We’re excited to announce our expansion into psychological/neuropsychological testing and behavioral treatment!

We’re excited to announce our expansion into psychological/neuropsychological testing and behavioral treatment!

We’re excited to announce that we’ve expanded our services and now offer psychological/neuropsychological testing as well as behavioral treatment! We’ve been providing behavior therapy to the community since 2018, but we know more people are in need of help than we can accommodate. One of the ways we address this need is by offering comprehensive psychological assessments and treatments to patients who may not qualify or want help through therapy, but still need guidance with their behavioral problems. With these new services, we hope to be able to serve our community even better!

What it means for you
We are expanding our practice! In addition to professional expertise in behavioral treatment, we now offer a wide range of neuropsychological services for children and adults in need of diagnoses and reassessment. These neuropsychological evaluations can be helpful for those experiencing age-related memory decline, concerns about Autism or developmental disabilities, or those with symptoms related to Parkinson’s disease, Alzheimer’s disease, stroke, or traumatic brain injury. We also provide behavior modification programs for children who have demonstrated behaviors that interfere with their academic and social success. For more information on these new services, please contact us at (972) 332-8733.

Our process
The first step in developing a program for your specific needs is a consultation. During these consults, we’ll discuss your goals and any barriers you may face along with your unique background, experiences, etc. Based on what we find during these initial conversations, we’ll provide recommendations regarding how best to proceed forward. We also use technology (iPad assessment apps) as well as paper-and-pencil tests if necessary (to get an even more accurate read on specific behaviors or abilities).

Contact us to schedule an appointment today!
If you’re interested in learning more about any of these services, please contact us for a free consultation. If we don’t have availability on your preferred date or time, we’ll do our best to accommodate you. Contact us today at (972) 332-8733. We look forward to hearing from you!

OCD: How to Overcome Your Fears

OCD: How to Overcome Your Fears

OCD: How to Overcome Your Fears

Obsessive compulsive disorder (OCD) is an anxiety disorder where people have unwanted thoughts and behaviors that feel out of control and cause significant distress or difficulty functioning in daily life. The condition often runs in families, suggesting that there may be some genetic component to it, but environmental factors like childhood trauma can also contribute to the development of OCD. People with this condition often develop rituals as a way to cope with the anxiety they experience; many of these rituals are repetitive behaviors, including hand washing or checking that no one has been in the house while they were gone.

What Is Obsessive Compulsive Disorder?
Obsessive compulsive disorder (OCD) is an anxiety disorder that can cause significant distress, as well as sometimes difficult to understand behaviors. In short, OCD is characterized by obsessive thoughts and behaviors that are performed in order to reduce or neutralize obsessions. For example, you may have an obsessive fear of germs, which leads you to perform excessive hand-washing or cleaning rituals. This behavior provides temporary relief from your anxiety but increases over time until it dominates your life and interferes with daily functioning.

What Causes Obsessive Compulsive Disorder?
OCD is a serious mental illness. Triggered by severe anxiety, it affects about 2.2 million American adults and impacts people of all races, ages, socioeconomic backgrounds and education levels. It’s generally treated with a combination of behavioral therapy and prescription medications (antidepressants or anti-anxiety medications). OCD may be caused by a myriad of contributing factors, including biology and environment. In many cases, no single cause can be identified. In some instances, OCD symptoms are related to an underlying medical condition that needs treatment. Regardless of the cause of OCD, a mix of behavioral and pharmacological treatment is usually most effective. Exposure Response Prevention Therapy is one type of behavioral treatment used in treating obsessive-compulsive disorder.

Are There Treatments For OCD?
Yes. There are a variety of effective treatments for OCD, with behavioral therapy being one of them. Exposure and response prevention (ERP) is an effective and common treatment that focuses on gradually exposing you to fearful situations that trigger your obsessive thoughts and compulsive behaviors, allowing you to learn how not to respond out of fear.

