ADAA Professional Blogs

Every quarter ADAA interviews three members for a blog that showcases new books by our esteemed experts. Our series – “In Conversation With ADAA Member Authors” – is a wonderful way to highlight our members' expertise and provide not only a brief synopsis of their books' focus areas but gives members a chance to relay in their own words what’s special or important about their respective publication(s).

While treatment for OCD is highly effective for many, it can be hard work! It’s not an uncommon experience to lose momentum midway through treatment or even in the final stages. Below are some helpful tips from an OCD specialist to help you make it across the finish line!

1.    Watch out for assigning the hard work to your “Future Self”

City life is attractive to many people, but seemingly endless high-rises and gridlocked traffic leave little room for city dwellers to reap the benefits that green spaces may have to offer. In our rapidly urbanizing world, more than half of the global population have made their homes in cities. Unfortunately, as we migrate to urban areas, access to green spaces is dropping, which may actually affect our mental well-being.

Individuals residing in cities are:

The idea that mental illness and psychiatric disorders are afflictions that only affect the brain is now regarded as incorrect. We know that the brain controls the body and when the brain doesn’t function properly, the body suffers the consequences, and vice-versa. A Roman poet by the name of Juvenal understood this connection when he wrote “a healthy mind in a healthy body”, echoing the fact that the body and brain are intertwined, and the health or ill-health of one can affect the other.

Are you a newly trained CBT therapist, wondering how to start your first independent practice?  Perhaps you want to join an existing group of therapists, or you dream of renting an office and having your own practice.  When I talk to our students and members at Anxiety Training who are working towards having a practice -- from those who are still deciding what degree is best for them to those who have started a practice and want help marketing -- I start by saying that I love my job.  I feel privileged every da

At the Anxiety and Depression Association (ADAA), we value each and every one of our members and feel that all of them are a distinguished part of the ADAA “family”. But when we have members who are actually related – mother, son, father, daughter, uncle, aunt, niece, nephew (you see where we’re going here) – we can’t help but find a way to highlight not only the relationship that they have to each other but to ADAA’s work and mission. 

 In true form, for OCD lovers like myself, I posed more questions than answers in the title.  That was intentional, to be funny, eye-catching, and thought-provoking.  Hopefully, I pulled off at least two of those.  These questions are often asked by clinicians, and sufferers alike.  How do I know if this is OCD or if this is social anxiety?  I’ll focus on answering this question as best as I can.   

This blog was originally posted on Ten Percent Happier on April 22, 2022 and is reprinted here with permission

I grew up in Brazil, in a little town called Governador Valadares.  Early on, my father left us, and it was my mom, my sister and me. Things were challenging. My mom did the best she could, she worked as hard as she could. But I remember how tough things were – there were times when we didn’t have enough to eat.  But we kept going.

1. Know the conference theme.

Every year, ADAA's annual conference has a theme. Be sure to consider how your submission may fit within the conference theme, and reference this in your submission!

2. Establish your target audience.

Many members of BIPOC communities deal with stress and trauma that can stem from specific socioeconomic struggles that consciously and subconsciously impact the everyday lives of the community.

In a world that is constantly evolving, BIPOC youth are actively working to change the way their communities acknowledge and embrace mental health. Youth (defined here as those between the ages of 15 to 24) are redefining what mental health means and are trying to “unlearn” some of the negative stigmas that have been taught or demonstrated by older generations.  

Pregnancy and childbirth can be a joyous time in a woman’s life but can also be a challenging one. Besides the physical changes that occur during pregnancy and postpartum, about 20% of women may experience mental health challenges. While increasing awareness of maternal mental health needs has led to various national efforts to improve maternal health care, Black mothers disproportionately face disparities in accessing and receiving appropriate health services.

“Polina came to our bedroom awakened by the sound of explosions. I didn’t know and still don’t know what to tell her. Her eyes today are full of fear and terror; eyes of all of us.”

Alina, a family friend who is a marketer and mother of two children from the Ukrainian capital of Kyiv – which is under seige by Russian forces – shared this reflection on her Instagram story. Her daughter Polina is 7 years old.

If you're like me, this may be one of the first in-person professional conferences you've attended for the past 2 years! I am thrilled for the opportunity to reconnect with old friends, meet and network with colleagues in my field, and drink in all the latest findings in research and clinical work. I'm also eager to attend the poster sessions!

ADAA’s conferences are incredible, offering unparalleled learning, networking, and engagement opportunities. However, for many attendees – both new and seasoned – the constant hustle can be overwhelming. As professionals, we want to gain the most we can from attending conferences, but the most effective way to do that can be elusive. One terrific tip we can take from mindfulness is to be present. Engaging in sessions and casual conversations can set off our minds about how we can take this information and best utilize it.

