That’s right. We are less than 1 mile from the Somerville border. 

We are located in Cambrdige, MA, just outside Somerville, MA and we provide counseling, therapy, and life coaching services to residents of Somerville, nearly 365 days a year.

Somerville Therapy Services include marriage therapy, somerville depression counseling, and somerville counseling for anxiety (to name a view).
Call Thrive Counseling to speak with a member of out team about Somerville Counseling Therapy.

617-395-5806

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Newton Therapy, Counseling, and Life Coaching

Thrive Boston Counseling, serves the greater Boston Area, Including residents of Newton, MA.

We are a short drive from Newton, MA and provide therapy services for a variety of life issues including:

• Newton Marriage Counseling Therapy
• Newton Depression Counseling Therapy
• Newton Anxiety Counseling Therapy

Here is a map to our office. We are a short 7 mile drive from Newton Center.

 
View Google Map Directions!

To speak with a member of our team, simply call 617-395-5806.

We look forward to hearing from you!

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Boston Marriage Therapy — Marriage Conflict

When Lauren and Les argue, they do so with gusto! Voices are raised, they talk over one another, and in the end they rarely come to any agreement. However, the next thing anyone knows they’re sitting snuggled up on the couch whispering and giggling to one another. A friend asks them, “You were just at each other’s throats. How can you now be laughing together?” “Oh that,” Les comments, “We forgot about that fight 10 seconds after we stopped yelling.” “Yeah. Why would we let a silly disagreement destroy our relationship?” Lauren adds.

“You never listen to me!” Gwen cries. “I never listen? I never listen!? Well I’m listening right now aren’t I? I listen, let me tell you. I listen to you who won’t stop nagging me every second of the day!” …The newlywed couple knew they had a problem with conflict. They come to you to ask if you can help them stop their terrible wars with words.

Marriage Therapy in Boston, MA: Definitions and Key Thoughts

Every marriage has conflict. The idea that some couples never disagree is crazy.

John Gottman, in his groundbreaking book, Why Marriages Succeed or Fail, writes that there are three perfectly acceptable conflict styles couples can use: volatile, affirming, and avoidant.

Volatile Conflict Style: 

With this conflict styles, conflicts erupt often, and they result in passionate disputes. Both parties voice their position, challenging and refuting their spouses. Hence the conflict is rarely resolved. However, the conflict is counteracted by all the good times in the marriage. When looking at the whole picture, the couple is well-satisfied with the marriage relationship.

Validating Conflict Style:

This is the conflict style psychologists and counselors have traditionally taught to their clients. With this conflict style, couples talk, listen, compromise and calmly work out their problems to their mutual satisfaction.

Avoidant Conflict Style:

With this conflict style, couples rarely if ever confront a conflict head on. Instead, the marriage motto is “agree to disagree.” The couple acknowledges that they are different, strong willed, independent individuals, and that they will have different opinions on some issues. As long as the couple agrees on most things, the relationship can continue to grow.

Historically, many mental health professionals have considered Avoidant and Volatile conflict styles to be destructive to marriages. However Gottman’s research suggests that all three styles are equally acceptable for maintaining or building a healthy marriage. (1)

Gottman has found that it doesn’t really matter what conflict style a couple uses. What matters is that there are enough positive interactions in the marriage to counter the negative ones. It is believed that between 4-20 positive interactions are necessary to counter one negative interaction.

However, arguments can sometimes lead to dirty fighting between husband and wife. A dirty fight is one that alienates or hurts a spouse. When this happens, bitterness, anger, resentment, and even thoughts of divorce or violence can take root in a marriage. Often when spouses are fighting dirty they are doing so because of a profound ‘heart problem.’

Patients with bad heart conditions need to change their unhealthy habits. Heart patients who have “hardening of the arteries” receive regular examinations. Like medical doctors, counselors can help those who need a “heart examination.” We can help to diagnose the problem by testing eight potentially problematic areas:

1.     Pride: “Do I focus on how much I’ve been wronged?”

2.     Faultfinding: “Do I rehearse the faults of others?”

3.     Avoidance: “Do I avoid being around people with whom I have conflict?”

4.     Silence: “Do I refuse to share my feelings in a healthy way?”

5.     Isolation: “Do I withdraw emotionally?”

6.     Unfaithfulness: “Do I share unnecessary information about my opposer?”

7.     Hopelessness: “Do I lack faith that God can work in any situation?”

8.     Resentment: “Do I hold on to my anger until it turns to bitterness?”

Thankfully, in the pursuit of marital peace, there are a great many skills couples can learn to fight fair when conflict shows up in their relationship.

Boston Marriage Therapy: Assessment Interview

Asking the following questions will help you to get a better picture of the spouses’ conflict styles and the impact conflict has had in their marriage:

How often do the two of you fight?

Do you have more good times or more bad times?

Are your fights ever violent?

Are your fights heated?

Are your fights more or less discussions or negotiations?

