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VIDEOS (SEASON 1)

 

Program 1 - LONELINESS
Treatment Team: Paul Coneff, Christina Cecotto, Nivischi Edwards, Rob Davison and Jennifer Schwirzer

Program 1 Outline

Presenting Problem: Adelina, a 33 year-old woman from Scandinavia working as a nanny, comes to counseling because of symptoms of depression. She has been in the US for three months and spends most of her free time with the children she nannies, whom she loves very much. She regularly attends church, and even takes some college classes, but because of her shy temperament has trouble with engaging in conversation. Adelina doesn’t quite feel homesick, though, because her mother is an alcoholic and she lost contact with her father when he left when she was four years old. She has no siblings. Her mother’s sister lives in Adelina’s town and is in fact the one who found her the nannying job. Adelina wonders if she needs treatment for depression.

Definition: Insufficient social connection and close bonds for optimal well-being.

Prevalence: Dr. John Cacioppo, the doyen of loneliness, suggests that loneliness is on the rise from around 20 percent in the 80s to more like 40 percent today. Dr. John Cacioppo

Cause: Insufficient affiliation and bonding skills, a family pattern of dysfunction, particularly denial and withdrawal, but also defensiveness, criticism, and other negative relationship patterns.

Prognosis: Loneliness is very curable! And people can learn how to love and be loved.

Treatments: Much research points to the therapeutic effect of church attendance and involvement. Emotions and Church.
Program 2 – TRAUMA
Treatment Team:Paul Coneff, Nivischi Edwards, David Guererro, Rob Davison and Jennifer Schwirzer

Program 2 Outline

Presenting Problem Thomas is a 38 year-old White middle-class married man who comes to therapy to talk through a difficult event surrounding a health crisis in his family. His second of four children, a four year-old, was recently diagnosed with epilepsy and will likely have to be on medication for the rest of his life. Thomas turned to his pastor, who had just graduated from seminary and was writing a book about why God allows suffering. In an effort to give Thomas some answers, he asked him to read one of the chapters. Thomas received the impression from the chapter that although God cared deeply, He couldn’t do anything to stop his son’s epilepsy, or human suffering for that matter. Since then, Thomas has wondered if God is in control at all. He has been having nightmares about various disasters occurring. These disasters began when he read the pastor’s chapter.

Definition: Trauma Definition Post Traumatic Stress Disorder is a response to traumas such as death, serious injury or sexual violence. The individual has difficulty processing memories. The three markers of PTSD are nightmares, flashbacks, and extreme triggerability. PTSD Markers

Prevalence: U.S. 7.8 percent lifetime prevalence, with rate of women double the rate of men.

Cause: Traumatic event such as war, sexual assault, domestic violence, severe accident. Limbic Brain Arousal

Prognosis: Very treatable.

Treatments: Talk therapy, deep relaxation, prayer, EMDR.

Program 3 –
EATING DISORDERS
Treatment Team: Shelly Wiggins, Nivischi Edwards, Paul Coneff, Rob Davison and Jennifer Schwirzer

Program 3 Outline

Presenting Problem Twenty-two year-old, single, and Asian-American, Blanch comes to the session swimming in a long dress, thick sweater and boots. Her wealthy mother and father have insisted on her attending counseling and are paying for the sessions. Blanch is friendly and engaging, willing to banter about various topics, particularly religion. She is a recent convert to the Seventh-day Adventist church and loves to talk about spiritual things. Because Blanch’s mother has indicated that Blanch is under-eating and weighs only 95 pounds at 5’6”, you broach the topic. Blanch cheerfully says she eats huge piles of food at every meal. You ask her if she thinks she’s underweight, and she says no, that she’s healthy. How do you help Blanch?

Prevalence:Three diagnoses- anorexia, bulimia, and binge eating disorder.

Cause: Virtually non-existent in poor areas of the world. In the US, .3 percent for anorexia, .9 percent for bulimia, and 1.6 percent for binge eating. Including the sub-threshold diagnoses, it’s up to over 5 percent for all disorders combined.

