Cognitive-Behavior Therapy, Mindfulness, CBIT, ERP, CBT-I, Behavior Consultation, and Treatment for Anxiety and Insomnia

Laura Van Schaick-Harman, Psy.D., BC-TMH


Dr. Laura's Meaningful Psychological Services

Online and Office Based Cognitive-Behavioral Therapy

Blog

What Not To Do

Posted on November 13, 2017 at 2:10 PM Comments comments (3)

“Don’t put that in your mouth!”

“Stop doing that!”

"No!"

When I was in graduate training, one of the most helpful and useful tools I learned was the dead person rule. No, I am not about to launch into some morbid explanation about behavior.

The dead person rule refers to a parenting behavior management principle. Avoid using language that a dead person could do. Instead, use language that specifically describes what someone should be doing rather than what they should not be doing.

Instead of "Don't touch that," say "Put your hands on the table."

Instead of "Stop pulling your sister's hair," say "Please move your seat over there."

This helps the child to understand what is expected of them and helps to redirect unwanted behavior in a non-punitive way.

Try it and see if it helps to create a calmer and clearer environment for your family

Making a Change

Posted on September 11, 2017 at 1:00 PM Comments comments (5)

It's the start of a new season. School is back in session. We are going from summer to fall. And yet many of us are stuck doing the same old habits.


What if there were a way to effectively and safely change a behavior? There is! It is important to make sure any method used is backed by science and research before setting off on a new lifestyle.


First, if you want to change a habit, you need to define it. While "living a healthier lifestyle" is an admirable goal and sounds great on the surface, what does this really mean? Does it involve changes in exercise, diet, relationships, work, friendships, or social media use? Let's say we target the domain of exercise for example. This is still not specific enough. Does this mean exercise running on a treadmill, kayaking down a river, going to the gym, or swimming? It is important to specifically define a target behavior before starting anything else with changing a behavior. You have to know what you are changing before you change it. An example of a well-defined target behavior for change would be "exercise as defined by walking, running, jogging, stretching, or doing yoga either at the gym or at home."


Next, you will need to track how often you are currently engaging in the target behavior and then modify the goal as needed. There are a variety of ways to track behavior, also known as collecting data. It is important to choose a method that is easy to use and not overwhelming. It can be as simple as writing down the amount of time you spend and type of exercise each day for a period of 2 weeks or more involved such as tracking the duration to spend at each time of exercise. This is to be done before any intervention is created and used, so you can get an accurate idea of how often you are currently engaging in the behavior and a baseline for measuring progress.


Next, you will use this information to revise your goal and develop an intervention plan targeting your specific goal. An example of a specific and measurable goal is "exercise 3 days a week at the gym for 30 minutes and 1 day a week at home for 30 minutes." This is also when the use of reinforcement comes in. This means using a reinforcer, or something pleasurable and rewarding, to reinforcing meeting goals. The intervention may involve redirection, problem solving, or the help of a professional.


If you want to dig deeper into these concepts and more, you can access my very affordable Behavior Change Ahead online course. You will have unlimited 24/7 access to 4 hours of content walking you through how to make a behavior change effectively and with science on your side. Here is the link.


Free Behavior Change Class

Posted on May 16, 2016 at 1:00 PM Comments comments (4)

Welcome to May! The flowers are blooming and the weather is getting warmer. It is a great time to practice being mindful and enjoy our surroundings. Of course, the beauty of mindfulness is that it is always a good time to practice since the only thing you need is the present moment, which we always have. Take a mindful walk this month and notice all the details of the world around you. You might be surprised by what you see (I know I have been!).

 

 

For this month, I am sharing an exciting resource with you. This is the first class of my habit change course, Behavior Change Ahead. This class includes information about how to change unhealthy habits and how to understand our behavior. Do you ever wonder "why do I do what I do?" This class will help you to answer this question and can provide you with beginning steps to change an unhealthy habit.

 

 

https://www.freeconferencecall.com/wall/recorded_audio?audioRecordingUrl=https%3A%2F%2Frs0000.freeconferencecall.com%2Fstorage%2FsgetFCC2%2FOrFzI%2Falw7&subscriptionId=5504662" target="_blank">Free Class: First 1 Hour of Behavior Change Ahead Course

 

 

I hope you find this first class helpful. It is my gift to you. If you would like to access the complete course, which includes an additional three hours of content about the functions of behavior, collecting data, reinforcement, and interventions, as well as a workbook to support your learning, click here to purchase.