Are either one of you “hit below the belt” when having conflict (see below)?

Do you stay calm when you fight?

Boston Counseling Insights

Rules for Fighting Fair

No matter what conflict style the couple has (and be aware each spouse can have a different style), anyone can benefit from learning the following basic rules to fighting fair.

Staying calm.

Make sure the spouse does not overreact to the situation. By remaining calm the spouse will be more likely to consider their partner’s perspectives. This could eliminate a conflict before it even starts, especially if the conflict is based on a misunderstanding (and many are). If a spouse feels he/she is so angry or upset that they will not be able to deal with the conflict in a healthy manner, instruct him/her to take a “time out” or help the spouse put the matter back into perspective. This one conflict is likely a small matter in the lifespan of the marriage.

One conflict at a time.

If a couple is having trouble resolving one issue, why would they be able to resolve more than one at a time? Some couples try to fix every problem in their marriage at the same time, and in the end they feel exasperated and overwhelmed. Hence, it is best to address one matter of conflict at a time, leaving all others off-limits until the matter at hand is resolved (or let go).  Note: If the couple has a lot of problems stored up, it could be challenging to pick one problem to begin. Sometimes many little problems will feel very intertwined because they are really parts of a larger overarching problem.  

Avoiding accusations.

The quickest way to make someone defensive is to accuse them of something. Therefore, instead of accusing a spouse (e.g., you hurt me!) of something, instruct the couple to emphasize how the spouse’s action(s) have made the other feel (e.g., when you said that it hurt me!).  

Don’t generalize.

Have the spouse be specific when they voice what the trouble is. It is imperative to have a clear understanding of what is bothering the spouse? Vague complaints are impossible to resolve. Moreover, the words “never” and “always” are two of the worst words to use during a conflict. The reason is that it is almost always an exaggeration. “You never pay attention” or “you are always late” are statements that—though they might feel true—over emphasize a less severe situation. “I would like you to pay better attention” and “It upsets me when you are late” are two much better ways to frame the same issue.

Don’t hit below the belt.

It’s a rule in boxing, and it’s a rule for marriages. While in boxing it refers to hitting the opponent in the, ehem, crotch region, hitting below the belt in marital conflict is an attack on the spouse as a person, not an attack on the issue. Moreover, it is usually an attack on a spouse’s area of personal sensitivity, delivered with intent to hurt the spouse, not resolve an issue.

Don’t stockpile.

Storing up small grievances is counterproductive to marital health. Therefore, it is best to deal with problems as they arise. This isn’t always possible of course. Sometimes the time is just not right to begin a conflict; such as right before bed, while someone is at work, or in front of company, family or friends. So, to help resolve small issues that pile up, some couples practice something called “withholdings time” where they can verbalize small grievances that have occurred such as “you offended me when our guests were over last night,” or “you forgot to turn off the heat when you left again this morning.” If not discussed (or just let go of) these small grievances build up and often explode with a wave of emotion when the couple has conflict regarding something more major. 

Boston Marriage Therapy - Conflict Action Plan

Damage Control

If a couple comes to your office, chances are a bad conflict has already occurred. Perhaps one spouse (or both) said or did something that hurt the other deeply. If this is where you find the persons you are counseling, have the couple implement the following guidelines.

Begin Reconciliation

The process of reconciliation can occur when both parties are willing to listen without interrupting. They both need to be respectful and understand that there are two sides to every story, two sets of feelings that need to be understood, and two hearts that need to be healed. The following lists of do’s and don’ts will be helpful to those who are trying to guide two people in reconciliation:

In the “do” column:

(1) See the situation from the other’s point of view.

(2) Repeat back: “I hear you saying . Is that correct?”

(3) Use words that encourage.

(4) Be respectful, even if you are not treated respectfully.

(5) Realize that you have the power to change only yourself.
(6) Be at peace, knowing that you have the Prince of Peace in your heart.

Now for the “don’ts”:

(1) Don’t forget that your opposer is also God’s creation. 

(2) Don’t harbor resentment, bitterness, or hatred.

(3) Don’t use “you” statements: “You make me mad . . . you should . . . you always. . . .”

(4) Don’t get drawn into useless arguments.

(5) Don’t expect an immediate change.

(6) Don’t assume that reconciliation is always possible.

Apologizing

Physical healing cannot take place unless the person chooses to do what is healthy. Similarly, the healing of two wounded hearts will not take place if both parties defiantly refuse to ask forgiveness. But since there are wrong ways and right ways of asking, you may need to explain the difference:

(1) Don’t make excuses: “I couldn’t help it.”

(2) Don’t use the blame game: “You made me do it.”

(3) Accept full responsibility: “My attitude was inexcusable.”

(4) Accept full blame for your part: “No one can make another person sin. I acknowledge that I sinned against you.”
(5) With a humble heart say, “I’ve tried to see our relationship from your point of view. I realize that I’ve been wrong in my attitude of . Would you forgive me?”

