Couple, Marriage, Family and Individual Therapy

In my practice (offices in Burnaby, Vancouver and Seattle, WA) I see individuals, couples and families for therapy. Often therapy for individuals or couples centers around specific behavioural issues and thinking processes which is addressed through the use of cognitive and behavioural techniques known as CBT or Cognitive Behavioural Therapy. For more information about CBT and what CBT is I would visit the following webpage: www.anxietybc.com and see how CBT is used to address issues relating to anxiety. It is also used to address depression and other issues. You might want to take a quick look at the wikipedia page that describes CBT-Cognitive Behavioural Therapy, it's history and practice. Click here: http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy

As it says, "Cognitive behavioral therapy (CBT) is short-term psychotherapy originally designed to treat depression, but is now used for a number of mental illnesses. It works to solve current problems and change unhelpful thinking and behavior. The name refers to behavior therapy, cognitive therapy, and therapy based upon a combination of basic behavioral and cognitive principles. Most therapists working with patients dealing with anxiety and depression use a blend of cognitive and behavioral therapy."

Short term, behaviour and skill focused.  A good place to look for more information about CBT is looking up the two therapist who originated CBT,  Dr. Albert Ellis (who for a short time served as my supervisor and it is from his psychotherapy institute in New York where I earned my advanced certificate in CBT or, as it was called then, Rational Emotive Behavioural Therapy, and Dr. Aaron Beck. I have also had the pleasure and privilege to attend trainings with Dr. Beck and others from his institute in Philadelphia.

I also see couples, and sometimes use CBT techniques with them, but often move to techniques and practices from Dr. John Gottman. Dr. Gottman has a training institute in Washington and focuses on working with couples. For more about Dr. Gottman and his form of couple's therapy click here: https://www.gottman.com/about-gottman-method-couples-therapy/

Gottman family therapy is really one of the few couple/marriage or family therapy methods that is based upon science, and you can read all about that on his web page above.

In addition to being a licensed and registered psychologist, my early training was in family therapy and I worked for many years as a couple's therapist and family therapist under my Marriage and Family Therapist license. I am currently a Registered Marriage and Family Therapist and a Clinical Member of the American Association for Marriage and Family Therapy.

Individuals who are Registered Family Therapists, or Licensed Family Therapists, generally have a two or three year MA or MS degree specifically in marriage and family therapy, with a specific set of coursework. Licensed and Registered Family Therapist have one or two years of full time supervised experience practicing marriage and family therapy under a specially trained therapist. I myself have completed towers in marriage and family therapy.

If you are interested in my services, please visit my website at either www.relatedminds.com or http://www.relatedminds.com/couple-family-therapy/ for more information. Whatever you decide to do, if your looking for help with a relationship, help with your marriage or help with your children, I suggest you consider a licensed or registered marriage and family therapist. While some counsellors claim to be family therapists or couples counsellors, they are not necessarily registered marriage and family therapists, and may have little more than a course or two in this field, and little if any supervised experience.

More information on couple, marriage and family therapy in BC can be found here: http://www.bcamft.bc.ca/ohana/website/index.cfm?p=95575656796

Information on couple, marriage and family therapy in Washington State can be found here: http://www.wamft.org/ohana/website/index.cfm?p=95575656262

Finally, information on the national association of family therapists can be found here:
http://www.aamft.org/imis15/AAMFT/Content/About_AAMFT/Qualifications.aspx?hkey=2d5f6fac-24c6-40fd-b74f-5f3eaf214e55

Your relationships are important. Make an informed choice, and find an informed professional.

For information about my practice please see my website at www.relatedminds.com or http://www.relatedminds.com/couple-family-therapy/

Couple and Marriage Therapy in Vancouver | Burnaby

Dr. Jim Roche is a Registered Psychologist and Marriage and Family Therapist providing counselling and therapy to individuals, couples and families in Burnaby and Vancouver. Dr. Roche also provides parent education/training for parents dealing with behavioural problems, including those relating to ADHD and ASD or Aspeger's Disorder. He also specializes in working with adults and couples where one or both of the couple have ASD or Aspeger's Disorder. He has been working in the field for over 20 years.

For more information on Marriage, Couple and Family Therapy visit Dr. Roches web page at www.relatedminds.com or the web page for the British Columbia Association for Marriage and Family Therapists.

Marriage and Couples Therapy in Burnaby and Coquitlam

Couple, Marriage and Relationship Counselling

I am often called to see couples who want therapy, and the call comes because they are looking for a psychologist to provide therapy for a couple - married or not - and their insurance provider will only pay a Registered Psychologist.  While I usually have time in my schedule in Burnaby for couples seeking counselling, when I don’t I urge them to look not on the BC psychology list, but on the BC Marriage and Family Therapist (RMFT) list because of the unique training and expertise that marriage and family therapists have. Luckily there are many good Registered Marriage and Family Therapists who are also Registered Psychologist, so their extended health care providers will pay for these services. Why do I point this out?

