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About Alturas

Alturas Counseling, LLC is a private mental health practice servicing Boise, Idaho and the surrounding area. Alturas Counseling provides therapy to empower clients, helping them to establish hope in their lives. We provide both family counseling and individual therapy. We accept private pay, private insurance and Medicaid. We accept Visa, MasterCard, American Express and Discover cards.

Our office is located at 5185 W Overland Rd, near the intersection of Orchard and Overland. Our hours of operation are Mondays 9-5, Tuesdays 2-4, Wednesdays 9-5 and Thursdays 9 to noon.

Additional Boise Idaho office information 

We proudly provide mental health services to Idaho’s Treasure Valley. This includes Boise, Garden City, Meridian, Eagle, Emmett, Kuna, Nampa, Caldwell and Star.

Our areas of Mental Health expertise include:

Academic Underachievement

An underachiever is a person and especially a student who fails to achieve his or her potential or does not do as well as expected.

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Of particular interest is academic underachievement. Studies of individuals who have not realized their apparent potential have identified learning disabilities, ADHD, and many other educational problems, and enabled methods of addressing these problems. Current theories among academic scholars prefer to address underperformance problems with remedial help.

Academic underachievement can also be attributed to relatively intelligent or gifted students, who do not perform as expected either because they are bored or choose not to excel.

Addiction

Addiction is a state defined by compulsive engagement in naturally rewarding behavior or compulsive drug use, despite adverse consequences; it can be thought of as a disease or biological process leading to such behaviors.

According to many addiction specialists, potential non-drug addictions can include, but are not limited to, exercise addiction, food addiction, computer addiction,

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sex addiction and gambling. Currently, only substance addictions and gambling addiction are recognized by the DSM-5.  Classic hallmarks of addiction include impaired control over substances or behavior, preoccupation with substance or behavior, continued use despite consequences, and denial. Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs).

Physiological dependence occurs when the body has to adjust to the substance by incorporating the substance into its “normal” functioning. This state creates the conditions of tolerance and withdrawal. Tolerance is the process by which the body continually adapts to the substance and requires increasingly larger amounts to achieve the original effects. Withdrawal refers to physical and psychological symptoms experienced when reducing or discontinuing a substance that the body has become dependent on. Symptoms of withdrawal generally include but are not limited to anxiety, irritability, intense cravings for the substance, nausea, hallucinations, headaches, cold sweats, and tremors.

Attention Deficit Hyperactivity Disorder | ADHD

Attention deficit hyperactivity disorder  is a psychiatric disorder  in which there are significant problems of attention, hyperactivity, or

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acting impulsively that are not appropriate for a person’s age. These symptoms must begin by age six to twelve and persist for more than six months for a diagnosis to be made. In school-aged individuals inattention symptoms often result in poor school performance.

Despite being the most commonly studied and diagnosed psychiatric disorder in children and adolescents, the cause in the majority of cases is unknown. It affects about 6–7% of children.  ADHD is diagnosed approximately three times more in boys than in girls.  About 30–50% of people diagnosed in childhood continue to have symptoms into adulthood and between 2–5% of adults have the condition. 

ADHD management usually involves some combination of counseling, lifestyle changes, and medications. Medications are only recommended as a first-line treatment in children who have severe symptoms and may be considered for those with moderate symptoms who either refuse or fail to improve with counseling. Long-term effects of medications are not clear and they are not recommended in preschool-aged children. Adolescents and adults tend to develop coping skills which make up for some or all of their impairments.

  • Adolescent Therapy

Alcohol Abuse | Alcoholism

Alcohol abuse is a psychiatric diagnosis describing the recurring use of alcohol despite its negative consequences.  Alcohol abuse is sometimes referred to by the less specific term alcoholism.

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However, many definitions of alcoholism exist, and only some are compatible with alcohol abuse. There are two types of alcoholics: those who have anti-social and pleasure-seeking tendencies, and those who are anxiety-ridden people who are able to go without drinking for long periods of time but are unable to control themselves once they start. Binge drinking is another form of alcohol abuse. 

When differentiating between alcohol abuse and alcoholism, one should remember that alcohol abuse is when the abuser has faced critical consequences for their actions, recently, while an alcoholic has experienced a sense of withdrawal in the same time period.

