If you have questions, or wish to discuss an appointment, please call staff at: (414) 877-1071
  1. Holiday Eating Tips

    Holiday Eating Tips By Stacey Nye, PhD, FAED Thanksgiving is right around the corner and many of my clients have a similar concern: How to handle all the food usually present at large family holiday events. Hopefully these tips will help get you through with little stress and much enjoyment.     Tip # 1 Eat all of your typical meals and snacks the day of the event. People often make the mistake of skipping meals so that if they end up overeating they won’t feel as guilty. This is a big mistake. Showing up starving to a huge meal containing many of your favorite foods is a set up for overeating or binge eating. “But then I won’t have room in my stomach for everything that I want to eat” you might argue. The reality is that our stomachs have a limited capacity (approximately 1.5 liters of food) and empty approximately every 1-3 hours (depending on the person and food eaten). Eating lunch at 12 will still leave you with a relatively empty stomach for a 4pm dinner, and certainly no less room than you would have had if you had not eaten all day. Plus, walking into the room feeling deprived from fasting all day makes you more vulnerable to feeling out of control once dinner is served. Tip #2 Create structure One of the problems people run into at big holiday meals is that the food is plentiful, available and left out for long periods of time. Most of us eat our meals and snacks in discreet episodes- we take the food out, eat, and then clean up the remainders. So, for all day holiday meals one must create structure where structure may not already exist. • Designate a time in your mind to eat your meal so that it has a discreet beginning, middle and end • Avoid walking around and eating directly from serving platters. Fill a plate for yourself and use utensils. Try to sit at a table designated for eating. If you want seconds, fill your plate again. • When you’re done, clean up your plate and leave the table and dining room. You are making room for someone else to sit and enjoy their meal and doing yourself a favor by not lingering where the food is. There may still be finger food in other rooms. If you decide you want some of this, find a cup or a plate and repeat the process. Tip # 3 Eat mindfully Eat when you’re hungry. Food tastes better when you’re hungry. Stop when you’re full. Guilt aside, the physical sensations of being overly full, such as abdominal pain, bloating or heartburn, are unpleasant and unhealthy. Don’t have room for you favorite desert or enjoyed the turkey so much but you’re too full? Most hosts expect to send home doggy bags. Save the food for when you’re hungry again. Alternatively, make your own Thanksgiving dinner, any day of the year. Eat what you want. Really taste what you’re eating. Don’t like green bean casserole? Don’t eat it. Love squash? Make sure you get some. Tip # 4 Go easy on the alcohol. Alcohol lowers our inhibitions and makes us vulnerable to eating errors like overeating. Drink plenty of water to avoid dehydration. Tip # 5 Remember why you’re there While food can be a major component of many holiday celebrations, most of the time it’s not the main reason. Thanksgiving is a day of counting our blessings and being thankful for what we have. It is also a day when family and friends joins together, often after not having seen one another for a while. Once you have eaten your thanksgiving meal, if you feel tempted to eat more, remember why you are there. Take a look around the room and find a friend or family member that you haven’t seen for a while and go talk to them. Stacey Nye, PhD, FAED American Behavioral Clinics (262) 241-3231 – Stacey Nye is a clinical psychologist specializing in the individual and group treatment of eating disorders, body image and women’s issues.

  2. Group Therapy

    American Behavioral Clinics Group TherapyDuring group therapy, patients meet in a small group with others who may relate to their current condition. Depending on the size and nature of the groups, the setup of group therapy will vary. Typically, groups may have as many as 12 people or as little as 4 people. Groups meet under the supervision of a therapist who guides the sessions. Depending on the group’s needs, our therapists will guide the questions and discussions to bring out the most productive group session.

    Advantages of group therapy

    Group therapy paired will individual therapy produces better clinical outcomes.  Group therapy instills hope. By meeting with others who can relate, or who also face life struggles, patients see they are not alone. In a group setting, patients may share stories or offer information to encourage and support one another. The power of relating to one another and encouraging one another often enables patients to make life changes. In addition, patients may experience that their guilt, stress or pain is lessened in the company of others who can empathize or have been through similar situations. Those in the group experiencing progress or recovery will model new behaviors for other group members; those members, in turn, may be encouraged and find hope.