Here is how the American Association of Marriage and Family Therapists put it (from the AAMFT website):

What are the qualifications to be a Marriage and Family Therapist?

Marriage and family therapy is a distinct professional discipline with graduate and post graduate programs. Three options are available for those interested in becoming a marriage and family therapist: master's degree (2-3 years), doctoral program (3-5 years), or post-graduate clinical training programs (3-4 years). This means that while a psychologist or “registered counsellor” may say they provide marriage and family therapy, usually they have taken one or two courses in the field and received little if any supervised experience. A Registered Marriage and Family Therapist has 2-5 years of coursework focused on relationships and family work - PLUS two years of supervised experience providing marriage and family therapy. That’s a big difference.

The US Federal government has designated marriage and family therapy as a core mental health profession along with psychiatry, psychology, social work and psychiatric nursing. Currently all 50 US states and most Candian Provinces support and regulate the profession by licensing marriage and family therapists.

The regulatory requirements in most states are substantially equivalent to the American Association of Marriage and Family Therapists Clinical Membership standards. After graduation from an accredited program, a period - usually two years - of post-degree supervised clinical experience is necessary before licensure or certification. When the supervision period is completed, the therapist can take a state licensing exam, or the national examination for marriage and family therapists conducted by the AAMFT Regulatory Boards. This exam is used as a licensure requirement in most states.

Who are Marriage and Family Therapists?

Marriage and Family Therapists (MFTs) are mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems.

Marriage and family therapists are a highly experienced group of practitioners, with an average of 13 years of clinical practice in the field of marriage and family therapy. They evaluate and treat mental and emotional disorders, other health and behavioral problems, and address a wide array of relationship issues within the context of the family system. 

Marriage and Family Therapists broaden the traditional emphasis on the individual to attend to the nature and role of individuals in primary relationship networks such as marriage and the family.  MFTs take a holistic perspective to health care; they are concerned with the overall, long-term well-being of individuals and their families. 

MFTs have graduate training (a Master's or Doctoral degree) in marriage and family therapy and at least two years of clinical experience. Marriage and family therapists are recognized as a "core" mental health profession, along with psychiatry, psychology, social work and psychiatric nursing. 

Since 1970 there has been a 50-fold increase in the number of marriage and family therapists. At any given time they are treating over 1.8 million people 

A family's patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn't just the person - even if only a single person is interviewed - it is the set of relationships in which the person is imbedded. 

Marriage and family therapy is:

• brief

• solution-focused

• specific, with attainable therapeutic goals

• designed with the "end in mind."

Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems.

Research indicates that marriage and family therapy is as effective, and in some cases more effective than standard and/or individual treatments for many mental health problems such as: adult schizophrenia, affective (mood) disorders, adult alcoholism and drug abuse, children's conduct disorders, adolescent drug abuse, anorexia in young adult women, childhood autism, chronic physical illness in adults and children, and marital distress and conflict.

Marriage and family therapists regularly practice short-term therapy; 12 sessions on average. Nearly 65.6% of the cases are completed within 20 sessions, 87.9% within 50 sessions. Marital/couples therapy (11.5 sessions) and family therapy (9 sessions) both require less time than the average individuated treatment (13 sessions). About half of the treatment provided by marriage and family therapists is one-on-one with the other half divided between marital/couple and family therapy, or a combination of treatments.

Why use a Marriage and Family Therapist?

Research studies repeatedly demonstrate the effectiveness of marriage and family therapy in treating the full range of mental and emotional disorders and health problems. Adolescent drug abuse, depression, alcoholism, obesity and dementia in the elderly -- as well as marital distress and conflict -- are just some of the conditions Marriage and Family Therapists effectively treat.

Studies also show that clients are highly satisfied with services of Marriage and Family Therapists. Clients report marked improvement in work productivity, co-worker relationships, family relationships, partner relationships, emotional health, overall health, social life, and community involvement.

In a recent study, consumers report that marriage and family therapists are the mental health professionals they would most likely recommend to friends. Over 98 percent of clients of marriage and family therapists report therapy services as good or excellent.

After receiving treatment, almost 90% of clients report an improvement in their emotional health, and nearly two-thirds report an improvement in their overall physical health. A majority of clients report an improvement in their functioning at work, and over three-fourths of those receiving marital/couples or family therapy report an improvement in the couple relationship. When a child is the identified patient, parents report that their child's behavior improved in 73.7% of the cases, their ability to get along with other children significantly improved and there was improved performance in school. Marriage and family therapy's prominence in the mental health field has increased due to its brief, solution-focused treatment, its family-centered approach, and its demonstrated effectiveness. Marriage and family therapists are licensed in 46 states and are recognized by the federal government as members of a distinct mental health discipline.