 

 

Let's change an unhealthy habit together.

 

 

 

Mindfully, Dr. Laura

Making Behavior Changes That Stick

Posted on January 19, 2016 at 6:15 AM Comments comments (4)

It's New Year's Resolution time. Did you make one?

 

 

Did you know that the calendar doesn't need to tell you when and when not to make a behavior change in your life? In fact, you can make a change when you decide you would like to.

 

 

However, it is helpful to join the momentum of support this time of year to help us stick to our resolutions. So, let's jump on, eh?

 

 

In order to make a change that lasts, there are several factors that need to be considered.

 

 

First, effective goal setting is key. There are a variety of strategies for choosing a goal that you can actually achieve. I recommend choosing a goal that is specific, not too general, and can be observed and measured. I also like to set up baby steps or objectives that assist us in working towards our goals.

 

 

Another is enlisting a social support network. If you have worked with me before, we probably talked about your social support. During New Year's Resolution time, social support may be more readily available to you and there may be others in your network who are looking to achieve a similar goal. Perhaps this could be a support for you as well.

 

 

If you're interested in learning more, see below for a video about my brand new course Behavior Change Ahead.

 

 

Let's get there together.


Behavior Change Ahead Course is Available Now

 

 

Climbing The Ladder

Posted on October 16, 2015 at 6:05 AM Comments comments (3)

 

 

 

 

Have you ever looked at a big project and felt like you would never get it done? Maybe you felt overwhelmed by the amount of work or defeated by the challenges that stood in your way. Maybe you want to quit smoking but the idea of a life without cigarettes is foreign to you. Perhaps you want to move out on your own but you are struggling to find a job that pays enough. Maybe you want to lose weight, but you haven't changed your eating habits.

 

 

Big changes are the result of small successes. It's like climbing a ladder. We can't get to the top without climbing the steps. If you have a broad goal in mind, such as being healthier, having a better relationship with someone, quitting your job, or getting into college-think about all of the steps on the ladder to get there.

 

 

Now that you have thought of the steps, start at the bottom. The most important aspect of this is to celebrate each step that you take and succeed in. Punishment decreases behavior. Reinforcement increases behavior. If you want to stop working at your goals, then punishment is the way to go. If you want to reach your goal, reinforcement is your friend and punishment is your enemy. Don’t punish yourself along the way!

 

 

What ladder are you ready to climb?

 

 

What Behavior or Habit Do You Want To Change?

Posted on September 11, 2015 at 9:00 AM Comments comments (4)

 

Have you ever seen the same thing many times and then one day it looked different to you? I recently decided to head the opposite direction (for example east instead of west) on the route I take for my daily (as long as the weather cooperates) mindful walk. Do you know what I saw? The whole route differently. New plants, backyards, trees, sides of houses, cars, potholes, and light posts. I walked on the very same roads I had walked on hundreds of times and a whole new panorama of interesting things to enjoy was illuminated just by walking the opposite direction. This experienced has inspired me to explore areas in the neighborhood I hadn't yet seen, knowing I would have to turn around once I reached a dead end or a cul de sac on which I did not live - taking the risk of the residents wondering who I was!

 

 

Making behavior changes in our lives is very similar process. We get into a habit and get comfortable (even if it is an unhealthy habit) with our daily routine. It is hard to see things differently. It is hard to see that there could be other roads not taken or routes untravelled. We are afraid to take the risk.

 

 

Change happens when we take the risk. Change happens when we see things differently. Change happens when we are mindful of our environment. Change is hard work. But Change can also be very rewarding!

 

 

Change is within our reach. Though it might be difficult, change is possible. It might be as simple as making a left instead of a right.

 

 

What do you want to change?

 

 

Help Wanted!

 

 

I am working on a brand new behavior change course to help people learn how to change unhealthy habits and behaviors. It is going to be an awesome program to participate in. In order for me to put together a great course, can you take a minute and help me?

 

 

In order to make sure that I address the concerns that most people might have concerning changing unhealthy or disruptive behaviors, I would really appreciate it if you could answer the following brief questions. Please note that your responses are only to help me create a more successful program. I will not be using your names in the course, but may share some of your responses to these questions. I would be happy to get suggestions from anyone else that you know too! Just ask them to email their answers to me. See my email address below.

 

 

Here are the questions:

 

 

What is the biggest hurdle you face when trying to change a behavior?

 

 

What is a behavior you have tried to change in the past but was unsuccessful?

