 

Tags:

relationships, friendships | Self-Care | Social Work | Suicide Bereavement | Suicide Prevention | Treatment Modalities

Suicide Prevention Blog Series: Clinical Tip #4

by Staff and Faculty of the QPR Institute Wednesday, November 6, 2013

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc., says 22 veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers. According to the Centers for Disease Control and Prevention, in just one day, more then 105 of our fellow Americans will die by suicide. Perhaps this clinical tip will save just one.

Clinical tip #4 -- Reassessing suicide risk

 

Suicide risk changes with time and circumstances.  A single, initial assessment of suicide risk is seldom adequate for safe practice.  Suicide risk assessments should be repeated both a fixed intervals and during times of increase stress. Based on the literature and the clinical experience of several of the QPR Institute faculty, we suggest four non-exhaustive circumstances where re-evaluating suicide risk is indicated:

 

Changes in health status, e.g., diagnosis of a life-threatening illness, exposure to HIV, continued experience of chronic pain, and when the consumer is faced with significant surgery or has suffered a significant physical injury.

Stressful life-transitions, e.g., loss of a major relationship, change in living arrangements, treatment transitions (between therapists or programs), threats to housing, income or access to care.

Response to treatment, to include side effects of psychotropic medications, non-therapeutic response to medication or other intervention failures, including impasse in therapy or conflict with therapist

Substance abuse dramatically increases suicide risk.  Relapse from recovery, binge drinking or drugging, relapse of one’s sponsor, and any significant use of intoxicants, even by non-addicted consumers.

 

A number of other circumstances suggest the need for a reassessment of suicide risk.  These include reports by third parties that suicide warning signs have been observed, any report of violent behavior, the sudden loss of a loved one through death, divorce, desertion and especially suicide.  Finally, anytime a consumer of any age is facing what may be a personal and public humiliation, suicide risk may be sharply elevated.

 

Basically, suicide risk increases dramatically with multiple successive losses, co-morbidity of illnesses, acute environmental stressors, and anytime the consumer begins to feel he or she is becoming a burden on others or care providers.  If in doubt, reassess!

 

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals includingMental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers. For more information please visit our full library of advanced courses!

Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRInstitute.com

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relationships, friendships | Self-Care | Social Work | Suicide Bereavement | Suicide Prevention | Treatment Modalities

Heros and the Heat of the Game

by Rosemary De Faria Wednesday, July 17, 2013

There has been a lot of buzz with the play-offs lately.  One has to live under a rock to avoid being affected by it in one form or another.

Not being a sports fan I decided to take a walk on the wild side by accepting an invitation to dinner at a local bar where the final game would be played on every screen in the place.

My immersion experience began with the driver of the shuttle who took us to the bar.  He recounted the story of the previous evening’s game, sharing with emotion how he had been close to tears when it looked like his beloved team may lose.     His voice, hoarse from all the screaming, now had a lilt in it as he spoke of the team’s dramatic win.  They had managed to turn things around and to listen to him; it had been close to a spiritual experience.

In the restaurant people were already seated in the front row.   Dressed in their Heat attire, they were screaming and throwing their hands up to clap for a play which brought the team a little closer to winning.   

I began thinking of the role these sportsmen played for people, young and old from all walks of life and I found myself wondering : “Who do we make our heroes and why? “

When I think of my heroes, the people that come to mind are rarely those with celebrity.  Oh, I admit, Oprah holds a special place for me as I’m sure she does for many, but I think instead, of Sister Mendonca my fifth grade teacher who had the kindest, most loving heart.   She made some difficult times a bit easier to bear and I have never forgotten her for it.  

Now in middle age, I think of my father as another hero.  This surprises me at first, but it is a good choice nonetheless.   He was a tough, scary man, but he modeled some of the most important principles in life for which I am very grateful.  The best parts of me are all as a result of having him as my father. 

I sometimes sit across from my clients and wonder, am I a hero for them?    If so, I hope I can be like my heroes, who in very humble and unassuming ways gave me so much. 

Take the time to seek out your heroes.   They often go unnoticed, flying under the radar with little or no awareness of their own magnificence, but they are heroes nonetheless.

Let them know how they have impacted you.  Then, think about how you can be a hero for someone else and do it.  You may just change a life in unexpected ways.   Unleash the hero within you.  I promise you it’s there …ready and waiting to get into the heat of the game.

Rosemary De Faria, LCSW has a psycho-spiritual psychotherapy practice in Miami, Florida.  With over 20 years experience she uses both traditional and alternative therapies in working with her clients.  To read more about Rosemary or to read more of her articles, please visit www.distincttherapy.com. Mention this blog article for a complementary phone consultation: 954-966-3446.

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relationships, friendships | Self-Care | Social Work | Therapeutic Relationship

Friendship, Love and Marriage

by Gil Shepard Thursday, April 18, 2013

 

When someone says, “She (or he) is just a friend,” this generally means the relationship is not romantic, not sexual and not too intimate. It is also understood to mean, “You need not take this too seriously.”

On the other hand we sometimes hear someone say in a reverent way about a spouse, or a partner, “He (or she) is my best friend.” This is saying, “Yes, lots of people are married, lots of people have sex and live together, but what we share is a special trust, support and a rich love.”

What does it take to have this rich enviable friendship? For a start it takes risking being open about one’s feelings, being gently honest about what one thinks and does, being able to deal with disagreements in a relatively calm manner and being able to negotiate differences.

Unfortunately these skills are rarely taught in childhood. Instead many of us learned not to trust because we found caregivers not safe, not trustworthy and it was not smart to trust. Suspicion and fear are often survival skills in childhood but as an adult they can impede love. To learn how to be a true friend and how to choose someone trustworthy may take relearning in a safe environment.

In effective relationship therapy you may learn techniques, like how to let another person know that you heard what they said by repeating what you think you heard back to them and checking to see if you are correct. You may learn certain "no-no's" like telling someone they "should" do or be a different way. That is a sure way to create distance in a relationship very quickly, almost as fast as by telling someone they are stupid. These things certainly do not gain intimacy.

But most effective may be observing the therapist's style and emotional tone. Or you may notice that the therapist may see things very differently from the way you have seen them and wonder what he sees that you don't. You may explore why your partner's comments are so upsetting to you. What does it remind you of in your history? It can be very helpful to have a wise and experienced guide to do this and feel safe.

 

 

Gil Shepard is a licensed Marriage and Family Therapist in Walnut Creek, California

 

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Social Work | Therapeutic Relationship | relationships, friendships | marriage

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