    Group Therapy – Building a Support System

    Group therapy builds a support system. Groups may form based on a variety of conditions. Some of our groups have formed to assist patients through relational struggles, psychological disorders, family problems, grief and loss, body issues, stress and anxiety and more. In group therapy, you can benefit from others even during sessions when you say very little.  By carefully listening to others many people find that they have important things in common with other group members. This often leads to learning more about yourself.  Group members may also bring up issues that will strike a chord that you may not have been aware of in your own life. An important benefit of group therapy is the opportunity to receive feedback from other group members in a supportive environment. Group therapy provides a safe place to learn more about yourself and others. Current Specialized Groups At American Behavioral Clinics
    • Adolescent Group
    • Bipolar Disorder Group
    • Fibromyalgia Group
    • Substance Abuse Relapse Prevention Group

    Ready to take the first step? Call (414) 281-1677 to schedule an appointment with a therapist.

  3. The Doctor-Patient Relationship

    The Doctor-Patient Relationship

    A successful doctor-patient relationship starts with good communication and a partnership where both work toward the best outcome. With preparation, you can become an active partner in your health, making sure that you leave each appointment well informed and satisfied with the care received. Below are some tips you can use to prepare and participate fully during each doctor’s appointment. These research-based suggestions also apply to other healthcare professionals, including counselors, physician assistants, nurse practitioners, and other healthcare providers.

    Before the Visit

    Gather your information and identify key goals for your visit. It may help to make lists that cover important details: your goals for the visit, your symptoms and current medications.

    Make Lists

    Your Goals
    Are you going to the doctor to solve a problem? If so, be prepared to explain that to your physician. If you’re trying to make sure you’re up to date on screenings, immunizations or other health preventative procedures, be sure to outline those concerns. You’ll want to clearly convey this to the receptionist when making the appointment so that he/she can recommend more appointment time, if needed.
    Your Symptoms
    When describing your symptoms, try to anticipate the types of questions a doctor might ask to better prepare. For example, below are questions a doctor might ask:
    • How would you describe the symptom?
    • When did you start to feel this?
    • How long does it last?
    • What seems to bring it on?
    • Have there been any changes in your life that might have something to do with your symptom?
    • What have you tried to do, and has it helped?
    • Has anyone else in your family experienced this problem?
    For recurrent symptoms, you may want to consider keeping a journal noting to record the frequency of the condition, your diet and other factors occurring that might be affecting you.

    Don’t Be Afraid to Discuss Sensitive Issues

    Be prepared to be absolutely honest with the doctor about your lifestyle, including mental health, diet, sexual history, alcohol intake, smoking history, supplements taken, and other care received. Although it may be awkward at first, just remember that the doctor is collecting all of the information needed to help you become healthier. By discussing difficult issues, you’ll learn more about your health and your doctor will obtain the information he or she needs to help recommend the best treatment. If you feel you can’t talk with your doctor or your doctor doesn’t take your concerns seriously, don’t be afraid to seek out another one.

    Your Medications

    Make a list of all the medications you take. Your doctor may even ask you to bring them with you. Be sure to list all your prescription drugs. Write down any over-the-counter medicines, herbs, or supplements you take. Write down medicines you’ve stopped taking and the reason you or your doctor stopped them. For each drug, note:
    • The name of the drug
    • How often you take it
    • When you take the drug
    • The strength of the drug
    • What the drug is for
    • The last time you took it

    During the Visit

    Start the conversation by asking your doctor when the best time would be to discuss your concerns and indicate that you have prepared a list of symptoms and goals you’d like to review with him/her. This will enable your doctor to determine how much time he or she will need to spend on each issue and whether a separate appointment is needed to discuss all of your concerns. During the visit, it’s also important to ask questions until you feel you completely understand the information and terms your doctor is discussing. Some questions you might consider asking are: When tests, treatments, or other procedures are recommended:
    • What happens during this procedure and why is it necessary?
    • How long will it last?
    • Are there risks with this procedure?
    • How much will it cost and will my insurance cover it?
    • Are there any other treatment options available?
    When a diagnosis is made:
    • How is this condition treated or managed and how long will it last?
    • What long-term effects will the condition/illness/diagnosis have on me?
    When medications are prescribed:
    • When should I take this medicine and should it be taken with food or milk?
    • What potential side effects could there be?
    • Will it interact with other medications?
    • What if I miss a dose?
    • Is there a less-expensive, generic brand of the same drug available?
    When discussing your concerns, it may be helpful to repeat back what you heard and ask, “Is that correct?” This will help establish that you are correctly interpreting information and will clarify any confusion you might have with terms or instructions.

