Psychology Resources
John J. Wagner, Licensed Clinical Psychologist # 6292

Resources

Anxiety
According to the National Institute of Mental Health, Anxiety is the most prevalent mental health difficulty in the United States, affecting an estimated 40 million Americans.  Despite the fact that numerous scientific studies have proven that psychotherapy and certain medications are effective treatments, only an estimated 1/3 of individuals suffering from anxiety will ever seek help.   

The Diagnostic and Statistical Manual of Mental Disorders -  DSM-5 (The resource psychologist, psychiatrist, and other mental health therapist use to diagnose mental health conditions) states that Anxiety is comprised of the following symptoms:  Excessive anxiety, worry, apprehension, difficulty controlling your worrying, restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances. An accurate diagnosis will depend on the particular symptoms experienced and their duration.  
Some subtypes of Anxiety that individuals may experience are:  Social anxiety, Specific Phobias, Agoraphobia (fear of being in a place where escape may be difficult or embarrassing), Panic Disorder, Acute Stress Disorders, Separation Anxiety Disorder, Post-Traumatic Stress Disorder (PTSD), and Obsessive-Compulsive Disorder.

Numerous research studies have proven that psychotherapy is an effective treatment for anxiety.  Of these, Cognitive-Behavioral therapy (CBT) has proven to be a well-established, highly effective, and lasting treatment.  CBT focuses on identifying, understanding, and changing thinking and behavior patterns.  Other effective psychotherapies are Behavior Therapy, Cognitive Therapy, and Systematic Desensitization.  

Behavior Therapy uses techniques to reduce or stop the undesired target behaviors that are associated with anxiety.  For example, one approach involves training patients in relaxation and deep breathing techniques to counteract the agitation and rapid shallow breathing that accompany certain anxiety disorders.

Cognitive Therapy helps patients understand how their thoughts contribute to their symptoms of anxiety.  Cognitive Therapy helps individuals change thoughts patterns, in turn reducing anxiety.  Individuals become cognitively aware and are able to have an increased sense of control over their symptoms.
Systematic Desensitization has proven effective for lessoning or eliminating specific phobias.

Systematic Desensitization teaches an individual to relax as they are gradually exposed to the feared object or situation.  Beginning sessions typically teach an individual to meditate or relax while thinking of the feared object/situation.  Latter sessions typically involve gradual increased exposure to the feared stimulus while maintaining a sense of relaxation.

Other proven methods for reducing anxiety are: Exercise, meditation, solution focused techniques, certain medications, mindfulness, and stress management.

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For more information on Anxiety please visit the National Institute of Mental Health at:

https://www.nimh.nih.gov/index.shtml

Depression
According to the National Institute of Mental Health, an estimated 20 million Americans currently suffer from depression. And antidepressant medications typically are listed as one of the top 10 most prescribed drugs in the United States.  Some believe that we live in the “age of depression and anxiety”.   Unfortunately, most people suffering from mental health difficulties, including depression, go untreated; despite the fact that numerous peer reviewed scientific studies have proven that psychotherapy is an effective treatment for depression.  

The Diagnostic and Statistical Manual of Mental Disorders -  DSM-5 (The resource psychologist, psychiatrist, and other mental health therapist use to diagnose mental health conditions) states that depression is comprised of the following symptoms:  Feelings of sadness, diminished interest and pleasure in most or all activities, significant weight loss or weight gain, sleep difficulties, psychomotor agitation or retardation, loss of energy, feelings of worthlessness, excessive guilt, diminished concentration, and recurrent thoughts of death.

Individuals suffering from depression often feel that there is no hope.  They feel powerless; believing that there is no way to get better.  This belief is simply not true.  Depression is treatable.

Numerous research studies have proven that psychotherapy is an effective treatment for depression.  Of these, Cognitive-Behavioral therapy (CBT) has proven to be a well-established, highly effective, and lasting treatment.  CBT focuses on identifying, understanding, and changing thinking and behavior patterns.  Behavior Therapy has also proven to be an effective treatment for Depression. Behavior Therapy uses techniques to reduce or stop the undesired target behaviors that are associated with depression.  Behavior Therapy seeks to alter behavior patterns to facilitate emotional health.

