Suboxone

Addiction to prescription painkillers is reduced when the individual is given consistent treatment with the drug Suboxone (buprenorphine plus naloxone), according to the first randomized large-scale clinical trial focused on the use of medication for treating prescription opioid abuse.

Pain medications are helpful when taken as prescribed; however, they have high abuse liability, especially when taken for nonmedical reasons. Researchers in this study set out to examine whether the FDA-approved medication Suboxone could help fight this growing problem.

“The study suggests that patients addicted to prescription opioid painkillers can be effectively treated in primary care settings using Suboxone,” said National Institute on Drug Abuse Director Nora D. Volkow, M.D. “However, once the medication was discontinued, patients had a high rate of relapse — so, more research is needed to determine how to sustain recovery among patients addicted to opioid medications.”

Interestingly, researchers also found that there was no extra benefit when intensive opioid dependence counseling was added to the drug treatment.

Suboxone is a combination of buprenorphine to reduce opioid craving plus naloxone, which causes withdrawal symptoms in a person addicted to opioids if Suboxone were taken by a route other than orally, as prescribed.

This combination was developed specifically to prevent abuse and diversion of buprenorphine and was one of the first to be eligible for prescription under the Drug Addiction Treatment Act, which allows specially trained doctors to prescribe certain FDA-approved medications for the treatment of opioid addiction.

Most research focused on treating opioid dependence has been conducted with heroin-addicted patients at methadone clinics. As a result, there has been limited information on how to treat those addicted to prescription painkillers, especially in the offices of primary care doctors. To help remedy this issue, the National Institute on Drug Abuse started the Prescription Opioid Addiction Treatment Study (POATS) in 2007, which was carried out at 10 treatment sites around the country.

“Despite the tremendous increase in the prevalence of addiction to prescription painkillers, little research has focused on this patient population,” said Roger Weiss, M.D., of Harvard Medical School, Boston, and the lead author of the study.

“This is the first large-scale study to examine treatments exclusively for people who were abusing prescription painkiller medications and were treated with buprenorphine-naloxone, which can be prescribed in a physician’s office.”

In the study, over 600 treatment-seeking outpatients addicted to prescription opioids received Suboxone along with brief standard medical management, in which doctors evaluated treatment effectiveness and suggested abstinence and self-help methods. Half of the subjects also received varying degrees of counseling provided by trained substance abuse or mental health professionals.

Results showed that approximately 49 percent of participants experienced a reduction in prescription painkiller abuse during the extended (at least 12-week) Suboxone treatment.

However, when Suboxone was discontinued, this success rate dropped to 8.6 percent.

Reductions in abuse were observed regardless of whether the patient reported suffering chronic pain, and participants who participated in intensive addiction counseling did not have higher success rates when compared to those who did not receive counseling.

According to an annual national government survey, an estimated 1.9 million people in the United States meet abuse or dependence criteria for prescription pain relievers. In addition, the Centers for Disease Control and Prevention report that annually, more people die from prescription painkiller overdoses than from heroin and cocaine combined.

The research is published in the Archives of General Psychiatry.

Source: National Institutes of Health

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An Anxious World

At Anchor Counseling Center we believe that s human beings, we all experience a form of anxiety at some point during our lives.  Anxiety is often thought of as worry and fear about uncertainties. It is usually depicted as a negative attribute, but it can also serve the useful purpose of alerting one of lurking danger. We may find ourselves worrying about school, work, our kids, or paying bills, and that’s all perfectly normal. When anxiety and worrying is a persistent, or common, feature causing disruption to your daily life, then it becomes a maladaptive. Excessive worrying may interfere with your relationships, your leisure activities, and can eventually lead to physical health issues.  According to the National Institute of Mental Health, approximately 40 million adults in the U.S., in the span of one year, suffer from an anxiety disorder². The average age of onset for anxiety is 11 years old; so many children are affected by anxiety disorders as well².  Also, women are more likely do experience anxiety disorders than men². So anxiety is not a new or unheard of phenomenon, and it is fairly common, however, some may not recognize symptoms of maladaptive anxiety because it may not look like the common perception of an anxiety-ridden individual.