    Follow Up Appointments

    Note that chronic conditions should be managed in doctor visits over the length of the condition. It is important to follow up as instructed. In other circumstances, you will need to follow up in a way agreed upon by both you and your doctor. Remember, you have a right and a responsibility to ask as many questions as needed to make sure you understand your condition and treatment.

    Write Down Instructions

    Be sure to ask the doctor to write down any instructions concerning medication or treatment. Also, ask for materials about your condition, which can help further educate you about your treatment. It’s also a good practice for you to write down details during your visit. Many times, it is very helpful to bring family members, care-givers, and/or other advocates to the actual appointment.

    After the Visit

    Be consistent in following the doctor’s orders and take steps to maintain good health.
    • Fill your prescriptions consistently — Make sure you use your pharmacist as a resource. The pharmacist can clarify your doctor’s instructions and may offer additional information. Don’t be afraid to ask about your medication.
    • Take drugs as directed — For your medications to work, you should take them at the same time every day. Make it a habit.
    • Exercise — You’ve got to exercise to keep your body healthy. When you exercise you will:
      • Help your heart pump better
      • Get more energy
      • Look and feel your best
      • Reduce stress
      • Increase self-esteem
      Be sure to discuss with your doctor the appropriate fitness program for you before you get started.
    • Eat healthy — If you don’t have dietary restrictions, you don’t have to give up fried chicken or ice cream completely. Just be smart about how often and how much you eat. Try using the “80/20” rule. Eat healthy foods 80 percent of the time. Then you can indulge – in moderation – 20 percent of the time.
    Most importantly be sure to discuss your daily diet with your doctor to make sure you understand the foods that you may need to avoid, due to existing conditions.   Source: LifeSynch. a Humana company
  4. Ten Reasons to Include Family Therapy

    Ten Reasons to Include Family Therapy in the Initial Treatment of Children and Adolescents

    Practitioners use many different strategies to engage parents early in the treatment process because: 1. The parent/guardian has an important story to share about the child and his/her target behaviors. 2. The parent/guardian’s perspective about the child’s behavior affects the child’s perception about his/her behavior. 3. Family strengths affect the child’s strengths and resources for change. 4. Family limitations also limit the child’s capacity for functioning and growth. 5. Important cultural considerations may only be available through contact with the parent/guardian. 6. Commitment of the parent/guardian to changing the child’s target behaviors affects the degree of change the child will make. 7. The parent/guardian can tell the practitioner how much progress the child has made and whether target behaviors are improving. 8. The parent/guardian’s behavior can accelerate positive changes in the child through active participation in treatment. 9. The parent/guardian may sabotage treatment gains unwittingly without input from the provider. 10. The parent/guardian can reinforce gains made in treatment with input from the practitioner. Source: LifeSynch. a Humana company
  5. What You Need to Know About – BIPOLAR DISORDER