When our family (KM) recently moved, my children discovered that in each of their new schools’ peers were using racist, sexist, and homophobic remarks, something they had not previously experienced. My kids were woefully unprepared - and it turns out this is not unusual. When it comes to these types of remarks, which we believe is a form of bullying, the research supports that while kids know what they are seeing/hearing is wrong, they often lack the skills to respond effectively¹.

Congratulations on your poster acceptance to the ADAA conference! First let's take a moment to celebrate that accomplishment and the opportunity to present your work! This is a testament to the scientific contribution of your work and many conference attendees will be looking forward to seeing your poster at the conference.

As a new postdoctoral resident in 2019, I was nervous about the prospect of transitioning from a “forever-student” into an early career psychologist. After so many years on a prescribed path, it was tough to imagine forging into the job force without a clear plan. Searching for a tether of sorts, my supervisor recommended ADAA and the Alies Muskin Career Development Leadership Program (CDLP). Little did I know the impact this program would have in the trying times ahead!

During the fall of 2019 I was at a pivotal point in my career trajectory. I had just started my pre-doctoral internship year and was preparing to apply for post-doctoral positions – a last step in my training as I pursued a career in research. So, when I learned about ADAA’s Alies Muskin Career Development Leadership Award Program (CDLP) and its focus on providing early career researchers and clinicians with intensive mentoring and professional development opportunities, I knew I wanted to apply.

A longstanding passion of mine has been exploring leadership opportunities and finding ways to develop my skills as a leader; in training, research, mentorship, and more. I love being able to interact with people, those similar to me and those different from me, and sharing my experiences and providing opportunities, tips, and support for their growth. I also happen to find leadership to be a very symbiotic relationship where I can learn and grow from those I “lead” - what better arrangement is there!

As summer heat waves break records across the country, many kids and teens have already started preparations for the upcoming school year. Given the many months of learning at home, virtual school, hybrid education, and socially-distanced classes (or some combination of all of these), students are in for another strange and anxiety-provoking back-to-school season. Here are a few things that parents and professionals need to know about back-to-school anxiety in 2021:

Parenting is an increasingly complex job. It’s layered with important responsibilities one of which is raising anti-racist children. In addition to being a Registered Psychologist, I am also a parent, a white parent, who wonders what I can do to engage with this important work. I have learned that I can be doing more at home to raise antiracist children, and that the responsibility is mine and not that of the Black and Brown communities.

It can be challenging to control your weight. In today’s modern world, it is more convenient to order take out than to cook a meal and take the elevator instead of the stairs. Over time, a pattern of eating unhealthy foods and being sedentary can lead to excessive weight gain. While many of the factors associated with weight (e.g., genetics, metabolism, finances, lived environment, etc.) are not in our complete control, there are lifestyle factors that can be adjusted. In particular, nutrition and physical activity have the strongest evidence for maintaining a healthy weight.

"What if” thinking is not unique to Obsessive-Compulsive Disorder (OCD).  It is a feature to a greater or lesser extent in several other conditions.  Using what we know about Exposure and Response Prevention (E/RP) for OCD might improve treatment for these other conditions.[i]

The virus has upended the world as we know it, and kids are struggling.  Kids were not meant to live this way.  None of us were meant to live this way, but as a child therapist, I have a special focus on kids and their well-being.

Back in 1994, I applied for a poster presentation for the ADAA annual conference based on my observations that there is a certain group of patients whose onset of OCD began after a certain level of trauma/PTSD. ADAA's committee accepted my presentation for a symposium which was supervised and led by one of the leading experts in the world on OCD and PTSD: Dr. Edna Foa (also an ADAA member). 

Have your clients faced those situations where, in getting ready to make values-based exposure exercises, their minds come up with thoughts along the lines of, “It will be too much; I won’t be able to handle it; It will be a disaster; how do I know it’s going to work; Do I really have to do it?” And next thing they know, they’re in a battle with those thoughts, sometimes trying to prove them wrong, other times giving up and going along.

Anya, a 26-year-old, was in charge of organizing the schedule for the annual camping trip with her college classmates. She was excited and ready to make phone calls and gather prices for transportation, camping sites, etc. But in the middle of preparing for those errands, she noticed a red stain on the hardwood floor of her house. Quickly her mind came up with the thought, “Did I step on it? What if its blood? What if I get an illness?

As the COVID-19 pandemic continues, teletherapy is one of the only ways to continue receiving mental health services...but what happens when therapy must continue across state lines? 

