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NP0038: Who’s Afraid of Couples Therapy?

Welcome to our “Who’s Afraid of Couples Therapy?” This exciting series, back by popular demand, is based on our November/December 2011 issue on this topic and will explore the challenges of couples work. What are the most effective strategies in working with couples? How can therapists structure therapy—particularly in the early sessions—so that couples leave with a sense of hope, rather than frustration? Can working with individuals who have serious issues in their relationships actually be detrimental to them? Find out the answers to these questions and much more. In this first session with expert couples therapists Ellyn Bader and Peter Pearson, the creators of the Developmental Model of Couples Therapy, you’ll find out why clinicians often avoid working with couples and how you can better prepare yourself for couples therapy work. How can therapists most effectively work with emotion in the consulting room—particularly when it comes to couples therapy? Learn with internationally known couples therapist Hedy Schleifer how to help create a nourishing connection between partners, define a role as therapist-as-guide, and much more. Schleifer, who’s pioneered the training of Imago Relationship therapists internationally, will go into how to use this theory in practice and how to best work with emotions. What happens when partners in couples therapy have two different agendas in mind? Hear from expert William Doherty on this little spoken about topic. Learn how Discernment Counseling, an approach that helps couples clarify their feelings about the next step in their relationship, can help both clients and therapists. Is it possible to rebuild trust and intimacy in a couple’s relationship after a partner has had an affair? How can therapists help? Hear from Esther Perel, author of the international bestseller Mating in Captivity: Unlocking Erotic Intelligence, on how to help couples after an infidelity and the role that cultural perspectives have in this emotional situation. Explore this classic dynamic of couples therapy—an angry woman and a withdrawn man—that’s often confusing for therapists, with couples therapist Jette Simon. Learn more about what’s behind the feelings of anger and the behavior of withdrawing, and how clinicians can more effectively work with shame and fear of disconnection. Hear an unconventional perspective on couples therapy from David Schnarch, who believes that the best way to help couples is to challenge partners to change their individual behaviors and attitudes. Schnarch’s direct, upfront approach to helping clients will illustrate a different viewpoint on effective couples therapy. Join Marty Klein, a marriage and family therapist and certified sex therapist, us for a candid discussion about the assumptions that both clients and therapists often share that can get in the way of improving couples’ sexual relationships. Discover with Kathryn Rheem how to respond effectively when clients express strong feelings in session. Based on Emotionally Focused Therapy, you’ll explore attunement and how to use your own emotions to help clients move beyond attachment injuries. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.

Whole Psychiatry: Alternatives to Conventional Psychopharmacology with Robert Hedaya

Meds: Myths and Realities: NP0035 – Session 4

Is psychopharmacology is a 'go-to' in your practice? Join Robert Hedaya as he discusses how to treat the bodily systems that underlay many mental health issues while avoiding medication. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.

Treating the Mixed-Agenda Couple

Bill Doherty On An Approach For Unaligned Relationships

Tough Customers: Is It Them or Us?

Tough CustomersBy Rich Simon As therapists, many of us practice in two different worlds. In the first, we see polite, well-behaved, articulate clients with solid values. They engage fully in therapy, talk cogently about their problems, listen attentively to our responses, make reasonably good-faith efforts to follow our suggestions, and sooner or later get better. No wonder we genuinely like these people!

Does This Kid Need Medication? with Ron Taffel

Meds: Myths and Realities: NP0035 – Session 3

Do you feel like you could be a more effective therapist with your younger clients? Do you find it hard to determine when interventions--psychological and pharmacological--might be needed? Join Ron Taffel and learn to identify key diagnostic signs that indicate medications could be helpful when dealing with depression, anxiety, AD/HD, and affective disorders. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.
Networker Excel Clubs
Clinicians Digest Jan/Feb 2007

Assessing Childhood-Obesity
Prevention Programs

By Garry Cooper

A More Powerful Antidepressant

Every few years, a promising new medication for a mental disorder--Prozac and the other SSRIs or the atypical antipsychotics, for instance--comes along. Typically, a few years later, their effectiveness turns out to be less than promised and their side effects worse than anticipated. So it's appropriate to greet the news about a recent study of ketamine hydrochloride that's gotten heavy media play with a healthy degree of skepticism. But this time, the optimism may be justified: in a small clinical trial, a single injection of the drug significantly alleviated treatment-resistant major depression within two hours, and the effects lasted at least a week.

The study of 18 people reported in the August Archives of General Psychiatry found that on the day after infusion of ketamine, 71 percent of the people had significant improvement in their depression and 29 percent actually had remission after receiving this drug. Meanwhile, none of the 14 people who received a placebo injection improved after seven days. Put another way, the effect size of the drug on depression was 1.46 after 24 hours and .68 a week later. By comparison, an effect size of .50 is considered high.

The study, led by psychiatrist Carlos Zarate under the auspices of the Mood and Anxiety Disorders Program of the National Institute of Mental Health, is part of growing research on the role of the amino acid glutamate (methyl-d-aspartate) in the brain. In the past few years, fluctuating glutamate levels have been implicated in such disorders as epilepsy, Parkinson's, Alzheimer's, bipolar disorder, and schizophrenia, as well as in depression. Glutamate, which Zarate calls "the director of the orchestra," is thought to control the firing of neurons, which transport and process neurotransmitters like serotonin and dopamine. Thus working on glutamate levels might be a more precise way of alleviating problems related to the brain's neurotransmitters. Targeting the neurotransmitters with SSRIs is like trying to fix static in the phone lines by adding amplifiers to the phone; targeting glutamate works directly on the transmission problem.

When you tinker with such a basic level of the brain, of course, you want to make certain you're using a accurate instrument, and researchers are a long way from knowing how to regulate glutamate levels just enough to only alleviate the intended symptoms. Ketamine is already in use illegally and has caused much damage--it's better known as the club drug Ecstasy. In Zarate's study, ketamine, in far lower doses than the street drug, caused euphoria, disorientation, dizziness, and depersonalization, and even though these effects lasted less than two hours after the injection, a medication with those kinds of strong, immediate effects needs considerably more research and fine tuning. Nevertheless, Zarate's study seems to imply that we've taken a major step toward developing antidepressant medications that act within an hour rather than days and have a much higher success rate.

 

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