Anger Management

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Anger management is training for temper control and is the skill of remaining calm.  Anger management programs consider anger to be a motivation caused by an identifiable reason which can be logically analyzed and if suitable worked toward. Some popular anger management techniques include relaxation techniques, cognitive restructuring, problem solving and improving communication strategies.

Anxiety | Anxiety Disorder

Anxiety disorders are a group of mental disorders characterized by feelings of anxiety and fear, where anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a racing heart and shakiness. There are various forms of anxiety disorders, including generalized anxiety disorder, phobic disorder, and panic disorder. While each has its own

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characteristics and symptoms, they all include symptoms of anxiety.

Anxiety disorders are partly genetic but may also be due to drug use including alcohol and caffeine, as well as withdrawal from certain drugs. They often occur with other mental disorders, particularly major depressive disorder, bipolar disorder, certain personality disorders, and eating disorders. The term anxiety covers four aspects of experiences that an individual may have: mental apprehension, physical tension, physical symptoms and dissociative anxiety. The emotions present in anxiety disorders range from simple nervousness to bouts of terror. There are other psychiatric and medical problems that may mimic the symptoms of an anxiety disorder, such as hyperthyroidism.

Common treatment options include lifestyle changes, therapy, and medications. Medications are typically recommended only if other measures are not effective.  Anxiety disorders occur about twice as often in females as males, and generally begin during childhood.  As many as 18% of Americans and 14% of Europeans may be affected by one or more anxiety disorders.

Asperger's Syndrome

Asperger syndrome (AS), also known as Asperger disorder (AD) or simply Asperger’s, is an autism spectrum disorder (ASD) that is

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characterized by significant difficulties in social interaction and nonverbal communication, alongside restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. Although not required for diagnosis, physical clumsiness and atypical (peculiar, odd) use of language are frequently reported. 

The syndrome is named after the Austrian pediatrician Hans Asperger who, in 1944, studied and described children in his practice who lacked nonverbal communication skills, demonstrated limited empathy with their peers, and were physically clumsy. The modern conception of Asperger syndrome came into existence in 1981 and went through a period of popularization, becoming standardized as a diagnosis in the early 1990s. 

The exact cause of Asperger’s is unknown. Although research suggests the likelihood of a genetic basis, there is no known genetic cause and brain imaging techniques have not identified a clear common pathology. There is no single treatment, and the effectiveness of particular interventions is supported by only limited data.  Intervention is aimed at improving symptoms and function. The mainstay of management is behavioral therapy, focusing on specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness. Most children improve as they mature to adulthood, but social and communication difficulties may persist. Some researchers and people with Asperger’s have advocated a shift in attitudes toward the view that it is a difference, rather than a disability that must be treated or cured.

  • Behavioral Issues

Bipolar Disorder | Bipolar Affective Disorder

Bipolar disorder, also known as bipolar affective disorder (and originally called manic-depressive illness), is a mental disorder characterized by periods of elevated mood and periods of depression. The elevated mood is significant and is known asmania or hypomania depending on the severity or whether there is psychosis. During mania an individual feels or acts abnormally happy, energetic, or irritable. They often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced. During periods of depression there may be crying, poor eye contact with others, and a negative outlook on life. The risk of suicide among those with the disorder is high at greater than 6% over 20 years, while self harm occurs in 30–40%. Other mental health issues such as anxiety disorder and drug misuse are commonly associated.

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The cause is not clearly understood, but both genetic and environmental factors may play a role. Many genes of small effect contribute to risk. Environmental factors include long term stress and a history of childhood abuse. It is divided into bipolar I disorder if there is at least one manic episode and bipolar II disorder if there are at least one hypomanic episode and one major depressive episode. In those with less severe symptoms of a prolonged duration the condition cyclothymic disorder may be present. If due to drugs or medical problems it is classified separately. Other conditions that may present in a similar manner include: drug misuse,personality disorders, attention deficit hyperactivity disorder, and schizophrenia as well as a number of medical conditions.

