UPCOMING WEBINAR: January 21 on Habit Reversal Therapy

THIS WEEK’S WEBINAR

Creative Applications of Exposure Therapy and Habit Reversal Therapy

January 21, 2015
Presented by Dr. Joelle Beecher-McGovern, a clinical psychotherapist at the Child & Adolescent OCD, Tic, Trich & Anxiety Group (COTTAGe) in the Department of Psychiatry at the University of Pennsylvania School of Medicine.

Cognitive-behavioral therapy has strong experiential support for a number of psychiatric disorders among children and adolescents. It includes several treatment modalities, including exposure therapy for pediatric anxiety and habit reversal training for tic disorders and trichotillomania. Despite the strong evidence for these treatments, they can be difficult for children and families to implement for a number of reasons, including logistical barriers, motivation issues and difficulties with follow-through in out-of-session work.

In this presentation, Dr. Hilary Dingfelder will briefly describe these treatment modalities and discuss some of the practical issues associated with implementing these treatments with children and adolescents. Dr. Dingfelder will then discuss some creative applications of these strategies to enhance these treatments for children and adolescents. Examples of areas that will be covered include:

  1. How technology can be used to supplement treatment (e.g., using the smart phone to monitor progress or supplement exposures)
  2. How to strengthen reward plans to improvement motivation
  3. Creative ways to enhance exposures with young children (e.g., through the use of games and puppets).

REGISTER FOR THIS WEBINAR »

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52 Weeks of TS: Week 32

EDITOR’S NOTE: Every Tuesday, noted Tourette Syndrome advocate Troye Evers shares his “52 Weeks of TS” blog journal with the TSParentsOnline community. In cased you missed any of the first 31 weeks, you can read them here. For more information about Troye, please click on his name or visit his website.

This week I have been doing a lot of thinking; well, I guess my brain is always thinking, but this week I guess, I’ve been listening to my thoughts more. I’ve been trying to listen and understand why my body does the things it does. Even at 37 years old, my body still confuses me.

I’ve been doing the back and forth trips between New York City and Martha’s Vineyard. In the beginnings of my time in Martha’s Vineyard, I said my anxiety levels were at an all time low, but my tics had stayed the same. With all the back and forth trips, I have realized that my tics might have calmed down a bit in more relaxing situations.

There is always something going on in my head, whether it’s my OCD, my anxiety, tics or ADHD. It often feels like Grand Central in my head, so sometimes it’s hard to notice if something has calmed down, like my tics. Sometimes you just don’t realize when the tics are calm outside of a stressful situation, until you’re back in a stressful situation.

For the most part, people don’t realize I have TS, unless they are with me later in the day or early evening when my body is tired of suppressing. My TS affects me in many ways, but I would probably have to say the actual tics are on the bottom of the scale. Even though I tic throughout the whole day, they are usually very mild. It’s really all of the underlying disorders that affect me almost every moment of the day.

There is usually not a moment in the day that there is not some sort of OCD thought racing through my head, which then triggers the anxiety. I know I need to pay more attention to my triggers, and focus on what helps. I take my Klonopin, but I’m beginning to wonder, how much is it really helping? I know the one mg that I take at night helps quiet my mind and helps me sleep, but I’m not sure how much the .5mg that I take in the morning is really helping.

When I first started taking the .5mg in the morning it would make me so zombie like, so I started taking it with a coffee to somewhat level me out. I think it’s time to cut out the coffee part of it. Within 10 minutes of drinking the coffee, the caffeine is racing through my blood stream, causing more anxiety feeling. HELLO, why am I taking something for anxiety, but mixing it with something that brings out my anxiety? It’s time to cut the caffeine.

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52 Weeks of TS: Week 30

EDITOR’S NOTE: Every Tuesday, noted Tourette Syndrome advocate Troye Evers shares his “52 Weeks of TS” blog journal with the TSParentsOnline community. In cased you missed any of the first 29 weeks, you can read them here. For more information about Troye, please click on his name or visit his website.

After a week in New York that seemed like a lifetime, I’m heading back to Martha’s Vineyard. Even though I was only home for a short time, I was nonstop busy, causing my anxiety to skyrocket, and we know what that means, more tics. I’m glad to head back to the vineyard and try to relax some more.

The first couple of days of the increased Klonopin dosage helped a little, now I feel like I’m back to normal. I have constant anxiety, but there are times when it gets so bad, causing an actual anxiety attack. During these attacks, I have realized I have to constantly urinate. It’s usually not a lot, but I just always have this feeling I have to use the bathroom. It’s not bad, as long as I’m near a bathroom, but if I’m not I feel as if I’m going to explode, and when I finally am able to go there’s hardly anything there.

This reminds of a time about 10 years ago when I was going through a very stressful time, and the same thing was happening a lot. I went to the doctor and they said nothing was wrong with me, I just had a small bladder. It makes me wonder, is this just another part of TS with my anxiety disorder or what?

