Dr. Edward Hallowell on adult Attention Deficit Disorder

I often suggest Dr. Hallowell's book(s) on ADHD (Attention Deficit Hyperactivity Disorder). I don't agree with everything he says, and differ somewhat in how I approach treatment, but still find Dr. Hallowell's writings to be useful, informative and more likely than not to set you down the right path.

This is a 25 min video. It will leave you with a lot of good information, and you'll have a good idea about where treatment of ADHD should be focused. Take a look, and enjoy.

For information on my services for children, adolescents and adults (families!) with ADHD check out my web page at http://www.relatedminds.com or contact me at jimroche@gmail.com or by phone at 778.998-7975

Information on my practice can also be found at: http://www.bcpsychologist.org/users/jimroche

or at http://therapists.psychologytoday.com/rms/name/Jim_Roche_JD,PhD,CAGS,RPsych,RMFT_Burnaby_British+Columbia_70682

About Cognitive Behaviour Therapy

Often clients come in or call and ask some basic questions about CBT. For instance, ""What is Cognitive Behaviour Therapy?" They've heard about it, or their medical doctor recommended it. So I've posted an introductory video on CBT (Cognitive Behaviour Therapy). You might want to look up more about CBT and to help you I would suggest googling CBT, Albert Ellis, Aaron Beck (this video is by his daughter Dr. Judith Beck) or going to wikipedia. These are really good places to start. If you come into the office I'll be suggesting some books, and most likely providing an introductory handout for you. If your concern is about CBT (Cognitive Behaviour Therapy) and anxiety a really good place to start would be the web site for AnxietyBC. You can reach that by clicking here. They also have an excellent selection of information for children and adolescents with anxiety, and most of the techniques are similar to what we use with depression.

I hope this introductory information is helpful to those who have questions about Cognitive Behaviour Therapy (CBT). One final note: Often practitioners claim to "do CBT." They say they have training or a "background" in CBT. Don't be afraid to ask them more about their background, education and experience. Someone providing cognitive behaviour therapy should have several courses and, more importantly, supervised experience doing CBT. They should have had six months or a year of weekly supervised experience. That means someone well trained in CBT watched them doing it, listened to recordings of sessions, and reviewed cases weekly. This is a little different than having attended a 3 day workshop in what is a rather complicated technique. Don't be afraid to ask!

This blog is not offered as medical advice or as a means of diagnosing or treating depression, anxiety, relationship problems or any other disorder. Don't go on line and take any mental health "test." Diagnosis is complex, and it involves not just looking for a list of symptoms, but also ruling out other disorders that might look just like what you suspect. So avoid these on-line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose, but a diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you. See a registered professional, either a Registered Psychologist or Registered Marriage and Family Therapist.

My web page lists a number of resources you can make use of yourself in dealing with individual, couple or family issues. Please visit it at www.relatedminds.com, one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.

Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com (couple/family therapy)

Does Couple Counselling Work?

Does couple counselling work? That's a hard question to answer because success can mean something very different to one couple than another. What I do know is that if your marriage is having problems, you shouldn't wait too long to seek professional help. Sometimes success is a couple staying together. Sometimes it means breaking up. Sometimes it means breaking up and acting in a decent enough way to each other that the divorce doesn't have detrimental effects on your children. And sometimes it means breaking up and NOT making the same mistakes over and over again in your future relationships. But for most couples who show up at my office door for couple therapy or marriage counselling, their goal is to stay together. So what are your chances of staying together?

Some people think the answer is found in these questions:
Did you marry at an early age?
Did you not graduate from high school?
Are you in a low-income bracket?
Are you in an inter-faith marriage?
Did your parents divorce?
Do you criticize one another?
Is there a lot of defensiveness in your marriage?
Do you tend to withdraw from one another?
Do you feel contempt for one another?

If you answered "yes" to most of these questions, then you are statistically a higher risk for divorce than couples who have realistic expectations of one another and their marriage, communicate well, use conflict resolution skills, and are compatible with one another. But remember, that means you are statistically more at risk, not that your marriage or relationship is doomed. There are things that you can do, and two of the most effective areas you can do work on are criticism and contempt. John Gottman things these are the nuclear weapons of marriage problems, and he has the data and science to prove it.