Prognosis: All eating disorders are treatable and respond well to treatment, however, because anorexia is ego-syntonic it is difficult to get anorexic people to hate their condition enough to seek treatment. Ten percent of anorexic people die. It has the highest death rate of any psychiatric illness.

Treatments: Counseling, particularly group therapy, psychoeducation, and sometimes medication, particularly for bulimia and binge eating disorder. Equine Therapy

Program 4 – ABUSE
Treatment Team: Paul Coneff, Shelly Wiggins, Jean Wright, Rob Davison and Jennifer Schwirzer

Program 4 Outline

Presenting Problem: Frank, a White man in his fifties, comes to counseling after his wife passes away. He reports a history of severe sexual and physical abuse at the hand of his psychopathic father who is now dead. He developed a severe sexual addiction that lasted almost his entire marriage; but when his wife died, he knew it was time to seek freedom. Frank has committed to counseling once a week, attending support groups two nights a week and a grief recovery group once a week and has ceased his pornography habit. He has an accountability partner at church and is attending services each week and volunteering. One of his therapy group leaders told him to review all of his childhood traumas with you. What do you do?

Definition: To treat something with cruelty or violence.

Prevalence: One in three women globally are raped, beaten or coerced into sex in their lifetimes. Child abuse in the US- one study suggests 25 percent of children were verbally abused, 15 percent physically abused, and 12 percent sexually abused. Think about it. For most kids raised in abusive homes, it’s their “normal,” so it’s greatly underreported. National Child Abuse Hotline

Cause: History of abuse, but 1/3 to 2/3 raised in abuse do not abuse. Any substance use, overwork, lack of social support.

Prognosis: People can learn new ways of functioning by God’s grace!

Treatments: Abusers, even sex offenders, respond to treatment. Counseling, group therapy, psychoeducation, can help. Equine Therapy

Program 5 – ANXIETY
Treatment Team: Christina Cecotto, Shelly Wiggins, Paul Coneff, Rob Davison and Jennifer Schwirzer

Program 5 Outline

Presenting Problem: Thirty-three year-old Karen, a middle-class White woman living in the suburbs, has a stable marriage and three elementary-aged daughters. She functions well in all respects except one: She has become completely obsessed with a high school friendship that ended in what seems to be an irreparable rift. She wishes she could simply leave this rift behind, but her ex-friend works at the coffee shop her husband manages and runs in her social circles. Being from a small town, encountering the ex-friend in conversation and in person is unavoidable. Yet Karen feels terrorized by the ex-friend’s criticisms of her, and worries that she will poison others’ views of her. Karen feels overwhelmed with anxiety, and is at times unable to sleep or function well.

Definition: A cluster of diagnoses Anxiety Definition;

Prevalence: Almost 20 percent, with women higher than men.

Cause: Anxiety disorders seem to come from a mix of nature, nurture, and sometimes current, triggering life situation. Parasympathetic/ Sympathetic

Prognosis: Treatable

Treatments: Lifestyle, breathing, talk therapy, social support, some herbs, supplements and medications, cognitive-behavioral therapy Cognitive Behavioral Therapy; Equine Therapy

Program 6 – CODEPENDENCY
Treatment Team: Nivischi Edwards, Shelly Wiggins, David Guererro, Rob Davison and Jennifer Schwirzer

Program 6 Outline

Presenting Problem: Nineteen year-old Swiss Lara comes to counseling at the request of her Austrian boyfriend Karl, who has taken a corporate position in the states. Lara’s father is a professor at a college in Switzerland, and her mother stays home with four other children. Karl reports that Lara is “too emotional.” You spend several sessions with her, and she shares with you the struggles she has when Karl treats her badly. Karl is 30, has a high-powered job in a big corporation and is an elder at the local church. You learn that Karl has convinced Lara that her family can’t be trusted, and that very few church members are saved. She has few relationships and those she has Karl describes as dysfunctional. After several sessions you tell Lara that she’s not too emotional, that her reactions to Karl’s criticism and control are normal. Where do you go next? Karl is paying for the sessions.