Today more than 50,000 marriage and family therapists treat individuals, couples, and families nationwide. Membership in the American Association for Marriage and Family Therapy (AAMFT) has grown from 237 members in 1960 to more than 23,000 in 1996. This growth is a result, in part, of renewed public awareness of the value of family life and concern about the increased stresses on families in a rapidly changing world. 

How can I find a Marriage and Family Therapist?

AAMFT Clinical Members meet stringent training and education requirements that qualify them for the independent practice of marriage and family therapy.  AAMFT requires Clinical Members to abide by the AAMFT Code of Ethics, the most stringent ethical code in the marriage and family therapy profession. This code delineates specific ethical behavior and guidelines for members to follow to ensure the ethical treatment of clients. Clinical Membership in the AAMFT signifies an MFT's dedication to his or her ongoing professional development. Each month, AAMFT Clinical Members receive important updates on current clinical and research developments in the field, as well as numerous opportunities throughout the year to attend professional development conferences.

Click here to find a Marriage and Family Therapist today!

For information on my own practice of Marriage and Family Therapy, providing counselling and therapy services to individuals with relationship issues, couples, married couples and entire families, check out my website at www.relatedminds.com or http://www.relatedminds.com/couple-family-therapy/

My offices are near Lougheed Town Centre and provide counselling services to individuals in Burnaby, Coquitlam, New Westminster and Maple Ridge. Please see my web page for details.

Treatment for Depression: Vancouver | Burnaby

DEPRESSION AND ANXIETY COUNSELLING & THERAPY IN VANCOUVER, COQUITLAM, BURNABY and NEW WESTMINSTER, BC

The rates of Depression and Anxiety are increasing all the time. This includes the rates of these disorders for children, adolescents and adults. Depression and Anxiety lead to difficulties at school, work, with friends and in our personal relationships, including couples and marriages. Both of these disorders are treated initially by the medical field with medication. This is often useful, and sometimes necessary, however comprehensive treatment of Depression and Anxiety also calls for psychotherapy. For over 30 years Cognitive Behavioural Therapy has been found to be highly effective with both Depression and Anxiety. Most research finds that therapy using both medication and psychotherapy (Cognitive Behavioural Therapy) is the most effective means of treating Depression and Anxiety. Throughout Vancouver, West Vancouver, North Vancouver, Burnaby, Coquitlam, New Westminster and Maple Ridge we have counsellors, therapists, psychologists and social workers trained in providing CBT treatment to individuals with depression and anxiety. They are available through both public agencies and private practices. Call the British Columbia Psychological Association to find a psychologist. Other groups have similar services.

WHAT IS DEPRESSION?

Sadness, low levels of energy and worry are common to all of us. We all have times of appropriate depressed mood. Depression becomes a problem when these symptoms of Depression become too frequent, start to interfere with our ability to get things done, and begin to take over our thinking patterns. These symptoms can include losing our appetite for life, or even for food that we use to enjoy, intrusive negative thoughts, low engery, weigh changes and changes in our daily habits and activities. We become isolated, lose our ability to tolerate common problems, and start to think in black and white terms about life, or ability to cope, and become consumed with feelings of hopelessness. These are some of the common signs and symptoms of Depression. Some of these symptoms may be caused by other problems, and one should never “self diagnose.” Many of these symptoms of Depression could be a simple problem with low iron, but they can be caused by many other physical issues that you need to have assessed before a diagnosis of depression is made. Start by talking to your family doctor or a psychologist. A medical evaluation is always best practice.  

HOW DOES ANXIETY RELATE TO DEPRESSION?

Anxiety, like depression, has been increasing in frequency for several years. We are not sure why, but the world of work, school and family responsibilities has become more complex as time has gone on. Symptoms of an Anxiety Disorder include an inability to get to sleep, or to stay asleep. Sometimes individuals have extreme reactions of fear or panic to situations that don’t cause these reactions to others. Both Depression and Anxiety can cause difficulty focusing on work, at school or on relationships. Symptoms can range from feelings of worry to increases in heart rate, blood pressure, dizziness, sweating and flushing of the face or hands.  Sometimes these are general symptoms that seem to imbue someone’s entire day, other times they become more specific and targeted and constitute a phobia. Regretfully Anxiety and Depression often occur together, causing an individual to nearly stop in their shoes, afraid to take any action. As with Depression, Anxiety is not something you should self diagnose. You should write out a list of symptoms, and specific situations they may have occurred in, the time of day and so on. Take this list and see your medical doctor. He or she can either help you with a diagnosis of Anxiety or Depression, or they may ask that you see a Registered Psychologist fpor a comprehensive examination and diagnosis. Again, like Depression Anxiety if often treated with medication, however Cognitive Behavioural Therapy has also been found to be highly effective. Best practice is a combination of both medical intervention (or at least observation and monitoring) and therapy.

WHAT CAN I DO?