Forgiving

Some persons have a wound that will not heal because they won’t leave the wound alone. Just as a wound needs to be allowed to heal, a person needs to allow forgiveness to do its work. As the counselor, you can be effectively used by God to present practical steps in the healing process. Some of these steps include:

(1) Realizing that forgiveness is not letting the offender “off the hook,” but an act of releasing the offender from your hook and onto God’s hook. 

(2) Deciding that you want to be free from the pain of the past.

(3) Recognizing the unmet need(s) in the one who hurt you.

(4) Listing every offense, and then, instead of “picking” at the wrongs, releasing each offense and the offender into the hands of God.

(For more see the section on forgiveness and reconciliation)

Enlisting a Mediator

If a doctor has been consulted and the medical condition seems uncertain, a “second opinion” is often sought. Sometimes another mediator is needed. Seek a person whom both spouses can respect. Say to them, “At times an outside person brings to the table a different perspective. Would you consider a mediator to help us think through the problems to reach a successful end?”

Each person must be prepared to experience the possibility of a negative outcome from the process of reconciliation. Ultimately, a relationship may not work out between two people. One person cannot be responsible for the outcome of a relationship. However, each person is responsible for handling the reconciliation process in a responsible manner.

 (1) John Gottman, Why Marriages Succeed of Fail, 

Thrive Boston Therapy and Life Coaching in Cambridge, MA helps hundreds of couples every year save and improve their marriages. To schedule an appointment, or for more information about therapy services, call 617-395-5806.

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Did you know that Thrive Boston Therapy is actually located in Cambridge, MA? That’s right, Thrive is on the Cambridge Side of the river, just outside Harvard Square on Massachusetts Ave.

If you are looking for counseling therapy or life coaching in Cambridge, MA, don’t let the name “Thrive Boston” fool you. 

Thrive Cambridge Therapy

875 Massachusetts Ave, Suite 83

Cambridge, MA 02139
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 Child Abuse and Neglect – Boston, MA

Jean had never told anybody what had happened when she was growing up.

She had hoped if she never talked about it, it would go away. After all, it had

only happened once. She had never told her parents because she didn’t think they would believe her. She had avoided her uncle as often as she could after that. She really didn’t think it made sense to talk about it now.

Growing up, Ryan’s parents were rarely ever home. When they were, they would tell Ryan, “I wish you were never born,” or “You were an accident!” Now, at 26, Ryan lives alone and experiences extreme stress anytime he receives the slightest social rejection. For example, today one of Ryan’s friends “took a rain check” for dinner because she had to work. Though Ryan rationally tells himself that his friend cares about him, and is not rejecting him, he feels extreme rejection. Memories of Ryan’s childhood flash in his mind, and he quickly pushes them away.

Definitions and Key Thoughts

Abused children are found at all socioeconomic levels. Abuse is a profoundly destructive experience for children. Symptoms such as irritability, oppositional defiance, poor educational performance, health complaints, sexual promiscuity, drug use, and running away from home are common with victimized children.

Depression, panic disorders, dissociative disorders, and suicide attempts can also result from abuse.

Research expert John Briere categorizes child trauma as either abuse by omission or commission.[i]

Omission. According to Briere, omission involves the neglect of a child through parent unresponsiveness, and psychological or physical unavailability. Described as “the great unrecognized trauma,” with omission a child does not receive normal social stimulation, soothing, or support from a parent. Also with omission, there are no parent-child interactions that promote self-awareness, security, and positive views of others.[ii] Lastly, research by attachment expert John Bowlby shows that neglect is a severe traumatic experience, depriving a child of his/her innate needs for nurturance and love.[iii]

Commission. The sibling of abuse by omission, act of commission, is abusive behavior—psychological, physical, or sexual—directed toward the child. Such abuse is the single most powerful risk factor for developing a mental disorder of any kind for it creates longstanding attachment issues that distort one’s core perceptions of self, others, and the world.[iv]

Another form of abuse occurs when children live in homes where domestic violence occurs. The child may not be a direct victim of physical contact but is traumatized by s seeing family suffer at the hands of an abuser. These children suffer similar consequences to the ones listed above.

Child Sexual Abuse

lSexual abuse occurs when a person exploits another to satisfy the abuser’s

desires. It consists of any sexual activity—verbal, visual, or physical.

Sexual abuse is most often perpetrated by an adult who has access to another

by virtue of real or imagined authority or kinship.

Because the child often knows and even loves the abuser, the emotional confusion

and damage can be intense. Statistics say that by age 18, 1 in 3 girls and

1 in 6 boys will be sexually abused by someone they love or should be able to

trust.2

The consequences of child sexual abuse are staggering:

Physical:

Many long-lasting physical symptoms and illnesses have been associated with

sexual victimization including chronic pelvic pain, premenstrual syndrome,

gastrointestinal disorders, and a variety of chronic pain disorders, including

headache, back pain, and facial pain.

Between 4 and 30 percent of rape victims contract sexually transmitted diseases,

including HIV.

