Improving Working Memory and Attention

Working memory is the brain function that allows us to hold information in memory long enough to manipulate or perform some function on it in order to solve a problem or come up with a response.  It is considered an "executive function", which is a set of cognitive abilities that allow us to plan, organize, self monitor, initiate and inhibit responses, and shift gears as needed.

We use our working memory everyday for all kinds of tasks.  Pearson's Cogmed website provides a handy chart (see below) of some of the ways we use working memory in all stages of development:

Age	Working memory is crucial for…	Indicators that a working memory needs exercise
Preschool	Learning the alphabet Focusing on short instructions such as “Come brush your teeth” Remaining seated to complete independent activities, such as puzzles	Seems unwilling or unable to learn alphabet, numbers Can’t focus long enough to grasp and follow instructions Flits from one thing to another
Elementary school	Reading and understanding the content (reading comprehension) Mental arithmetic Interacting and responding appropriately in peer activities such as playing on the school ground	Reads (decodes) but does not understand or remember material read Problems memorizing math facts Difficulty participating in group activities (e.g. awaiting turn); makes friends but cannot keep them
Middle school	Doing homework independently Planning and packing for an activity Solving multi-step math problems, especially word problems Participating in team sports	Does not begin or persist with homework without supervision Packs but forgets items essential for activity Reads the problem but can’t break it into understandable parts Problems grasping rules of a game, functioning as a “team player”
High school	Getting a driver’s license – and driving safely Understanding social cues, responding to demands of a social situation Writing essays, reports	Problems with spatial awareness, reading and following traffic cues Interrupts, talks excessively, doesn’t listen to others Essays and reports are short, sloppy, and disorganized
College	Focusing on and following a conversation Making and adhering to work plans, such as studying for an exam successfully Participating in group activities in school and socially Sustaining focus and interest throughout lectures	Changes topics suddenly, makes irrelevant comments Procrastinates, then tries to “cram” the night before an exam Doesn’t listen or participate during group activities Falls asleep or “zones out” during lectures
Adults	Getting to work on time Meeting deadlines at work Prioritizing multiple activities Handling conflicts within the family	Frequently late to work Often underestimates time required for a task Has problems breaking a project into manageable steps Often loses temper with children and spouse
Seniors	Actively participate in group discussions Being able to perform what you are planning to do Organizing your materials and activities Managing important financial transactions	Forgetfulness Distractability Losing track of the topic in a conversation Misplacing things like glasses, mobile phone, keys etc

As you can see, if an individual has problems with their working memory they may experience significant difficulties across a broad range of tasks and in a variety of situations.  A number of different conditions can be correlated with working memory problems such as:  attention deficits or learning disorders, brain injury, stroke, being over-committed, or even the natural effects of aging.

Fortunately, we are discovering that working memory can be improved.  One way of doing so is using a working memory training program such as Cogmed.  According to Pearson, "Cogmed Working Memory Training is an evidence-based training program developed by leading neuroscientists to improve attention in individuals with weak working memory.  Cogmed is backed by peer-reviewed, controlled research done at leading universities around the world and is proven to lead to significant, real life improvements in 80% of users."

If you are interested in learning more about Cogmed, please visit the Pearson Cogmed website or the YouTube Cogmed Video Channel.  My website provides additional information about ADHD, learning differences and other mental health concerns, http://www.kctherapist.com/.

The Approach-Avoidance Cycle in Relationships

The Approach-Avoidance Cycle (AAC) - also known as the Pursuer-Distancer Dynamic, Push-Pull Relationship, or Engulfment vs. Abandonment - is a pattern that emerges in relationships where one individual wants more of something (or wants the other person to change in some way) – this is the pursuer - and the other individual resists or withdraws – this is the distancer.  It has been often described as two people “attached by a 10 foot pole”.  When the pursuer moves forward, the distancer is pushed back.  When the distancer withdraws, the pursuer is pulled forward.

While everyone needs a balance of attachment and autonomy in their lives, the ideal formula varies from person to person.  When one person in a relationship wants more attachment and the other wants more autonomy, this is often the perfect storm for an AAC to develop.  At its extremes, the AAC can be quite damaging to a relationship because it becomes a self-perpetuating “war” that is exhausting and builds resentment over time in both individuals.