If you think you suffer from a Depressive Disorder of Anxiety Disorder the first step is always: See your medical doctor and talk it over. If you don’t have a family physician most walk in clinics in Vancouver, Burnaby, Coquitlam and the surrounding areas have general practitioners who are trained to help you. They can walk you through the steps of diagnosis, and make a referral to either a psychologist or psychiatrist if they feel unsure about the diagnosis. If medication is a concern, talk over your concerns directly with your doctor. Write down your questions, copy any articles or other information you may have come across that you find worrying. You doctor can explain the pros and cons of different treatments. Don’t get information about treatment - especially medical treatment - from the internet. Often internet pages provide overblown and negative information about medical treatments in order to sell you something else, which is neither effective nor proven. Be careful. Trust your doctor!

A Registered Psychologist can offer you therapy that specifically addresses both Anxiety and Depression. Cognitive Behavioural Therapy (CBT) has been found to be effective with both Depression and Anxiety. CBT teaches you skills to address immediate symptoms, such as relaxation, thought stopping and “Mindfulness.” CBT also focuses on teaching you new healthier ways to approach problems and conflicts, and helps you change negative, depressive and anxious thoughts to more realistic and helpful ones. Here in BC you will find information on Cognitive Behavioural Therapy (CBT) for anxiety at www.anxietybc.ca  You can also go to another government sponsored website: www.heretohelp.ca for information on CBT for Depression. I provide therapy and counselling for Depression and Anxiety in both my Vancouver and Burnaby offices, which serve Burnaby, Vancouver, Coquitlam, New Westminster, Port Moody and Maple Ridge. This includes treatment for children and adolescents with Depression and Anxiety.

DO I HAVE DEPRESSION OR ANXIETY?

Start by talking to your doctor. He or she can help you in determining if you have an Anxiety Disorder or Depression.  If you don’t feel comfortable talking to your medical doctor you can also talk to a Registered Psychologist. You can find a list of Registered Psychologists in Vancouver, Burnaby, Coquitlam and the surrounding area by contacting the British Columbia Psychological Association. Their website can help you find a psychologist who treats Depression and Anxiety near you. You can, of course, also check my web page and contact me if you’d like. The information is below.

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My own services, as a Registered Psychologist are located at the addresses below. You can find out more information from my web page at http://www.relatedminds.com

Other information about my practice can be found here (counsellingbc) , here (Psychology Today) or here (BC Psych Association)

Vancouver Counselling: Suite 303-338 8th Ave West, Vancouver, BC V5Y3X2

Burnaby and Coquitlam Counselling: 9304A Salish Court, Burnaby, BC V3J7C5

Phone for counselling services in Burnaby, Coquitlam, New Westminster, Port Moody and Coquitlam: 778.998-7975

Copyright 2011/2012 RelatedMinds Psychological and Educational Services - All Rights Reserved

RelatedMinds Psychological Services in Vancouver, Coquitlam and Burnaby

British Columbia. Specializing in the assessment, diagnosis and treatment of depression, anxiety, relationship issues, anger management, learning disabilities, Autism and other related conditions.

KEY WORDS: Depression, Anxiety, Burnaby, Vancouver, Coquitlam, New Westminster, North Vancouver, West Vancouver, Psychologist, therapist, counsellor, therapy, Cognitive Behavioural Therapy, CBT

Infidelity and Couples Therapy (Gottman's Thoughts)

John Gottman points out that it a myth that infidelity, cheating, is the cause of divorce. He reports that 20-25% of people in divorce mediation do say that an affair was a reason for the marriage ending, but THE reason given by nearly 80% of these couples is a "deterioration of intimacy." In fact, researchers (Fisher et al 2009) have found that relationship problems- usually noted as a :deterioration of intimacy" is reported in over 80 percent of cases by men. Other researches have supported this finding. IT starts with a breakdown in the love component of your relationship. The affair is often just the last straw.

There are several other myths about relationships that Gottman addresses in his work and practice as a couples therapist. One big one is that "communications problems" cause marriage problems and conflicts. This sounds good, and sounds simple. The truth is, distressed people communicate quite clearly what they feel and mean.

What Gottman suggests is that couples are never going to learn to "not communicate" the often hurtful and damaging things they say. Rather, what is important is to learn how to properly argue, disagree and differ in wants, needs, ideas and feelings. It's not what they are doing, we all disagree and get upset, instead it's about HOW they do it. Gottman offers clear, understandable tools for fixing this problem, which doesn't include the typical, " Say everything ...."  Instead it's "say what's appropriate, in a way that shows your still committed to the relationship."  In other words, make each other feel safe, especially when angry.

When you think about this, this is a skill any good parent has. They learn how to set limits, correct and when necessary even punish their children without driving a nail through their self esteem. We need to learn to do that with each other.