What Role Does Exposure And Response Prevention Play In Treating OCD?
Exposure and response prevention (ERP) is an important part of behavioral treatment for obsessive compulsive disorder (OCD). It’s a long and involved process that involves gradually exposing yourself to things that scare you until you get used to them, which allows your brain to rewire itself so you can deal with whatever it is you’re scared of without needing excessive reassurance or avoidance. Think of exposure as desensitization therapy.

Get to Know Us: Better Living’s Mission, Vision, and Values

Get to Know Us: Better Living’s Mission, Vision, and Values

Every organization must have a guiding set of values and a vision to orient itself though grow, changes, and challenges. This is the mission, vision, and values that orient us at the Better Living Center for Behavioral Health.

Vision:

Better Living for a Better World. To create contexts that improve lives. To develop a team environment that promotes the most effective clinical care. To be thought leaders in integrative evidence-based treatment technology, leadership, and advocacy in the applied and academic communities. To integrate behavioral principles, at all levels, to produce more effective treatment, team functioning, and thought leadership.

Mission:

To use leaders in effective treatment using clinical behavior analysis to improve the lives of others.

Values:

  1. Growth
  2. Integrity
  3. Accountability
  4. Initiative
  5. Curiosity
  6. Humor

Contact us at 972-332-8733 to inquire about joining our team, seek care, or seek professional consultation.

 

Mindfulness as a Mediator Between Trauma Exposure and Mental Health Outcomes

Mindfulness as a Mediator Between Trauma Exposure and Mental Health Outcomes

The prevalence of traumatic events among adults in the United States range from 40-90%. The highest prevalence is seen in veterans or current individuals in the armed forces. Exposure to traumatic events, such as being in war, can lead to the development of mental health problems such as posttraumatic stress disorder (PTSD), major depressive disorder, substance use disorders, anxiety disorders, and suicidal ideation. Gaining knowledge of potential mediators of the link between trauma exposure and mental health outcomes help enrich treatment and the development of more targeted clinical interventions.

Mindfulness is a clinical intervention that has become part of a component package for treatment of experiencing a traumatic event. Mindfulness is paying attention to the present moment in a nonjudgmental way and cultivating awareness of one’s mental state; and shifting attention from ruminative thought patterns to the present moment (Kachadourian et al., 2021). This allows a person to respond with flexibility when in a situation that has previously evoked distress caused by the traumatic event(s). The individual will be more likely to engage in adaptive behaviors by increasing acceptance of trauma-related experiences and decreasing the impact of trauma related stimuli.

Interventions to help bolster mindfulness may further help alleviate the negative mental health impact that aggregate traumas on individuals, particularly for U.S. military veterans. Other mindfulness factors that should be further researched include observing (i.e., ability to notice or attend to internal and external experiences), describing (i.e., ability to label internal experiences with words), nonjudging of inner experience (i.e., taking a nonevaluative stance toward thoughts and feelings), and nonreactivity to inner experience (i.e., tendency to allow thoughts and feelings to come and go). These may help with differential associations between trauma exposure and mental health.

Reference:

Kachadourian, L. K., Harpaz-Rotem, I., Tsai, J., Southwick, S., & Pietrzak, R. H. (2021). Mindfulness as a mediator between trauma exposure and mental health outcomes: Results from the National Health and Resilience in Veterans Study. Psychological Trauma: Theory, Research, Practice, and Policy, 13(2), 223–230. https://doi-org.ruby.uhv.edu/10.1037/tra0000995

To seek care with us – please call 972-332-8733.

 

LGBTQ populations: Psychologically vulnerable communities in the COVID-19 pandemic

LGBTQ populations: Psychologically vulnerable communities in the COVID-19 pandemic

The novel COVID-19 outbreak escalated the mental health crisis of the LGBTQ+ community. These crises include an increase in suicidality, anxiety, PTSD, and depression confounded with prior psychological effects such as pre-existing social inequality. Social distancing and stay-at-home orders that were established to help stop the spread, led to uniquely negative challenges for LGBTQ+ populations. These challenges included an increase in the susceptibility of school age LGBTQ+ groups in abusive and traumatic home environments, and older LGBTQ+ groups experiencing loneliness from social isolation, along with existing physical and mental health conditions (Salerno et al., 2020).