A myth of American culture is that certain individuals have “chemical imbalances” that can only be treated with medication.   This belief is not true.  Here is a list of some of the factors that have proven to alter your brain chemistry, and hence can improve or degrade your physical and emotional health depending on the quality, amount, or absence of these criteria.

  • Psychotherapy
  • Exercise – or lack of
  • Your thoughts (all of them).  Thoughts of yourself, the past, the future, your surroundings…
  • Relationships (all of them) (ones in the past and present)
  • Nutrition
  • Sleep
  • Sunlight – or lack of
  • Time spent outside – inside
  • Medication
  • Career
This list is in no way complete.  Numerous other factors alter the chemistry of your mind and body (significantly effecting your physical and emotional health). Effective psychotherapy (In particular CBT and Behavior Therapy) seek to improve/alter those areas of your life that are negatively effecting your emotional health.  By effectively discovering what factors contribute to an individual’s depression, psychotherapy should aim to alter those target thoughts and behaviors leading to increased feelings of happiness and well-being.

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For more information on Depression please visit the National Institute of Mental Health at:

https://www.nimh.nih.gov/index.shtml

Addiction

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) approximately 10% of Americans currently use illicit drugs and 52% of Americans drink alcohol. Tobacco, alcohol, and illicit drug use cost our country an estimated 700 Billion dollars in annual cost related to health care, lost productivity, and crime. The National Institute on Drug Abuse (NIDA) estimates that approximately 44,000 Americans die each year from drug overdose. And According to the Center of Disease Control an estimated 88,000 Americans have died each year from excessive alcohol use (between the years of 2006-2010).


According to the Diagnostic Statistical Manual IV-TR (the manual psychologist, psychiatrist, and other therapist use to diagnosis mental health conditions), an individual can be diagnosed with Substance Dependence if they have a maladaptive pattern of substance use leading to clinically significant impairment or distress - as manifested by three (or more) of the following seven symptoms:

  1. Tolerance, as evidenced by either a need for increased amounts of the substance to achieve intoxication or desired effect or diminished effect with continued use of the same amount of the substance.
  2. Withdrawal, as manifested by withdrawal symptoms or the individual must take the substance to avoid withdrawal.
  3. The substance is taken more and for longer than intended.
  4. There is persistent desire or unsuccessful efforts to cut down or control the substance use.
  5. A great deal of time or effort is spent acquiring the substance.
  6. Important social, occupational, or recreational activities are given up or reduced because of the substance.
  7. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by the substance.


According to the Diagnostic Statistical Manual IV-TR, an individual can be diagnosed with Substance Abuse if they have a maladaptive pattern of substance use leading to clinically significant impairment or distress - as manifested by one (or more) of the following:

  1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
  2. Recurrent substance abuse in situations in which it is physically hazardous.
  3. Recurrent substance-related legal problems.
  4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.


People can and do recover from their addictions every day. To date, the most scientifically supported treatments for drug and alcohol addiction are Cognitive Behavioral Therapy and Behavior therapy.

Cognitive-Behavioral therapy (CBT). CBT is a well-established, highly effective, and lasting treatment. CBT focuses on identifying, understanding, and changing thinking and behavior patterns.

Behavior Therapy uses techniques to reduce or stop the undesired target behaviors that are associated with addiction. Behavior therapy can help an individual stop destructive habits and begin new healthy behaviors.

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For more information on addiction visit:

Tobacco-Nicotine Addiction
According to the Centers of Disease Control, cigarettes kill more people than AIDS, alcohol, car accidents, illegal drugs, murders and suicides combined. Cigarettes kill approximately 480,000 Americans each year.  That is 1,300 deaths a day and approximately one in five American deaths. Additionally, another 42,000 Americans die each year from second hand smoke.  Tobacco use is the leading preventable cause of death in the United States; and, for every one person who dies from smoking, about 30 more suffer from a least one serious tobacco related illness.  Despite these grim facts, approximately 42 million Americans continue to smoke.  Why?  Nicotine is one of the most addicted substance on the planet.  Thankfully, there is help available.