The COVID-19 pandemic and subsequent increased awareness of systemic racism have left me, a white psychologist, at a loss for words. I wanted to write a post for other anti-racist allies who are also struggling to voice and act in increasingly anti-racist ways both personally and professionally. Here are some things that I have been working on, and I thought that it would be a useful list for other white psychologists who aim to promote anti-racism in their practices.

1. GET INFORMED

As I was being discharged from the hospital after an 11-day stay, a friend texted me: “The hard part’s over!” In one sense she was correct – I’d completed the antibiotics for COVID, my sepsis was gone, and my pneumonia and kidney function were improving. But that was just the physical battle.

Body Dysphoric Disorder (BDD) is described as the disease of “self- perceived ugliness” or “self-imagined ugliness.” It is also seen as a distressing preoccupation with one or more physical non-existence “defects.” In the DSM-5, BDD is classified under Obsessive Compulsive and Related Disorders. Within the general population, 1%-2% have being diagnosed with BDD, which is nearly 5 million people in the United States alone. Additionally, about 70 % of cases indicate that the onset of BDD occurs before the age of 18.

A new wave of high school dropouts is looming and the stakes couldn’t be higher. Dropping out of high school has been linked to higher instances of suicide attempts, substance abuse, and criminal activity.

Though none are immune to COVID-19, the rippling impacts of the current pandemic are unequal, due in part to pressing economic and social needs of minorities in the United States that are largely overlooked in response efforts.

In an already challenged, and often under-resourced mental health care system, the COVID-19 pandemic has led to an increase in mental health needs across the globe^1,2. The World Health Organization’s models of pandemic impacts project a significant uptick in these needs both in the acute and long-term outcomes of this crisis³. To rapidly respond and continue the vital mental health services we need in the changing reality of wide-spread isolation measures, governments and insurance companies have rapidly aligned to adjust policy for telehealth.

The night of Sunday April 19, I stayed home with my dog Ritz watching TV and eating takeout from one of my favorite restaurants. Later that night I became very ill, surprising because I’d been eating at that place for a decade without issue. When my alarm went off Monday morning, I felt terrible and my temperature was 100.9°. When Ritz and I take our morning walk we usually go two to three miles, and Sunday had been no exception, but Monday morning I struggled to make it 100 feet. I knew something was wrong.

The use of positive behavioral strategies in the treatment of anxiety and comorbid behavior disorders is incredibly helpful during therapy sessions.  Whether the child is practicing exposures or destroying the therapy room, these strategies can help therapists to increase therapeutic time and decrease frustration for all involved.  Just remember the basic principle of consequences in operant conditioning (a la B. F. Skinner): 

Overnight the world changed. Public health terms have become common phrases; we hear people talking about flattening the curve and social distancing. Scientists have become household names, with Dr. Anthony Fauci not only appearing in press briefings but chatting with Stephen Curry. And people are staying home. Millions of people’s homes have suddenly become their workplaces. For many, that brings new challenges like learning how to join videoconference calls and not disturb family members.

In the early 2000s, patients started reporting a new worry to their OCD therapists: what if I’m gay? This thought was often prefaced by patients declaring that they weren’t homophobic, but the fear was still there. The theme was dubbed homosexual OCD or HOCD. However, around that the same time, patients who were gay had a very similar fear: what if I’m actually straight? The issue of sexual orientation creeping into OCD is a sign of the ever-evolving societal environment.

*With the pandemic creating untold new challenges for us all, many therapists have completely switched to video visits with their patients. For those of you who are new to telehealth, it may be useful to check out some of these links for technical and ethical guidance:

Before COVID-19 was declared a pandemic, many of us in mental health became aggressively helpful. We gave interviews to media outlets small and large and wrote content for wide distribution. Just before the World Health Organization made its declaration, some of us were already fatigued. We decreased our output and refused interviews. Much like medical experts had exhausted the limits of their advice—keep your social distance, cover your coughs and sneezes, do not touch your face, wash your hands for at least 20 seconds—we’d said all there was to say.

What is Trichotillomania (TTM)?

This consists of compulsive urges to pull one’s hair resulting in noticeable hair loss. Hair-pulling can be any part of the body like arms, pubic hair, eye lashing, legs, etc. 

Why do people do this?

What is OCD? OCD is composed of two components: obsessions and compulsions.  Obsessions are recurrent and persistent thoughts, impulses, or images. The thoughts, impulses, or images are not excessive worries about real-life problems. Individuals attempt to ignore, suppress, or neutralize such thoughts, impulses, or images. Typically, individuals recognize the thoughts, impulses, or images that are merely products of his/her own mind. For example, an individual might have a fear of being contaminated, losing control, or might focus on an idea excessively. 