The AAC can be an overarching pattern in a relationship or it might occur only within certain hot-button issues.  In marriages, these issues often include sex, money or parenting.  For example, one partner might want more frequent sexual intercourse with the other partner or may want them to spend more time with the children, manage the money better, engage in more house work or go out on more dates.  In families or friendships, it can include how much personal contact people engage in or the level of involvement in each other’s personal lives.  For example, how often an adult child visits their parents or the degree to which friends confide in each other.  It is tempting for each person to think they are in the right and the other is wrong, but its really often a matter of personal preference and both people are responsible for their part in perpetuating the pattern.

In the AAC, the pursuer wants more “we” focus and the distancer wants more “I” focus.  The pursuer typically appears to over-function in the relationship and the distancer appears to under-function.  The pursuer’s efforts to get the distancer “on board” feels like manipulation, pressure, control, or smothering to the distancer.  The distancer’s resistance feels like rejection, abandonment or a lack of love/caring to the pursuer.  Each becomes more and more entrenched in their stance and they make increasing assumptions and judgments about the other’s motivations and intentions.  Each tries harder to “win”, thus it becomes a battle with the potential for serious casualties along the way.  Unchecked over time, the damage can become irreversible.

The good news is, if at least one of the partners recognizes and disrupts the pattern early enough, the relationship may be salvageable.  Interrupting the pattern means that the pursuer stops pursuing and/or the distancer stops distancing.  In other words, the pursuer has to decrease the “we” focus and become more “I” focused.  They have to stop expecting the other to change and focus more on what is actually under their control (one’s own thoughts, feelings and behavior).  Or, the distancer has to stop withdrawing/resisting and begin to reach out to the pursuer or make some observable efforts toward change.  Because both individuals are attached by a “10 foot pole”, when one person stops pushing or pulling, often the other will follow suit.   

This is not as simple as it sounds as the behavior can be so ingrained, the individuals involved may have trouble identifying which of their behaviors are pursuing or distancing.  It can also be very difficult to let go of these behaviors when there is a strong fear of abandonment or losing ones autonomy.  In these cases, a psychologist with experience in family or marital therapy can help guide one or both individuals through the process.  Of course there is also a risk that even when the pattern is disrupted, one or both individuals may remain dissatisfied with the relationship due to irreconcilable differences in wants, needs or values.

 If you suspect you are struggling with an AAC in a relationship, it may be helpful to talk to a mental health professional. A good therapist can help you understand the function of your behavior, identify triggers, and maintain your changes. You can find mental health professionals in your area through online therapist locators such as those hosted by the American Psychological Association, Psychology Today, Network Therapy and GoodTherapy.

Please also visit my website http://www.kctherapist.com/ for more information and resources regarding a variety of mental health concerns.

Walking in Their Shoes: ADHD and Learning Disorders

Have you ever wondered what it is like to have ADHD or a learning disorder like dyslexia, dysgraphia or dyscalculia?

The PBS Misunderstood Minds website offers a number of experiential activities along with a wealth of other useful information and resources.  Try a few of the links below to walk in their shoes for a moment:

1.  Visual Activity: Reading with Distractions "simulates what a child with an attention problem might experience during a classroom reading assignment"

2.   Auditory Activity: Listening to Directions "attempts to illustrate what it might be like for a first-grader with an attention disorder to try to concentrate on a set of oral instructions amidst a cacophony of classroom distractions"

3.  Decoding Activity: Recognizing Phonemes simulates dyslexia by having you try to sound out words without automatic decoding abilities

4.  Memory Activity: Recall and Understanding "simulates the effect that memory and attention problems can have on reading comprehension"

5.  Graphomotor Activity: Tracing Letters "is designed to simulate what a child with a graphomotor writing disability might experience every day"

6.  Composition Activity: Putting Ideas in Sequence "is designed to simulate what a child with a writing disability might experience during a classroom writing assignment"

7.  Arithmetic Activity: Using Basic Facts simulates dyscalculia by having you solve math problems without efficient recall of basic math facts

8.  Spatial Activity: Making 3-D Inferences simulates dyscalculia by impairing your ability to visualize "three-dimensional objects presented on the flat surface of a piece of paper or computer screen"

9.  Sequence Activity: Multistep Problems "is designed to evoke in you the intimidation and frustration a young student with a math disability might feel working out a problem that requires the integration of mathematics skills"

Please visit my website for more information about ADHD, learning differences and other mental health concerns, http://www.kctherapist.com/.