 

 

You can post a comment here or send me an e-mail at [email protected]

 

 

*Please remember that internet communications are not confidential. Please see http://www.meaningfulpsychservices.com/policies-resources for more information.

 

 

If you would like to answer but are not comfortable with posting a comment or sending an e-mail, you can also call me at 631-484-9679.

 

Focus on Mental Health

Posted on May 11, 2015 at 3:30 PM Comments comments (1)

 

May is National Mental Health Awareness Month. It is my hope in this month's post to reduce stigma around mental health concerns and utilizing therapy. There is great need for psychological services in our communities. It is an area ever evolving, changing, and growing.

 

Notice May is Mental Health not Mental Illness Awareness Month. As mental health professionals, our commitment to our work involves not only reducing symptoms, but also identifying and building strengths and abilities. Mental health is so much more than not having mental illness. It is not the absence of symptoms. Many mental health professionals will be able to help people not only get better but to also enhance strengths, skills, and abilities. A favorite Twitter bio of mine by NY Psychiatrist Dr. Samantha Boardman (@sambmd) includes the phrase "Fix what's wrong AND build what's strong." I love this sentence and I am on board.

 

Early in my training, I was introduced to the concept of looking at what goes right and not always just what is wrong. I am forever grateful for this. It is easy to get caught up in worry, anxiety, stress, and negative thinking patterns. It is not so easy to climb out from under these powerful thoughts and feelings, but it is possible. Therapy can help you dig out, breathe, and keep growing. This is the same concept as the saying "April showers bring May flowers."

 

In my practice, I utilize cognitive-behavior therapy and positive psychology. These styles of treatment have lots of research behind them and have been shown to help. The American Psychological Association has developed several brief animated videos to demonstrate how psychologists can help. You can watch them here.

 

Think you don't have time to go to therapy? No problem. With advancing technology, we can offer online therapy services. You can dig out and grow from your own home, office, car, playground, etc. There are options available so that your mental health can be nourished.

 

If you have questions or would like to learn more about how therapy can help you, I'm happy to talk with you for a free 15 minute consultation. All you have to do is schedule a time.

Telepsychology: I'm So Excited For Step 3!

Posted on December 12, 2014 at 7:10 PM Comments comments (0)


And here we are...Step 3. I am super excited to be writing this month's article. I am feeling full of gratitude, hope, and love as I am developing some new telepsychology programs and expanding current ones in my practice. This is an exciting time to be active as a psychologist, as I am watching the field evolve in front of me and within me. I am striving to embody the new changes while providing effective care. I know my colleagues are as well.

 

There are so many options available to you. From apps and video sessions to virtual reality offices and in-person visits. E-mail, online chat, text messaging, and phone mediums are up for grabs. Which is the right one for you? Goodness of fit is an important factor of the therapeutic relationship, which in turn affects the outcome of treatment. The fit I am speaking of is not only between the client and therapist, but also the method they use to work together as well.


 

Telepsychology services might be a great option for you and they might not. Phone sessions might be really convenient, or they might not. Perhaps information gathering, such as an online educational group (see below), is appropriate for you, but you prefer therapy sessions in-person. Goodness of fit varies from person-to-person, and this is healthy. I am hoping to encourage the community to step out of the comfort zone (after all, with preparation and skills, stepping out can lead to amazing growth), and explore the multitude of treatment and educational options available. Communities no longer need to be inhibited by location, income, anxiety, transportation, distance, or schedules.


 

I wish to communicate some telepsychology options available in my practice. Lets explore if we and any of these options might be a good fit for you.


 

Dr. Laura on Demand App

This is a brand new feature. Download it for free at this website: https://drlauraondemand.appsme.com/app/dr-laura/live-life-meaningfully. The Dr. Laura on Demand app allows you to contact me quickly and conveniently, read and watch meaningful content, articles, and resources, schedule appointments, and access unique discounts on services.


 

Live Meaningfully With Anxiety Room

Opening in early 2015, the Live Meaningfully With Anxiety Room is an online resource to help people dealing with anxiety to live healthy and fulfilling lives. Purchasing access to the Room will allow 24/7 availability of resources for dealing with anxiety, including panic-attack talk-downs, coping skills, the biology of anxiety, beating anxiety, progressive muscle relaxation, and more. Members will be able to log-in any time they feel anxious (as well as any other time they would like) to cope with the unpleasant feeling. Members of the Room will receive a discount on individual therapy services if they would like to continue work on an individual and personal level.


