Autism Awareness: Focus on Early Detection and Intervention

Posted by on Jul 17, 2018 in Ask The Therapist | 0 comments

Information about Autism Spectrum Disorder (ASD) awareness is very important for an early diagnosis and intervention is to an individual’s success. ASD refers to a collection of developmental disorders that relate specifically to communication, socialization and learning challenges, as well as restrictive or repetitive behaviors. People with ASD often have trouble communicating and interacting with others, understanding emotional nuances and social cues, and adjusting to minor changes in routine or surroundings. There is also a wide range, or “spectrum,” of symptoms and levels of severity that accompany it. Some people are very mildly affected, while others have significant challenges in their daily life. The definition of ASD now also encompasses what was known as Asperger Syndrome, which is a higher functioning version of the disorder.

How do I know if my child has ASD? In recent years, the rates of children identified with ASD have increased. It can be diagnosed early in life, at 2 to 3 years old and sometimes earlier; however, ti is still a challenging diagnosis to make. Some children with the typical symptoms may not have autism, and not all children with autism exhibit the typical symptoms. Some children will show signs in early infancy, others develop normally for the first couple of years of life, then stop meeting developmental markers or lose skills they have already learned. Some children have difficulty learning and gave signs of lower intelligence, while other children learn quickly and have normal to high intelligence. Some of the common red flags for ASD in infants/toddlers are:

  • Limited or no eye contact
  • Limited or no smiling/joyful expressions when interacting with others
  • No response to name when called
  • Minimal to no reaching for affection or being held
  • Lack of hitting developmental markers or regression of previously learned skills (i.e. speech/social skills)

Prevention and Treatment: There’s no way to prevent ASD, but early diagnosis and intervention is crucial for improving behavior, skills and language development. The first step is to set up an evaluation with a specialist in ASD, who can do a clinical interview and evaluate your child using standardized diagnostic instruments to assess ASD (such as the Autism Diagnostic Observation Schedule or ADOS) and help develop a plan for treatment. Treatment is helpful at any age, even in adulthood. There are a variety of treatment options available; behavioral, communication, educational, and family therapies. Medication is also helpful. There is no “one size fits all” treatment plan, and your child’s treatment needs could change over time. Working closely with your child’s medical or mental health professional is key to determining the right treatment plan.


Written by Dr. Beth Holmes, Ph.D., Clinical Psychologist

How to Talk to Your Kids About School Shootings

Posted by on Jul 9, 2018 in Ask The Therapist | 0 comments

When a tragedy like a recent school shooting occurs, we all feel a little shaken up. Some very tough questions also come up, for kids and adults alike. “Why did this happen? Is anyone really safe? Can this happen in my town?” It’s likely your kids are thinking about it. While they may need an adult to coax them into a discussion, it’s important for parents to use this traumatic event as an opportunity to talk to their children about their fears involving school safety and reassure them that the adults around them are doing everything they can to keep them safe.

But what is the best way to do this? Well, it depends on the child. Here are some tips to follow when bringing with the topic:

The Right Time and Place: Bring up the discussion with enough time to let your child be fully heard and when you are able to address all your child’s concerns, like right after dinner. Avoid right before bedtime, so your child can process and “wind down” afterward.

Listen: It’s important that you give your child the chance to talk about his/her feelings, but keep in mind that younger children might not know how to express their concerns. You could start the conversation by asking if they “feel safe at school.” Remember to talk to your child at their level in your response. With younger kids, stick to the basic facts, using words that are meaningful to them. Too much detail can be scary and less understood.

Be Honest, But Reassuring: It’s important to acknowledge that bad things do happen sometimes, but make it clear that their entire community (parents, teachers, law enforcement) are doing everything they can to keep kids safe in school so they can learn. Discuss the safety procedures that are in place at school: visitors need to check in at office, some doors are locked during the school day, etc. These are all precautions to ensure his or her safety.