Treatment commonly includes psychotherapy and medications such as mood stabilizers or antipsychotics. Examples of mood stabilizers that are commonly used include: lithium and anticonvulsants. Treatment in hospital against a person’s wishes may be required at times as people may be at risk to themselves or others yet refuse treatment. Severe behavioural problems may be managed with short term benzodiazepines or antipsychotics. In periods of mania it is recommended that antidepressants be stopped. If antidepressants are used for periods of depression they should be used with a mood stabilizer. Electroconvulsive therapy may be helpful in those who do not respond to other treatments. If treatments is stopped it is recommended that this be done slowly. Most people have social, financial or work related problem due to the disorder. These difficulties occur a quarter to a third of the time on average. The risk of death from natural causes such as heart disease is twice that of the general population. This is due to poor lifestyle choices and the side effects from medications.

About 3% of people in the United States have bipolar disorder at some point in their life. Lower rates of around 1% are found in other countries. The most common age at which symptoms begin is 25. Rates appear to be similar in males as females. The economic costs of the disorder has been estimated at $45 billion for the United States in 1991. A large proportion of this was related to a higher number of missed work days estimated at 50 per year. People with bipolar disorder often face problems with social stigma.

  • Bisexual Issues

Borderline Personality Disorder

Borderline personality disorder (BPD) (also called emotionally unstable personality disorder, emotional intensity disorder, or borderline type) is a cluster-B personality disorder, the essential feature of which is a pattern of marked impulsivity and instability of affects, interpersonal relationships and self image. The pattern is present by early adulthood and occurs across a variety of situations and contexts.

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Other symptoms usually include intense fears of abandonment and intense anger and irritability, the reason for which others have difficulty understanding. People with BPD often engage in idealization and devaluation of others, alternating between high positive regard and great disappointment. Self-harm and suicidal behavior are common.

The disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders. Because a personality disorder is a pervasive, enduring, and inflexible pattern of maladaptive inner experiences and pathological behavior, there is a general reluctance to diagnose personality disorders before adolescence or early adulthood. However, some emphasize that without early treatment symptoms may worsen.

  • Chronic Relapse

Codependency | Codependent Relationships

Codependent relationships are a type of dysfunctional helping relationship where one person supports or enables another person’s addiction, poor mental health, immaturity, irresponsibility, or

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under-achievement. People with a predisposition to be a codependent enabler often find themselves in relationships where their primary role is that of rescuer, supporter, and confidante. These helper types are often dependent on the other person’s poor functioning to satisfy their own emotional needs. Codependency often involves placing a lower priority on one’s own needs, while being excessively preoccupied with the needs of others. Codependency can occur in any type of relationship, including family, work, friendship, and also romantic, peer or community relationships. Codependency may also be characterized by denial, low self-esteem, excessive compliance, or control patterns.

Coping Skills

In psychology, coping is expending conscious effort to solve personal and interpersonal problems, and seeking to master, minimize or tolerate stress or conflict. The effectiveness of the coping efforts depend on the type of stress and/or conflict, the particular individual, and the circumstances.

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Psychological coping mechanisms are commonly termed coping strategies or coping skills. Subconscious or non conscious strategies (e.g. defense mechanisms) are generally excluded. The term coping generally refers to adaptive or constructive coping strategies, i.e. the strategies reduce stress levels. However, some coping strategies can be considered maladaptive, i.e. stress levels increase. Maladaptive coping can thus be described, in effect, as non-coping. Furthermore, the term coping generally refers to reactive coping, i.e. the coping response follows the stressor. This contrasts with proactive coping, in which a coping response aims to head off a future stressor.

Coping responses are partly controlled by personality (habitual traits), but also partly by the social environment, particularly the nature of the stressful environment.

Depression

Depression is a state of low mood and aversion to activity that can affect a person’s thoughts, behavior, feelings and sense of well-being. Depressed people can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable or restless. They may lose interest in activities that were once pleasurable, experience loss

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of appetite or overeating, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present.

Depression is a feature of some psychiatric syndromes such as major depressive disorder but it may also be a normal reaction to life events such as bereavement, a symptom of some bodily ailments or a side effect of some drugs and medical treatments.

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Developmental Disorders

Developmental disorders is a group of psychiatric conditions originating in childhood that involve serious impairment in different areas.