When I made it to the airport on Sunday, my anxiety level was at an increased high. I love traveling, but I’d much rather just blink my eyes and be in a new place. I would much rather fly than take a bus, or train, but there is still anxiety. Airports are always so crowded with so many people, and I often find it hard to hide most of my tics. It’s just one more setting of people staring, and whispering.

As I enter the airport, I make sure to pull out my driver’s license and my TS medical card just in case any problems occur. I had about an hour and a half to wait unlit my flight was going to start boarding, and with all the anxiety of my surroundings, I ended up in the restroom four times.

Just imagine a fully tattooed person walking around twitching, rubbing and touching his nose and face and constantly going into the bathroom. I was just waiting for some type of drug accusation. Although all the time I spent in the restroom got me wondering, is it possible to get an automatic flushing urinal in my apartment? Not having to touch a toilet seat would be the greatest thing in the world, but I guess I still have to sit sometimes. Oh well, my dream bubble has been popped.

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52 Weeks of TS: Week 28

EDITOR’S NOTE: Every Tuesday, noted Tourette Syndrome advocate Troye Evers shares his “52 Weeks of TS” blog journal with the TSParentsOnline community. In cased you missed any of the first 27 weeks, you can read them here. For more information about Troye, please click on his name or visit his website.

I’m spending my time in a writer’s paradise — well, anyone’s paradise. People from all over the world come to Martha’s Vineyard. It’s the “Lap of Luxury” for the New England area. You have it all — sun, relaxation, great food, and much more. I have been trying to take advantage of all that I can, trying to relax and get some sun. I have realized that I don’t tic as much as usual when I am relaxing on the beach.

Could it be the vitamin D from the sun, or am I just that relaxed that my tic decided to take a break? I’ve tried to pay attention, and I’m pretty sure I’m not suppressing them. I have been suppressing my tics for so many years, it’s second nature. Half the time I’m not even sure if I’m suppressing or not. However, I have found it interesting, and when I get back to New York, I want to try to take some vitamin D supplements. Hey, why not? It’s worth a shot. Just one more attempt to escape from the beast inside of me.

I have been quite relaxed in the sense of my anxiety, but still have been a bit stressed out. I know that sounds like an oxymoron, but after 37 years, I have realized there is a difference. When you look up stress in the thesaurus, anxiety is one of the top words, but there is a difference — especially if you have anxiety disorder.

They are very similar, but I have been so relaxed, that my anxiety level has been so low, and life is quite enjoyable. Anxiety controls and takes over your whole body, but I feel as if stress is just in your mind. You can breathe off some stress, but at least for me the anxiety just lives there. If you’re anxious, you almost have to just ride it out, and I’ve been riding it out for a long time.

You think that living in the “Lap of Luxury” would be stress free, but paradise isn’t always what it seems. The house that I’m staying at is my cousin’s and her wife’s home, and there are many people staying there. This week the number of permanent people has increased to 10 people. We all have our own separate spaces — there is the main house and a guesthouse. Still, with the amount of people, there are bound to be some head butting issues.

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52 Weeks of TS: Week 27

EDITOR’S NOTE: Every Tuesday, noted Tourette Syndrome advocate Troye Evers shares his “52 Weeks of TS” blog journal with the TSParentsOnline community. In cased you missed any of the first 26 weeks, you can read them here. For more information about Troye, please click on his name or visit his website.

Find a penny, pick it up, all the day you’ll have good luck. Do you think this really works? I don’t know, but I have a secret: I’ve only told one person this so far, and it’s not even my husband. In the past month, I have started to develop some sort of OCD/germaphobia to pennies. It’s actually growing to all change.

It used to be if I saw a penny on the street and it was face up I would pick it up, and if it were face down I would flip it over for the next person to find. My husband would always leave change all over the house, and it was my morning ritual to walk around and collect it all and put it in the change jar, this is no longer the case.

It started about a month ago, I saw a penny on the carpet in my house and it was facing head down. I didn’t even want to touch it, to flip it over, because I knew it would still be me who picked it up later. Wouldn’t that defeat the whole purpose if I were the one who originally flipped it over?

I find myself now walking around avoiding all change I find anywhere. If I really start thinking about it, (OK, I’m not thinking about it — I’m obsessing about it, but anyway) how many people, with how many germs have touched that coin, or any type of currency for that matter. Even look at the trail of paper currency, they actually have a web site where you can track where that single dollar bill has been.

When I get to thinking about this (obsessing), I think about rumors per say, about there being residue of cocaine on most paper currency. REALLY? After a million people have touched that dollar bill, you’re comfortable to shove that up your nose. I’d like to invite the world to come pick my nose. I don’t think so!

Enough with the bitching about my germaphobia with money, I’ll figure out another way to save money. Let’s talk about change, but not that kind of change, change that we can achieve.

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