In happy couples Gottman's research shows that number of positive interaction to negative interactions is 20-1.  Yes, 20-1. In conflicted couples it 5-1. Maybe you thought 5-1 was good enough? Research says that 5-1 is a dangerous place to be. In soon to be divorced couples it's 8-1.  Unhappy couples tend to have a filter that screens out positive events and makes even neutral events look negative.  You need to learn to increase the number of daily positive interactions between you.  And, going back to the beginning of this submission, you need to figure out how to renew the intimacy between you. To do that Gottman uses what are called "Love Maps."

If your interested in learning more about Dr. Gottman and his techniques, yuou can visit his website or just Google him on YouTube. He has his own YouTube channel! You'll find a good number of videos on his practice.  If your interested in seeing me for marriage therapy, couples counselling or family therapy, feel free to call me. More information is available on my website at http://www.relatedminds.com or on my marriage counselling | family therapy page at: http://www.relatedminds.com/couples-therapy

I see couples for therapy in both my Vancouver office (serving Vancouver, West Vancouver, North Vancouver and Richmond) and Burnaby (serving Burnaby, Coquitlam, Port Coquitlam, Port Moody, Maple Ridge, New Westminster, Langley and Surrey). In addition to being a Registered Psychologist in BC I am also a Registered Marriage and Family Therapist (RMFT) with the British Columbia Association of Marriage and Family Therapists, and a Clinical Member of the American Association for Marriage and Family Therapy.

Jim Roche
http://www.psychologists.bc.ca/users/jimroche
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Keywords: Marriage therapy, marriage counselling, couple therapy, couple counselling, marriage and family therapist, psychologist, infidelity, cheating, Gottman, Vancouver, Burnaby, Coquitlam, New Westminster

Skills for Dealing with Depression

Depression is one of the main focuses of research into the effectiveness of Cognitive Behavioural Therapy (CBT). CBT has been found to be very effective, and in some cases as effective or more effective than medication. The gold standard for the treatment of depression (especially moderate to severe depression) remains a combination of medication and Cognitive Behaviour Therapy.

Over the past few weeks I've gone into some details about Cognitive Behavioural Therapy self-help programs that are available for individuals with Anxiety or Depression to use, either on their own or with the support of their therapist or counsellor. One of the programs I've recommended is the Desling with Depression books available from the Minsitry of children and Family Services, or from www.heretohelp.ca.

These are excellent, short, easy to use, step-by-step books that guide you through the therapeutic process. Several people have asked me about the major three skills and how I teach them. It would be inappropriate to go into any detail here, you either should be using these books on your own or with the help of a therapist, and internet questions and answers are no replacement for a proper medical/psychological diagnosis and treatment. (Remember: ALWAYS start by seeing your medical doctor! Sometimes what we think is depression, and what looks like depression, is really something physical. Go to your family doctor, or a walk-in clinic and get a good check up.) However, I will go over the three "antidepressant Skills" that most of these programs discuss. You should make sure your plan for dealing with depression includes these.

1) Realistic Thinking.  Much of what Cognitive behavioural Therapy is about is "Realisitic Thinking." This is a process you will review and PRACTICE again and again in many settings and situations. You will learn to spot depressive thoughts that lead to depressed moods; challenge those depressive thoughts; come up with realistic thoughts; and then practice this realistic thinking. These are not happy thoughts, it's not about "positive thinking," or some other simplistic distraction from reality. It's about learning to think "realistically" even when your brain, your mood and the situation want to keep you from doing that.

2) Problem Solving. Problem solving is the next skill you will learn in Cognitive Behavioural Therapy (CBT).  Through exercises, worksheets and face-to-face practice you will learn to: Better understand the problems your dealing with- because they are real and have real effects; come up with several different solutions to those problems; and then select the best solution and start the problem solving process. Sounds easy, but often this is difficult in a time of crisis, depressed mood or anxiety.

3) Goal Setting. Goal setting is about moving from a position of knowing what your going to go to planning how your going to do it. Once you know what you want, unless you have a good plan, your just going to be waiting for it to come to you unless you have a plan. In goal setting sessions you will: Learn to set goals that are important to you; make goals that are likely to succeed; and move on to new goals. 

Some of the other things we do in face-to-face sessions for depression are: dealing with sleep issues, dealing with anxiety, learning to cope with intrusive negative thoughts (thought stopping), learn how to relax by using external cues, examine our diets and....sorry...making sure you are exercising enough. Studies show that moderate exercise (under the supervision of your doctor) is one of THE most effective tools you have to deal with depression.

As I look over this list it seems simple, easy, and you wonder why anyone needs a therapist ..or even a book? Well, these things are not so easy to do when you are suffering from depression and anxiety. Thinking clearly, which is something we all need to do to do this right, is difficult at these times. Support and advice help to keep you on track and monitor your progress. And much of what we have discussed here is really about learning to think differently than you do now. In the early days of Cognitive Behavioural Therapy (CBT), when it was called Rational Emotive Behaviour Therapy (REBT) this learning how to think differently was called "the disputation," because, in effect your therapist disputes your irrational thoughts and makes you defend them...or pick new thoughts that can be defended. This is a critical part of the process.

