1footprintsAs you can see by my extensive education in this area, Couples counseling is one of my greatest passions! Couples present to counseling for a variety of reasons. All couples run into relationship issues, so you are not alone. Seeking help early is the key. I look forward to helping you both get from where you are to where you want to be. In my opinion, there is no problem impossible to reconcile. I have seen miraculous healing occur when couples decide to simultaneously forgive, put their relationship and each other first, own their part in the problem, and do the work it takes to create lasting change.

Here are some of my relationship specialty areas:

Intimacy issues

Boundaries

Sexual Dysfunction/Issues

Communication (#1 by the way)

Relationships and Recovery (Mental Health and/or Addictions)

Separation, Divorce, Break-ups

Infidelity

Reconciliation

Same Sex Relationships

Spirituality/Religious differences

Problem Solving/Decision Making

Domestic Violence (Emotional, Physical, Mental, Verbal, Sexual)

Parenting disagreements

Long distance relationships

Financial disagreements

Extended and Blended Family issues

Insecurities and Abandonment issues

Addictions

Mental Illness

Codependency/Enmeshment

I just love what Dr. John Gottman has to say on marriage. He has spent over 40 years researching couples. Here are some FREE tips! Look at what he has to say:

“Although a marriage in trouble is upsetting, it can often be repaired more easily than you think. The “honeymoon” phase in any committed relationship is not meant to last; eventually it becomes obvious that sharing life with another person requires a special set of skills. Most couples start to come apart because our culture doesn’t teach us how to maintain and strengthen these bonds.  The 7 ideas below, from Dr. John Gottman’s four decades of renowned research – and clinical practice with Dr. Julie Schwartz Gottman – go a long way toward building the kind of relationship couples can rely on.”

  1. Seek help early.

The average couple waits 6 years before seeking help for relationship problems. (And keep in mind, half of all marriages that end do so in the first 7 years). This means the average couple lives with unhappiness for far too long.

  1. Edit yourself.

The happiest couples avoid saying every critical thought when discussing touchy topics.

  1. Soften your “start up.”

Arguments often “start up” because one partner escalates the conflict by making a critical or contemptuous remark. Bringing up problems gently and without blame works much better.

  1. Accept influence from your partner.

In studying heterosexual marriages, we found that a relationship succeeds to the extent that the husband can accept influence from his wife. For instance, a woman says, “Do you have to work Thursday night? My mother is coming that weekend, and I need your help getting ready.” Her husband then replies, “My plans are set, and I’m not changing them.” As you might guess, this guy is in a shaky marriage. A husband’s ability to be influenced by his wife (rather than vice-versa) is crucial – because research shows that women are already well practiced at accepting influence from men. A true partnership only occurs when a husband can do the same thing.

  1. Have high standards.

Happy couples have high standards for each other. The most successful couples are those who, even as newlyweds, refused to accept hurtful behavior from one another. Low levels of tolerance for bad behavior in the beginning of a relationship equals a happier couple down the road.

  1. Learn to repair and exit the argument.

Happy couples have learned how to exit an argument, or how to repair the situation before an argument gets completely out of control. Examples of repair attempts: using humor; stroking your partner with a caring remark (“I understand that this is hard for you”); making it clear you’re on common ground (“We’ll tackle this problem together”); backing down (in marriage, as in the martial art Aikido, you often have to yield to win); and, in general, offering signs of appreciation for your partner and his or her feelings along the way. If an argument gets too heated, take a 20-minute break, and agree to approach the topic again when you are both calm.

  1. Focus on the positives.

In a happy marriage, while discussing problems, couples make at least five times as many positive statements to and about each other and their relationship as negative ones. For example, “We laugh a lot” as opposed to “We never have any fun.” A good marriage must have a rich climate of positivity. Make regular deposits to your emotional bank accounts.

1-man holding headAs a Licensed Mental Health Counselor with over 15 years in the field, I know the challenges a mental health diagnosis has on individuals and their families. Whether you are already diagnosed or just searching for answers, we will work together to get your from where you are to where you want to be in your life. I provide a safe, friendly, non-judgemental, and comfortable environment where you can talk about life’s difficulties. I offer a unique strength based approach, which simply means, we look at what you are doing right and how to do more of it. I believe we all have our own unique inner strengths, resources, and gifts; we just need a little help sometimes finding them. In counseling we will also focus on solutions, different perspectives, and coping skills on how to become a healthier you!