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These disorders comprise language disorders, learning disorders, motor disorders and autism spectrum disorders. In broader definitions ADHD is included, and the term used is neurodevelopmental disorders. Yet others include antisocial behavior and schizophrenia that begins in childhood and continues through life. However, these two latter conditions are not as stable as the other developmental disorders, and there is not the same evidence of a shared genetic liability.

Developmental disorders are present from early life. They usually improve as the child grows older, but they also entail impairments that continue through adult life. There is a strong genetic component, and more males are afflicted than females.

Dissociative Disorders

Dissociative disorders (DD) are conditions that involve disruptions or breakdowns of memory, awareness, identity or perception. People with dissociative disorders use dissociation, a defense mechanism, pathologically and involuntarily. Dissociative disorders are thought to primarily be caused by psychological trauma.

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The dissociative disorders listed in the American Psychiatric Association’s DSM-5 are as follows:

  • Dissociative identity disorder (formerly multiple personality disorder): the alternation of two or more distinct personality states with impaired recall among personality states. In extreme cases, the host personality is unaware of the other, alternating personalities; however, the alternate personalities are aware of all the existing personalities. This category now includes the old derealization disorder category.
  • Dissociative amnesia (formerly psychogenic amnesia): the temporary loss of recall memory, specifically episodic memory, due to a traumatic or stressful event. It is considered the most common dissociative disorder amongst those documented. This disorder can occur abruptly or gradually and may last minutes to years depending on the severity of the trauma and the patient. Dissociative fugue (formerly psychogenic fugue) is now subsumed under the Dissociative amnesia category. It is described as reversible amnesia for personal identity, usually involving unplanned travel or wandering, sometimes accompanied by the establishment of a new identity. This state is typically associated with stressful life circumstances and can be short or lengthy.
  • Depersonalization disorder: periods of detachment from self or surrounding which may be experienced as “unreal” (lacking in control of or “outside of” self) while retaining awareness that this is only a feeling and not a reality.

  • Divorce
  • Domestic Abuse or Violence

Drug Abuse | Substance Abuse

Substance abuse, also known as drug abuse, is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods which are harmful to themselves or others. The exact cause of substance abuse is impossible to know because there is not just one direct cause. However substance abuse and addiction is known to run in families. One theory suggests there is a genetic disposition which predisposes certain individuals toward substance abuse. Another suggests substance abuse is learned there for people subjected to substance abuse by those around

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them begin to copy the same behaviors. Substance abuse might start out as a bad habit but when and if addiction develops it manifests as a chronic debilitating disease.

The terms have a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect. All of these definitions imply a negative judgment of the drug use in question (compare with the term responsible drug use for alternative views). Some of the drugs most often associated with this term include alcohol, substituted amphetamines, barbiturates, benzodiazepines (particularly alprazolam, temazepam, diazepam and clonazepam), cocaine, methaqualone, and opioids. Use of these drugs may lead to criminal penalty in addition to possible physical, social, and psychological harm, both strongly depending on local jurisdiction. There are many cases in which criminal or anti-social behavior occur when the person is under the influence of a drug. Long term personality changes in individuals may occur as well. Other definitions of drug abuse fall into four main categories: public health definitions, mass communication and vernacular usage, medical definitions, and political and criminal justice definitions. Substance abuse is prevalent with an estimated 120 million users of hard drugs such as cocaine, heroin, and other synthetic drugs.

Dual Diagnosis | Co-occurring disorders

Dual diagnosis (also called co-occurring disorders, COD) is the condition of suffering from a mental illness and a comorbid substance abuse problem. There is considerable debate surrounding the appropriateness using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and

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alcoholism, or it can be restricted to specify severe mental illness (e.g. psychosis, schizophrenia) and substance misuse disorder (e.g. cannabis abuse), or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. Diagnosing a primary psychiatric illness in substance abusers is challenging as drug abuse itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness.

Those with co-occurring disorders face complex challenges. They have increased rates of relapse, hospitalization, homelessness, HIV and Hepatitis C infection compared to those with either mental or substance use disorders alone. The cause of co-occurring disorders is unknown, although there are several theories.

Eating disorders

Eating disorders are psychological illnesses defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health. Bulimia nervosa and anorexia nervosa are the most common specific forms of eating disorders. Other types of eating disorders include binge eating disorder and OSFED.