In fact, anxiety disorders can take on many forms, and one person’s experience with excessive worrying can be completely different than another person’s experience. Some people have very general based anxiety of which they worry excessively about every little thing throughout the day, from work, school, paying bills, to having enough time to complete a task, or to what will happen if my car stops working. A popular perception of an anxiety disorder is of people with specific phobias. For instance, an individual’s fear-based worrying may only be provoked by exposure to specific stimuli, such as a bridge above water, or snakes. Even though the phobia is highly specific, it may be clinically significant if the individual experiences anxiety about it on a daily basis and it interrupts his/her daily tasks.

Obsessive-Compulsive Disorder, commonly termed OCD, is also a form of an anxiety disorder¹. A person with OCD will have obsessive thoughts, which tend to cause marked anxiety or distress, and/or compulsions, which are often performed in order to reduce anxiety.  Take for example, a man who has a fear of germs contaminating his body. This man worries constantly throughout the day about contracting some disease from all the germs he believes surrounds him. In order to reduce the likelihood of him contracting this horrid disease, he washes his hands 52 times, every time he goes to the bathroom or touches an object he does not own. As a matter of fact, he also showers at least twice a day for more than 45 minutes, and if he forgets to clean any body part, he goes back and re-showers entirely.

Posttraumatic Stress Disorder, or PTSD, and Acute Stress Disorder, are characterized by “anxiety from re-experiencing a traumatizing event, often accompanied by symptoms of increased arousal, and avoidance of stimuli associated with the trauma”¹. While PTSD can occur any time after the traumatic event, Acute Stress Disorder occurs immediately after the traumatic event, lasting for at most, four weeks. In this form of anxiety disorder, there is a distinct trigger event where the individual felt threatened.

Other forms of an anxiety disorder to mention is Panic Disorder With and Without Agoraphobia, Agoraphobia without a history of Panic Disorder, and Social Phobia.  Panic Disorder without Agoraphobia is characterized by recurrent, unexpected panic attacks about which there is persistent concern, while a person suffering from Panic Disorder with Agoraphobia may experience both recurrent, unexpected panic attacks, and anxiety about places or situations that may not be easily escapable.  That being said, Agoraphobia, “is anxiety about or avoidance of places or situations from which escape may be difficult (or embarrassing)”¹. Social Phobia is basically when a person’s “anxiety is triggered by exposure to social situations in which he/she is exposed to unfamiliar people or to possibly scrutiny by others”¹.

As you can see, there are a variety of anxiety disorders; however, one thing to note is that anxiety has an altering effect on one’s perception of the world around them and an effect on one’s interpretation of the stimuli he/she is exposed to. A Common behavior associated with people who have anxiety disorders is avoidance behavior. For example, the man with a phobia of bridges above water may stop going to visit his parents because he refuses to drive or walk over any bridge above water. In fact, he may miss a work conference next week that is detrimental to his job security because it’s across a bridge over water.  Another example is people with social phobias who avoid public speaking at all costs. Even with OCD, the compulsions acts as an avoidance mechanism set to reduce ones anxiety about an obsessive thought.

Also many anxiety stricken individuals have cognitive errors set in place that alter their ability to make judgments and function in the every-day world. Most people with anxiety tend overestimate the probability of the occurrence of the worry at hand. On the other hand some people assume that an outcome will be much less manageable than it actually is, also known as catastrohpizing. A big commonality amongst those suffering anxiety is the human tendency to be intolerant of uncertainty, the fear of ambiguity, and the acceptance of change.

Most people don’t like to be surprised by negative events, and more often than not, we want to try and control (or limit) the amount and impact of those negative events. But humans cannot know, or evade every problem—sometimes we just have to go through the pain. And attempting to control or change something you have no power to control or change is physically exacerbating to the human body and psyche. Taking risks, accepting change, and understanding that uncertainty is not an abyss of pain and negativity is a part of alleviating some anxiety.  Dr. Biali (2012), as do many psychologists, argues that anxiety is not always bad—it’s a part of experiencing life and trying something new^3,4. Now, excessive anxiety about things you truly can’t control becomes tiresome and is often how clients present—overly stressed. Biali (2012), suggests several healthy ways to help people reduce anxiety, including, writing one’s worries down, practice breathing exercises, do yoga or stretching and exercise to alleviate muscle tension, and to avoid stimulants (like caffeinated beverages)³. Will this rid you of your anxiety? Probably not, but it can help you manage it.