Definition: A dysfunctional helping relationship where one person supports or enables another person's addiction, poor mental health, immaturity, irresponsibility, or under-achievement. Codependency Definition

Prevalence: Most homes where addiction or severe dysfunction is present mean codependency is present.

Cause: Observing codependent behavior in the home of origin; also certain teachings or ideas, even religious ideas, can encourage codependency. Child/parent illustration.

Prognosis: We can learn better ways.

Treatments: Groups such as al-anon are excellent helps because others can hold us accountable for what feels like the “nice” thing to do.

Program 7 – (OCD)
OBSESSIVE COMPULSIVE DISORDER
Treatment Team: Christina Cecotto, Paul Coneff, Shelly Wiggins, Rob Davison and Jennifer Schwirzer

Program 7 Outline

Presenting Problem: African American William is a high school senior from an upper middleclass family presenting with symptoms of what he believes is OCD. His girlfriend broke up with him because he was completely obsessed with bodybuilding and had no time for her, nor inclination to engage in any kind of normal relationship. With her gone, he doubts the value of his perfect biceps, triceps, and quads, yet can’t seem to let himself be a normal person. His psychiatrist prescribed an SSRI drug, but it did little good. A few weeks into counseling the psychiatrist prescribed Vivanse for ADD and it revolutionized William’s life. He said he could focus for the first time in years and was starting to actually be able to have conversations with people. What was going on with William?

Definition: OCD is a disorder characterized by intrusive, unreasonable thoughts which provoke anxiety, and compulsions used to control the anxiety.

Prevalence: Worldwide lifetime prevalence of 1-2 percent. Among the top 20 causes of disability.

Cause: Genetics, environment, trauma, substances.

Prognosis: Counseling and medication can help. Sometimes people “grow out of” OCD.

Treatments: Counseling- particularly exposure and response prevention.

Program 8 – MISCOMMUNICATION
Treatment Team: David Guererro, Christina Cecotto, Nivischi Edwards, Rob Davison and Jennifer Schwirzer

Program 8 Outline

Presenting Problem: Tina and Roger are an older, upper middle-class African American couple with a long-established pattern of miscommunication in their 38-year marriage. Tina wishes Roger would talk to her more, and Roger interprets Tina’s pushing for more communication as criticism. Tina feels abandoned and Roger feels that Tina finds him inadequate. She says, “He doesn’t love me!” He says, “I’ll never be good enough for her!” Tina has a group of lady friends at church who engage in various missionary

Definition: Poor habits of transmitting thoughts and feelings.

Prevalence: Pandemic!

Cause: Most often, absence of good communication in the home of origin.

Prognosis: People can learn better habits of communication!

Treatments: Seminars, self-help books, and practice, practice, practice.


Program 9 – CONFLICT
Treatment Team: David Guererro, Jean Wright, Christina Cecotto, Rob Davison and Jennifer Schwirzer

Program 9 Outline

Presenting Problem: In their sixties, upper middle class and Hispanic, Mr. and Mrs. Fernando report a long-standing conflict with their ex-best friends, which are actually Mrs. Fernando’s sister and husband, the Acostas. The couples came to the area twenty years before to plant a church in order to reach the Hispanic population in the city. All went well until the church voted Mr. Fernando into the position of lay pastor of the church. Because the same honor was not extended to Mr. Acosta, he wrestled with hurt feelings. As you chat with Mr. Fernando, you sense that his approach to the situation

Definition: A serious disagreement or argument.

Prevalence: Pandemic. “Anthropogenic disasters” (wars) WW II alone- 75 million people.

Cause: Poor listening; James 1:19- “Let every man be quick to hear, slow to speak, slow to wrath.”

Prognosis: People can work through conflict using the right communication habits!