Encourage and Empower: Find ways to empower your children to take part in school safety and find positive outcomes. For younger children, if they hear that another student is getting bullied or has mentioned suicide, encourage them to notify their teacher or guidance counselor. For older children, encourage them to raise money for the families affected by the event or participate in a student run anti-violence program. Even small activities can make a difference, such as drawing or writing poetry about the experience.

Limit Exposure to News: Monitor how much exposure your child gets to media coverage about the event.

Seek Help When Needed: Most children are resilient and bounce back to normal after a couples of days. If you are noticing significant changes in your child’s behavior after that point (isolation, withdrawal, excessive worry, fear of returning to school, sleeplessness, etc.) seek out guidance from a mental health professional.


Written by Lisa Borchert-Hrivnak M.A.Ed., LPCC, Owner of Avenues of Counseling and Mediation, LLC

Starting Mental Health Treatment for the First Time

Posted by on Jul 2, 2018 in Hot Topics | 0 comments

Seeking out and starting a mental health treatment such as a counselor or a psychiatrist can be a very intimidating task. It is difficult to know who would be right for you. Luckily, there are plenty of people along the way to help you out, and all the decisions are not just on your shoulders.


How the Process Normally Goes

Typically, the best way to shop around for a mental health provider is to take a look at where you are in life. Do you already have a Primary Care Physician (PCP)? If so, they may have referrals for you. If you do not have a PCP, you could call your insurance and ask them for providers in your network. If you do not have insurance, you pretty much have your pick and will be self-pay. Try to find someone online from there. Most website of practices have bios for their clinicians including their specialties, and style.

Once you have decided on a clinician, get in touch with them through their practice. When you call, most places have a screening process to get a feel of your needs. They will likely ask you to give a brief description on any issues you are having, and why you are seeking out counseling. You do not have to go into a lot of detail, but it is helpful for them to get you set up. When trying to get a certain clinician, you may or may not be able to be seen by the person you had chosen. It largely has to do with the provider’s availability and specialties. Trust the person you are speaking with from their practice. They will set you up as best as they can with someone who fits your needs.

It is important to know if you meet a couple times with your new clinician, and they just aren’t working out, it is okay to switch clinicians. Sometimes styles just do not match up with needs, and that’s okay. Do note however, that sometimes it can take a couple sessions to fully build rapport.

Your first session will mostly be paperwork and talking with your clinician about things going on in your life. They will have a lot of questions for you, so try not to be intimidated and be honest. If you feel uncomfortable talking about something, tell them. You can always go back to it another time. Do remember that you need to put in effort as well. The clinician can’t do the work for you.

After you have been seeing your clinician for a while, you both will decide if you feel like you need medication or not. Sometimes, you will be recommended to seek out a Psychiatrist in addition to going to counseling. They may have someone in-house who is qualified to prescribe medication, but sometimes you may have to find someone else outside of the practice. It is likely they will have referrals of psychiatrists, and not everyone may need medications, but these are all things to be discussed and decided in your sessions to come.

A Nurse Practitioner’s Perspective on Mental Health

Posted by on Jun 25, 2018 in Blog From The Experts | 0 comments


What are Some Causes of Depression and Anxiety?

Depression and anxiety are very common in the US. High stress with work, family commitments, or pressure to instantly respond with social media are just a few common causes. Anxiety with overwhelming worry and difficulty letting the worry go can be very uncomfortable physically and can interfere with normal functioning.


How to Handle Depression and Anxiety

If you have depression or anxiety that is affecting your day-to-day life (for example: your sleeping or eating habits are disrupted, you are struggling to manage daily tasks at work or home that you didn’t have trouble with before, you feel like your relationships with family, friends, or coworkers are becoming strained, or you are having physical symptoms like headaches or stomach aches that do not have medical causes), the key to recovery is to learn strategies for managing the anxiety and depression in combination with medication for stabilizing the symptoms.