A longitudinal study in the United States estimated that over 32,000 pregnancies

result each year from rape.

Psychological:

Immediate reactions to rape include shock, disbelief, denial, fear, confusion,

anxiety, and withdrawal.

Victims may experience emotional detachment, sleep disturbances, and

flashbacks. Approximately one-third of rape victims have symptoms that

become chronic.

Rape victims often experience anxiety, guilt, nervousness, phobias, substance

abuse, sleep disturbances, depression, alienation, suicidal behavior, and

sexual dysfunction. They often distrust others, replay the assault in their

minds, and are at increased risk of revictimization.

Social:

Rape can strain relationships because of its negative effect on the victim’s family,

friends, and intimate partners.

Victims of sexual violence are more likely than non-victims to engage in risky

sexual behavior including having unprotected sex, having sex at an early

age, having multiple sex partners, teen pregnancy, and trading sex for food,

money, or other items.

Rape victims are more likely than non-victims to smoke cigarettes, overeat,

drink alcohol, and are less likely to use seat belts.

As you counsel a person who has been sexually abused, you must know the

limits of confidentiality:

Sexual abuse is illegal and must be reported if the person is a minor. You

must report it to the appropriate agencies, such as local law enforcement,

the Department of Social and Health Services, or Child Protective Services.

You must report it within a period of time, usually between twenty-four

hours and seven days. Even if the client does not admit to abuse but you highly suspect it, you should report your suspicions.

Boston Therapy Assessment Interview

Rule out any suicidal risk, depression, or medical concerns (especially if the

abuse was recent).

Assess for the type of abuse perpetrated—its degree and its history. Sometimes the

person is seeking help for other problems that actually stem back to an earlier abuse.

You need to get him/her to talk about that core issue.

Be careful, however, not to re-traumatize the person with your questions. Trust and safety are of vital importance.

The following questions are most appropriate for a victim of child abuse or neglect who is now either an adolescent or adult. Of course, these questions will change depending on who you are interviewing, and what that person’s age is:

Q1 What has happened that has brought you here today?

Q2 Is this the first time you’ve sought help?

Q3 Tell me about your family. How are things going at home?

Q4 Tell me about your past. Have you had any painful or unusual things happen—even a long time ago?

Q5 How long did that go on?

Q6 Can you tell me who was doing that to you? (If the person seems reticent,

explain that you need to know in order to help him, others who might be

abused, and the abuser himself. In addition, if your client is a minor and still

in contact with the abuser, immediate action must be taken.)

Q7 Do you know if others are being abused?

Q8 What problems are you currently having as a result of what has happened?

(Listen to how the abuse affected him. No two people are alike in the story

or the consequences of abuse. Be aware that victims tend to minimize the

impact of the abuse.)

Q9 Tell me how you feel about what has happened to you. (The client needs to

have permission to feel his true emotions.)

Q10 Do you feel responsible for the abuse? (Reassure him that he is not alone,

and that he is not responsible for the abuse.)

Q11 What do you believe about yourself? (Dig down for unhealthy beliefs that

have developed as a result of abuse. For example, what does he think about

himself that he would allow this abuse to continue?)

Q12 What do you believe about the person who is abusing you? (Listen for rationalizations.

“He couldn’t help it; he was drunk.” These defenses have helped

the client cope but have also made him less capable of seeing himself as a true

victim of abuse.)

Q13 Have you ever tried to stop the abuse? What happened?

Q14 What would you like to have happen as a result of our meeting today?

Q15 What kinds of boundaries do you think need to be set up to protect you?

Q16 Who else have you told about this?

Q17 How did that person respond?

Q18 Who can help you maintain the boundaries that you set? Who will be your

ally?

Q19 Where do you think God has been in all of this?

Q20 What do you as a person need in order to heal from this?

Counseling Therapy Insights

People who have been abused have had their boundaries violated in a horrible way. Healing from abuse involves restoration of healthy boundaries and of trust.

The counseling process must be gentle and not contribute to an unintentional rewounding or shaming of the person.

Follow the client’s lead in the telling of his story. Reassure him that the abuse was not his fault.

One of the questions often asked by someone who has been sexually abused is “Why me?” Sometimes feelings of worthlessness result from sexual abuse.

As the counselor, you need to keep your own anger in check to provide a safe environment for the client to truly share.

Boston Therapy Tips and Action Steps

Treatment is crucial for abused children. The majority will need some type of medical and/or psychological help. However, the first step is to stop the violence. This may involve legal procedures to remove a perpetrator. Note: Counselors who suspect a child has been abused must report this information to Child Protective Services.

Assume three things in the process of treatment:

1. The problem is treatable and the abused person will overcome the abuse.

2. The person is not responsible for the abuse; he/she is only responsible for his/her recovery.

3. The person needs to express, accept, and be prepared to deal with his feelings in order to heal.

1. Be Patient

l Healing from sexual abuse is a process and people will vary in the amount of time required for their healing.

l It takes courage to seek help for healing, to talk about your experience, and to bring what was once in darkness into the light.

