Tuesday, May 2, 2017

Mental Health and Stigma



Mental Health and Stigma
by Guest Blogger, Kathy L. Lin

Did you know May is Mental Health Awareness month?

 


Although mental health treatments have had great advances, many individuals who may benefit from such services do not seek out these interventions. One reason is stigma towards mental health. Mental health stigma can consist of social stigma and self-stigma. Social stigma represents the discrimination and prejudice directed towards people with mental health problems while self-stigma occurs when individuals internalize these prejudicial attitudes and discriminating behavior (Corrigan, 2005).

Stigmatizing beliefs about mental health are held by a variety of individuals, even family members of individuals with a mental health illness. In a study examining stigma directed at adolescents with mental health problems, Moses (2010) found that 46% of adolescents experienced stigma from family members, 62% from peers, and 35% from school staff. Stigma matters as it can not only influence an individual’s quality of life in a negative manner, but also adversely affect treatment outcomes. Research has shown that stigma is correlated with increased social isolation and poorer employment success (Yanos, Roe, & Lysaker, 2010).


As mental health awareness and knowledge have increased, the reduction of mental health stigma can further contribute to mental health care. Some proposed ways to fight mental health stigma include (NAMI, 2015):
  • Educate self and others about mental health 
  • Question and push back against how individuals with mental health problems are portrayed in the media 
  • Talk openly about mental health issues 
  • Explain mental illness in a similar manner as any other illness 
  • Advocate for mental health reform 
  • Love and respect individuals living with a mental health condition 
The National Alliance on Mental Illness and (NAMI) and Substance Abuse and Mental Health Services Administration (SAMHSA) provide opportunities for individuals to get involved in reducing mental health stigma:

https://www.recoverymonth.gov/resource-category/mental-illness

http://www.nami.org/Get-Involved/Take-the-stigmafree-Pledge/stigmaFree-Community/stigmaFree-on-Campus


References:

Corrigan P. W. (2005). On the stigma of mental illness: Practical strategies for research and social change. Washington DC: American Psychological Association.

Moses, T. (2010). Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders. Social Science & Medicine, 70(7), 985-993.

National Alliance on Mental Illness (2015). 9 Ways to Fight Mental Health Stigma. Retrieved from http://www.nami.org/Blogs/NAMI-Blog/October-2015/9-Ways-to-Fight-Mental-Health-Stigma

Yanos, P. T., Roe, D., & Lysaker, P. H. (2010). The impact of illness identity on recovery from severe mental illness. American Journal of Psychiatric Rehabilitation, 13(2), 73-93.

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Kathy L. Lin, B.A., is a second-year graduate student in Miami University’s Clinical Psychology program. She works in the Culture, Affect, Relationships (CARE) Lab and her research interests consist of examining body image within a cultural context, looking at how body image may be impacted by cultural influences and perceptions.

Wednesday, April 5, 2017

Political Reactions and Coping



Prior to the election, APA released a survey showing that 52% of people were very or somewhat stressed about the election (APA, 2016). It is likely that, for many people, this stress has continued post-election, including as executive orders were issued over the past week on topics such as immigration, refugees, abortion, healthcare and more. You may have noticed that you and your family, friends, clients and/or colleagues are experiencing many emotions, physical reactions, and questions or concerns. These may be similar or different from people around you. 

What do I do?

The answer to this question will look different for every person. In addition, the answer might change depending on the day, how you’re feeling, or the topic. However, it is important to take care of yourself using healthy coping strategies as often as possible. These might include:

  • Give yourself a set amount of time to connect with your emotions
  • Reach out to family, friends, or other people for support
  • Exercise (e.g., running, walking, yoga)
  • Meditate
  • Do something you enjoy, such as;
    • Write, read, listen to music, cook, color, be creative, play video games, watch a movie
  • Limit time reading the news or using social media
  • Volunteer for an organization you feel passionate about
  • Contact your representatives at the local and national level
If you find that you or someone around you is having a difficult time coping, seek professional support.