Treatments: Marriage or family counselor, mediator, or simply meeting and praying together, then talking honestly in the spirit of Christlike love.
Program 10 – ANGER
Treatment Team: David Guererro, Jean Wright, Nivischi Edwards, Rob Davison and Jennifer Schwirzer

Program 10 Outline

Presenting Problem: Joseph Strong, a very tall 53 year-old retired policeman of Irish descent, strides into the office and warmly says hello in a deep bass voice. He sits down in the chair and begins to explain his situation, immediately melting into tears that continue to flow for most of the session. He explains that he can’t control his temper, and then can’t shake the feelings of despair that linger after he explodes. For instance, he exploded when a neighbor insulted his dog, but immediately regretted losing his temper. Now he feels deep shame and remorse and wants to learn anger management.

Definition: A serious disagreement or argument.

Prevalence: Pandemic. “Anthropogenic disasters” (wars) WW II alone- 75 million people.

Cause: Poor listening; James 1:19- “Let every man be quick to hear, slow to speak, slow to wrath.”

Prognosis: People can work through conflict using the right communication habits!

Treatments: Marriage or family counselor, mediator, or simply meeting and praying together, then talking honestly in the spirit of Christlike love.

Program 11 – PSYCHOSIS
Treatment Team: David Guererro, Jean Wright, Nivischi Edwards, Rob Davison and Jennifer Schwirzer

Program 11 Outline

Presenting Problem: Although a Medicaid client and low income, forty-three year-old, Hispanic Tony looks the picture of success as he strides into the office in a designer suit, well-groomed facial hair and a cloud of cologne. He explains that he works as an advocate for the mentally ill, being diagnosed bipolar himself. Tony has just been baptized and is a strong believer in the Bible. He talks enthusiastically about his faith, but by the third or forth session you notice he has some extreme ideas regarding what the Bible teaches about spiritual gifts. By the fifth session, Tony tells you that he believes you are a prophet, and that Gabriel the archangel has spoken to him, telling him that the two of you have a special mission to fulfill in giving the last message to a dying world.

Definition: Psychosis Definition Psychotic disorders are severe mental illnesses that cause abnormal thinking and perceptions. The most common is schizophrenia but bipolar can also have psychotic symptoms. Also, drugs and alcohol as well as traumatic or other brain injury can cause psychosis. Symptoms of Psychosis

Prevalence: The latest research for schizophrenia says it’s about 7.2 per 1000, which is close to 1 in 100. US lifetime prevalence for bipolar is 4.4 percent.

Cause: Thought to be a combination of genetics and environment. Dopamine Pathways Relevant to Schizophrenia Symptoms

Prognosis: Schizophrenia and bipolar must typically be treated with medication, but it is possible to live a functional life with antipsychotic medications.

Treatments: Medications. Lifestyle can also help with symptom alleviation. Social support is essential, particularly for schizophrenia because the tendency is to pull away.

Program 12 – MOOD DISORDERS
Treatment Team: Christina Cecotto, Jean Wright, Nivischi Edwards, Rob Davison and Jennifer Schwirzer

Program 12 Outline

Presenting Problem: Presenting Problem: Tamika, a 29 year-old upper middle-class mother of Jamaican heritage, with two small children, presents with severe depression over the last several months. She feels overwhelmed by her responsibilities and can’t seem to function as a stay-at-home mom. Her husband, a 30 year-old second-generation Romanian immigrant and mechanical engineer working for General Motors, provides well for the family, but feels bewildered by his wife’s difficulties, given their beautiful home and healthy children. She reports that he has insisted that she get help for her depression, and this is why she is here.

Definition: Mood disorders include major depressive disorder, dysthymia (a milder form of depression), bipolar and cyclothymic disorder (a milder form of bipolar).symptoms. Also, drugs and alcohol as well as traumatic or other brain injury can cause psychosis. Symptoms of Psychosis

Prevalence: About 10 percent lifetime prevalence. Higher for women and much higher for certain subgroups, i.e. physicians in training.

Cause: Depression seems to come from a mix of nature, nurture, and sometimes current, triggering life situation.

Prognosis: Very treatable

Treatments: Lifestyle, talk therapy, faith, social support, some herbs, supplements and medications, cognitive behavioral therapy.