Specializations / Areas of Specialty

Specializations



Elders and Caregivers

Older adults face the challenges that typify their stage of life:  Illness, retirement, loss, unresolved family issues, and cognitive decline.  Like younger persons, older adults can experience depression, anxiety, and other ills, though these can present differently in older adults than in younger individuals.  My approach is to work collaboratively with my older clients so they can engage these challenges in a manner that results in growth, fulfillment, serenity, and even joy.

Building trust is essential in any therapeutic relationship and especially working with older adults who may not have been in therapy before and who may feel stigmatized by seeking help.  I genuinely enjoy working with older adults and find it easy to relate to them on many levels.  As a young person I was fascinated by my grandparents and the stories of their lives.  I continue to be attracted to the uniqueness of each person’s life story, to celebrate their successes and to empathize with their struggles.

I use evidence-based practices such as cognitive behavior therapy to work collaboratively with older clients to address irrational thoughts, beliefs, and behaviors that are causing distress and preventing individuals from leading a meaningful and enjoyable life.

Research shows that mindfulness mediation techniques can improve attention and cognitive functioning, while reducing depression and anxiety.  Where appropriate, I help older clients to master these skills and incorporate them into their daily lives.

Many of the problems facing older adults can be resolved through a step-by-step problem solving process:  (1) Identifying the actual problem as opposed to the presenting problem, (2) generating solutions, (3) deciding on the best solution, (4) formulating concrete steps to achieve the solution, and (5) progress review.  I work with older adults to guide them through the problem solving process.

The caregivers of older adults with dementia (and other disorders) are susceptible to depression, anxiety, and burnout.  I work with caregivers to develop strategies for minimizing the sources of stress and better managing their own emotional responses.  My work with caregivers may involve individual therapy or facilitating support groups.

To quote the novelist Somerset Maugham, “Old age has its pleasures, which, though different, are not less than the pleasures of youth.”

  • Old age has its pleasures, which, though different, are not less than the pleasures of youth.
    Somerset Maugham, Novelist


  • Preparing for College

    Applying for college can be a stressful experience for a student and his or her parents/guardians. The tasks involved in reaching that point are daunting:

    • Maintaining a high GPA
    • Finding the right extracurricular activities to build a strong college application
    • Standardized Test Preparation
    • Finding a good topic for a personal statement
    • Sifting through the thousands of colleges and universities to find the ones that suit the student’s interests, talents, and preferences

     

    The conflict between parents and students can be intense at times, making the process all the more stressful for everyone involved.

    I can help make the process more manageable, less intimidating, and ultimately more successful.

    I provide coaching for…

    • Building study skills, e.g., memory techniques, organizing, planning
    • Finding extracurricular opportunities that will make your application more compelling to college admissions officers
    • Relaxation, mindfulness meditation, and cognitive reframing techniques to reduce stress and anxiety – for both students and parents
    • Creating a pool of colleges and universities that match the interests and needs of the student
    • Brainstorming ideas for a personal statement
    • Connecting the family with further resources

     

  • Writing is its own reward.
    Henry Miller, Author


  • Obstructive Sleep Apnea Treatment Compliance

    Imagine a serious, even life-threatening, disorder that afflicts 4% of the population.  A very effective, life-enhancing treatment is available but most people won’t use it and continue to suffer – unnecessarily.

    The disorder is Obstructive sleep apnea (OSA).  With OSA, the muscles in the back of the throat relax and obstruct the airway, causing loud snoring or a complete cessation of breathing.  Deprived of oxygen, the brain triggers a fight-or-flight response that opens up the airway again, allowing re-oxygenation.  In the process the sleeper awakens, though usually not fully, and may do so as often as 60 times an hour.  OSA is described as feeling like “somebody is pushing a pillow down on your face, trying to kill you.”

    The consequences of OSA can include high blood pressure, diabetes (hormonal changes reduce the effectiveness of insulin), daytime sleepiness, cognitive decline and depression. The disorder takes a toll on loved ones as well. “I don’t really get to sleep much at night,” one spouse says.  “I spend the night with my hand on my husband’s chest, afraid that he’s going to stop breathing.”

    The “gold standard” of treatment for OSA is the continuous positive airway pressure (CPAP) device.  Studies show that the CPAP is highly effective in reducing the symptoms of OSA with virtually no side effects.  Day-time sleepiness goes away.  Cognitive functioning returns to previous levels.  Some describe the results as “life-changing.”

    However, many people who would benefit from using the CPAP refuse to do so for a variety of reasons, including claustrophobia and irrational beliefs about what it means to be a user of the device.  Usage (“compliance”) rates are as low as 29%.

    The Research:  Cognitive behavior therapy (CBT) has been demonstrated to be a highly useful approach for increasing CPAP compliance.  A recent study shows treating OSA-sufferers with CBT can more than double the rate of CPAP compliance.

    The Approach:  Therapy sessions follow this sequence:  (1) Identifying negative thoughts/fears/beliefs about the CPAP, (2) collaboratively gathering evidence to invalidate these thoughts/fears/beliefs, (3) training in relaxation techniques, and (4) systematically increasing exposure to the CPAP to reduce negative emotions and improve compliance.

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    Older Adults    Preparing for College    Sleep Apnea