Find a local psychologist: http://ohpsych.site-ym.com/search/custom.asp?id=4247

If you are in immediate distress and need to talk to someone, contact a hotline:
http://suicidepreventionlifeline.org/ or 1-800-273-8255

References:  http://www.apa.org/news/press/releases/2016/10/presidential-election-stress.aspx

Friday, March 24, 2017

Managing Hot Topics in Therapy

by Guest Bloggers, Amy Untied Ph.D., & Amanda M. Mitchell, Ph.D.

Clinicians are charged with the important task of managing challenging topics during therapy appointments. These topics range from encounters with clients who hold differing values from providers to discussing current political, social, economic and other related issues during the therapy visit. Even though psychologists are instructed on therapeutic skills like empathic listening and reflection during graduate school and supervision, it can be challenging at times to manage personal reactions. 

 Additional collaboration or supervision can be sought if needed and many psychologists and professional organizations offer suggestions for navigating these discussions. The list below includes links to articles that address some of these potentially challenging topics and more general tips for talking about difficult issues or varying viewpoints.

Ten Tips to Talk About Anything with Anyone

https://www.psychologytoday.com/blog/fulfillment-any-age/201107/10-tips-talk-about-anything-anyone

Is Your Therapist’s Personal Life Confidential

https://www.psychologytoday.com/blog/in-therapy/201108/is-your-therapists-personal-life-confidential

Success Stories with Challenging Clients

http://ct.counseling.org/2010/10/success-stories-with-challenging-clients/

Talking About Sensitive Subjects (Geriatric population; topics such as mental health, long-term care, financial barriers)

https://www.nia.nih.gov/health/publication/talking-your-older-patient/talking-about-sensitive-subjects

Post-Election Blues

https://www.psychologytoday.com/blog/drifting-adulthood/201611/post-election-blues

Talking to Kids about Politics

https://www.psychologytoday.com/blog/our-gender-ourselves/201211/talking-kids-about-politics

Talking to children about the Election

http://www.apa.org/helpcenter/election-talk.aspx


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Dr. Amy Untied earned her B.A. from Ohio University and her M.A. and Psy.D. in Clinical Psychology from Xavier University in Cincinnati, Ohio. She has received training in a variety of clinical settings and completed her internship at the Dayton VA Medical Center with rotations in PTSD focused treatment, drug and alcohol rehabilitation, and general outpatient mental health. She has published several articles on the topic of sexual trauma, alcohol use and assault risk reduction. Dr. Untied is employed at a CBOC of the Chalmers P. Wylie VA Ambulatory Care Center as a Clinical Psychologist.

Dr. Mitchell is currently a Postdoctoral Researcher at The Ohio State University Wexner Medical Center. She received her doctorate in Counseling Psychology at the University of Louisville and completed an APA-accredited internship at the University of Utah Counseling Center. Her research examines links among cognitive and systemic coping strategies with neuroendocrine and immune functioning in the context of chronic stress.

Tuesday, February 7, 2017

Did You Know? World Day of Social Justice is February 20

By Guest Blogger, Amanda M. Mitchell, Ph.D.

World Day of Social Justice was officially declared as February 20th by the United Nations (UN) General Assembly in 2007.1 The UN describes social justice as central to their mission of promoting development and human dignity.1 Although social justice definitions vary widely, one relevant to the field of psychology is a “perspective emphasizing societal concerns, including issues of equity, self-determination, interdependence and social responsibility.”7

In the context of psychology, justice is a core principle in the American Psychological Association Code of Ethics.3 Over the past decade, we saw increased calls in the literature for the integration of social justice and advocacy into various psychology settings, including training.e.g., 2, 5, 6, 7 In addition, advocacy is a competency described in the American Psychological Association’s Benchmarks Evaluation System, a set of competencies professional psychology programs can use to ensure students are obtaining the necessary knowledge and skills for their career.4 As social justice and advocacy continues to evolve in the psychology field and society, it is meaningful to consider or reexamine the role it plays in your life.

As we observe World Day of Social Justice, some questions to reflect on:
  • How do you define social justice?
  • What is your reaction to the term social justice?
  • How do you integrate social justice into your personal and professional identities? 
    • What does it look like on a daily basis?
  • What other words come to mind when you think of social justice (e.g., oppression, privilege, equity, access to care, health disparities)? 
  • What personal experiences have informed your understanding of social justice?
  • What types of social justice and advocacy-related activities would you like to become involved in?