Breaking Bad Habits

A habit is any action that is performed so often that it becomes almost an involuntary or automatic response. Some people use the words "habit" and "addiction" interchangeably; however, there are important differences between them.

A habit is something a person is inclined or accustomed to doing routinely, almost without thinking, There is often no forethought or planning in it and they may even be unaware they are doing it. There are "bad" habits like snacking on fatty foods while watching TV, biting ones nails when nervous, or twirling ones hair when tired. A habit can also be something helpful like going to the gym after work, flossing after meals, or eating a nutritious breakfast in the morning.

An addiction is something you are dependent upon or that you need more and more of to satisfy you. Someone who is addicted spends time deliberately thinking about and planning for the activity - like going to the liquor store to stock up on alcohol or going to the casino over a long lunch for some clandestine gambling. People who are addicted make a conscious effort to obtain the things they need to satisfy their addiction and they deliberately arrange time for it in their day, sometimes even putting off other important things to do it. Addiction is never helpful in that the behavior is engaged in too frequently or intensely such that it causes problems.

Some behaviors, like smoking, are part habit and part addiction. Lighting up after dinner may be a habit in that it is automatic and done without much thought, but the smoker is addicted to the nicotine and might even pass on lunch to spend his or her last dollar to obtain a fix. In addition, quitting the smoking will result in physiological symptoms that do not occur when stopping a pure habit.

A habit is learned in that over time the behavior is rewarded and becomes consistent. For instance, biting your nails might provide you a little relief when you are feeling stressed. After several repetitions, your brain learns to associate the nail biting with stress relief and a habit is formed. The common lore is that learning a habit takes about three weeks of frequent repetition with reinforcement.

Overcoming an addiction can be a very difficult and complicated process, but changing a habit is something that can often be done on one's own with a little focus and persistence. The trick is to make the involuntary voluntary and the unconscious conscious so that good choices can be made about behavior instead of letting things just happen.

How to Break a Bad Habit

First it is important to determine your level of motivation. Ask yourself if you really want to make a change and why. Identify the pros and cons of the habit (its payoffs and tradeoffs) and this will help you understand the function your habit serves. Write down what you want to change and why - there is some evidence that writing down your goals contributes to success in achieving them.

Work on one habit at a time. Start small and go slow. Well planned, measured, reasonable changes are the most lasting changes. Impulsive, dramatic changes such as rapid weight loss or spontaneous New Year's resolutions are often short-lived.

Identify your triggers and plan for them. Keep a diary logging the situations, thoughts, feelings, and actions surrounding your habit. With whom do you perform your habit? Where? When? This way you will have a better understanding of your patterns.

In the early stages of change, you will want to avoid your triggers or replace your habit with another more productive behavior when your triggers are unavoidable. Substitute a helpful habit for the problematic one - preferably one that satisfies that same underlying need you discovered when examining your motivation for change. For example, if you twirl your hair when you are sleepy, you can replace it with better sleeping habits. Once you are secure in your habit change, you can begin to safely expose yourself more and more to your old triggers without risking a slip.

Self-control and will power are learned skills that can be developed with practice. Each time you restrain yourself from performing your habit, your will power and self-control become stronger.

Since habits are learned through reinforcement, remember to reward your successes. When you slip, don’t become discouraged and "throw out the baby with the bathwater". Just as it takes time to develop a bad habit, it also takes time to break one.

If you suspect you are struggling with addiction and want to make a change, it is important to consult with an addictions specialist to assist you in your recovery. If you have tried unsuccessfully to change a bad habit despite your strong desire to do so, it also may be time to talk to a mental health professional. A good therapist can help you understand the function of your habit, identify triggers, and maintain your changes. You can find mental health professionals in your area through online therapist locators such as those hosted by the American Psychological Association, Psychology Today, Network Therapy and GoodTherapy.

Please also visit my website http://www.kctherapist.com/ for more information and resources regarding a variety of mental health concerns.

Learning Differences & Higher Education

Getting into college is not always the biggest challenge for students with learning differences. It’s the adjustment to college level work and a more independent lifestyle that can be the greatest hurdle.