The Effectiveness of Marriage Counselling
The science of marriage counselling is being studied in great detail these days, especially by science practitioners like John Gottman. Although some research studies have shown that marriage counselling is not as effective as people think, that women seem to get more from it than men, and that it might not have a lasting effect on the couple's marriage, we think that receiving professional help before problems reach critical stage is beneficial to a marriage. A study by AAMFT shows that families do want therapy and place a high value on the experience.

What Type of Couple Gets the Most From Marriage Counselling? Heres the list:
Young couples.
Non-sexist couples.
Couples who are still in love.
Couples who are open to therapy and change.

What Type of Couple Receives the Least from Marriage Counselling?
Couples who wait too long before seeking help.
Marriages with one or the other spouse set on getting a divorce.
Married individuals who are closed to any suggestions that may save the marriage.

Solutions Learned From Happy Couples
John Gottman's research looks at happy couples for solutions. He has discovered that even though all couples experience conflict in their marriages, happy couples apparently know how to handle their disagreements because of a foundation of affection and friendship.
Unhappy couples do not have this skill. Gottman suggests that the goal of couple therapy needs to change. Rather than trying to change marriages, he thinks counsellors should teach communication skills to couples. And this is best done by practice, practice and more practice. There are several books, DVD's and complete packaged programs available from the Gottman Institute. These can help, but most couples need personal guidance. My web page contains a number of these resources and your welcome to click here to check these resources out.

My practice, with offices close to Burnaby/Coquitlam/New Westminster and Vancouver can offer you this help. Click here for more information.

Finally, if you need a family therapist or couple therapist elsewhere in the province I suggest you look at the web site for the British Columbia Association for Marriage and Family Therapy, the American Association for Marriage and Family Therapy or the BC Psychology Association. If you go to the AAMFT or BCAMFT sites you will find licensed or registered family therapists who are also registered psychologists, this may help in finding someone who your insurance plan might cover. But most of all, see someone who is a registered marriage and family therapist. Others may claim they do family or couples therapy (such as RCC / Registered Clinical Counsellors or Registered Social Workers), but RMFTs, Registered Marriage and Family Therapists have specialized training working with couples, including on average two years of supervised clinical practice. Others may have taken a course in family therapy, but are not specialists.

Please feel free to contact me if you have questions about finding a family or couples counsellor.

Dr. Jim Roche
778.9987975
www.drjimroche.com

Children, Behaviour Problems and Couples Therapy: Which First?

Often couples come in to see me who are having problems both with their relationship and with their children's behaviour. "Which should we work on first?" is often the question. Well, it's hard to say, but I do know you can't get anywhere working on your children's behaviour issues while your fighting. So, generally I think it's relationship, then kids.

That doesn't mean that you should wait for your relationship to be fixed before you begin working on the kids. There are some simple techniques that will help improve things quickly, and working on these issues will be a good place for you and your spouse to try out your new couples and communications skills.

For those who are not familiar with my programs for children I do a considerable amount of child and adolescent therapy. This usually includes seeing the children briefly, so that I have a fairly good idea of how they are doing, and then training the parents. This is what works best, because parents spend the most time with their children and will have the greatest chance of effecting change.

Often initial child therapy involves developing some interactions skills that will come in useful. I often recommend Dr. Ross Greens book "The Explosive Child" in order to understand how to soften and reduce the frequency of temper tantrums. Yes, these are also good skills to use with each other, and even for couples without children I sometimes recommend this book! Next we try to develop a comprehensive behaviour plan that includes ignoring, as much as humanly possible, inappropriate behaviours, and reinforcing new appropriate behaviours. That means understanding why your child does something, and knowing what the "function" of the behaviour is. We then try to teach the child a new functionally equivalent replacement behaviour which still gets the child what he or she needs or wants, but to do it in an appropriate way. You may be thinking, well, maybe that's what we should be doing with each other as well. You right if that's what your thinking.

Often marriage or couple therapy is about developing a deeper understanding of the needs of the other, and together developing new appropriate ways to meet those needs. That goes for you, your spouse or your child.

If you would like to know more about family or marriage counselling please go to my web page at www.relatedminds.com If your having particular trouble with your child, especially one who has ADHD (attention deficit hyperactivity disorder, autism or other problems, you could go directly to my attention deficit hyperactivity disorder website at www.adhdhelp.ca Finally, you can find out more about me at my Psychology Today web site by clicking here.