Please also see the “ About Counseling” section for more information.

Here are some of my Mental Health Specialty Areas:

Mental Health and Addiction

Anxiety Disorders

Panic Attacks

PTSD-Post Traumatic Stress Disorder

Obsessive Compulsive Disorder

Depression and other Depressive Disorders

Bipolar and other Mood Disorders

Schizophrenia and other Psychotic Disorders

Attention Deficit and Disruptive Behavior Disorders

Sexual and Gender Identity Disorders

Sleep Disorders

Personality Disorders

Sexual Abuse/Childhood Trauma

Grief/Loss

Spirituality

Self-Esteem

Stress Management

Balanced Lifestyle

Feeling Stuck in life

1-drugsI offer Individual Counseling to those suffering from the misuse of alcohol and/or drugs. I am CAP certified (Certified Addiction Professional), which qualifies me to provide Substance Misuse Evaluations for the court or any other agency ordering you to complete a Substance Abuse Evaluation. There are several stages of substance misuse, ranging from mild, moderate to severe. Upon evaluation, the stage of misuse and your level of care will be determined. If you meet the criteria for a higher level of care than what I can provide for you, I will assist you in collaborating that care with other treatment facilities and professionals.

Here are some of my Alcohol/Substance Misuse Specialty Areas:

Coping skills for Relapse Prevention

Understanding the 12 Steps and Sponsorship

The Disease Concept and Progression

What are my triggers

How to handle cravings and urges

Types of Defense Mechanisms and Denials

Stages of Addiction

How to manage addictive thoughts, feelings, and behaviors

Relationships and Recovery

Spirituality

Stress Management to avoid relapse

Self-Esteem

Acceptance

Family Support

Cross Addictions

Dual Diagnosis (Mental Health and Addiction Diagnosis)

Please see the “ Do I have a problem? ” section for a brief questionnaire.

Please also see the section on  “Dual Recovery” if you also suffer from a mental health diagnosis along with your substance misuse, such as depression and alcohol.

Please see the section on “ Evaluations” if you are inquiring about needing a Substance Abuse Assessment or Evaluation.

2-counselingMany people are suffering from more than one diagnosis. Often times, one of the diagnosis is left untreated or never diagnosed. Many chemically dependent individuals suffer from a mental health disorder, such as depression, anxiety, mood disorders, and personality disorders. If this mental health disorder is not properly treated, the individual may experience years of relapses back into active addiction, numerous treatment stays, and even hospitalizations. Due to its complex nature, those suffering from a dual diagnosis require longer periods of strategic treatment and counseling.

Chemical dependence is present in between 40%-60% of all mental health clients. It is very common for individuals diagnosed with a mental health diagnosis to self-medicate his or her symptoms with drugs or alcohol. In these cases, the stage and level of substance abuse must be determined, and worked with directly, to get the individual abstinent so that the related mental health diagnosis can be properly established and treated. In some cases, once the mental health diagnosis has been properly diagnosed and treated, the need to self-medicate with drugs and alcohol becomes less likely.

I strategically implement concrete and specific interventions based on cognitive behavioral therapy principles for resolving the target problem in order to bring it into a stable remission. I coordinate care with your psychiatrist to assure for the best concurrent and collaboration possible as coexisting diagnosis are interrelated and require simultaneous treatment for a high success rate towards dual recovery,

Here are some of my Dual Recovery Specialty areas:  Depression and Alcohol/Substance Misuse, Anxiety and Alcohol/Substance Misuse, Bipolar/Mood Disorders and Alcohol/Substance

Please refer to our “Do you have a problem” section for a quick questionnaire.

marchm1Substance Misuse Evaluations

Have you recently been arrested for a drug or alcohol crime? Have you received a Court order for a substance abuse evaluation? Are you being referred by your EAP (Employee Assistance Program) for testing positive on the job? Are you already on probation and required to complete a Substance Abuse Evaluation due to a positive urine screen? Do you need to have a substance misuse evaluation as part of your case plan with the Department of Children and Family? If so, I am a Certified Addiction Professional (CAP) and meet the requirements by The State of Florida to assess, diagnose, treat, make recommendations, and document for legal purposes.