2. Grieve Your Loss

l Much has been taken from you, so you are allowed to feel the pain and

grieve the loss.

l Allowing yourself to feel the feelings will help you regain some of the

power you need.

3. Regain Control

l Being believed and being able to say what happened have been the first

steps.

l You have permission to stand strong, to say no, to be empowered over

the one who has exerted power over you.

4. Find Support

Attending a group for survivors of abuse/neglect can be an excellent next step.

5. Establish Boundaries

You now need to learn how to take care of yourself and re-establish healthy

boundaries. What are the healthy boundaries you need to establish?

Be sure trusted people are aware of those boundaries. That’s why others

will need to be let in on what is happening—no matter how painful. You

may need their help in dealing with the abuser.

This will take the form of (1) speaking the truth to the abuser, (2) having

the support of others in the Christian community, and/or (3) informed

withdrawal from the abuser.

If the abuser will not honor the boundaries, then other strategies may

need to be put in place.

6. Know that You Will Heal

 You do have a bright future. You’re not a victim, but a survivor.

 You may have lost a lot, but you are not “ruined” for the future. God can

heal you.

7. Trust God

 Know that God did not leave you nor was He working against you as

this abuse occurred.

 Plan on several more visits back to discuss the spiritual concept of God’s

love even in the midst of such painful circumstances.

8. Get More Intense Guidance

 As much as you can help with the spiritual aspect, the person may need

some professional guidance in order to truly deal with the depth of pain

that abuse/neglect causes.

 Refer to a Christian counselor with expertise in this area.

Quotes

According

to a national survey

of high school students,

approximately

9% reported having

been forced to have

sexual intercourse

against their will.1

Based on a review

of state records,

86,830 children in

the United States

experienced sexual

abuse in 2001.

- www.cdc.gov

In 8 out of 10 rape

cases, the victim

knew the perpetrator.

- www.cdc.gov

To be abused is to

be touched by evil.

Chronic childhood

abuse does damage

to the body, the

mind, the emotions,

and the ability to

relate to another

person.

—Diane Langberg

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Examples - Helping Aging Parents

l Will and Marilyn had married late and had kids even later. With their kids

entering adolescence, they were confronted with the possibility of becoming

caregivers for Marilyn’s widowed mother after she fell, breaking her hip.

l Sarah has been a frequent volunteer for years, ever since retiring from the

school district. But her health has been failing recently and she’s not sure how

much longer she can live alone. She doesn’t want to live in a retirement home, but the last thing she wants to do is disrupt her children’s lives.

l Edward is a widower and has cancer that has spread to his liver. His children have A expressed concern over his living conditions, believing that he has not been caring for himself properly.

Definitions and Key Thoughts for Helping Aging Parents

l Aging is a natural process. The rate at which people age varies widely according

to many factors such as family history, emotional attitude, chronic medical conditions, and lifestyle.

l Although the risk of disability and illness increases with age, poor health is not an inevitable consequence of aging. Persons with healthy lifestyles that include regular exercise, balanced diet, and no tobacco use have half the risk for disability than those with less healthy lifestyles.

l Caring for aging parents can be gratifying, but that depends on a lot of complex issues, such as your own health, whether you are still raising children, financial resources, and emotional resilience. Even though being a caregiver is laudable, it is not necessarily the wisest decision if there are other options.

l The “sandwich years” is a phrase referring to middle-aged people who are

still raising children and are also caring for their parents. They are “sandwiched”

between these two generations, and it can feel like a vice grip or a well-coordinated

dance.

l As people age, their idiosyncrasies tend to become more pronounced. Easygoing

people may continue to be laid back, but those who were uptight at a

younger age may become more anxious or paranoid as they age.

l Persons entering their later years experience many transitions and endure many losses such as retirement; moving from parenthood to grandparenthood; lessened physical abilities, strength, and energy; the deaths of friends and peers; lowered social status; a tighter financial budget; and the loss of a

spouse.

Boston Therapy Assessment Interview

As you talk to the aging person or a family member, remember that aging and caregiving take many forms. Try not to project your own values. The older person may value independence far more than you would think is healthy, or the family member might be convinced that anyone older than 65 can’t be independent. Listen first, then gently respond as necessary.

Boston Therapy Assesment: Rule Outs

Medical:

Q1 If the elderly person is confused, has he or she been ill? Is there a chance of

depression, dehydration, other medical problems, or poor nutrition? (Several

medical conditions and depression can mimic the symptoms of dementia,

so always be sure that medical problems and depression have been ruled

out by professionals before making any assumptions about a person’s ability

to live independently.)

Emotional:

Q2 Is the older person lonely/depressed? (Simple loneliness can prompt a person

to reach out for help, sometimes acting needier than he or she truly is.)

General Counseling Therapy Questions

Q3 What level of care do you think you (or your loved one) need?