References
1UN, 2017. World Day of Social Justice: 20 February. http://www.un.org/en/events/socialjusticeday/
2Ali, S. R., Liu, W. M., Mahmood, A., & Arguello, J. (2008). Social justice and applied psychology: Practical ideas for training the next generation of psychologists. Journal for Social Action in Counseling and Psychology, 1, 1-13.
3American Psychological Association (2017). Ethical Principles of Psychologists and Code of Conduct. http://www.apa.org/ethics/code/
4American Psychological Association (2017). Benchmarks Evaluation System. http://www.apa.org/ed/graduate/benchmarks-evaluation-system.aspx
5Burnes, T. R., & Singh, A. A. (2010). Integrating social justice training into the practicum experience for psychology trainees: Starting earlier. Training and Education in Professional Psychology, 4, 153-162.
6Constantine, M. G., Hage, S. M., Kindaichi, M. M., & Bryant, R. M. (2007). Social justice and multicultural issues: Implications for the practice and training of counselors and counseling psychologists. Journal of Counseling & Development, 85, 24-29.
7Vera, E. M., & Speight, S. L. (2003). Multicultural competence, social justice, and counseling psychology: Expanding our roles. The Counseling Psychologist, 31, 253-272.


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Dr. Mitchell is currently a Postdoctoral Researcher at The Ohio State University Wexner Medical Center. She received her doctorate in Counseling Psychology at the University of Louisville and completed an APA-accredited internship at the University of Utah Counseling Center. Her research examines links among cognitive and systemic coping strategies with neuroendocrine and immune functioning in the context of chronic stress.

Thursday, January 19, 2017

Treating Pediatric Bipolar Disorder

by Kelsey Ross, M.A., Guest Blogger

In the United States, at least 750,000 children and adolescents are diagnosed with pediatric bipolar disorder (PBPD) (Killu & Crundwell, 2008). PBPD is a biological brain disorder that causes fluctuations in a youth’s mood, energy, and ability to function (Killu & Crundwell, 2008). PBPD is characterized by a slightly different presentation than the adult presentation of bipolar disorder, yet the adult criteria are used to diagnose children (American Psychological Association [APA], 2013; Grier, Wilkins, & Szadek, 2005). This is one reason why PBPD remains one of the most difficult disorders to diagnose and treat in youth, and under-detection, misdiagnosis, and inappropriate treatment are serious problems (Lofthouse & Fristad, 2004; McDonnell, 2010).

Evidence-Based Treatments

Lofthouse, Mackinaw-Koons, and Fristad (2004) found that pharmacological treatment is often the first step for children and adolescents with PBPD, and it is not uncommon for youth with PBPD to take several medications. Youth are often given a mood stabilizer, followed by a low dose anti-depressant to reduce depressive and anxiety symptoms and/or psychostimulants to reduce ADHD symptoms of inattention, impulsivity, and hyperactivity. These medications may be supplemented by anti-psychotic medications to reduce aggressive or psychotic symptoms and/or anti-hypertensive medications to improve the sleep-wake cycle.

To address the significant impairment in family life, social relationships, academics, and behavior, psychotherapy is often needed (Lofthouse et al., 2004). Psychoeducation, which teaches parents and youth about the disorder, its treatment, and the signs of relapse so that they can seek treatment early, can be an important component of psychotherapy (NIMH, 2012). The major psychotherapy options for PBPD include cognitive behavior therapy (CBT), which helps the youth change harmful thought patterns and behaviors; family-focused therapy (FFT), which teaches the family coping strategies, communication skills, and problem-solving skills; and interpersonal and social rhythm therapy, which aims to improve peer relationships and manage daily routines and sleep schedules (NIMH, 2012). Psychotherapy that combines these approaches can also be effective: one study found promising results for an FFT and CBT combined treatment for PBPD (Pavuluri et al., 2004).

School-Based Interventions


There are currently no research-supported school-based interventions for PBPD (Lofthouse et al., 2004). The pharmacotherapy and psychotherapy discussed do not primarily involve school professionals and would not be appropriate if administered solely in school settings. However, school professionals still play an instrumental role in treating youth with PBPD.