I use a combination of diagnostic tools required by most court mandates, such as the ASAM, DSM V, SMAST/CAGE, and ASSIST criteria. Through these tools and by gathering an extensive assessment history, I will determine which stage of substance misuse you are in, as well as any recommended treatment.

If you have any other reasons not mentioned above, please do not hesitate to contact our office to see if we can help.

coupleraceThe following information is provided for your personal education, and is not meant to offer a diagnostic opinion.

ALCOHOL OR DRUGS

Answer the following yes or no questions. If you answer “yes” to four or more questions, you may have a serious substance problem. The word substance is used to indicate alcohol or drugs.

  1. Have you decided to stop using drugs or alcohol for a week or so, but only lasted for a couple of days?
  2. Do you wish people would mind their own business about your drug or alcohol use, and stop telling you what to do?
  3. Has your substance use consistently increased?
  4. Do you spend a great deal of time in activities necessary to get the substance, use the substance, and/or recover from the effects of the substance?
  5. Have you given up or reduced important social, occupational or recreational activities because of substance use?
  6. Have you had problems connected with substance use during the past year?
  7. Has your substance use caused problems at home?
  8. Have you continued using substances despite the knowledge that the substance is interfering with your daily activities?
  9. Do you tell yourself that you can stop using substances any time you want to, even though you keep getting high when you don’t mean to?
  10. Have you missed days at work or school do to substance use?
  11. Have you ever felt that your life might be better if you were not using substances?

WHO IS A PROBLEM USER?

  1. Anyone who goes to work under the influence of substances, or who must use substances in order to get to and perform his/her work is a problem user.
  2. Anyone who sustains bodily injury requiring medical attention as a consequence of an intoxicated state is a problem user.
  3. Anyone who comes in conflict with the law as a consequence of intoxication is a problem user.
  4. Anyone who under the influence of substances does something he/she contends he/she would never do without substances is a problem user.
  5. Anyone who has become dependent upon substances as a way of life, and is uncomfortable in situations where no substances are available is a problem user.
  6. Anyone who needs to increase the amount of drugs taken in order to get the desired effect is a problem user.
  7. Anyone whose work performance or attendance is impaired by his/her use of drugs is a problem user.
  8. Anyone whose family life has been disrupted by continued use of substances is a problem user.
  9. Anyone who hides or “sneaks” substances is a problem user.

INDICATIONS OF POTENTIAL MENTAL HEALTH DIAGNOSIS:

Changes in sleep and eating patterns

Rapid mood swings or mood swings that become a pattern

Changes in, or lack of personal hygiene

Isolation from family and friends

Discussion of suicide or consistently morbid topics

Hyperactivity

Lethargy and/or staying in bed

No need for sleep and not tired

Rapid speech

Racing thoughts

Impulsivity

High Risk Taking

Excessive Spending

Rapid weight loss or gain

Inability to articulate thoughts and emotions

Acting out with aggression or violence

Confusion and inability to make decisions

Decrease in concentration, focus, and follow-through

Constant physical complaints, and unexplained symptoms

Inability to enjoy previously pleasurable activities

Feeling devoid of joy or happiness for a prolonged period

Loss of sexual feelings or sexual ambiguity

Giving personal possessions away

Sudden bursts of emotion such as crying or laughing inexplicably

Cutting,Self-mutilating,hurting or bruising self on purpose

Inability to concentrate or stay on topic

Undue prolonged anxiety

Depression or prolonged sadness

Questionnaire To Identify Signs Of Codependency

This condition has various degrees, whereby the intensity of symptoms are on a spectrum of severity, as opposed to an all or nothing scale. Please note that only a qualified professional can make a diagnosis of co-dependency; not everyone experiencing these symptoms suffers from co-dependency.