Q4 What are your (or your loved one’s) financial resources?

Q5 What medical issues are there? Are these terminal? Chronic? Permanent

but not debilitating? Degenerative and progressive? (Clearly, if a medical

condition is temporary, the future plans will be very different than if it is

terminal, progressive, or chronic.)

Q6 How do you feel emotionally about the possibility of needing to get more

care (give care to a loved one)?

Q7 What family members are available to help?

Q8 Is the aging person in danger?

Dangerous conditions would include:

– memory loss that leads to accidental fires, wandering, or destructive behavior;

– medical conditions that require constant supervision or that contribute to sudden loss of stability or consciousness;

– a residence that is deteriorated, unhealthy, or structurally too demanding

(e.g., too many stairs);

– an emotional state that could lead to extreme despondency or psychosis

(distorted thinking, such as paranoia).

Wise Counsel

When counseling, or providing therapy to, a caregiver, impress upon the person the complexity of issues

related to aging and the wealth of resources for caregivers and for the elderly.

Encourage the person to gather all the facts (from doctors, other family members,

neighbors, etc.). The goal is to find out how the aging person has been doing and

whether there are critical concerns.

Assess whether there is any possibility of physical or financial elder abuse or

neglect.

l Financial abuse occurs when friends or family members take financial resources

from an older person for their own benefit. This is a particular risk

when the older person is confused and no longer controlling his or her

own finances. Financial Abuse tends to increase during times of economic recession (Boston, MA is not immune to this). 

l Elder neglect occurs when a spouse or live-in family member deliberately

neglects the needs of the older person for food, clothing, shelter, a clean environment,

and protection from extremes of temperature. Sometimes, this

occurs inadvertently when a previously healthy spouse becomes confused

or sick and is no longer able to provide a safe environment for a vulnerable

spouse.

l Elder abuse is physical violence directed at an older person. This could be a

form of domestic violence that has been ongoing for years but the victim is

now over 65. Or, it could be abuse of an older person by a caregiver who is

a family member or a stranger.

Action Steps  –Boston, MA Therapy Tips

For older persons:

Poor health and the loss of independence are not the inevitable consequences of

growing older. To preserve health and independence, older persons should consider

the following strategies:

l Early detection of diseases. Screening to detect diseases early, when they

are most treatable, saves many lives. Older adults should be encouraged to participate in recommended screenings.

l Healthy lifestyle. A healthy lifestyle is more influential than one’s genes in

helping older people avoid the decline traditionally associated with aging.

l Immunizations. Flu shots, pneumonia vaccines, and other important immunizations

reduce a person’s risk for hospitalization and death from illness.

l Preventing injuries. Falling is the most common cause of injury with older

adults. More than one-third of adults 65 and over fall each year, and of

those, 20–30 percent suffer moderate to severe injuries that reduce mobility

and independence, says the CDC. Remove tripping hazards in the home

and install grab bars in key areas, like bathrooms. These simple measures

will significantly reduce an older person’s chance of falling.

l Programs to help adapt and self-management. Consider finding programs

to teach older Americans self-management techniques. These programs

help older adults cope with and manage the transitions of their later years.

1. Rank the Need

l Have the caregiver and the elderly person rank needs in order of importance.

Begin to brainstorm with the elderly person how those needs

can be met with minimal upheaval. Most of the time, the choice is not

between living alone or moving to a nursing home. There are dozens of

options in between, including:

– Non-medical home care for cleaning, meals, or home maintenance

– Meals on Wheels and similar programs for delivery of meals

– Help at home during key hours for things like bathing and dressing

– Adult daycare during daytime hours for those who have family members with them at other times

– Seniors housing complexes (apartment complexes with some extra supports available that are offered at a lower price for needy older persons)

– Shared housing with a younger person (who is not a family member)

– Retirement home living (that often relieves an older person of loneliness

or the need to make meals, maintain a home, and so on)

– Catered/sheltered care or assisted living (situations that provide meals,

some medication reminders, transportation to stores, and other support

services)

– Care in a private group home (where 2–6 older people might be cared for

by a couple who make caregiving their full-time job)

2. Consider the Effects

l Consider the effect of any changes in lifestyle on all family members,

not just the older one. A change in location, for example, will not just

affect the older person but also any family members who are going to

be involved.

l Attempt to keep upheaval to a minimum, especially if family life for

caregivers is already tense or demanding. (Adding a family member requiring

24-hour care to a household with teenagers or a special-needs

child, for example, might not be the best idea.)

3. Consider All Options

l Enumerate all the options and then give all of them much prayerful

consideration.

l Enlist several people—both in and outside the family—to pray about

the possibilities.

4. Give them something to live for

l Hobbies, prayers, purpose of any sort, giving and receiving love.

5. Develop Schedules

l A sense of stability and structure gives confidence to everyday life.

Thrive Boston Therapy provides help for Families dealing with difficult issues. To speak with someone from our team, call: 617-395-5806.