Biali (2012) and Markway (2012), both suggest that in order to address and solve issues regarding your anxiety and excessive worry, one should invoke the assistance of a professional that is trained to guide you in restructuring your current cognitive methodology, and avoidance behaviors. According to the National Institute of Mental Health and the Psychological Diagnostic Manual, people with anxiety disorders usually benefit from methods of Cognitive Behavioral Therapy and/or Exposure Therapy. Here at Anchor Counseling Center, we have therapists trained in both CBT and exposure therapy to help you reduce your anxiety and manage healthier lifestyle.

By: Aryssa Washington

Sources

¹The American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Washington, DC, American Psychiatric Association, 2000.

²www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml

³Biali, S. (2012). How to manage the anxiety that comes with change. Prescription for Life: Psychology Today com

⁴Markway, B. (2012). Can Willpower help you overcome social anxiety: willpower is not always about giving something up. Shyness Is Nice: Psychology Today.com

By: Aryssa Washington

To where is escape but after the dive—a liberating plunge

I may find it, or an abyss of nothingness

Face over the edge—barely breathing

Or should I hold it in forever?

Until breaking past the first cold sweep of water shivering over my body, pushing me deeper into the dark

The murky puddle remains expansive to my sight

My toes lurk at the edge in anticipatory trepidation, tipping and teetering toward the damp darkness as one lonely droplet scantily clad in ache, sears a path into icy cold bleakness

Down towards the plunge

Into the dark, out of the light

Out of the dark, into the light

I know not the escape.

A wavering shape, she stares back at me mirrored in the murky pools

Heated eyes, pelt livid drops of rain lightly across the shimmering abyss

Stretched and taut, I poise my body firmly for flight

I let my feet leave the sturdy form of concrete, diving in

An inferno of blazing anger and fight crash into the stark impact of cool, ice swarming to attack the invading heat

The fire-lit scar indolently marking my life draws out the light

Mouth formed to scream the words, hands itching to gouge free, digging deep, tearing it apart to burn by the drop, by the dive, to melt away in the dark.

Uttering a shriek I break in, seeping into the darkest chasm

Dismal lights fade, giving way to the waves of deeper ocean, a different sea

The tears and pain once searching, relax into a calming ebb and flow

The last flickering blaze burning out, melding into icy cold waves

Towing and tugging me willingly to the cold pillow lit to drench my rest in serenity

I see her, standing over me, before she dives, after the dream—liberated from a sleeping image, replaced by her, by me.

My minds whisper a lit by the wish that tranquility remain.

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Many people come into therapy hoping the process will be a quick and easy fix. But at Anchor Counseling Center we realize that humans are complex beings; it’s a bit presumptuous to think that human issues can be solved by a simple resolution. In most cases the resolution to an individual’s problem is fairly simple; it’s the process to get to the desired resolution that takes time and effort. For example, if I were to just tell a client, “just change your thinking,” the problems most likely wouldn’t immediately dissipate, leaving my client worry free and on a straight-shot path to all the joys of life. To be perfectly honest, true therapy takes work, on the part of the therapist as well as the client.

Choosing to go into therapy can be scary, daunting, and quite frankly it almost seems like an invitation for more anxiety. It is human nature to not exactly enjoy change in one’s life, but that decision to try therapy is making the statement that, “I want things to change,” or “I want something to be different.” That’s the first step and it’s a big one for a lot of clients. As a side-note, as therapists, we don’t have this hidden agenda to change you into some mythical creature of all things moral or a “mini-me,” and we aren’t going to force you to change. Our desire is to help you figure out who it is that you want to be, or what it is that you want, and then give you a little push in that direction. Coming into therapy may be anxiety provoking—anything new is going to be—but in the midst of change, anxiety can be a good thing. And a bit of anxiety now, in order to alleviate your suffering, may be minor in the aftermath of the therapeutic process.  At Anchor Counseling Center, you will never be left in the wind hanging by a coat hanger off the ledge of a cliff wishing you had never made that leap into therapy. Our therapists are dedicated to helping those in the community who want something different, and who want something to change.

