Urban Balance is committed to supporting mental health causes and organizations that our therapists’ are involved with. This month, we donated funds to A Night Out, a nonprofit organization committed to providing adult victims of domestic violence and abuse a brief escape from their everyday world.
UB Therapist Shelly Skrypnyk, LCPC , describes the importance of the organization and her work with them:
As a therapist I have helped many men and women process through abusive relationships and domestic violence issues. It takes strength and bravery to be able to walk away from an abuser or an abusive situation. In Chicago and the Chicagoland area there are many domestic violence agencies that help men and women rebuild their lives after leaving an abusive situation. Some of these individuals also leave with their children and bring them to these agencies. The agencies help them with housing, clothing, employment, schooling, child care, counseling and any other necessity that they need to move on with their lives and to provide a better life.
Another thing I’ve learned from being a therapist is the importance of fun. Laughter can inspire hope. That is why I jumped at the opportunity to be a part of a one of a kind organization that provides fun, laughter and hope to survivors of domestic violence called, A Night Out.
At A Night Out, we understand the struggles that survivors go through in rebuilding their lives and we offer them a brief escape from their everyday world. In a nutshell, we coordinate with domestic violence agencies and take groups of women out to different events in Chicago and Chicagoland areas. We have gone to the ballet, musicals, spas, salons, private dinners, comedy shows and much more. Our goal is to help bring hope and encouragement to survivors to keep going and to know that they can have a better life. We also provide free childcare for their children when they go out for the night.
A Night Out began in 2012 and is completely donation and grant funded. Every aspect of the events are completely free for the participants and the agencies. We have a wonderful team of volunteers that make everything possible. I am proud to be a founding board member, as well as, a volunteer. It brings me great joy to be a part of this organization and to be able to provide happiness in just one evening.
Want to know more? Visit: www.anightout.org
Three days a week, I work as a psychotherapist in a group private practice, downtown in Chicago. The other four days each week, I work as a full time, mom, wife, and friend, in addition to my many other roles. I try my best to appear professional and put together at work. Outside of work, I’m the mom of a toddler – simply brushing my hair can feel like an accomplishment and truthfully, “put together” seems far from reach most days. Many clients often insinuate that they expect therapist’s lives to be perfect or at least smooth and easy. On occasion, my professional life and my personal life collide. I think it can be quite surprising for a client to see their therapist out in the real world.
This past weekend, I was out with my family, and I ran into not one, not two, but three current and former clients of mine in the span of one morning. I have been working as a therapist for several years now, and I can count on one hand the times that I have bumped into clients outside of my office. This weekend was very unusual. Here are some tips on managing these experiences so that as a client, you can feel as comfortable as possible…
Be prepared to bump into each other
During my first session with new clients, we complete some paperwork including basic demographic information. At this time, I take down a client’s address and place of work, amongst other information. There are times when I realize that a client lives in my neighborhood, or in my friend’s building, or they work somewhere I frequent, this kind of thing. In these situations, I take the time to be up front with my client and tell them that I live in the neighborhood, or that I have a friend in their building, or that I frequent their place of work, etc. This gives me the opportunity to tell them that because I frequent the area, I may bump into them. I then ask if the client has a preference as to how we should handle an unexpected meeting. I think it is important early on to be up front about the possibility of seeing each other outside of the office, and to discuss what to do to make the client feel comfortable.
Lead by example
I often tell clients that if I do bump into them outside of my office, I will follow their lead. This means, if they smile, I will smile, if they say, “Hi” I will say, “Hi” back, and also, if they ignore me and keep on walking, I will certainly do the same. It is important for you as the client to lead by example so your therapist can follow your cues in an effort to make you feel as comfortable as possible.
Remember that your therapist is bound by confidentiality
It is worth noting that you as the client, you have the “right of way” in these situations. You can say as much or as little as your like during these outer office encounters. Therapists though, are bound by confidentiality. This means, your therapist probably won’t call you by name or introduce you to whoever they are with, should you run into each other outside of the office. Please do not feel insulted or slighted if you bump into your therapist and they are brief in their communication. Remember, your therapist is only trying to protect your confidentiality.