So, to sum up, CBT for Depression focuses on three areas: Realistic Thinking; Problem Solving; and Goal Setting. In addition to that several very specific skills are taught to address intrusive thoughts, sleep problems and other specific symptoms giving you difficulty. I hope this addresses the questions people emailed.

For more information about the services I provide my web page can be found at www.relatedminds.com, http://www.relatedminds.com/depression. Other information on my practice can be found at: http://Therapists.Psychologytoday.com/70682, http://www.bcpsychologist.org/users/jimroche, and http://psyris.com/drjimroche

Help in Preventing Relapse of Depression

On my web site I've just added a useful link for those with a history of depression interested in relapse prevention. I often recommend "Mindfulness Training" for relapse prevention, however  this is a short workbook, easy to follow and evidence based workbooks for those with depression. Visit my site's Depression page to find links to these effective and free materials that are primarily designed to use on your own.

For the link, click here: www.relatedminds.com/depression

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

Fundamentals of Anger Management

For more information about my services, both individual and training programs for schools, please visit my web page at http://www.relatedminds.com/the-angry-child  General information can be found at http://www.relatedminds.com  My offices are located in both Burnaby and Vancouver, BC

Many families come to me because of issues relating to anger and aggression.  They hope to receive anger management training of some sort, and are often surprised by the exact nature of anger management programs which often include a component on assertiveness training.  For the next few blogs I'd like to walk you through some information about anger management and what is out there that is helpful. There are a lot of anger management books available, some make much more sense than others. Some are evidence based, that is, developed through a process of program assessment, and others are not.  I'm going to start with a review of a program we often use in the schools- Aggression Replacement Training. This program comes with staff training videos, workbooks, social skills programming as well as specific training in anger replacement and cognitive therapy. That will be today's post. In the next post I'll be reviewing a workbook I often use: The Anger Control Workbook by Matthew McKay and Peter Rogers.  This workbook is a cognitive therapy based program about anger management and when used with some materials on assertiveness training can form the basis of a good program on anger management.

Aggression Replacement Training: ART

Aggression Replacement Training (ART) is manual-based program focused on teens. It is designed to  help them to with aggressive emotions. It is a complex, multichannel, program that uses three coordinated components to reach the youth; Social skills, Anger management and moral reasoning.  These three components cover most of the materials necessary to make significant changes in children with problems with aggression. (For younger children there are specific social skills books, and an alternative suggestion is The Explosive Child by Green.)

Anger Replacement Training is used in schools and correctional settings in North America as well as Europe. It was designed by Arnold P. Goldstein, Barry Glick and John C. Gibbs in the 1980s. They took concepts from a number of other theories for working with youth and incorporated them into one comprehensive system. The main methods for the youth to learn from the various components is though repetition. Practice, role play, and practice again. The model also focuses on Jean Piaget’s concept of peer learning. 

Social Skills
Social Skills training is the behavioral component of ART. Many youths who are involved with criminal behavior and/or have difficulties with controlling their anger lack social skills. Many of the concepts of the social skills component are taken from Albert Bandura’s. There are many different social skills that these youth are thought to lack, such as;

Making a complaint

Apologizing

Understanding the feelings of others

Dealing with someone else's anger

Keeping out of fights

Dealing with an accusation

The program begins with an assessment of the youth’s social skill levels. Then these social skills are broken down into various steps (both thinking and action steps). The facilitator discusses the day's skill, bringing out relevant examples. Then the facilitator demonstrates a practice situation to give the youth a picture of using the skill. The youth are asked to point out each of the steps using behavioural techniques such as sub-vocalizing while engaging in the behaviour. This component also provides a great deal of psycho-education for each student. Each of the youth is asked to use a practice situation that they have recently had using the skill. Again the other youth go though and discuss each of the steps each time. Modelling and practice are key components, with homework for generalizing these skills.

Anger Control Training
Anger control training is the emotional component of ART. This moves from the teaching of social skills, to losing anti-social skills and replacing them with pro-social skills. The anger control training uses what is called the “anger control chain.” This is a process taught to the youth to deal with situations that cause them to get angry. Once again, one segment of the anger control chain is taught each week and the both the facilitators and the youth practice the new skills with relevant life activities.

The anger control chain is as follows:

Triggers (internal & external) -- The situation that starts the slide into anger and the self talk that perpetuates it

Cues -- physical signs of becoming angry

Anger reducers -- activities that are done to reduce or take our mind off of the situation

Reminders -- short positive statements

Thinking ahead -- If then thinking

Social Skill -- Implementing a pro-social skill into the situation

Evaluation -- Looking back over the use of the anger control chain and evaluating how was implemented

Again, youth practice these skills, use subvocalization, model the skills, role play and use homework assignments to generalize the behavioural skills.