Bulimia nervosa is a disorder characterized by binge eating and purging. Purging can include self-induced vomiting, over-exercising, and the usage of diuretics, enemas, and laxatives. Anorexia nervosa is characterized by extreme food restriction to the point of self-starvation and excessive weight loss. There are two subtypes of anorexia nervosa—the restricting type and the binge/purge type. Those who suffer from the restricting type of anorexia nervosa lose weight by restricting weight, sometimes by over-exercising, whereas those suffering from the binge/purge type overeat and/or compensate through some method of purging. The distinction between the binge/purge type and bulimia nervosa is that those diagnosed with binge/purge type are below a healthy body weight, while those with bulimia nervosa are at least normal weight. Though primarily thought of as affecting females, eating disorders affect males as well. 

Get 10 Facts about Eating Disorders

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Although eating disorders are increasing all over the world among both men and women, there is evidence to suggest that it is women in the Western world who are at the highest risk of developing them and the degree of westernization increases the risk. Nearly half of all Americans personally know someone with an eating disorder.

The precise cause of eating disorders is not entirely understood, but there is evidence that it may be linked to other medical conditions and situations. Cultural idealization of thinness and youthfulness have contributed to eating disorders affecting diverse populations. One study showed that girls with ADHD have a greater chance of getting an eating disorder than those not affected by ADHD. Another study suggested that women with PTSD, especially due to sexually related trauma, are more likely to develop anorexia nervosa.

  • Elderly Persons Disorders

Emotional Disturbance

Emotional disturbance is a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

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(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems.
The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.

  • Entitlement
  • Family Conflict
  • Gay / Lesbian (LGBT) Issues

Grief

Grief is a multifaceted response to loss, particularly to the loss of someone or something that has died, to which a bond or affection was formed. Although conventionally focused on the emotional response to loss, it also has physical, cognitive, behavioral, social, spiritual, and philosophical dimensions. While the terms are often used interchangeably, bereavement refers to the state of loss, and grief is the reaction to loss.

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Grief is a natural response to loss. It is the emotional suffering one feels when something or someone the individual loves is taken away. Grief is also a reaction to any loss. The grief associated with death is familiar to most people, but individuals grieve in connection with a variety of losses throughout their lives, such as unemployment, ill health or the end of a relationship. Loss can be categorized as either physical or abstract, the physical loss being related to something that the individual can touch or measure, such as losing a spouse through death, while other types of loss are abstract, and relate to aspects of a person’s social interactions.

Impulse Control Disorders

Impulse control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a

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temptation, urge or impulse that may harm oneself or others. Many psychiatric disorders feature impulsivity, including substance-related disorders, attention deficit hyperactivity disorder, antisocial personality disorder, borderline personality disorder, conduct disorder, schizophrenia and mood disorders.

Infidelity

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Infidelity (also referred to as cheating, adultery, or having an affair) is the subjective feeling that one’s partner has violated a set of rules or relationship norms and this violation results in feelings of sexual jealousy and rivalry. Infidelity is a violation of a couple’s assumed or stated contract regarding emotional and/or sexual exclusivity.

Intimacy Issues

Fear of intimacy is generally a social phobia and anxiety disorder resulting in difficulty forming close relationships with another person. The term can also refer to a scale on a psychometric test, or a type of adult in attachment theory psychology.

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The fear of intimacy is the fear of being emotionally and/or physically close to another individual. This fear is also defined as “the inhibited capacity of an individual, because of anxiety, to exchange thought and feelings of personal significance with another individual who is highly valued”.  Fear of intimacy is the expression of existential views in that to love and to be loved makes life seem precious and death more inevitable. It often results from past traumas such as rape or child sexual abuse. Fear of intimacy is also related to the fear of being touched.

Learning Disabilities

Learning disability is a classification including several areas of functioning in which a person has difficulty learning in a typical manner, usually caused by an unknown factor or factors.

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While learning disability, learning disorder and learning difficulty are often used interchangeably, they differ in many ways. Disability refers to significant learning problems in an academic area. These problems, however, are not enough to warrant an official diagnosis. Learning disorder, on the other hand, is an official clinical diagnosis, whereby the individual meets certain criteria, as determined by a professional (psychologist, pediatrician, etc.). The difference is in degree, frequency, and intensity of reported symptoms and problems, and thus the two should not be confused. When the term “learning disabilities” is used, it describes a group of disorders characterized by inadequate development of specific academic, language, and speech skills. Types of learning disabilities include reading disability (dyslexia), mathematics disability (dyscalculia) and writing disability (dysgraphia).