    Bipolar disorder is identified by mood swings. If your mood often swings back and forth from severe lows (depression) to unrealistic or unstable highs (mania), you may have bipolar disorder. These periods are called episodes. Do the following types of episodes sound familiar? Use the following examples as a guideline. If you think these episodes describe you, report them to your doctor for a proper diagnosis of your medical condition. Bipolar is a serious, life-long illness, but it can be controlled with treatment. • Depression Everyone has occasional low periods in life, but that’s notunusual. It is unusual to have periods so low and prolonged that they affect your ability to function. Losing your desire to get out of bed, eat, or take part in activities that once brought you joy are some of the signs of depression. You may be so intensely sad that you have thoughts of death. • Mania Mania is the flip side of depression. You feel good at first, but your feelings escalate to racing thoughts and ideas and youcannot stay focused. You may become agitated, highly irritable, and engage in risky behaviors without regard to your ownwell-being. Mania doesn’t always feel like a “high,” but it canbe expressed as volatility, anger, or even violent outbursts. • Hypomania Hypomania is a milder form of mania. You may be productive and feeling better than ever or you may feel angrier. Yourfeelings could escalate into mania or backslide into depressionif you have bipolar illness. • Mixed You may feel as if you are caught in a wave that tosses you back and forth between the depths of depression and the heights of mania. When this happens in the same day, it may mean you are possibly at risk for suicide. Treatment of bipolar disorder involves the use of medications. Your doctor will seek the right combination that works best for you. Mood stabilizers help prevent mood swings and antidepressants may help control depression.Your doctor may use other medications as needed to address issues suchas sleeplessness or irritability. There are new advances in medicines helping both phases of this illness. What role do you play in getting better? • Research bipolar disorder and encourage your family to do the same. Your knowledge will help you become an active participant in your care, and your family will have a better understanding of your medicalsituation and how they can help you. • Take your medications as prescribed by your doctor. You may want to stop your medications when you start to feel better, but do not give into the temptation. It will only set your treatment back. • Establish a regular routine of going to bed and getting up at the same time everyday. Exercise, unless your doctor tells you not to, and eat ona regular schedule. • Be your own watchdog. If you notice changes in your mood orbehavior, tell your doctor. • Avoid stress, if possible. Ask your doctor how much, if any, alcohol youcan drink and about the use of any medications that are not prescribed as part of your care. • Consider joining a support group to shareexperiences and information. Source: LifeSynch – a Humana company
  6. What You Need to Know About Depression

    Depression is a medical disorder characterized by feelings of sadness, hopelessness, pessimism, and a general loss of interest in life, combined with a sense of reduced emotional well-being.  The three most common types of depression are major depression, dysthymia, and bipolar disorder. In most instances, major depressive disorder is a recurrent, episodic illness. This means that a person who has been depressed once and has recovered is likely to have one or more episodes of depression in the future, often within two to three years. In bipolar disorder, episodes of depression alternate with episodes of mania, a condition in which inappropriate or extreme “high” feelings may lead to dangerous, destructive behavior. Dysthymia involves symptoms similar to those of major depressive disorder. The symptoms are milder but longer lasting, and although they might not be disabling, they prevent a person from feeling good or operating at “full steam.” The following are some of the signs and symptoms of depression: • A loss of interest in activities that are normally pleasurable, including sex • Appetite and weight changes (either loss or gain) • Sleep disturbances (insomnia, early morning wakening, or oversleeping) • Feelings of guilt, worthlessness, or helplessness • Feelings of hopelessness or pessimism • Difficulty in concentrating, remembering, ormaking decisions • Thoughts of death or suicide; suicide attempts • Persistent body aches and pains or digestive disorders not caused by physical disease Anyone who experiences five or more of these symptoms for at least two weeks may have a depressive illness and should seek the advice and assistance of a psychiatrist or other behavioral health practitioner. Major depressive disorder is not caused by any single factor. Researchers now believe that it is a result of genetic, biological, and psychological influences combined with life stresses. Disturbances in brain biochemistry (the chemicals in the brain and how they work) are an important factor in depression. Irregularities in specific brain chemicals, called neurotransmitters, occur in depression as well as in other mental illnesses. Scientists are now examining which of these irregularities may cause depression and which are a result of the illness. The first step in treating depression is a thorough diagnostic evaluation. Mild tomoderate depression can be diagnosed and treated by a general medical doctor, but patients who have severe depression – with or without other psychiatric disorders – and those who do not respond adequately to treatment, should be evaluated and treated by a psychiatrist. The diagnostic evaluation includes a review of the signs and symptoms, a physical examination, and a thorough medical and psychiatric history. Most depressed patients can be treated as outpatients, either in a doctor’s office or in an outpatient clinic. In some instances, however, a patient may require a brief period of hospitalization. During hospitalizations, careful evaluations can be done, the patient can be detoxified from illicit drugs or alcohol, the patient can be protected, and intensive treatments can begin. Several different approaches are highly effective in treating depression. These approaches fall into two general categories: • Somatic, or physical, treatments (including antidepressant medications, electroconvulsive therapy [ECT], and light therapy) • Various types of psychotherapy Psychotherapy comes in many variations and is offered for groups, families, couples, and individuals. Common to all forms of psychotherapy is a patient talking with a therapist. Source: LifeSynch a Humana company  
  7. Oppositional and Defiant Behavior By Mary Ann Grochowski