In terms of pharmacotherapy, school psychologists and school nurses can create a behavioral intervention plan that schedules a youth’s medication to be taken during the school day (Grier et al., 2005). This plan increases medication compliance, which can be an issue for youth with PBPD (Grier et al., 2005). School psychologists should also be aware of common side effects of PBPD medications (Grier et al., 2005). Then, school psychologists can include accommodations and modifications that address these side effects in a youth’s Individualized Education Program (IEP) or 504 plan (Grier et al., 2005). For example, one common side effect is frequent urination (Casey, 2006). A school psychologist could suggest an accommodation that allows the child to have unlimited access to the bathroom.

Regarding psychotherapy, school psychologists can supplement the community-based therapy with additional skills training sessions. For example, perhaps a child with PBPD receives Child and Family Focused Cognitive-Behavioral Treatment (CFF-CBT) in the community. Phase three of CFF-CBT teaches the child social and problem-solving skills (Casey, 2006). The school psychologist can collaborate with the community mental health professional to provide a school-based social skills intervention that reinforces the CFF-CBT social skills training (Grier et al., 2005).

Though pediatric bipolar disorder affects 2.2% of U.S. adolescents ages 13 to 18, it is not yet entirely understood (Merikangas et al., 2012). Researchers debate almost everything about the disorder, including the label, age range, prevalence, and risk factors. However, what is not debated is that PBPD can negatively impact students’ academic, social, and psychological functioning. Fortunately, evidence-based treatments exist; however, additional school-based interventions are needed to provide comprehensive support for youth with PBPD.

References:
  1. American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  2. Casey, K. (2006). Effective interventions for students with bipolar disorder. In C. Franklin, M. B. Harris, & P. Allen-Meares (Eds.), The school services sourcebook: A guide for school-based professionals (119-127). New York: Oxford University Press.
  3. Grier, E. C., Wilkins, M. L., Szadek, L. (2005). Bipolar disorder in children: Treatment and intervention, part II. NASP Communique, 34(3), 1-7.
  4. Killu, K., & Crundwell, R. A. (2008). Understanding and developing academic and behavioral interventions for students with bipolar disorder. Intervention In School & Clinic, 43(4), 244-251.
  5. Lofthouse, N., & Fristad, M. A. (2004). Psychosocial interventions for children with early-onset bipolar spectrum disorder. Clinical Child And Family Psychology Review, 7(2), 71-88. doi:1096-4037/04/0600-0071/0
  6. Lofthouse, N., Mackinaw-Koons, B., & Fristad, M. A. (2004). Bipolar spectrum disorders: Early onset. Retrieved from http://www.nasponline.org/communications/spawareness/bipolar_ho.pdf
  7. McDonnell, M. A. (2010). Race, gender and age effects on the assessment of bipolar disorder in youth (Doctoral dissertation). Retrieved from Nursing dissertations. (d20000351)
  8. Merikangas, K., Cui, L., Kattan, G., Carlson, G., Youngstrom, E., & Angst, J. (2012). Mania with and without depression in a community sample of US adolescents. Archives of General Psychiatry, 69(9), 943-951. doi:10.1001/archgenpsychiatry.2012.38
  9. National Institute of Mental Health (NIMH). (2012). Bipolar disorder in children and adolescents. Retrieved from http://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-adolescents/Bipolar_Children_Adolescents_CL508_144277.pdf
  10. Pavuluri, M. N., Graczyk, P. A., Henry, D. B., Carbray, J. A., Heidenreich, J., & Miklowitz, D. J. (2004). Child- and family-focused cognitive-behavioral therapy for pediatric bipolar disorder: Development and preliminary results. Journal of the American Academy of Child and Adolescent Psychiatry, 43(5), 528-537. doi:10.1097/01.chi.0000116743.71662.f8

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Kelsey Ross, M.A., is a third year doctoral student in school psychology at The Ohio State University (OSU). She received a B.A. with Honors Research Distinction in psychology and English from OSU. She currently serves as the Social Justice Chair for OSU's Student Affiliates in School Psychology (SASP). Kelsey's research interests include reading instruction and interventions.