The unknown factor is the disorder that affects the brain’s ability to receive and process information. This disorder can make it problematic for a person to learn as quickly or in the same way as someone who is not affected by a learning disability. People with a learning disability have trouble performing specific types of skills or completing tasks if left to figure things out by themselves or if taught in conventional ways.

Individuals with learning disabilities can face unique challenges that are often pervasive throughout the lifespan. Depending on the type and severity of the disability, interventions and current technologies may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simplistic, while others are intricate and complex. Current technologies may require student training to be effective classroom supports. Teachers, parents and schools can create plans together that tailor intervention and accommodations to aid the individuals in successfully becoming independent learners. School psychologists and other qualified professionals quite often help design the intervention and coordinate the execution of the intervention with teachers and parents. Social support may improve the learning for students with learning disabilities.

Intellectual Disability

Intellectual disability (ID), also called intellectual development disorder (IDD) and formerly known as mental retardation(MR),[is a neurodevelopmental disorder characterized by

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impaired intellectual and adaptive functioning which is defined by an IQ score below 70 as well as a delay in general daily living skills. Other common symptoms include speech delays and lack of social functioning. Down syndrome and Fragile X syndrome often overlap with ID.

Mood Disorders

Mood disorder is a group of diagnoses where a disturbance in the person’s mood is hypothesized to be the main underlying feature.

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Two groups of mood disorders are broadly recognized; the division is based on whether a manic or hypomanic episode has ever been present. Thus, there are depressive disorders, of which the best-known and most researched is major depressive disorder (MDD) commonly called clinical depression or major depression, and bipolar disorder (BD), formerly known as manic depression and characterized by intermittent episodes of mania or hypomania, usually interlaced with depressive episodes. However, there are also psychiatric syndromes featuring less severe depression known as dysthymic disorder (similar to but milder than MDD) and cyclothymic disorder (similar to but milder than BD).

Narcissistic Personality

Narcissistic Personality Disorder (NPD) is a personality disorder in which a person is excessively preoccupied with personal adequacy, power, prestige and vanity,

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mentally unable to see the destructive damage they are causing to themselves and to others in the process. It is estimated that this condition affects one percent of the population. First formulated in 1968, NPD was historically called megalomania, and is a form of severe egocentrism.

Obsessive-Compulsive Disorder | OCD

Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviors aimed at reducing the associated anxiety (compulsions), or a combination of such obsessions and compulsions. Symptoms of the disorder include excessive washing or cleaning, repeated checking, extreme hoarding, preoccupation with sexual, violent or religious thoughts, relationship-related obsessions, aversion to particular numbers and nervous rituals such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms are time-consuming, might result in loss of relationships with others, and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and potentially psychotic. However, people with OCD generally recognize their obsessions and compulsions as irrational and may become further distressed by this realization. Despite the irrational behavior, OCD is associated with high verbal IQ.

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Treatment for OCD involves the use of behavioral therapy and sometimes selective serotonin reuptake inhibitors (SSRIs). The type of behavior therapy used involves increasing exposure to what causes the problems while not allowing the compulsive behavior to occur.

Obsessive–compulsive disorder affects children and adolescents, as well as adults. Roughly one third to one half of adults with OCD report a childhood onset of the disorder, suggesting the continuum of anxiety disorders across the lifespan. The phrase obsessive–compulsive has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is excessively meticulous, perfectionistic, absorbed, or otherwise fixated.

Parenting

Parenting (or child rearing) is the process of promoting and supporting the physical, emotional, social, and intellectual development of a child from infancy to adulthood. Parenting refers to the aspects of raising a child aside from the biological relationship.

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The most common partaker in parenting is the biological parent(s) of the child in question, although others may be an older sibling, a grandparent, a legal guardian, aunt, uncle or other family member or a family friend. Governments and society take a role as well. In many cases, orphaned or abandoned children receive parental care from non-parent blood relations. Others may be adopted, raised in foster care, or placed in an orphanage. Parenting skills vary, and a parent with good parenting skills may be referred to as a good parent. Views on the characteristics that make one a good parent vary from culture to culture.