Moral Reasoning Training

Moral reasoning training is the “values component” of the program. This component takes various scenarios and asks whether various activities would be right or wrong to do in those situations. Thinking errors are also taught during this day of training. The thinking errors that are taught are:

Self-centered thinking -- "it's all about me"

Assuming the worst -- "it would happen anyway" or "they would do it to me"

Blaming others -- "it's their fault"

Mislabeling / minimizing -- "it's not stealing, I'm only borrowing it..." or "everybody else does it"

This, and all other componets, of the program are all well planned out. Lessons are specific with a good deal of teacher specific suggestions incorporated into the written materials. The program comes with an excellent training video to help facilitators learns these specific skills, although having some supervision for new trainers would be best. 

The books: Berj Harrootunian, Arnold P. Goldstein, Jane Close Conoley (1994), Student Aggression: Prevention, Management and Replacement Training, Guilford Press, 

All of the necessary materials are available from Research Press. 

If your a teacher or behaviour specialist, take a look at these materials. They are all you really need to start an excellent program addressing aggression and anger within the school. A great way to start!

Next blog post will be addressing Anger Control for adults. This will specifically look at readings and skills programs for individuals with anger management problems from a cognitive behaviour   therapy perspective. After that, which may take two or three posts, we will discuss assertiveness training and how it is a critical component of any successful program.

Bringing Up Emotionally Intelligent Children

What are the five elements of emotion coaching according to John Gottman?

1. Be aware of a child's emotions
2. Recognize emotional expression as an opportunity for intimacy and teaching
3. Listen empathetically and validate a child's feelings
4. Label emotions in words a child can understand
5. Help a child come up with an appropriate way to solve a problem or deal with an upsetting issue or situation

It's really that simple! And, yes, it's that hard too. But Gottman has a great idea going (and a great book and video to go with it) that your job as a mom or dad is to simple be a coach to your child. In Dr. Gottman's research he has found that children of "emotion-coaching" parents had more general abilities in the area of their own emotions than children who were not coached by their parents. In other words, these "coached" children grew up to become what Dan Goleman has referred to as "emotionally intelligent" people. What are characteristics of these children?

Dr. Gottman's research demonstrated that emotion-coached children: Are able to regulate their emotional states; Are better at soothing themselves when they are upset; Could calm down their hearts faster after something upsetting happens; Have fewer infectious illnesses; Are better at focusing attention; Relate better to other people, even in tough situations like getting teased in middle school; Are better at understanding people; Have better friendships with other children; Are better in school situations that require academic performance.

Those are the beefits of coaching your child appropriately, and another nice thing is that while doing this your monitoring your own behaviour! Caching involves modelling! I highly recommend Dr. Gottman's book (you can find it on my web page for resources by following www.relatedminds.com). And if your too busy ....get the video. As a matter of fact, donate one to your local library! Here is a sample: Click-http://youtu.be/eVDMATVzhTk You can also go to Dr. Gottman's web page for more of his ideas...based in science and research.

for more information on my services as a marriage and family therapist or registered psychologist you can visit my web page: www.relatedminds.com or my Psychology Today website or at the AAMFT website.

Counseling, Drugs Combo Better for Anxiety Disorders - in Psychiatry, Anxiety & Stress from MedPage Today

Often individuals come in to see me for relationship therapy and have issues relating to anxiety, depression and stress related disorders. One of the things that goes on is that they seem to feel they need to make a choice between either a psychological intervention for their problems, or a medical intervention. Often this is a struggle they are going through and can't seem to move on until they decide, "is this physical, or is it in my head?" The truth is, as far as moving on and fixing a problem goes, the best interventions, especially for moderate to severe issues of anxiety, depression and stress, are "multi-modal" therapies. Therapies that include both medical and cognitive (psychological) interventions. Intervention plans that include both are by far the best intervention plans. This article address more of the recent research on this topic. It's a good read, short, direct and very clear. Medical News: Counseling, Drugs Combo Better for Anxiety Disorders - in Psychiatry, Anxiety & Stress from MedPage Today

for information about my practice you are welcome to go to my website: www.relatedminds.com for more information on Cognitive Behaviour Therapy.

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)

John Gottman Couples Therapy Interview

John Gottman Couples Therapy Interview

Everybody comes for "communications help" when they come for marriage therapy or couple or family therapy. But often the problem isn't one of lack of communication, they are communicating enough. The problem is often their expectations. This little video shows John Gottman talking about just this issue.

For information on my marraige and family therapy practice please go to www.relatedminds.com

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

An Introduction to John Gottman: Part 1

John Gottman has been conducting marital therapy research for over 25 years. (His web page can be found at www.gottman.com) There are many theorist in the field, but John Gottman is one of the few who have written books on marriage and couple therapy, practices marriage and couple therapy and has based his practice on research. Most others write books based upon their "experience," which we know is often wrong, and what they "feel" should work. Gottman does what has been scientifically been show to work!