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Mark A. Yarhouse and James N. Sells

Inter Varsity Press, 2008

Written for students, therapists, and pastors, the textbook Family Therapies is designed to provide intelligent content about psychotherapy topics, while not losing readers with less clinical inclinations. The book accomplishes this goal.

Students reading the textbook will receive an ample review of major family therapy models, while counselors will benefit from the more nuanced clinical insights of the authors, such as the “respect commitment,” a concept that can be implemented during times of family stress or crisis. According to the authors: 

The respect commitment is a pledge to not provoke secondary crisis through acts or attitudes that are known to cause additional pain for other family members. For example, a family member might sooth their pain by stopping at a sports bar after work and watching a NASCAR race and drinking a beer, or walking alone in the woods [for two hours] before coming home…Or an adolescent might choose to spend $400 of his or her money saved for college on clothes or stereo equipment—impulsively, without consultation with a parent. The respect commitment says that for the time being each member will respect others by not engaging in behaviors that are within your “individual right” but are also known to be potentially incendiary (p. 320).

Ideas like this one are scattered throughout the text like so many chocolate espresso beans in my trail mix. And like those beans, they have helped me to think sharply about new techniques that could work with current clients, and brainstorm new ways of approaching therapy with future ones.

While a textbook by definition, it is conversational enough to read straight through. Granted, 500 pages will take you a while, so you may want to start with the family therapy models in which you have interest. The text surveys major family therapy models including:

·         Bowenian Family Therapy

·         Strategic Family Therapy

·         Structural Family Therapy

·         Psychodynamic Family Therapy

·         Contextual Family Therapy

·         Experiential Family Therapy

·         Solution-Focused Family Therapy

·         Cognitive-Behavioral Family Therapy

·         Narrative Family Therapy

In the second half of the book, Yarhouse and Sells take a topic-based approach and address a selection of family therapy issues including crisis and trauma, marital conflict, and substance abuse.

Bottom Line

This is not a ground breaking study, a Yalom page-turner, or a self-improvement must-read. But it is an unusually well written textbook. It’s a good choice if you’re a therapist or counseling pastor looking for a serious guide to Christian family therapy.  

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Can My Marriage be Saved?

True Stories of Saved Marriages

Mae Chambers and Ericka Chambers

 Pass it On Publications, 2008

Mae and Ericka Chambers are an unlikely duo to write a marriage book. Or are they? This blue grass singing, guitar playing, mother-daughter duet doesn’t have any training in marriage and family therapy, but what they do have is real life experience.

Mae Chambers’ marriage had problems from the Opening Bell, and by its 7^th year, the stock was at an all time low. Three out of four counselors said it was time to sell. Mae writes,

“The first three counselors, after hearing of John’s re-involvement with drugs and alcohol, his raging verbal abuse, and his adamant refusal to seek help, all advised me to go along with the divorce…But I simply couldn’t accept their conclusion…so I found myself in yet another counselor’s office…she [the fourth therapist] challenged me to go home, get alone with God, and honestly ask Him to show me what I had done to cause problems in my marriage. My face flushed with anger, but I held my tongue. Obviously she had missed the fact that I was a victim in this mess of a marriage. John was the guilty one.

While John was obviously out of control, Mae began see subtler ways she had contributed to the marital mess. She sought forgiveness and then, as she describes it, began to “stand for her marriage” by remaining faithful to a prodigal husband. In time, her marriage improved.

Real Marital Problems

The book, Can My Marriage be Saved?, is a collection of 22 auto-biographical accounts of severely troubled marriages that survived. The problems are severe, and true to life: cheating husbands, cheating wives, a spectrum of verbal and physical abuse. Some couples describe being estranged for years before reconciliation. Warning, Disney boycotters: its sex, drugs, and blue grass.

He Said, She Said

In each story, the spouses take turns writing from their own point of view. This provides good perspective, though the frequent changing of literary voice can damage a story’s flow—and it gives me a migraine. Still, the drama is a page-turner, and the narrative is far superior to the anonymous vignettes typical for a marital help book.

Real Marriage Solutions

How do you save a marriage? In the book, some couples used therapy, many used prayer, and all had a unique path to healing. Consider this excerpt from the story of Gary and Mona,

…the counselor had suggested I read a book on codependency. I had almost laughed out loud…I remember looking at him and saying, “You think I’m codependent?” He looked at me calmly.

“I know you are.”

I went ahead and took the book home, but just to prove him wrong. I read it, and before long I realized he was probably right.

In the story of Bev and Tom, after an argument where Bev lost her composure, she met with a professor for a lesson on neurobiology. She writes,

I wasn’t sure what neurobiology had to do with my marriage, but I was about to find out. “Brain function has a great deal to do with how we respond to real or perceived pain…Beneath the new brain lies the brain stem, or old brain. Painful memories from childhood can trigger the old brain’s fight-or-flight response.”

“You mean I’m not crazy?” I asked, heaving a huge sigh of relief, unable to hold back a floodgate of tears.