Peer Relationships

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Children’s friendships have inevitable ups and downs. Yet the feelings of satisfaction and security that most children derive from interacting with peers outweigh periodic problems. For a number of children, however, peer relations are persistently problematic. Some children are actively rejected by peers. Others are simply ignored, or neglected. It even appears that some popular children have many friends but nevertheless feel alone and unhappy.

Personality Disorders

Personality disorders are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual’s culture. These patterns develop early, are inflexible, and are associated with significant distress or disability.

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Personality, defined psychologically, is the set of enduring behavioral and mental traits that distinguish human beings. Hence, personality disorders are defined by experiences and behaviors that differ from societal norms and expectations. Those diagnosed with a personality disorder may experience difficulties in cognition, emotiveness, interpersonal functioning, or control of impulses. In general, personality disorders are diagnosed in 40–60 percent of psychiatric patients, making them the most frequent of all psychiatric diagnoses.

These behavioral patterns in personality disorders are typically associated with substantial disturbances in some behavioral tendencies of an individual, usually involving several areas of the personality, and are nearly always associated with considerable personal and social disruption. A person is classified as having a personality disorder if their abnormalities of behavior impair their social or occupational functioning. Additionally, personality disorders are inflexible and pervasive across many situations, due in large part to the fact that such behavior may be ego-syntonic (i.e. the patterns are consistent with the ego integrity of the individual) and are, therefore, perceived to be appropriate by that individual. This behavior can result in maladaptive coping skills, which may lead to personal problems that induce extreme anxiety, distress, or depression. These patterns of behavior typically are recognized in adolescence and the beginning of adulthood and, in some unusual instances, childhood.

Psychosis

Psychosis refers to an abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a “loss of contact with reality”. People with psychosis are

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described as psychotic. People experiencing psychosis may exhibit some personality changes and thought disorder. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out daily life activities.

The term “psychosis” is very broad and can mean anything from relatively normal aberrant experiences through to the complex and catatonic expressions of schizophrenia and bipolar type 1 disorder. In properly diagnosed psychiatric disorders (where other causes have been excluded by extensive medical and biological laboratory tests), psychosis is a descriptive term for the hallucinations, delusions, sometimes violence, and impaired insight that may occur. Psychosis is generally given to noticeable deficits in normal behavior (negative signs) and more commonly to diverse types of hallucinations or delusional beliefs, especially as regards the relation between self and others as in grandiosity and pronoia/paranoia.

  • Relationship Issues

Self Esteem

Self-esteem is a term used to reflect a person’s overall emotional evaluation of his or her own worth. It is a judgment of oneself as well as an attitude toward the self. Self-esteem encompasses beliefs (for example, “I am competent,” “I am worthy”) and emotions such as triumph, despair, pride and shame. 

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As a social psychological construct, self-esteem is attractive because researchers have conceptualized it as an influential predictor of relevant outcomes, such as academic achievement or exercise behavior. In addition, self-esteem has also been treated as an important outcome due to its close relation with psychological well-being. Self-esteem can apply specifically to a particular dimension (for example, “I believe I am a good writer and I feel happy about that”) or a global extent (for example, “I believe I am a bad person, and feel bad about myself in general”). Psychologists usually regard self-esteem as an enduring personality characteristic (“trait” self-esteem), though normal, short-term variations (“state” self-esteem) also exist.

Self Harm

Self-harm (SH) or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidal intentions. 

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The most common form of self-harm is skin-cutting but self-harm also covers a wide range of behaviors including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing, hair-pulling  and the ingestion of toxic substances or objects. Behaviors associated with substance abuse and eating disorders are usually not considered self-harm because the resulting tissue damage is ordinarily an unintentional side effect. Although suicide is not the intention of self-harm, the relationship between self-harm and suicide is complex, as self-harming behavior may be potentially life-threatening. There is also an increased risk of suicide in individuals who self-harm to the extent that self-harm is found in 40–60% of suicides. However, generalizing self-harmers to be suicidal is, in the majority of cases, inaccurate.