After an out of office siting, talk to your therapist about the experience. What was it like for you to see your therapist outside of the office? Were you comfortable with how the encounter went? What would you like to change should it happen again? It is important to follow up and discuss the encounter in order to ensure your comfort both inside and outside of the office moving forward.
I hope these tips can be helpful to you so that if/when you do run into your therapist outside of the office, you can manage the situation in a way that is comfortable for you.
Rebecca Wolf LCSW, PCGC is a psychotherapist with Urban Balance. She is passionate about strength-based and solution-focused therapy. She works diligently to build strong, trusting relationships with clients in order to allow for optimal change. Rebecca moved to Chicago in 2009 and she currently lives in Lakeview with her husband and son. You can contact Rebecca at firstname.lastname@example.org with any questions, feedback, or to schedule an appointment.
by Joyce Marter, LCPC
In this time of rapidly developing technology, it’s challenging for parents to stay current and informed about how to help their children have a positive experience with computers, cellphones, social media and other 21st century communication tools.[to fix repeat and be more specific] Many parents have a difficult time walking the fine line between encouraging their children’s use of technology (for learning, development and positive social interaction) and protecting them (from online predators, cyberbullying, or from developing addictive or compulsive behaviors with technology).
But there is a happy medium between allowing kids(to fix repeats and make it look less textbooky) full access to technology with no supervision and over protecting them to the point that they are alienated them from positive social and learning opportunities. Based on my experience as a therapist, I recommend that parents be aware of the following.
What are the ways kids are using technology to communicate?
Texting or chatting through social media sites, online forums and games
Video chatting through sites like FaceTime and Skype
Social media postings (text, photos and video) via sites such as Facebook and Twitter[I don’t know that anyone uses MySpace anymore, but they do use Twitter]
At what age is this an issue?
There is a range of ages when kids begin to use various forms of technology, because parents have different financial capabilities, comfort levels and values. These differences can cause social challenges for kids if their friends have access to these things and they do not. Peer pressure can drive children to find the means to access this technology behind their parents’ backs, and use it without supervision. Parents need to consider the maturity of their child and ask if he or she can follow the guidelines, be responsible for the device, and handle the possible distraction[repetitive].
Verizon Wireless and Parenting.com conducted a survey asking 519 parents with children ages 6 to 17 at what age did they or would they give their child a cellphone. About 10 percent of respondents chose the ages of 7 to 9, 32 percent opted for ages 10 to 12 and nearly 40 percent said they wouldn’t give their child a cellphone until he or she was age 13 to 15.
In my practice, many parents report giving children as young as 4 or 5 an iPod touch or similar device, which gives them access to the Internet, email, video chatting, free calling through Skype and texting through apps like TextNow. However, many social media sites have an age restriction (for instance, Facebook users must be at least 13).
What are the benefits to a child having a cellphone or device with Internet access?
Being able to reach your child
Knowing where your child is via a GPS tracking device
Helping your child learn through educational applications
Providing social inclusion in a technological age
What are the safety concerns?
Vulnerability to predators on the Internet
Access to inappropriate content on the Internet
Susceptibility to cyberbullying
The possibility your child could share inappropriate content via text, photo or video
How can you keep your child safe?
Use the restrictions page and block some things like YouTube, Safari and iTunes[??? I don’t think you can block Safari on an iPhone, for instance. Does the author mean use the restrictions page on these sites to block content?] IOS devices (iphone and ipad) have a restrictions configuration page in Settings -> General -> Restrictions. The following apps can be disabled: Safari, YouTube, Camera, FaceTime, iTunes, Ping, Installing Apps, and Deleting Apps. On this page you can also adjust the allowed content.
Use a parental control app to block pornography[how does this work? Is this an app you download to your kid’s device? If so, what’s the name of this app, so parents can find it?] See Above. If you have an Android device, you can install a free app called Android Parental Control that does similar things to the IPhone restrictions page mentioned above.
Restrict your child’s contacts (email, text and social media) to family and friends whose parents you know
Request that your carrier block content or prevent a child from texting photos
Use your Wi-Fi settings to disable Internet service to certain devices after 9 p.m. It depends on the Wi-Fi router your using at home (Cisco, Linksys, Netgear, Belkin, ASUS), check your router’s configuration or read the documentation. If your present WIFI router doesn’t offer the services look into purchasing one that does. To answer the question on how to do this from an iphone or macbook, keep in mind that: all routers can be configured from a web browser. The WIFI router configuration URL is almost always http://192.168.1.1. You’ll need to know your username and password for the router to login (usually default settings are “admin admin”).