  1. Do you keep quiet to avoid arguments?
  2. Are you always worried about others’ opinions of you?
  3. Have you ever lived with someone with an alcohol or drug problem?
  4. Have you ever lived with someone who hits or belittles you?
  5. Are the opinions of others more important than your own?
  6. Do you have difficulty adjusting to changes at work or home?
  7. Do you feel rejected when significant others spend time with friends?
  8. Do you doubt your ability to be who you want to be?
  9. Are you uncomfortable expressing your true feelings to others?
  10. Have you ever felt inadequate?
  11. Do you feel like a “bad person” when you make a mistake?
  12. Do you have difficulty taking compliments or gifts?
  13. Do you feel humiliation when your child or spouse makes a mistake?
  14. Do you think people in your life would go downhill without your constant efforts?
  15. Do you frequently wish someone could help you get things done?

Do you have difficulty talking to people in authority, such as the police or your boss?

  1. Are you confused about who you are or where you are going with your life?
  2. Do you have trouble saying “no” when asked for help?
  3. Do you have trouble asking for help?
  4. Do you have so many things going at once that you can’t do justice to any of them?

If you identify with several of these symptoms; are dissatisfied with yourself or your relationships; you should consider seeking professional help.

family-pictureMy years of experience not only in the field, but in my personal life of being married to someone who suffers from a dual diagnosis of Bipolar I disorder and Addiction, has given me the foundation to deliver compassionate therapeutic care in this area. I offer education, family support, and counseling to those whose loved one is suffering from an addiction or a mental health diagnosis or both. We will collaborate on treatment goals and coping skills to educate you on your loved one’s diagnosis and how to not fall into the traps of codependency.

The definition of codependency has changed over the years. The best way I would define codependency is when YOUR life has become powerless and unmanageable due to someone’s addiction (drugs, alcohol, sex, gambling, food) or mental illness. You become so preoccupied by the person’s behavior that you become unhealthy yourself in disillusioned attempts trying to cure and control your loved one and their behavior. You begin to sacrifice your own needs to take care of the person who is suffering. Codependency is also known as “Relationship Addiction.” It can be a learned behavior or passed down from one generation to the next. It affects an individual’s ability to have a healthy, mutually satisfying relationship. In counseling, we will attempt to understand why you may overcompensate to fulfill everyone’s needs but your own, as well as how to not lose yourself in this way.

Here are some of my Family Support Specialty Areas:

How to set boundaries

What is enabling and how do I stop

Detaching from the illness

Control vs.Letting Go with Love

Physical Effects of Codependency

The 4 “C’s” of Codependency

The Stages of Codependency

Recovery from Codependency

12 Steps of Codependency

Self-Esteem

Fixing vs. Support

Changing beliefs and behaviors

Please see our section on “Do I have a problem?” for a brief questionnaire.

doctorsA large part of my clientele consists of those who highly value their privacy and do not want a diagnosis on their medical record. Many of you are in the healthcare field, such as Physicians, Psychologists, Psychotherapists, and Nurses. Others of you may be Business Executives or in the public eye. As we all know, we as professionals, are often reluctant to seek help due to the stigma, fear of possible confidentiality breeches from third party insurance payers, and do not want to take the chance of having a diagnosis that may affect our future access to insurance when changing jobs or careers.

  1. Here are some of my Help for Professionals Specialty areas: How to transition into retirement, Stress Management, Anger Management, Decision making on changing careers, Coping with co-worker drama, How to be more assertive in the workplace, Should I file for disability?, What do I do if I think my workplace is unethical or abusive? I tested positive for alcohol or drugs at my workplace, what’s going to happen and how do I get help? I think I need accommodations for my disability at my workplace, what do I do?

Please see the section on “Should I use my insurance?” for more information to help you make your decision.

 

1-supervisi0jI am happy to announce Supervision is now available. If you are working at a site that does not include the necessary 2 years post graduate Supervision, I will now be available on Thursdays for Mental Health Counseling and/or Marriage and Family Therapy Interns at a discounted rate of $100.00 per hour. This does not include contact hours.

Florida Statue requires MHC/MFT interns to complete 1 hour of supervision every 2 weeks. This should include 1 hour of supervision per every 15 hours of psychotherapy for a total of 100 hours per 1500 hours of face to face psychotherapy and shall be accrued in no less than 100 weeks. If you are interested, please call our office for more details. For more information on the Florida requirements go to: http://floridasmentalhealthprofessions.gov/