There are clear treatment standards for the treatment of obsessive compulsive disorder (OCD) which offer impressive outcomes and allows individuals to return to high-levels of functioning. Exposure with response prevention (ERP) and a combination of medication are the gold-standard treatment for OCD and through a goal-oriented treatment approach, individuals with OCD (across severity levels) can significantly reduce their overall symptomology, learn tools for relapse prevention and enter the maintenance stage for their diagnosis. 

This blog post is presented by the ADAA 2020 Conference Gold Sponsor VistaGen Therapeutics.

My newest way to explain OCD to a patient and family.

I love trying to come up with new ways to explain OCD to new patients and families. In my 20 years of treating OCD, I like to think that I have honed in on it pretty well, and thought I would share it with all of you. I would appreciate your feedback and would love to hear if you use it with your patients and how it went.

Here we go.

Prior to joining the Stress, Trauma and Anxiety Research Clinic (STARC) at Wayne State University (WSU), I did not know much about the refugee community, aside from what was publicized as a political point of contention during the 2016 election. I now see it as the crisis that it truly is. The STARC team, directed by of Dr. Arash Javanbakht, had found a high prevalence of anxiety and depression in both Syrian and Iraqi refugee adults and children, with symptoms shared between mothers and their children. While watching a CNN report on this research work, an art therapist at WSU, Dr.

I presented a complex case recently at the Anxiety and Depression Association of America that challenged my clinical skills, but more importantly, deeply affected the quality of life of the person I was treating. It is always an honor to walk alongside my clients on their journey to living well with anxiety and OCD. This particular person struggled from a trauma he experienced when he was young and from there he developed severe OCD with themes of harming, responsibility, and perfectionism. I am happy to say he is living his life fully now.

You may already feel overwhelmed by reading the title of this blog! How do I keep up with the changing trends and use social media effectively to promote myself? It’s easy to use social media as a form of entertainment, to post personal pictures and videos, and to connect with others who have similar interests. But, when it comes to having a professional presence on-line, it can be difficult to know where to start.

In this blog post we will provide a description of Problematic Internet Use, describe screening measures existing in the field and key unanswered questions, provide clinical patients examples, introduce COST project, suggest a design of an upcoming study, describe applications (“apps”) available for intervention, and will seek patient advocates feedback for the proposed study design, screening measures development and feedback on different digital apps available.

Introduction

Postpartum mood disorders are among the most common and debilitating mental health problems in the U.S. (1-2), with the capacity to interfere with maternal function, infant health (3-4), and maternal-infant bonds (5). There are unique concerns that clinicians and patients should know to recognize and treat these conditions. In my recent ADAA continuing education webinar, I discuss the structure and techniques of an effective behavioral intervention for perinatal depression.

1. What makes an application “wow” you? And the converse, what makes you want to stop reading an application on the spot? 

1) Certainly experience is a major factor in making a job application impressive. However, two factors that are particularly appealing are the applicant’s ability to convey eagerness to learn and genuinely communicating a desire to be involved in the prospective employer’s work. Applicants who communicate in a diplomatic fashion that they are familiar with your work while simultaneously highlighting good experience and a desire to take their own program of research and practice to the “next level” are particularly ideal.

Kids and teens often react with anger to the prospect of facing their fears. Doing things like engaging in exposure therapy or going to school when they are feeling panicked or overwhelmed, can trigger fight-or-flight responses, in which anxious children not only experience a desire to avoid things but sometimes actively fight or resist when we try to push them.  

On average, it takes 17 years for an evidence-based treatment to reach the community, and because of stigma, it may take an additional 10 years before a person suffering from mental illness actually receives treatment. The goal of implementation science is to address this gap between science and practice, helping the most vulnerable people to access high quality care. Providers and researchers are both crucial to bridging research to practice, especially in community settings.

Focal brain stimulation techniques are potentially powerful tools for the investigation and treatment of neuropsychiatric disorders. These approaches include transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation among others. In general, focal brain stimulation applies electrical stimulation to a discrete region of the brain to generate neurophysiological effects.

We have all felt afraid.  Fear makes some feel unique, alone, embarrassed, or ashamed, while others may become angry, defensive, or hostile.  Socially, group experiences of fear of the unknown and xenophobia can drive negative political movements and mass hysteria.

Elizabeth Spencer and I just finished giving an ADAA continuing education webinar called, The Magic of CBT for Anxiety and Depression. We have found, from our workshops, that many master level clinicians have never learned the foundations of cognitive behavioral therapy. This is unfortunate in that it becomes difficult to understand some of the more advanced concepts of CBT with ERP if you don’t know the basics. We were thrilled with the number of participants in this webinar.