You Need a Team

It’s important to have professionals on your team who are on the same page for your care. Your counselor and prescriber should be coordinating together to make sure you are getting what you need. Your prescriber should follow you closely to monitor your medications, symptoms, and adjust your dosages to fit you. There are many medications that are non-addictive; prescribed to help you feel better so you can utilize what you learn in counseling and build on your strengths to cope with life’s changes and challenges. Many people have never been on medications for issues like this, so if you have questions, don’t hesitate to talk to your prescriber about your concerns or fears. Worries and fears are part of anxiety and addressing the concerns is essential to a positive outcome. If you are currently taking medication for anxiety or depression but you are still experiencing symptoms, it might be good to seek a second opinion.


Written by Lois Nicholson, MSN, CNS Certified Psychiatric Clinical Nurse Specialist, Adult Psychiatry 

When Summer Doesn’t Cure Sadness

Posted by on Jun 18, 2018 in Blog From The Experts | 0 comments

Summer is  has finally begun. Perhaps you are relishing the sun, the longer days and the easier schedule. Perhaps you find your mood is better and you have more energy. Great! Drink it in and relish each moment.
But perhaps you have noticed you are feeling irritable or more down, less energy but not sleeping well. A sense of disappointment is also there because many of us tell ourselves, “I’ll feel better once this awful winter is over”. And it’s over. And you don’t. Or perhaps you are puzzled by someone in your life who appears to be more grumpy!
There are a few possibilities for these feelings.
 One is the illness of depression. Frequently I will see someone in June who decides to come to counseling because the improved weather just doesn’t help. This is because depression is an illness that impacts our emotions, our thinking and our bodies. With treatment – counseling and maybe medication, too – people find their spirits lift and they can enjoy the beauty of summer.
Another reason is Seasonal Affective Disorder (SAD) Wait, you say, that is only in the winter! Well, there is a type of this disorder that impacts people who have difficulty adjusting to the increased light. They cannot fall asleep and wake up way too early. Sometimes blackout blinds and curtains, going to bed at a set time and limiting light in the evenings is all they need. Sometimes medical help is needed. Doing some research, speaking with your PCP and making some small changes may be just the ticket.
Lastly, if we are facing major losses or challenges in our lives, they do not just disappear with the snow. Speaking with a counselor can frequently help to lessen the emotional pain and allow the person to enjoy moments of hope.
Finally – get outside, run through a sprinkler, list to children laugh. Life can be good. If you are struggling, please call.
Written by Marty D. Laska LPCC-S, LICDC-S, ACHT

Are You Raising Your Daughter to be Resilient?

Posted by on Jun 8, 2018 in Blog From The Experts | 0 comments

We all want our daughters to be secure in themselves and make positive choices in their lives. We want them to feel good about the way they look and recognize each of their individual talents. We want them to be prepared to work through their own problems and grow up to be a healthy and happy adult. As parents, why does it seem so challenging at times to encourage resiliency?

Even girls growing up in the best homes with loving and supportive families experience emotional injuries. Failures and disappointments, criticisms, disapproval, or exclusion from peers – these moments of anxiety, sadness, and anger are part of life and are invaluable lesson-learning opportunities. How they learn to deal with and heal from these injuries will lay the groundwork for how well our daughters will problem-solve and function in daily life as adults. As we all know, these emotional blows do not decrease as we get older.


Ways You Can Encourage Resilience in Your Daughter:

Promote High Self-Esteem: Talk to your daughter about negative thought patterns that decrease self-esteem and identify strengths that encourage it.

Foster Communication: Teach your daughter how to identify and verbalize her feelings. Teach your daughter that all emotions are okay.

Discuss Relationships and Boundaries: Teach your daughter how to recognize unhealthy relationships or significant others and how to set boundaries in her current relationships.

Don’t Accommodate Every Need: It’s important to provide certainty and comfort, but don’t get in the way of your daughter’s development of problem-solving skills.