Block inappropriate sites through a Wi-Fi firewall. Again, some WIFI routers have firewall services that can be enabled to block inappropriate content.
Set up your children’s email account on your own devices so you can monitor their content and conversations
What are the social concerns?
Communication problems such as misunderstood messages
How can you combat these concerns?
Provide education and guidance about appropriate communication via technology, and set the following boundaries:[copy moved from below to keep the bullet points parallel]
When they can use it—for instance, not during school hours or after 8 p.m., not during social events such as family gatherings or play dates when they should be relating face to face rather than through technology
How much can they use it. I recommend less than two hours a day to reduce development of addictive/compulsive behaviors
Where they can use it—for instance, not at school or events related to school, religion or athletics
In my experience, the most important thing you can do to promote safety and wellness in your children’s use of technology is to talk with them directly about it. Educate them at a level that is developmentally appropriate about the pros and cons of technology. Be clear about the rules and the consequences for breaking them. Then trust your child to be responsible. Follow through with the consequences if the rules are broken. View your child’s mistakes as opportunities for learning and growth, and keep the dialogue going. Parents need to provide roots but also wings: Educate and set parameters, but allow your kids the freedom to learn and grow.
UB’s Evanston is growing. Welcoming Dawn Grdinic, a Licensed Professional Counselor with experience working with children, adolescents and adults in individual and group therapy settings. Ms. Grdinic’s sessions are centered upon compassion and acceptance as she creates a comfortable, judgement-free, casual, welcoming environment. Using a solution-focused, client-centered, cognitive behavioral approach to therapy, she helps clients identify their challenges/struggles and works with them to employ effective, healthy strategies to tackle them. Her prior work in schools provides Dawn with a unique framework and understanding of the struggles confronted by children and adolescents, and has resulted in the development of very strong, collaborative relationships with counselors and social workers in many of her clients’ schools.
Postpartum depression seems to be brought on by the changes in hormone levels that occur during and after pregnancy. Any woman can get postpartum depression. Situational factors or stress may trigger or exacerbate PPD.
o sadness, uncontrollable crying
o fatigue or total exhaustion
o trouble concentrating, confusion
o feelings of guilt and worthlessness
o disturbances with appetite and sleep
o Lack of interest in the baby/difficulty bonding with the baby
o Mood swings
o And most seriously, sometimes thoughts of harming the baby and/or herself.
There are different types of PPD. Which is the most common?
There are several different postpartum psychiatric disorders.
1. First, there is Postpartum Depression which affects as many as one in ten women. It is important to note that Postpartum Thyroid Disease is equally as common, and may actually be the underlying cause of the PPD in some women. Any woman with PPD symptoms should have her thyroid functioning checked to determine the appropriate course of treatment.
2. There is also Postpartum Anxiety which can manifest as more of generalized anxiety or panic disorder.
3. Postpartum Obsessive-Compulsive Disorder affects about 3-5% of new mothers and consists of obsessions (or intrusive thoughts) about some harm coming to the baby or of the mother harming the baby or both and compulsions (or behaviors) the mother does to reduce her fears and obsessions (like cleaning, counting and other rituals).
4. Postpartum Post-traumatic Stress Disorder: PTSD symptoms caused by a real or perceived trauma during delivery or afterwards.
5. And finally, Postpartum Psychosis which is very severe and involves a break from reality and often requires immediate medical attention. Symptoms include delusions, hallucinations, paranoia and decreased need for or inability to sleep.
What causes PPD?
Postpartum depression seems to be brought on by the changes in hormone levels that occur during and after pregnancy. Any woman can get postpartum depression in the months after childbirth, miscarriage, or stillbirth. Situational factors or stress may trigger or exacerbate PPD.
Is there any way to prevent PPD?
· Pregnant women and their partners can also prepare for the possibility of PPD by talking with their doctors and becoming informed about the symptoms to promote early detection and treatment.
· If a woman has dealt with depression in the past, they should speak about that with their OB-GYN and connect with a psychiatrist or therapist to make sure support systems are in place to reduce the likelihood or severity of a postpartum mood episode.