Picking the Right College
The first step in successful transition to higher education is picking the right college. Every college and university is different and some are more accessible than others. It is important to research college disability service centers as a part of a prospective student's selection process. There are a number of good books and articles written especially for students with learning differences to help with picking colleges. The LDonline website has a great article addressing this.

After a college has been selected, it is up to the student to send in disability documentation and obtain appropriate accommodations. The school will not initiate this, so it is the student's responsibility to find out what is needed and gather the documents together. This information can often be found on a college's disability services web page or by giving the admissions department a call. It is important to note that most colleges require a comprehensive evaluation that is less than three years old to register a student with the disability services office and qualify them for accommodations.

The majority of colleges offer some sort of orientation to new students. It is a wise idea to attend this and find out about the resources that may come in handy as you go along. Remember that these orientations are geared toward the majority, so students with disabilities may need to be assertive and ask for specific information they need. It is also important to visit the disability services center early on and often. They can be a valuable support throughout your college career and they generally won't make retroactive exceptions for you if you run into trouble before registering with them.

Knowledge & Advocacy
In college, self-identification and self-advocacy is required. Nobody will be asking about an adult student's disability status as this is considered a breach of privacy. Therefore, students must be able to anticipate their own needs and be proactive about getting them met.

Some students with learning differences are not aware of their strengths and limitations or how their disability might affect their college experience. Even those who are aware may not understand their educational rights or be adept at communicating their needs. It is important for students to know how to explain their disability to others when appropriate, how to ask for what they need, and how to protect their rights. The Wrightslaw education law and advocacy website is a good place to educate yourself in these matters.

College vs. Primary/Secondary Education
Each college has its own specific documentation requirements and different accommodation options. At this higher level of education, options for remediation are limited or unavailable and there are often no modifications allowed.

New college students may find they need different or adjusted accommodations in the college environment as the demands are different from high school. Many students with learning differences learn best through doing rather than just through seeing or listening, so they need to put their accommodations into practice and try different things to find out what works for them.

In college there is less structure and feedback and generally things are less predictable. Having good habits in place before leaving for college is important. Also, students should be prepared to self-monitor and adjust their behavior rather than relying on others to give them feedback and direction. Students have limited time in class with their teachers and class sizes are larger; therefore, they must learn to be assertive and seek out what they need outside of class time. There is increased competition and greater expectations for the quality and amount of work produced, so good time management and study skills are necessary.

In light of the greater independence required, students need to arrive armed with solid independent living skills. Strong decision making and problem solving skills will also make the transition to an independent lifestyle easier.

Stumbling Blocks
In my experience working with children, adolescents and adults with learning disabilities in private practice, at colleges and at a university disability services center, I've become aware of a number of early missteps that can cause problems later on down the line.

• Don't automatically assume students understand their disabilities just because they have been living with them. Children need to be told over and over again in ways that are appropriate to their changing development. Some students lack awareness of how their disability affects them and others avoid thinking about it because of shame or intimidation. These students will have trouble asking for what they need and may be reluctant to protect their rights.
  
• Don't forget the saying "wherever you go, there you are". Some students think they will grow out of their disabilities or they hope that things will be different in college and they won't need the help they were used to in the past. Most research tells us that although people can compensate for their disabilities such that they are almost imperceptible, there is currently no cure. Students who believe otherwise often never even register for services at their college.
  
• Use it or lose it. Some students register with disability services, but do not use their accommodations when they really need them. Often their grades do not accurately reflect their knowledge. It is true that not all college students with disabilities need accommodations; however, a good rule of thumb is if you needed it through high school, you are likely to need it in college and you may need things in college you didn't need in high school.
  
• Stand up for yourself. Some students try to use their accommodations, but run into roadblocks and don't advocate for themselves. They may become discouraged and stop using their accommodations. Know your rights and don't be afraid to protect them.

Transition Planning
The law requires public schools to provide transition planning for students with disabilities once they reach a certain age. As with any service, the quality can vary from school to school and from district to district. It is important for parents to monitor this process and make sure it is meeting the student's needs. If you feel more is required, there are a number of good resources on the web. The National Joint Commission on Learning Disabilities has a nice brochure on transition planning (revised 2007).

Part of transition planning should involve helping students understand their rights, how their disability affects their current functioning, how to communicate this to others, and how to find and utilize the tools they need to succeed.

Counseling
Some students have emotional and identity issues related to their disability that are getting in the way of reaching their potential. In counseling students with learning differences, often work has to be done to raise awareness and self-esteem.