Identify Stress and Teach Coping Skills: Help your daughter learn what triggers her stressors and other negative emotions, and how to cope with stress.

Model Resiliency: Be aware of how your actions affect your daughter. Try to be calm and consistent. But also, if you react poorly to a situation, admit it. Use it as an example and talk about better ways to handle it next time.


Written by Lisa Borchert-Hrivnak, M.A.Ed., LPCC, Owner of Avenues of Counseling and Mediation, LLC

Make a Resolution Early… Work on Your Marriage

Posted by on Jun 2, 2018 in Ask The Therapist | 1 comment

Now is the time to honor your relationship by investing your time and energy into enhancing it. Research shows that if couples do not continue to put energy into a relationship, it deteriorates. In truth, you have to put energy into a relationship to just keep it where it is. For it to improve, you have to put more energy into it.


What Predicts Divorce or Continued Relationship Misery?

1. Positive to Negative Ratios: The couples who are happy in their relationships have a 5:1 ratio of positive to negative during conflict discussions; and a 20:1 positive to negative ratio when just hanging out. Conclusion: Relationships have to be a very rich climate of positivity to feel good: lots of kindness, attention, interest in one another, affection, humor, good sex, and so on.

2. Criticism: Complaining as if there is something defective in your partner’s personality. Conclusion: Be gentle in your approach.

3. Defensiveness: Self-protective responses, victimhood. Conclusion: accept responsibility, even for a small part of the problem.\

4. Contempt: Speaking from a superior plane, a holier-than-thou position. Conclusion: appreciate, catch your partner doing something right.

5. Stonewalling: Emotionally disengaging, withdrawing, isolating, not listening when overwhelmed. Conclusion: self soothe, so you can be present, listen, actively hear, take breaks to not get overwhelmed, and check out.


If your marriage is in the negative ratio or negative perspective, it’s because something is wrong with the friendship in the marriage. One or both of you don’t feel your partner is really interested in the relationship; there’s not much affection going on. There are feelings of rejection, there’s not much romance or good sex in the relationship.

Counseling can be a tool to learn to turn toward one another, cherish one’s partner’s positive qualities and nurturing gratitude for what one has with this person, instead of comparing one’s partner to an “imagined” other.


Written by Anjelica Nelson, M.Ed., LPC, MFT

How to Turn Confusion Into Certainty When it Comes to Career Choices

Posted by on May 19, 2018 in Ask The Therapist | 0 comments

If we roughly calculate that hours that we as Americans spend at work throughout our lives, they add up to a significant chunk of our time on Earth. Of all the waking hours across the average American’s lifespan, 35% of them are spent at work. If you think about your work-life in that way, it’s glaringly clear that having a job that fits your natural skills and leaves you feeling fulfilled is important to your short-term and long-term life satisfaction. But many of us feel “stuck” in our current jobs. If can be really challenging to even imagine what the next step might be in becoming satisfied with your work-life, especially if you have spent years of even decades in the same job or field of work. It can be even more frightening to actually make the decision to change job or career paths.


How Can Career Counseling and Life Designing Help?

My approach to career counseling involves life designing, in which I have individuals with career concerns use their own autobiographies to clarify decisions and make commitments. I begin by asking individuals to tell a set of five stories about themselves, interests, and aspirations. I use these stories to compose a life portrait. If the individual wishes, I can administer an interest inventory that shows which occupational groups the individual resembles. I help people conceptualize and envision the next chapter in the story of their career. I then work to systematically transform these intentions into actions in their lives, whether on campus, on the job, or in a new position. Life Designing is a transformational experience that can change confusion to certainty about choosing a college, declaring a major, considering graduate or professional school, changing occupations, or even planning retirement.