    Mary Ann Grochowski

    Mary Ann Grochowski

    Definition of Oppositional Defiant Disorder as outlined in DSM IV: A recurrent pattern of negativistic, disobedient, and hostile behavior towards authority figures that persists for at least six months and is characterized by the frequent occurrence of at least four of the following behaviors:
    • losing temper
    • arguing with adults
    • actively defying or refusing to comply with the requests or rules of adults
    • deliberately doing things that will annoy other people
    • blaming others for his or her own behavior or mistakes
    • being touchy or easily annoyed by others
    • being angry or resentful
    • being spiteful or vindictive.
    The behavior must occur more frequently than is typically occurring in children of comparable age and developmental level and must lead to significant impairment in social, academic, or occupational functioning. Most typically the negativistic and defiant behavior is present in the child’s home but is not always present in school or with other social settings. There is often a vicious cycle in which the parent and child persistently provoke each other. It is more common in families in which there has been inconsistent childcare or harsh or neglectful child rearing practices. Normal Developmental Behaviors Periods of oppositional, defiant behavior are very common around ages 2-5 and again in early adolescence. Boys typically show more behavior problems before puberty. But after puberty, the ratio of boys to girls with oppositional behavior appears about equal. Many children who are oppositional, hostile or defiant may be suffering from a temporary adverse situation in their environment, low self-esteem, depression, anxiety, or some other difficulty such as Attention Deficit Hyperactivity Disorder (ADHD). Referral to a therapist familiar with childhood disorders is advisable if:
    1. The oppositional behavior has begun to affect the child’s school performance.
    2. The child’s behavior seriously disrupts the family milieu to the point siblings are also impacted or parental schedules are routinely ineffective.
    3. The child’s behavior changes from oppositional to aggressive.
    4. The child becomes isolated from family and friends.
    5. Parents are feeling overwhelmed, vulnerable or fearful of their own interaction with the child.
    Ways to Help Your Child Improve
    1. Try to understand the feeling behind the behavior.
    2. Pay attention to your child’s interests and play.
    3. Use praise and positive attention to promote compliance.
    4. Offer rewards for good behavior.
    5. Use discipline that is a direct consequence of the misbehavior.
    6. Use time outs to promote emotional control.
    7. Plan ahead for public activities and events your child may find uncomfortable.
    8. Work with your child’s school to encourage understanding.
    9. Get support for yourself. Parents need to work together. If you are a single parent, find a friend or other relative to give you outlets.
    10. Take time to set your own priorities and goals.
    Always try to use positive statements when relating to your child rather than negative. Use Power Talk to communicate using ”I” statements rather than blaming “You statements.” Power Talk Formula: I feel: When you:_______________________________ Because:_____________________________________ Please:______________________________________ If you must approach your child with a negative criticism, try the “Sandwich” approach by first making a positive statement about your child; then state the negative, and follow with another positive statement. Example: “John, that was very generous of you to share your computer time with your brother. I’ve noticed that your homework has not gotten much attention lately, though. I am sure that from now on you are going to be more conscientious of making your homework a priority.” Remember, flexibility within a structure is also important There are no universal tried and true parenting rules other than love and understanding. Being a good parent is hard work so praise yourself for trying and acknowledge your successes. Learn to laugh at your imperfections and get lots of hugs! For additional information or to make an appointment with Mary Ann contact: Mary Ann Grochowski American Behavioral Clinics 7330 West Layton Avenue Milwaukee, Wisconsin 53220 Phone: (414) 281-1677   References Gordon, Thomas PET Parent Effectiveness Training NY Plume/Penguin 1975 Faber, Adele and Mazlish, Elaine Siblings Without Rivalry NY Avon Books, 1998 Greene, Ross The Explosive Child NY Harper Collins 1998 Barkley, Russell Your Defiant Child NY Guilford 1998

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