It is critical for servicing groups such as mental health therapists, to further provide online delivery of care to assuage the mental health demands brought on by COVID-19. Leadership stakeholders need to engage in efforts that encompass LGBTQ+ affirming virtual extracurricular activities that strengthen social support and connection within the community. Social Media should be utilized to connect the LGBTQ+ community with viable mental health services. Intervention efforts, such as surveillance and reporting the occurrence of LGBTQ+ child abuse, need to be established. State Laws should allow therapists to practice outside of their state licensure stipulations to reach more LGBTQ+ groups who have had to relocate due to the pandemic. In addition, ACA health plan open enrollment needs to be emphasized further, as well closing the Medicaid gap so that all uninsured LGBTQ+ persons can obtain health insurance and access to effective physical and mental health care.

Reference:

Salerno, J. P., Williams, N. D., & Gattamorta, K. A. (2020). LGBTQ populations: Psychologically vulnerable communities in the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S239–S242. https://doi-org.ruby.uhv.edu/10.1037/tra0000837

To seek care with us – please call 972-332-8733.

 

School-Based Racial Microaggressions

School-Based Racial Microaggressions

Research has shown that African American youth are exposed to approximately 33% more Adverse Childhood Experiences (ACEs) than rates of Caucasian children (Woods-Jaeger et al., 2021). ACE’s are potentially traumatic events that take place during childhood and include circumstances such as caregiver substance abuse usage, bullying, racism, witnessing intimate partner violence, abuse or neglect, and community violence.

Resilience, defined as being able to successfully adapt and function despite severe adversity and trauma, is a key factor in African American youth survival. There are now more opportunities to support African American youth, collaboration across systems is still needed for a more successful development of community-level solutions. There are numerous barriers to resilience among African American adolescents exposed to trauma and adversity. The school system is one of those barriers.

Although schools can be one of the sources of support for youths exposed to ACEs, African American youth experience school-based racism such as racial profiling, disproportionate rates of removal from the classroom and school suspensions compared with their White peers. Studies also report that African American students encounter racial/ethnic microaggressions (e.g., expressions about academic inferiority, expectations of aggression, or stereotypical misrepresentations). School-based racial/ethnic microaggressions and the health and well-being of these youth need to be further examined and researched. The cascading effects of microaggressions experienced in school settings, violence exposure, and ACEs can have severe negative impacts, and are critical to address to improve trauma-informed programs and policies within schools.

Reference:

Woods-Jaeger, B. A., Hampton-Anderson, J., Christensen, K., Miller, T., O’Connor, P., & Berkley-Patton, J. (2021). School-based racial microaggressions: A barrier to resilience among African American adolescents exposed to trauma. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi-org.ruby.uhv.edu/10.1037/tra0001091

To seek care with us – please call 972-332-8733.

 

Measuring Outcomes: Reducing harmful outcomes associated with treatments

Measuring Outcomes: Reducing harmful outcomes associated with treatments

Despite numerous systematic efforts to assess the efficacy of structured treatment protocols, there has been little research done on how treatment interventions could be potentially harmful to clients. Treatment interventions are not assessed thoroughly, nor have there been proper standards upheld with regards to harmful events being reported. Harmful effects could be multifaceted, encompassing factors such as deterioration of functioning and worsening of symptoms, client dropout within the interventions due to deterioration of functioning, the therapeutic alliance and its role in symptom improvement being uncertain other than for the prevention of client dropout, family members and loved ones viewing  interventions as a form of abuse; producing  false allegations against the practicing clinician, and interventions assuaging the initial presenting symptom but then causing adverse effects to develop in other areas functionally.

Evaluation of harm from interventions need to be regularly and systematically assessed. Solutions would entail statistical evaluation of potential benefits and harm from treatment based upon routine reporting of the number of clients needed to be treated to attain clinically notable improvement (NNT) and the number of clients needed to be treated before one is harmed (NNH). Measurement-based care (MBC) and the systematic collection of patient-reported measures are also important for improvement of assessing possible harm. Overall, these routine assessments can help clinicians better determine when their treatment is becoming insufficient or aversive and modify their choice of interventions accordingly.