Students may feel inadequate, weak, abnormal, or “dumb”, because they do not view their disability in the same way they might view a more visible disability. For example, a student with dyslexia may understand that her friend who has a spinal cord injury needs an elevator to get to the 2nd floor, but she cannot accept that it is okay for her to need books on tape to complete her reading assignments for her classes. People with "invisible" disabilities sometimes internalize the unrealistic expectations of others. Counseling can help such students learn to see their disability for what it is, capitalize on their strengths, understand their limitations, and positively incorporate these factors into their lives.

Please visit my website for more information about learning differences and other mental health concerns, http://www.kctherapist.com/.

Finding Balance in Relationships

Photo by Sean Ochester

Most of us understand that being repeatedly selfish, cruel and neglectful in relationships is a sure way to destroy them.  But, did you know you can also kill a relationship with kindness?  If you have been told you are “too nice”, you may be inadvertently skewing the balance of equity required for healthy adult relationships.  Successful long-term friendships and romantic relationships tend to have a fairly equal balance of power, but people who are too nice tend to give away their power and do more than their fair share of the work.

The following are some specific "too nice" behaviors that tend to cause problems in friendships and romantic relationships as well as some suggestions for finding a better balance.

• Being overly-responsible for your relationships: When you do most of the work in a relationship, you show the other that its okay to do less and you risk eventually becoming burned out and resentful.  Resist being the sole cheerleader for your relationship, constantly pointing out the good things and going out of your way in an effort to convince the other person to stick around.  Avoid talking them out of their doubts regarding the relationship. Try instead to listen and really hear what they are saying, believe them and respond appropriately.  In the best case, you both may be able to identify problems and address them.  In the worst case, if you are not well-matched, it is better for you both to discover that as early as possible and move on to someone who is.  Not everyone you like is going to be right for you.

• Over-focusing on others: We tend to respect people whom we perceive to be capable, confident and accomplished in their own right.  When you over-focus on someone else’s wants and needs, you neglect your own.  Legitimate relationships which are one sided or power-imbalanced include caregiver-patient, parent-child, or manager-employee.  Hardly anyone really wants a parent, nurse, or boss as a long-term romantic partner or a friend.  Invest time and energy in your own life:  try new things, spend time with other friends, engage in hobbies, take care of yourself (exercise, eat well, sleep) and place more focus on the parts of your life that are good.  Acknowledge and honor you own wants and needs - treat them as equal to those of other adults in your life.

• Doing too many unasked for favors:  The danger is that the recipient feels uncomfortable or even irritated with you because they feel they owe you or they are inconvenienced by your unwanted favor. Over time, your acts of kindness can begin to appear ingratiating or manipulative to them.  You may start feeling resentful because you have put much time and energy into something that was unappreciated.  If in doubt, ask first or turn your energies to something more certain and productive.

• Being overly available:  If someone in your life consistently expects you to take care of their responsibilities at the drop of a hat, set a boundary.  Being overly available sends the message that you don't have a life of your own, which is generally not an attractive quality to other people.  Say "no" sometimes and let them know you have your own life to attend to.  This way you will avoid a buildup of resentment and show them how to treat you in a way that is sustainable for the long term.

• Being overly forgiving: When someone routinely mistreats or neglects you (unfairly criticizes or ignores you, hurts your feelings), you might be tempted to tolerate it because it's a hard time in their life, they are vulnerable in some way, or they were hurt in the past. Set a boundary and don’t continue to let them take their angst out on you - they will respect you more for it and they will be forced to find other (hopefully healthier) ways to cope with their problems.

• Repressing your own feelings, wants and needs: Do you describe yourself as easy going, flexible and giving, yet you find yourself feeling increasingly irritable, angry, and resentful with certain people?  You may be ignoring feelings you consider unacceptable so you can continue to see yourself as a “nice person” or because you believe this is the only way others will accept you.  That’s not sustainable in the long term because your feelings are sending you important messages and will not go away if ignored.  Repressing your feelings also keeps others from learning important information about you which makes it hard for them to know how to treat you.  Acknowledge your feelings and assert yourself so that others in your life can make better decisions about how to relate with you.