“No, you are not crazy, just reactive.”

Final Word

In Can My Marriage be Saved?, the reader is never told what to do to save their marriage; just what 44 other people did. The book drips inspiration. I challenge you to read this book, and when you’re done, close it and reread the question on the front cover. Then, answer the question yourself. 

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At a recent marketing convention, a keynote speaker addressed the audience. He said, “Everyone I meet wants to have the #1 website on Google, have the biggest and most responsive email list, and have the most followers on Twitter. Today, I have a surprise for you…” The speaker looked out over the crowd—there were 1000 people in attendance.

“I have placed a bright green card under one of your chairs. If you have that card, you will receive all those things today. Take a look, and whoever has the card, come up on stage and tell everyone why you deserve to have all these things.” The speaker then waited a moment as the crowd started to shuffle and reach under their chairs. Then he said, “Ok I lied. There’s no card, but you should have seen your faces! First TERRIFIED it was going to be you, and then smug, as if you were thinking to yourself ‘I can’t wait to hear what that poor sucker with the card is going to say.’”

The persons in the audience were nervous about the reward because, simply, they didn’t deserve it. No one in the room was worthy of the things the “green card” was supposed to bring them. Hence, the number one rule of being online famous: you need to be worthy of that fame.

How to Become Worthy of Online Counseling Fame

How does the story above apply to online therapists? Very well, in fact. Here are a few things to keep in mind as you are promoting your therapy services online.

1)      Find a Therapy Niche

Imagine the Internet as a loud, crowded room. As someone who wants to be seen by others, you need to stand out. You need to find a niche. Often I encounter people who think that “online counseling” is their niche. It’s not. Online counseling (or telephone counseling) is simply the portal through which therapists provide their niche services.

Similarly, Christian therapy is too big to be a niche. Maybe if you are providing Christian therapy in an underserved area, you can be known as the town’s local Christian therapist, but online there are thousands of Christian therapists, so you won’t stand out. Need ideas? Here are some examples of niches: Christian Anorexia Specialist, Sports Psychology for X Games Athletes, Broken Heart Recovery Therapist.

Many therapists avoid niches, trying to make their area of focus as broad as possible. The hope: broad offerings will appeal to more people. This is not true online. The question of potential clients is often “why see a therapist by computer, if I can see one in my home city?” Answer: because the X Games athlete specialist is too far away to see in person, and that’s the person who can help them the most.

2)      Speak, speak,  and speak some more

Once you decide on your niche (hopefully one in which you have a genuine competency), then it’s time to speak on it, and speak on it, and speak on it some more. It’s time to establish yourself as the quintessential professional on the topic.

Often times, a person will have great ambitions, but their enthusiasm wanes before they can see the fruit of their labors. An example of this would be someone who decides on a title for their blog, and then never writes anything; or someone who has a Facebook profile without so much as a personal photo uploaded.

Even if you are time-starved, you can still work toward being an online famous counselor. The general consensus is that a person can grow their online fame with an hour a day of contribution. Micro-blogging (i.e., Twitter.com) has made it easier to post frequently, because every post is limited to 140 characters. One of the great things about this format is that, if you don’t have time to generate new content, it’s completely acceptable to point people to other people’s content on your topic. Matt drudge (Drudge Report) almost exclusively directs readers to content created by others, and he has one of the most visited websites on the web (give Matt Drudge the green card, and he’ll tell you exactly why he deserves it—he broke the Monica Lewinski story in 1998, and now he updates the news on his web site every 3 minutes, 24/7/365. He posts top news stories, written by others, in a no-frills format).

3)      Master the Online Tools

If you are serious about becoming famous online, you must become an expert with online social platforms. Buys books on Twitter, Facebook, Myspace, and any Blogging, Vlogging, or Web 2.0 application you might use. Attend seminars, webinars, and adult education classes. Spend time learning these tools and it will pay off.

I tell this to some counseling professionals and they say, “I’m not interested in all that. That’s not what I want to do.” They expect that their web developer can take care of “the technical side”. But when it comes to online social networking, it doesn’t work that way. You can’t be ignorant to how things work, and expect to appear competent —not unless you hire someone to sit next to you and tell you when to post, what to title your post, where to tag it, how to bookmark it, who to syndicate it to, and so on.  Just knowing about therapy isn’t enough.

A final word of advice: As you move forward, I promise you will do a lot of things wrong, but you will do more things right. Just being online, communicating and interacting will lead people to your niche; in time, an hour a day will make you worthy of the online fame you’re destined for! 

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The following is a list of DSM-IV Diagnosis Codes, for use in Psychotherapy, Mental Health Counseling, and Counseling Therapy. 

The following Diagnsis Codes are generally required by all major insurance companies when submitting a claim for Mental Health Counseling Therapy Services. Hence, they are often a useful reference for therapists, as well as therapy clients and client advocates. 

Note: NOS = Not Otherwise Specified.

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