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The Adolescent Struggle for Autonomy and Self-Identity:

Using Creativity in Group Therapy

By: Aryssa Washington, Roger Williams University (2011)

Therapeutic work with adolescents is often seen as a challenging task, especially in the initial stages of the therapy processes (Allen, 2005). It is important to remember that while some adolescents may be in therapy voluntarily, others are required to participate in therapy by parents and/or court mandate. Since adolescents are not often in the position to initiate the process of therapy, they may express apprehensive attitudes that work against the formation of a healthy therapeutic relationship. As with adults, some teens may not have the insight to perceive the need for therapy. Also, adolescents involuntarily participating in therapy may feel that clinicians are allied with their adult guardians, as opposed to with them. Regardless, if the therapeutic experience is new, most youth will be processing feelings of discomfort in the therapy environment; thus, creative and culturally-aware approaches that address adolescents’ uneasiness and resistance become a necessary feature in therapy (Allen, 2005).

According to Erikson, social and cultural experiences are integral to human development (Zayas, 2001). His theory expressed the need to cogitate both the individual and the common needs all humans share (Zayas, 2001). During latency and preadolescent development, youth are challenged with assuming socially-specified roles and balancing a sense of autonomy with the sense of inferiority (Erikson as cited in Zayas, 2001). For adolescents, developing a sense of individuation and independence is an important achievement, and the society surrounding the youth “provides the guidance, opportunities, challenges, motivation, experience, counsel, and instruction for accession into adulthood” (Zayas, 2001, p.363). In accordance with Erikson’s theory, youth will rehearse the roles that perceived to be essential to later success in life, as observed within his/her social culture (Zayas, 2001). The confidence that is associated with a sense of autonomy helps form the adolescent’s identity, and occurs when he/she feels supported (Zayas, 2001). Because of the universal adolescent struggle with self-identity and independence, group therapy is often thought to be an effective option. Aadolescents, with and without a clinical disorder, have ongoing issues with low self-esteem, and developing problem solving skills (Hartz & Thick, 2005; Richmond, 2000). Group work with adolescents often aims to address this over-arching issue, in the process of targeting more specific issues such as, behavioral/conduct problems, trauma, medical illness, and substance abuse (Veach & Gladding, 2007). One way of targeting the issue of self-esteem, self-identity, and autonomy, as it is associated with more specific clinical issues, in adolescent group therapy is through creative therapy modalities.

Creativity, in the therapeutic setting may be described as the “ability to produce work that is both novel, and appropriate” (Sternberg & Lubert, as cited in Veach & Gladding, 2007, p.72 ). Creativity is the creation of original work by clients that is useful to the therapeutic goal. Contrary to popular belief, creativity is not to be misconstrued as unstructured work. Many therapists recommend the use of creative therapies within the construct of some theory basis—most often found as an adjunct to cognitive behavioral or client-centered group therapy (Veach & Gladding, 2007; Pardeck, 1994).  In fact, working creatively in groups with youth requires structure, albeit a subtle use of directives when facilitating groups (Vick, 1999; Backos & Pagon, 1999; Pifalo, 2002).  For the purpose of this paper, creative therapies and expressive art therapies are used interchangeably.

Expressive arts therapy, as posited by person-center theory, includes “movement, art, music, writing, sound , and improvisation  in a supportive setting  in order to facilitate growth and healing” (Rogers, 1993, pg. 3). Person-centered theory supports the notion that all individuals are innately creative, thus expressive art therapy can be used as a process of self-discovery through emotional depth and self-expression. Humanistic principles support that the focus of expressive art therapy has nothing to do with the end product or the mechanical principles of any art form, but its focus is on the clients ability to “let go, express, and release emotions and to gain insight from studying the presented symbolic and metaphoric messages” (Rogers, 1993, pg.4). For adolescents, the production of artwork operates as a medium of ownership and a means to explore personal identity. The group setting provides the social support necessary in increasing confidence, as well as provides another modus to gain insight and learn new ways of thinking from social peers. Based on the adolescent struggle for self-identity, and desire to be self-productive, this paper examines the use of several creative therapy methods with different adolescent populations.

Music Therapy

Music therapy may include the creation and/or deconstruction of musical pieces. This could comprise the analysis of musical lyrics, the composition of musical pieces, or even playing beats on a drum (Towse, 2007). In their overview of the literature on creative techniques with adolescent groups, Veach and Gladding (2007), found that music therapy was often used to help improve social communication and as a preventative measure by increasing the development of coping skills. DeCarlo and Hockman (2003), found that the use of RAP therapy in conjunction with psychoeducational therapy promoted prosocial behaviors. These researchers posited the use of rap music in order to connect with African American juvenile offenders, status offenders, and high school students (with no record) from the same urban setting. The rap music served as a connection between therapy and the contemporary customs of the youth.  The rap therapy condition analyzed the lyrics of chosen songs that related to the specified psychodeducational topic of the day. While very much a goal-oriented treatment, DeCarlo found it was important to use cultural customs, to relate to the adolescents on their level, in order to influence desired behaviors.