Who Can Benefit from Life Design:

  • Students transitioning from high school to college
  • Current college students who aren’t sure if they picked the right major
  • College grads having trouble launching their career after graduation
  • Any adult at any point in their work-life who is currently dissatisfied with their current job, or wants to explore a career path that best suits their abilities, interests, and personality


Written by Suzanne Savickas, M.Ed., M.F.A., CRC, LPC

Social Media, Smartphones, and Teen Mental Health

Posted by on May 12, 2018 in Blog From The Experts | 0 comments

It’s probably a surprise when you don’t see the teenagers in your life entertaining themselves with a smartphone, tablet, computer, or video game. Often they’re texting sharing, trolling, and scrolling on social media apps like Snapchat, Instagram, Twitter, or Facebook. You might expect that they spend time using these apps because it makes them happy, but most data suggests it does not.


The Monitoring the Future Survey, funded by the National Institute of Drug Abuse, analyzed teenagers from 8th to 12th grades, starting back as early as 1975. The survey asked teens how happy they were and how much of their leisure time they spent on different activities, including non-screen activities and, in recent years, screen activities (social media, browsing the web). The results could not be clearer: teens who spent more time than average on screen activities were more likely to be unhappy. Teens who spent more time than average on non-screen activities were more likely to be happy. There was not a single exception. All screen activities were linked to more unhappiness, and all non-screen activities linked to more happiness. Other current research is also finding more negative effects of social media and screen time than positive.


So why can’t they put that phone down? Many apps and social media platforms are carefully designed to capture the brain’s pleasure centers, (the “like-feedback loop”) and young people with developing brains have less ability to resist. Adults and teens alike are easily sucked into the mindset that likes, loves, comments, and followers are a barometer for popularity and self-worth. The “fear of missing out” on what friends are doing or liking online can also cause overwhelming pressure to stay connected.


It’s also challenging for teens to recognize that what they see on social media is often the rosiest possible picture of their peers’ lives. As adults, we cab all relate to going on Facebook and seeing other traveling, smiling with their spouse, showing their best selves, while leaving out the inevitable low points of real life. Now put yourself in the mindset of a teenager.


What Can Parents Do?

  • Be involved in what apps are on your teen’s phone, read messages, follow them and their friends on social media.
  • Discuss the feelings you have at the times when on Facebook.
  • Have phone-free days or hours.
  • Encourage active online presence (looking up info, learning) not passive such as gaming or social media.
  • Be more active! Extracurriculars, outdoor activities, family activities (game night).
  • Model good smartphone behavior (put your phone away during dinner).
  • No phones after 9 pm (get an alarm clock instead of a phone alarm).
  • Limit passive screen time to 1.5 hours a day or less.



Written by Lisa M. Borchert-Hrivnak, M.A.Ed., LPCC, Owner of Avenues of Counseling and Mediation, LLC

End of the School Year Stress

Posted by on May 5, 2018 in Hot Topics | 0 comments

It is all too familiar the feelings of nervousness and panic students feel as they are wrapping up their school year. It can seem almost impossible to avoid the extra stress. Here are some ways to let go of that stress to be more productive, and overall happier during the final months of school.

Starting off, one thing to remember during this time is to be kind to yourself. You are very busy right now and may not feel like yourself, but don’t forget to be caring towards your needs. Studying or worrying about studying can seem like your top priority right now, but take a few hours to do something you enjoy. Unrealistic expectations can really set you back, so know your limits. Exercising is supposed to be a great way to relieve stress, so if you are into that, maybe try it out during a study break.

Something that will help immensely is creating a to-do list. At first, it can be difficult to keep track and follow, but once you get the hang of it, it is life changing. You will easily be able to stay on track and see what is ahead. Also, something about getting to check things off a list give you a great sense of accomplishment and pride. Try to plan out your day as much as possible, because the more prepared you are, the more at ease you will feel.

A big component of relieving stress during the end of the school year it to remember to snap out of the mindset that “I am going to fail all my finals” or “I just hate school so much.” Thinking negatively can actually make stress much worse. Try to remind yourself that if you plan out and prepare, the end of the year will be here before you know it and you will be ready for any finals.