You can set up an appointment for my Burnaby office by calling 778.9980-7975 My Burnaby office serves Burnaby, New Westminster, Coquitlam, Port Moody, New West Minster and Maple Ridge. I also have offices in Vancouver. You will find a map to my office on my website.

How to Choose a Marriage and Family Counsellor or Therapist

How to choose a Marriage and Family Therapist

You will find a list of Registered Marriage and Family Therapists (RMFT’s) in British Columbia by clicking this link AAMFT.

All REGISTERED Marriage and Family Therapist are all clinical members of the British Columbia Association for Marriage and Family Therapy (BCAMFT) and the American Association of Marriage and Family Therapists (AAMFT). This includes a graduate degree focused on family therapy and two years of close clinical supervision by an approved and specially trained supervisor.

When you have identified one or more RMFT from the list who are accessible to you, call and interview them briefly over the phone. Some questions you may want to consider are:

What is your educational and training background?

All registered marriage and family therapists therapists on this list are qualified and experienced, but you may like to find out where they went to school, their specialty, or how long they have been doing this work.

Do you have experience treating the kind of problem I have?

Remember, not all therapists can treat all problems. Sometimes a therapist specializes in certain areas. If the therapist’s area of expertise is not the one you are looking for, ask for a referral to a therapist who can best help you. You will need to briefly indicate the problems you are experiencing (eg. marital difficulties, stress, anxiety at work etc). You should expect the therapist to ask you a bit about your problems to se if THEY are a good fit.

How much do you charge and what is your method of payment?

Fees typically range in B.C. $100.00 to $125.00 for those with an MA. Those with doctorate degrees (PhD’s) typically charge $160.00 to $175.00 per hour.

Would you be covered under my employment insurance policy or any other plan?

Some employers, typically the larger ones, have extended health benefits that cover some counselling. Read the fine print carefully. Sometimes MFTs are covered, sometimes they are not. A number of larger companies have employee assistance plans (EAP’s) that do cover MFTs. Again, check a carefully with your employer’s human resources or personnel department. Although the therapist may not know the answer off hand (as there are many policies and they keep changing) he/she should be able to guide you to find out the information you seek. As well, some employers or insurance companies will add a particular therapist or professional therapy designation to their list of those who are covered if employees make the request.

A number of MFT here in British Columbia are also Registered Psychologist (in addition to their MFT training). Their services are almost always covered by extended health care plans.

Also, remember that you may see a number of individuals advertising, especially on the web, who say they are marriage and family therapist or practice marriage counselling. Many of these are RCCs (Registered Clinical Counsellors) or CCC (Canadian Clinical Counsellors). Unless they are members of the British Columbia Association of Marriage and Family Therapist they are not registered family therapists. Often they will have had a course of two in family therapy, and maybe have practiced family therapy for a while. However, this is very different from a clinical member of AAMFT and BCAMFT who have completed specialized graduate programs in the field and have had a minimum of 1,200 hours of supervised clinical experience under the supervision of an approved and specially trained supervisor. (Some RCCs may have as little as 100 hours of supervised training, CCCs even less.) Ask, "Are you a clinical member of the British Columbia Association of Marriage and Family Therapists?" If couple or family issues are your problem, go to an expert.

Where are the sessions held and what is the length of time of a session?

After you have had a brief conversation based on the above questions you should have a “feel” for this therapist. If you feel fairly positive, proceed with booking an appointment. If you don’t feel comfortable for any reason, interview some one else.

Finally, the usual length of session is 50 to 60 minutes. Sometimes you can arrange a longer
session.

For more information on specialized Family and Couple Therapy in British Columbia you can click here and go to BCAMFT website.

For information about my website go to www.relatedminds.com

John Gottman on Repair

For more information on Gottman oriented therapy and counselling please visit my web site at www.relatedminds.com

John Gottman on the Four Horsemen

For more information on Gottman oriented marriage and couple counselling please visit my web page at www.relatedminds.com

John Gottman: The Magic Relationship Ratio

For more information on Gottman based marriage and family therapy please visit my website at www.relatedminds.com