Movement

A common use of movement, or dance, therapy is with adolescent female groups (Veach & Gladding, 2007). Movement therapy often has a preventative focus for young females experiencing radical body changes, or with teenage females struggling with self-image or self-identity conflicts (Block, 2001). In her clinical work with female adolescents and in dance, Block (2001) has created a framework for dance therapy in efforts to address young women’s issues with self-confidence, identity, and image. Again, the group setting functions as social support and a forum for discussion and insight development. In her framework, Block (2001), proposes that the members chose an undesired body part to lead with in a sequence of movements. Then the girls go into a group and discuss how social media and cultural assumptions contribute to their own perceptions of their self-image and self-concept. Following this, the group works as a team to build a dance with their new perceptions of the previously unwanted bodily feature.  The final stage is for the members to create a dance that illustrates how they view their bodies now (Block, 2001). In this type of dance therapy, transformation occurs when the teens become aware of his/her Self, and how society may contribute to the formation of one’s Self. The members must also become aware of others and how they relate (physically and mentally) to others (Block, 2001).  The resultant creation is an external demonstration of how he/she views him/herself. The performance of the Self for the group helps to facilitate confidence in how the youth identify themselves.

Literature

The use of literature in therapy is often termed “Bibliotherapy.” In essence, participants read specifically themed books, poems, or news articles, to explore particular issues that the members of the group may be dealing with (Pardeck, 1994; McArdle & Byrt, 2001). Bibliotherapy is often used as an adjunct to cognitive behavioral therapy with teen groups because it is a creative method that allows for therapists to address cognitive distortions or faulty impressions adolescents may have. Group members work through the stages of identification, catharsis, insight, and universality in relation to the main character and the other group members. Group bibliotherapy usually includes interactive projects, writing exercises and discussions (Pardeck, 1994). This creative methodology has been effective with various teen and even adult populations, but there has been a large amount of research done with the use of bibliotherapy and juvenile delinquent populations, or with teens that have emotional and aggressive regulation difficulties (Bogestad et al., 2010; Schetman, 2000; McArdle & Byrt, 2001).  McArdle and Byrt (2001), and Pardeck (1994), found that bibliotherapy was efficient in providing a place for emotional purging, problem solving opportunities, increased personal insight, and a medium for positive expression.

Expressive Writing

Prominent psychologist, Stanley G. Hall’s “intellectual emancipation” concept coincides with Aristotle’s notion of empowerment through understanding language and how it is used (Leary, 2006). The idea of teaching writing principles and then allowing the individual to narrate his/her own story applies to the use of expressive writing in group therapy with adolescents. As with bibliotherapy, expressive writing provides the means for emotional purging, self-expression, and personal insight. Expressive writing is often used with juvenile offenders, youth suffering from chronic or acute illness, or with youth who have suffered some form of trauma (Baerg, 2003; McArdle & Byrt, 2001; Veach & Gladding, 2007). The issue, as it relates to these aforementioned populations, is the youth’s feelings of powerlessness and/or low self-esteem.  According to Dr. Kane (as cited in McArdle & Byrt, 2001), the aim of expressive writing is to generate creativity and empowerment which is likely to assist in the establishment of self-identity.  In most cases, the group members are taught basic writing principles and are given a writing prompt, the resultant product provides each member with a narration of his or views and experiences (McArdle & Byrt, 2001). Basically, it provides teens with a tangible visualization of his/her thought processes and cognitive patterns.  This provision of self-understanding promotes feelings of power and self-esteem in situations where adolescents may not actually have/ or did not have a lot of control over. McArdle and Byrt, (2001), also found that in adolescent forensic populations, expressive writing promoted social interest, helped develop decision-making skills, as well as aided in increasing youth accountability.