References: McKay, D., & Jensen-Doss, A. (2021). Harmful treatments in psychotherapy. Clinical Psychology: Science and Practice, 28(1), 2–4. https://doi-org.ruby.uhv.edu/10.1037/cps0000023

 

Trichotillomania: What is problematic hair-pulling?

Trichotillomania: What is problematic hair-pulling?

Trichotillomania (TTM) is currently classified as an impulse-control disorder. TTM entails the phenomenon of repetitive hair pulling that results in hair loss. The diagnostic criteria for TTM include: an increased level of tension immediately before hair pulling or during attempts to avoid pulling and a feeling of relief, pleasure, or gratification in response to hair pulling. Trichotillomania must also cause the individual distress or impairment in occupational, social, or other areas of functioning. Hair is most often pulled, one hair at a time, either from the scalp, lashes, or eyebrows. Hair pulling from the pubic area is also common.

Pulling is generally executed by way of the fingers; however, tools such as tweezers, brushes, or combs may be used as well. TTM suffers will often partake in post-pulling actions that involve handling the pulled hair using the mouth, hands, or face. The hair can be chewed or ingested as well. Ingesting hair may also lead to a number of significant health issues. TTM is considered to be more common among females, although it is not certain whether this sex difference results from an actual variance in the occurrence of the disorder, represents a female treatment-seeking bias, or simply reflects higher acceptability in society of hair loss in men.  

At the Better Living Center for Behavioral Health we treat patients with trichotillomania with evidence-based treatments including Habit Reversal. Habit reversal helps the individual break down the series of actions that lead to hair pulling and engage in alternative behaviors to reduce hair pulling. If you would like to learn more about treatment of trichotillomania or other Body Focused Repetitive Behaviors (BFRBs) please contact us at 972-332-8733.

 

References:

Woods, D. W., Flessner, C., Franklin, M. E., Wetterneck, C. T., Walther, M. R., Anderson, E. R., & Cardona, D. (2006). Understanding and treating trichotillomania: What we know and what we don’t know. Psychiatric Clinics of North America, 29(2), 487-501. doi:10.1016/j.psc.2006.02.009

Differences in Early and Late Onset OCD

Differences in Early and Late Onset OCD

Pinto et al. (2006) defined OCD as “a neuropsychiatric condition characterized by recurrent intrusive thoughts (obsessions) and repetitive behaviors that the individual feels driven to perform (compulsions)” (pg.1 ).  The researchers sought to investigate predictors of remission/relapse among those treated for OCD.

Over five years, 293 adults were monitored and researchers measured their OCD symptoms. Researchers found those with early and late onset symptoms experience an increase in symptoms over time without effective treatment. Additional findings show a considerable amount of time between symptom onset and first initiation of treatment. Individuals in the study reported an average of 17 years from initial symptom experience to treatment initiation and 11 of delay from meeting diagnostic criteria for OCD until treatment initiation. Many clients reported spending a number of years misdiagnosed before initiating appropriate treatment for OCD.  

Researchers found the average onset for early onset OCD was 11-12 years old, while late onset OCD was 25-26 years-of-age. The first clinical symptom(s), obsessions and compulsions, 53% of participants indicated an obsession and 47% experiencing a compulsion. Interviews also found aggressive content obsessions, hoarding obsessions and compulsions as primary themes in distress. Contamination was shown as the most frequently reported subcategory for obsessions. Those with earlier onset symptoms also experienced higher rates of panic symptoms and disordered (Pinto et al., 2006).

Written by Perry Leynor, MA, LPC Associate supervised by Paula Maloney, LPC Supervisor.

Pinto, A., Mancebo, M. C., Eisen, J. L., Pagano, M. E., & Rasmussen, S. A. (2006). The Brown Longitudinal obsessive COMPULSIVE Study. The Journal of Clinical Psychiatry, 67(05), 703-711. https://doi:10.4088/jcp.v67n0503