In the next few blogs I want to review his work. I am going to start today by discussing some of the myths and truths about marital dysfunction.

1. Affairs cause divorces. Almost true. While 20-25% of people in mediation groups say that their spouse having an affair was A reason for their divorce, the major reason for divorce given by 80% was a "deterioration in intimacy."

2. Gender differences cause divorce. Well, as some have pointed out, if this were true we would expect a very high number of divorces in heterosexual couples and near zero with gay and lesbian couples. Gay and lesbian couples are not that lucky. It must be something else!

3. Communications problems cause divorce. Most couples coming to see me, like those coming to see most therapists, say they are having trouble with communication. The truth is distressed people communicate very clearly what they feel and mean. Sometimes too clearly. Therapy sometimes stressed expressing even more, only to further damage the relationship!

4. No "quid pro quo" makes unsuccessful marriages and relationships. Research shows this is not the case for troubled couples, but neither is it for happy couples.

What does the research show?

1. Positivity - positive statements - in happy couples is seen at a rate of 20-1! In couples in conflict its only 5-1. The best way to tell if a couple is getting divorced is to watch the number and quality of the interactions when they are NOT in stress and conflict.

2. Marriage tend to end at two times: at 5-7 years due to conflict; and at 10-12 years due to loss of intimacy.

3. When it comes to arguments the type of person you are with (an attacker, soother, avoider) is not as important as the MISMATCH between them.

4. And surprise! Most problematic issues (65%) don't get solved, they just get managed. Temper your expectations!

How does this research apply to you? I recommend reading Gottman's book Seven Principals for Making a Marriage Work to find out. It will guide you through how to understand this research, and how to make changes in your relationship. Much of this information translates into understanding two kinds of states that marriages can be in: 1) Positive Statement Override, where positive statements and behaviours outweigh negatives by 20-1, and Negative Statement Override where the ration is in favour of the negative, or the positives are below 5-1.

Therapy consists of learning what you can do about this, and in reality you can't confront the negative system override directly. Rather you need to develop and support the infrastructure of the positive override system. In therapy we learn to do this through practicing what are called "softened startups; self soothing;working to improve our "acceptance of influence"; making what are called "repair attempts; learning to de-escalate and compromise; making what are called "bids for affection," and avoiding "gridlock."

Most important, we must learn to avoid what Gottman calls the 4 Horseman: Criticism (what kind of person are you?); Contempt (I would never be so low as to do something like that!); Defensiveness (Yeah:? Well what about what you do?); and finally Stonewalling (shutting down).

In Gottman based therapy we focus on six basic skills: 1) Recognizing and avoiding the 4 Horseman; softening startups; Accepting influence (especially for men, yes, it's true); soothing physio arousal; recognizing and responding to repair attempts and finally compromise. Over the next few posts we will be addressing these skills, but we will follow this outline:

1. How to move from gridlock to dialogue
2. Learn how to recover after a fight
3. Reviewing these six basic social skills we just addressed
4. Making effective repairs

I hope this brief outline I will be offering will get you interested in the work of John Gottman. It's my opinion there is nothing that can help more in most cases. Sometimes couples are not ready for therapy and need to be seen individually first. And sometimes there is so much irrational thinking going on that a short period of individual cognitive behaviour therapy or rational emotive therapy might be the best way to start. See a therapist for help, and if you need to see a psychologist remember that a number of therapist here in BC are both registered psychologist and registered marriage and family therapists. You can locate a family therapist at the web site of the American Association of Marriage and Family Therapist on their "Therapy Locator." Their licenses and registrations will be specified.

For more information on my practice you can visit my web page at www.relatedminds.com

Marriage and Family Therapy Blog

Welcome to the Vancouver Marriage and Family Therapy Blog. Here I will try to provide some basic information on current practices in marriage, family and couples therapy, as well as some specific techniques that any couple might find useful to help their relationship grow.

I am a registered marriage and family therapist in British Columbia, as well as a registered psychologist. Additionally I am a clinical member of the American Association for Marriage and Family Therapists (AAMFT) and have licenses in social work and counselling in several other jurisdictions. I have a private practice in the lower mainland with offices in Burnaby and Vancouver. My Burnaby office is located at Lougheed Mall near Port Coquitlam and New Westminster. You can find out more about my practice at my professional website at www.drjimroche.com or at my Psychology Today site. My office hours include evening and weekends.

The next posting will begin with some basic information on marriage and couple therapy. After that I will try to explain some of the new research in the field of marriage therapy and give an explaination of the work of Dr. John Gottman, a leader in the field of marriage and couple's counselling. If you have any specific questions that you feel would be good for the blog just email me.

Key Words: Marriage therapy, marriage counselling, couples counselling, couples therapy, Vancouver, Burnaby, Coquitlam, New Westminster, Port Moody, psychologist, counsellor.