Drama Therapy

Drama in group therapy with adolescents can be used as both a preventative or intervention method. For instance, group members may be asked to role play and act out parts of life in order for them to practice different behaviors (Veach & Gladding, 2007).  One study used Shakespeare’s play Hamlet, to explore the idea of consequences in relation to personal choices and accountability (Veach & Gladding, 2007). Participants were asked to act out the play and discuss the various choices the characters made in relation to how they would respond and the associated consequences.

With the intention of promoting positive youth development, Dutton (2001) used drama as a preventative measure for preadolescent youth. Positive youth development included building competencies, increasing the teens self-worth, and promoting the recognition of individual and group strengths (Dutton, 2001). In this type of drama therapy, the initial step is to form a group, then to get the group to form an identity, and then to get the group to use the forum as a place to enhance decision-making skills. In Dutton’s study (2001), a group of ten members was formed and then asked to put on a performance using any art medium they chose. The group facilitator acted as a monitor, mediator, and was there to reflect the ideas of group members. The main decisions had to be made by the group as a whole. The ten members agreed to do a Hip Hop drama, and created their own group name. The group was provided with a snack, over which they discussed ideas, concerns, and problems. They also created their own session times to accommodate students with busy schedules, and agreed to go see a different play outside of therapy to get ideas. Eventually, the group chose and performed Romeo and Juliet, which included setting up a dress rehearsal, charging admissions, advertising, and selling concessions during intermission. Allowing the teens to create together and agree on all major decisions, promoted a sense of autonomy, and helped in the development and verbalization of problems, concerns, and decisions. Granted this creative modality generates a sense of autonomy and prosocial behaviors, certain populations of youth may not benefit from such a therapy as it relies heavily on participant responsiveness and group work.

Activity Therapy

Activity therapy is basically the extension of play therapy with children, however, developmentally appropriate (Paone, Packman, Maddux, & Rothman, 2008). For the most part, the literature shows that activity therapy with adolescents is often used to promote a sense of achievement, teamwork, and prosocial behaviors (Veach & Gladding, 2007). Paone et al. (2008), used activity therapy with at-risk ninth grade students to examine the effects of group work on the development of moral reasoning. Paone et al. (2008), measured moral reasoning via pre and post test scores on the Maintaining Norms Schema Subscale of the Defining Issues Test 2 (DIT-2). This study addressed issues regarding the adolescent struggle of autonomy versus the constraints of social authority. Paone et al., (2008) posited that the moral values that help humans make decisions about what is right versus what is wrong, are formed by the observed patterns each individual learns(or perceives) in his/her social surroundings. This notion supported the use of the group as a social support unit and environment to observe and re-learn new behaviors or thoughts.

Participants were split into 12 small groups (N = 61) and received either group activity therapy (GAT) or group talk therapy (GTT). Each group was given 5 different dilemma situations over the course of 10 weeks.  While the GTT group simply talked through the issues and consequences presented with the dilemma, the GAT group had several stages.  First, the GAT group was presented with the dilemma by the group facilitator, then the group participated in a developmentally appropriate structured activity relating to the dilemma. Afterwards, the members could have free play by themselves or with other members, and the final stage consisted of a snack and discussion table.  Throughout all of these stages the facilitators reflected feelings, content, and behaviors to be incorporated in the activity (Paone et al., 2008).  The results revealed that the increase in moral reasoning was greater for those who had received the group activity therapy intervention. This creative therapy is heavily structured, but implements movement, interest (or fun), and interaction. The idea that youth can learn by simply being youth and having fun, was important in understanding how group activity therapy works. With this technique, teens can do developmentally appropriate activities that are set up within the context of situation the group facilitator desires the youth to derive knowledge from. Activity therapy allows for adolescents to actively make personally relevant choices/decisions as it relates to a problem, as well as see other ways to handle the same problem.

Art Therapy

Art therapy (visual art) has been used with a variety of juvenile populations. Hartz and Thick (2005), used visual art therapy with female juvenile offenders and found that it improved their self-esteem. They also found relevance for the discussion of social change elements when the group was discussing each other’s art work. Fliegel (2000) and Vick (1999), found that art therapy was useful in short-term psychiatric inpatient treatment programs for adolescents. An abundance of literature exists on the use of art therapy with sexually abused adolescents, and adolescents who suffer from chronic and acute illnesses. Unfortunately, most of the research with these two populations of teens in particular is focused on females. The emotional component of expressive art is used to its advantage with these two juvenile populations.