Sexual Abuse

Sexual abuse, also referred to as molestation, is forcing undesired sexual behavior by one person upon another. When that force is immediate, of short duration, or

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infrequent, it is called sexual assault. The offender is referred to as a sexual abuser or molester. The term also covers any behavior by any adult towards a child to stimulate either the adult or child sexually. When the victim is younger than the age of consent, it is referred to as child sexual abuse.

Sleeplessness| Insomnia

Insomnia, or sleeplessness, is a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired. While the term is sometimes used to

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describe a disorder demonstrated by evidence of disturbed sleep, this sleep disorder is often practically defined as a positive response to either of two questions: “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?”

Insomnia is most often thought of as both a medical sign and a symptom that can accompany several sleep, medical, and psychiatric disorders characterized by a persistent difficulty falling asleep and/or staying asleep or sleep of poor quality. Insomnia is typically followed by functional impairment while awake. Insomnia can occur at any age, but it is particularly common in the elderly. Insomnia can be short term (up to three weeks) or long term (above 3–4 weeks); it can lead to memory problems, depression, irritability and an increased risk of heart disease and automobile related accidents.

Suicidal Ideation

Suicidal ideation is a medical term for thoughts about or an unusual preoccupation with suicide. The range of suicidal ideation varies greatly from fleeting

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thoughts, to extensive thoughts, to detailed planning, role playing (e.g., standing on a chair with a noose), and unsuccessful attempts, which may be deliberately constructed to fail or be discovered, or may be fully intended to result in death, but the individual survives (e.g., for example in the case of a hanging in which the cord breaks).

Most people who undergo suicidal ideation do not go on to make suicide attempts, but it is considered a risk factor. Suicidal ideation is generally associated with depression; however, it seems to have associations with many other psychiatric disorders, life events, and family events, all of which may increase the risk of suicidal ideation. Recurrent suicidal behavior and suicidal ideation is a hallmark of borderline personality disorder. One study found that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts. Currently, there are a number of different treatment options for those experiencing suicidal ideation.

Thought Disorders

Thought disorder (TD) or formal thought disorder (FTD) refers to disorganized thinking as evidenced by disorganized speech. Specific thought disorders

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include derailment, poverty of speech, tangentiality, illogicality, perseveration, neologism, and thought blocking.

Psychiatrists consider formal thought disorder as being one of two types of disordered thinking, with the other type being delusions. The latter involves “content” while the former involves “form”. Although the term “thought disorder” can refer to either type, in common parlance it refers most often to a disorder of thought “form” also known as formal thought disorder.

Trauma | Post traumatic Stress Disorder

Post traumatic stress disorder (PTSD) may develop after a person is exposed to one or more traumatic events, such as sexual assault, warfare, serious injury, or

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threats of imminent death. The diagnosis may be given when a group of symptoms, such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal, continue for more than a month after the occurrence of a traumatic event.

Most people having experienced a traumatizing event will not develop PTSD. Women are more likely to experience higher impact events, and are also more likely to develop PTSD than men. Children are less likely to experience PTSD after trauma than adults, especially if they are under ten years of age. War veterans are commonly at risk for PTSD.

More on PTSD here

Traumatic Brain Injury

Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on

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severity, mechanism (closed or penetrating head injury), or other features (e.g., occurring in a specific location or over a widespread area). Head injury usually refers to TBI, but is a broader category because it can involve damage to structures other than the brain, such as the scalp and skull.

Brain trauma can occur as a consequence of a focal impact upon the head, by a sudden acceleration/deceleration within the cranium or by a complex combination of both movement and sudden impact. In addition to the damage caused at the moment of injury, brain trauma causes secondary injury, a variety of events that take place in the minutes and days following the injury. These processes, which include alterations in cerebral blood flow and the pressure within the skull, contribute substantially to the damage from the initial injury.

TBI can cause a host of physical, cognitive, social, emotional, and behavioral effects, and outcome can range from complete recovery to permanent disability or death. Depending on the injury, treatment required may be minimal or may include interventions such as medications, emergency surgery or surgery years later. Physical therapy, speech therapy, recreation therapy, occupational therapy and vision therapy may be employed for rehabilitation.

 

Feel free to contact us with any questions or to schedule an appointment.  You can also visit our Resources page to find helpful links to other services.

 

 

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