Studies have shown that 20 minutes after you stop smoking, blood pressure and heart rates return to normal.  Most people are not successful quitting cigarettes on their first attempt, yet studies have shown that those individuals that continue trying, have a much greater chance of success.  The leading treatments for nicotine addiction are counseling, coupled with either nicotine replacement therapy (e.g. nicotine patches, nicotine gum, and nicotine lozenges…) or medication (Most notable Bupropion and Varenicline).  Most studies report that a combination of counseling and either nicotine replacement therapy or medication is more effective the either treatments alone. 

According to research, the most effective types of counseling to end tobacco use include Practical Counseling/Behavioral Methods, Social Support, and Group Counseling.  NetPsych Online Counseling practices  Practical Counseling/Behavioral Methods in which individuals learn triggers for nicotine use, learn to apply alternative behavior strategies to implement pattern interruption, become adept at apply coping and stress reduction strategies, and learn to apply Practical-Solution Focused Strategies.

Some Practical-Solution Focused Strategies include:  Setting a quit date, notifying friends, family and co-workers or your plans  to quit (in order to gather support), anticipating challenges, anticipating and preventing withdraw symptoms, removing tobacco from your environment, remembering past attempts to quit - focusing on what helped and what did not, limiting alcohol, and avoiding and replacing triggers.

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More information:

The National Center for Biotechnology Information analyzed 8,700 research articles and has formulated guidelines for nicotine addiction treatment.  The latest guidelines can be viewed at:
http://www.ncbi.nlm.nih.gov/books/NBK63948/

Another Institution providing helpful information for nicotine addiction treatment is the National Institute on Drug Abuse, which can be visited at:
www.drugabuse.gov

Relationships
Relationships can often be the most fulfilling or detrimental part of one’s life.  All of us typically interact on a daily basis with either family, friends, roommates, acquaintances, teachers, colleagues, neighbors, supervisors… or other members of our community.  Each of these relationships (no matter how involved or uninvolved) has an impact on your life; and therefore has an impact upon your emotional health.  Many psychologist believe that relationships with family (and especially one’s parents) can be the most powerful factor effecting one’s mental health.

The Diagnostic and Statistical Manual of Mental Disorders -  DSM-5 (The resource psychologist, psychiatrist, and other mental health therapist use to diagnose mental health conditions) describes several relationship difficulties, including:  Relational Distress with a Spouse or Intimate Partner, Parent-Child Relational Problems, Sibling Relational Problems; and also describes maladaptive relationships resulting in abuse and neglect of children and adults.  Furthermore, the DSM-5 describes various Personality Disorders such as Borderline Personality Disorder, Narcissistic Personality Disorder, and Avoidant or Dependent Personality Disorder; all of which encompass interpersonal relationship difficulties as one of their main components.

The DSM-5 describes Relational Distress with a Spouse or Intimate Partner  when:  the major focus of clinical attention is to address the quality of intimate relationships or when the quality of that relationship is affecting the course, prognosis, or treatment of a mental or other medical disorder.  Typically this relationship distress is associated with impaired functioning in behavior, cognition and/or affective (emotional) domains.

The DSM-5 describes Spouse or Partner Psychological Abuse as nonaccidental verbal or symbolic acts by one's partner that results in significant harm to the other partner.  The DSM-5 further describes Spouse or Partner Psychological Abuse as acts of berating or humiliating the victim, interrogating the victim, restricting the victim’s ability to come and go freely, obstructing the victim’s access to assistance, threatening the victim with physical harm or sexual assault, harming or threatening to harm the victim, unwarranted restriction of the victim’s access to or use of economic resources, isolating the victim from family, friends, or social support, stalking the victim, and/or trying to make the victim think that he or she is crazy.

Psychotherapy for relationship issues focuses on identifying maladaptive and destructive behaviors and cognitions; then works to eliminate or change those actions and thoughts.  Families, couples, and individuals are first challenged to identify what factors about the relationship are causing distress, then are guided to identify how these factors (behaviors and interpretations of these behaviors) affect each member of the relationship (psychologically), and then are asked to change these target behaviors and cognitions.  Several key ingredients in Relationship Counseling are honesty (both with one’s self and others), learning to compromise, learning how your behavior affects others, learning how other’s behavior affects you, trust, integrity, respect,  learning how to replace maladaptive cognitions and behaviors with healthy thoughts and actions, problems solving skills, and learning effective communication skills.

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