Pifalo (2002) found that art therapy provided female adolescents with a sense of power and control, which increased their overall self-esteem. Allowing the adolescents to explore their emotions in creating art and then attaching their own meaning to it put the power back into the hands of the victim. Pifalo (2002) also found that therapy through art reduced the anxiety, posttraumatic stress, and overt disassociation of adolescent victims. Backos and Pagon (1999) revealed similar results with their study of female adolescent sexual abuse survivors. They found that art therapy allowed survivors to first withdraw, then reflect, and finally explore their associated emotions and thoughts. The goal of their experiment was to assist adolescent survivors in forming a sense of a unified persona, with a feeling of mastery, or control over his/her life (Backos & Pagon, 2008).

According to Baerg (2003), many adolescents may not have the words to effectively express the depth of emotion they feel with regards to their sexual abuse or medical illness—art operates as a modus to express first, explore, and then attach meaning. Baerg (2003), who does art therapy with adolescents with chronic or acute illness, states that her role as the therapist is to make general and encouraging comments about the artwork group members present, and allow that individual to discuss their own work further, find their own meaning, and provide their own insight. The use of art in this fashion allows adolescents to feel in control, and provides them with the opportunity to explore those emotions and thought processes. Baerg (2003) also found that with adolescents suffering from a medical illness, showcasing his/her art work was an important part of group and individual therapy, because it enabled the members to tell their story as they perceive it in a very supportive setting (which an individual may or may not have outside of the group; Pifalo, 2002).

Conclusion

What seems to be an important focus of group therapy with adolescents is the fact that during this developmental stage, an individual may be struggling with more than a clinically diagnostic disorder (i.e. psychotic disorder, personality). Most teenagers are in that stage where they are trying to figure out who they are and who they want to be. Alongside the question of self-discovery, adolescents struggle to be independent, productive and successful, but they also fear the responsibilities associated with independence (Richmond, 2000). Both of these concerns result in conflicts with self-confidence and self-esteem, especially if the youth exist in an environment that lacks social support or proper role models of the desired success. What I found interesting was that the use of creative mediums in group therapy with adolescents often aimed to address these two over-arching issues.

Structure is a major element of therapy to be conscious of when using creative techniques, because adolescents do require more structure than adults in order to reach a therapeutic goal. In some art therapy settings, facilitators actually went as far as lighting a candle at the beginning of the session and blowing out the candle before the end of the session. The symbolic boundaries the lighting created allowed for the emotions or trauma an adolescent may have been expressing during the session to remain contained in that setting so the depth of the experienced emotions did not flow over into participants daily lives. In another study, the art materials were set up as a demarcation of creative space versus discussion and instruction space.  There also appeared to be more use of foods/snacks in group therapy with adolescents, which, from my experience, is a fantastic idea.  In a couple of the studies I presented, a snack was set up to separate the space of creation and activity, from the discussion and social interaction space.

Prior to doing the research on various creative group therapy methods, I thought that expressive arts was seen as ineffective or a waste of time in the therapeutic arena, but I found that most of the creative art therapies with adolescents are used in brief, or short-term therapy. For example, the predominate number of the studies presented in this paper had a therapy period of approximately 10 sessions or 10 weeks. Because I desire to do clinical work with both children and adolescents in individual and group settings, I was excited to discover that these creative methods really are not all that unconventional. I was impressed with how easily applicable creative methods are to theories such as cognitive behavioral, positive, existential, and humanistic.

References

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Baerg, Susan (2003). “Sometimes there just aren’t any word”: Using expressive therapy with

adolescents living with cancer. Canadian Journal of Counselling, 37, 65-74.

Block, B. (2001). The psychological cultural relational model applied to a therapeutic,

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Bogestad,A., Kettle, R., & Hagan, M. (2010). Evaluation of a cognitive intervention program

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Anxeity

From an existential standpoint, humans are often plagued with anxiety when they discover the inescapable truths about life. Often times we feel trapped by the things we can’t change or the things we must go through to end up in a different position. The questions is, are these anxious feelings the problem or is it our chosen way of being in the world that makes it a problem?

Discovery

By: Aryssa Washington

Trapped in fragile transparency, the echo of my image blemished by apathy

The single last glint, a streaking spark of a fading sun,

lain unseen.