· Risk of PPD can be reduced with support (from a therapist, support group, friends, family, babysitters) and continued psychopharmacological treatment if the woman is already on medication for depression.
Who suffers from PPD? Is it specific to any demographic or race or ethnicity?
Anyone can suffer – any race, ethnicity, or socioeconomic status. However, there is higher prevalence of PPD in low-income women because they typically have increased stressors and less support.
What are the risk factors for PPD?
· a personal or family history of depression, PPD or mental illness
· stressful events during the past year
· short intervals between pregnancies
· problems in your relationship
· a poor support system
· financial problems or low income
· trauma or abuse
· if the pregnancy was unplanned or unwanted
· if the baby has health issues or is colicky
· And finally, women who have had IVF due to hormone issues
Are all types of PPD curable?
Yes, with appropriate treatment recovery is possible for all postpartum disorders.
What are the treatments of PPD?
· A combination of medication and counseling or therapy is the most effective treatment.
· Many women are reluctant to take antidepressant medication because of fears that it will hurt the baby while “in utero” or during breastfeeding. Some antidepressants can be used during pregnancy and breastfeeding. I encourage women to talk with their doctors about any concerns they have about side effects, however, it can be more dangerous to yourself and your child to NOT take medication if you have serious depression or PPD.
· These women also need support from friends, family, support groups, caregivers, etc.
· They need to have a healthy lifestyle in terms of sleep, nutrition, and exercise.
· For women with postpartum thyroid disorder, they will also need to work with their doctor to treat the thyroid issues.
· For severe cases, the woman may need hospitalization
How do therapists at Urban Balance help treat PPD?
At Urban Balance, we create a safe place for a woman to talk with a therapist who specializes in PPD to talk confidentially about her thoughts and feelings without judgment. Therapists help clients by normalizing and validating feelings and providing information, support and resources.
The research shows that cognitive behavioral therapy is very effective in reducing the symptoms of depression and anxiety. Together, we work with a client to identify thoughts, belief systems and behavioral patterns that are negatively impacting their life. With mothers with PPD, there are often fears that they are a “bad” or inadequate mother that may lead to social isolation, feelings of guilt and anxiety, and low self esteem. We work to restructure those thoughts into more positive belief systems and more proactive behaviors that empower the mother to take good care of herself and receive positive support.
If someone suffers from PPD during one pregnancy will she experience it again after a 2nd baby?
· No, not necessarily. Recurrence is about 25-50%.
· Women can reduce risk by having a plan in place for prevention and support.
· For women who had PPD with their first pregnancy, we highly recommend the book, “What Am I Thinking? Having a Baby After Postpartum Depression” by Karen Kleiman.
· Postpartum depression can develop after the birth of any child, not just the first.
How long do the symptoms of PPD last?
· If treated, symptoms can improve significantly in a few weeks.
· If untreated, symptoms may last months to years and may become chronic.
How are the children of PPD mothers affected by the illness?
· If a mother is adequately treated, there will be no difference in
· her mothering ability when compared to women w/o PPD.
· However, there are many studies showing that women who suffer from chronic, untreated depression are significantly impaired in their ability to mother. Bonding, attachment and breastfeeding may be impaired. The children of these mothers will show developmental, psychological, and behavioral problems.
How can families and husbands help if they fear their loved one is suffering from PPD?
· Be supportive, accepting and non-judgmental.
· If she is not asking for help herself, but you think she needs it, don’t hesitate to ask a professional for guidance. It is better to over respond than to under respond.
· The NorthShore University HealthSystem has an excellent Perinatal Depression Program and their hotline is 866-364-MOMS. This is available for all people living in the Chicagoland area. They can help with screening, information, resources, crisis support and connecting you with doctors and therapists who specialize in PPD.
· For more information about PPD, visit: www.postpartumprogress.com and www.postpartum.net.
Are there any misconceptions you’d like to clear up about PPD?
· This is a medical illness, not a weakness or a failure or does not mean a woman is a “bad mother”. She did not do anything to cause this or bring it upon herself.
· It is much more common than a lot of people think.
· This is not just baby blues or adjustment, she cannot just “snap out of it”.