If you suspect you are "too nice" and you want to learn ways to create greater balance in your relationships, it may be time to consult a mental health professional. You can find mental health professionals in your area through online therapist locators such as those hosted by the American Psychological Association, Psychology Today, Network Therapy and GoodTherapy. You can also call the behavioral health number on the back of your insurance card or visit your insurance company website to get some referral options.

For more resources relating to relationships and other mental health concerns, please visit my website http://www.kctherapist.com/.

Getting Motivated

Motivation is our drive to meet basic and higher needs and pursue desires. It energizes us and directs our behavior. We need to be able to meet our more basic needs before we can expect to meet higher needs.

Basic and higher needs:

• Belonging - love, acceptance
• Survival – hunger, thirst, safety, shelter
• Esteem – achievement, competence, approval, recognition
• Self Actualization – personal growth, improvement

Motivation is a powerful force for change and growth. It can focus behavior on goals, increase effort, energy and persistence, improve thinking and performance, and enhance self-confidence and self-esteem.

Where Does Motivation Come From?

The source of motivation can be internal or external, positive or negative. Positive motivation involves obtaining desired or pleasant consequences (rewards) while negative motivation involves escaping or avoiding undesired, unpleasant consequences. Internal motivators are often more powerful and enduring than external ones.

Examples of internal motivators include:

• Desire
• Pleasure
• Pride
• Growth
• Meaningfulness
• Power
• Guilt
• Pain

Examples of external motivators include:

• Money
• Promotion
• Good grades
• Praise
• Disapproval from others
• Punishment

Business consultants and life coaches will say there is no simple formula for motivation, but expectancy theory makes an attempt at one (based on Vroom, V. H. (1964). Work and motivation. New York: Wiley):
Motivation = Perceived likelihood of success x Belief that success will lead to reward x Value of reward

This formula indicates that the more you believe you can succeed, that your success will be rewarded, and that the rewards will be great, the higher your motivation will be. We are most motivated when we feel capable, responsible, self-directed, respected, and hopeful.

Blocks to Motivation

When motivation is external, it tends to wane when the source is absent. Most children rebel against their parents' attempts to motivate them to keep their rooms clean. When we grow up and are living on our own, most of us are able to keep our living spaces relatively neat. This is because internal motivation eventually takes the place of our parents. We find our own important reasons for keeping our rooms clean.

Even internal motivation has its challenges. Many of us start out with high motivation, but we find it fading as time passes. This can be due to poor planning and limited short term rewards (see entry on goal setting). It can also be due to poor self-confidence or lack of resources to succeed. Or we may discover that the rewards we anticipated aren't as powerful as the challenges we meet and sacrifices we make along the way.

Some common blocks to motivation include:

• Fear of failure
• Fear of success (success leads to greater expectations from others as well as increased independence and responsibilities which can be overwhelming)
• External locus of control – relying on luck, not taking responsibility, feeling that others will stand in your way

Increasing Motivation
Since internal motivation is more enduring and we work hard for rewards, it makes sense that finding internal and positive reasons for doing what you are doing is essential to staying motivated. Ask yourself why you are doing something – then ask five more times to see if you can find an internal and positive motivation. For example, lets say you want to become more organized.

1. Why do I want to be more organized? So that my house will be neater and cleaner.
2. Why do I want my house to be cleaner? So that I can find things more easily.
3. Why do I want to find things more easily? So that I can be more efficient.
4. Why do I want to be more efficient? So that I can save time.
5. Why do I want to save time? So that I can spend more time relaxing and enjoying my family.

From the motivation formula mentioned above, you can see that self-confidence is also an important factor in motivation. Believing in yourself increases your perception of likelihood for success and increases your confidence that you can manage that success once you get there. Know your strengths and weaknesses and capitalize on natural talents and interests to increase your chances for success. Choose a source of inspiration and surround yourself with successful people to remind you it can be done and what you stand to gain by succeeding.

Build in smaller, short-term rewards along the way. The further away you are from your ultimate goal, the more likely you are to lose steam as time passes. Breaking tasks into manageable pieces, each with their own rewards, will help you stay on task and remind you of what you are working so hard for. Incremental rewards will also help prevent you from being overly discouraged by setbacks.

If you are having trouble getting motivated, a mental health professional like a psychologist can assist you in taking a look at your concerns and generating options. Please feel free to visit my website http://www.kctherapist.com/ for more information and resources regarding a variety of mental health concerns.