Sneaking stillness quickens in pace roving across a vast, bleak space of time,

leaving silence in its wake

consumed by darkness.

My hands and fingers in harried tremors grasp at everything—anything

This gravity of terror, a pressured panic preying on the single seeker

Am I nothing?

An edging horizon, a lone last flickering speck,

In trepidation, a shimmering glance of recognition—

I walk alone.

• 1. A strong desire or sense of compulsion to take the drug;
• 2. Difficulties in controlling drug-taking behavior in terms of its onset, termination, or levels of use;
• 3. A physiological withdrawal state when drug use is stopped or reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
• 4. Evidence of tolerance, such that increased doses of the drug are required in order to achieve effects originally produced by lower doses;
• 5. Progressive neglect of alternative pleasures or interests because of drug use, increased amount of time necessary to obtain or take the drug or to recover from its effects;
• 6. Persisting with drug use despite clear evidence of overtly harmful consequences, such as harm to the liver, depressive mood states or impairment of cognitive functioning

The World Health Organization recognizes opiate dependency as a brain disease and it can be treated with Suboxone.  Suboxone is medication in a pill or film form available by prescription and administered by specially trained physicians.  Suboxone, combined with counseling, is effective in treating the opiate dependency and allowing individuals to live productive lives without the cravings or negative consequences of drug addiction, and physical and emotional withdrawal from the opiates.  An outpatient Suboxone clinic allows you to maintain privacy and dignity while receiving safe and supportive treatment by a Suboxone certified physician and qualified counselors.

Alex Irving is a Licensed Marriage and Family Therapist (LMFT) who received her Master degree from the University of Rhode Island. Alex recently completed an Approved Marriage & Family Therapy Supervisor Program from the University of Rhode Island. She is currently supervising students and clinicians who are pursuing their Marriage & Family Therapy degree and license. Alex is a member of the American Association of Marriage and Family Therapists (AAMFT) and the Rhode Island Association of Marriage and Family Therapists (RIAMFT). She is also supervising an intensive home based clinical program providing crisis intervention services to emotionally and behaviorally disturbed children, who are at imminent risk of hospitalization, and their families. With over 10 years of experience in the field Alex provides individual, couples and family therapy. She has experience in treating children, adolescents and families. She primarily uses a strength-based, family systems approach to improve individuals overall well-being and develop healthier families. Alex works hard to develop positive relationships with her clients and empower them to achieve the changes they are looking for in their lives

Suboxone Treatment

Anchor Counseling Center is offering medication assisted treatment for Opioid dependency.  We treat Opiod addiction with Suboxone.  Opioid dependency is an addiction to heroin or prescription painkillers such as Vicodin, Percocet and Oxycontin.   Opioid dependency is a very serious condition affecting millions of people across the country.  Dependency is categorized by the DSM-IV as having 3 or more of the following 6 characteristics present:

• 1. A strong desire or sense of compulsion to take the drug;
• 2. Difficulties in controlling drug-taking behavior in terms of its onset, termination, or levels of use;
• 3. A physiological withdrawal state when drug use is stopped or reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
• 4. Evidence of tolerance, such that increased doses of the drug are required in order to achieve effects originally produced by lower doses;
• 5. Progressive neglect of alternative pleasures or interests because of drug use, increased amount of time necessary to obtain or take the drug or to recover from its effects;
• 6. Persisting with drug use despite clear evidence of overtly harmful consequences, such as harm to the liver, depressive mood states or impairment of cognitive functioning

The World Health Organization recognizes opiate dependency as a brain disease and it can be treated with Suboxone.  Suboxone is medication in a pill or film form available by prescription and administered by specially trained physicians.  Suboxone, combined with counseling, is effective in treating the opiate dependency and allowing individuals to live productive lives without the cravings or negative consequences of drug addiction, and physical and emotional withdrawal from the opiates.  An outpatient Suboxone clinic allows you to maintain privacy and dignity while receiving safe and supportive treatment by a Suboxone certified physician and qualified counselors.

If you need help please call us today 401.475.9979

You can also visit our web site at www.AnchorCounselingCenter.com

Many people deal with depression in so many ways.  One way is to write, another could be draw.  Many people choose other forms of therapy.  One of my favorite ways is to sing or use music.

Even more therapeutic when you sing your own songs.

Click below to listen to this song.

We are just sitting here.