 

Behavior Management Group

Available for parents of children aged 2-12 years, the Behavior Management Group is designed to teach strategies for dealing with problem and difficult behavior effectively, safely, and positively. This is a great option for parents who would like to manage behavior and need ideas, resources, and want to learn what works and what doesn’t. Parents can choose to participate in live workshops, or just listen to them at a later more convenient time. There is a one-time fee for complete 24/7 access to this group.


 

There are more options available, not only in my practice, but in other psychology practices as well. I hope you find a good fit for you.


 

Oh, and if any of these choices are a great fit, and you access any one of them, you will get $10 off your first therapy session should you choose to pursue individual services.

How Do We Actually Keep Our New Year's Resolutions?

Posted on January 8, 2014 at 8:35 PM Comments comments (0)


How do we actually keep our New Year's Resolutions? This is a question that is asked each year, usually by the end of January. New Year's Resolutions are essentially goals that we set for ourselves to accomplish during the year. These goals, however, may not be met and are set to be the following year's resolutions. Why does this happen? How can we achieve our resolutions?


In my practice, we spend the first session or two, and then as often as needed, discussing long term and short term goals/objectives. These are different terms, to be discussed below. Often, a New Year's Resolution is a long term goal (e.g., "I want to loose weight," "I want to have a good bathing suit body," "I want to get a new job," "I want to quit smoking") and it does not reflect the certain attributes that are needed to actually be successful in attaining this goal.


If we want our resolutions to be kept, we need to have an understanding of what healthy goal setting looks like. Long term goals are the broad aspirations that we would like to achieve later in the future. They are the end destination in a particular area of our lives. Long term goals may be large or small. Short term goals or objectives are the steps on the ladder to get you there. We don't jump on the roof of a three story building from the ground without climbing each step on the way up (unless we are Spider Man or another superhero-which is highly unlikely). For example, a long term goal may be for a child to learn how to wash their hands independently. Now, this may seem like a simple task and too simple to be a long term goal. However, take a moment and think of all of the objectives that need to be accomplished before the child achieves the long term goal of washing their hands independently. If you need some help, here are just a few of the steps on the ladder: walk to appropriate sink, turn water on, wet hands, pump soap, lather hands (both hands, between fingers, palm and outer hand), rinse soap off, turn water off, and dry hands. The child needs to be able to complete each of the objectives in order to achieve the long term goal.


Why am I writing about hand washing steps? If we have a resolution to go to the gym and loose weight and we have never been to the gym before, we are not likely to start going 4 times a week and maintain this schedule for long. If we haven't been looking for a new job, we are not likely to get hired by a company with a 50% salary increase by January 15th. There are objectives and short term goals that need to be accomplished first.


Goals need to be measurable (go to the gym 2 times/week for 30min each time), attainable (look for a new job to earn more money, not win the lottery), specific (target one behavior-eating, drinking, or exercising, not "be healthier") and realistic (learn 2 new healthy dinner recipes, not become a famous gourmet health chef on TV within 1 month).


When we set long term and short term goals, it can be helpful to make sure that we have enough steps on the ladder (objectives), a realistic long term goal, and that we make sure each goal is measurable, attainable, specific, and realistic.


Let's not confuse goals with dreams. You can dream about winning the lottery or becoming famous. These just don’t make for good resolutions or goals.


Consider revising your resolutions so they have enough short term goals and are measurable, attainable, specific, and realistic. It's never too late. If you noticed, I noted earlier that goals are discussed as often as needed throughout treatment in my practice. Goals can and should be revised whenever needed. Circumstances, desires, feelings, and finances change. Be flexible with your goal setting and enjoy climbing the ladder!


What are your revised New Year's Resolutions?

Helpful Strategies for Celebrating with Special Needs

Posted on December 12, 2013 at 8:35 PM Comments comments (0)


 

Celebrating holidays with family and friends can be challenging. There may be more people, sounds, visual stimuli, and expectations. Many families experience heightened stress around the holidays, especially if you have a child with special needs. Here are some strategies that may be helpful to remember when celebrating during this holiday season.


 

Be Proactive

If you are traveling by train, bus, or airplane, it is important to research certain information prior to your trip. It may be helpful to call ahead and find out wait times, what waiting areas are like, traffic conditions, possible detours, places to sit, places to eat, location of bathroom, when rest stops will be, etc. If you are travelling by car, look ahead for traffic and construction. Waiting is a difficult skill for many individuals with special needs (and for some individuals who do not have special needs too!). Some facilities (such as amusement parks and airports) may offer shorter wait times or early board times with appropriate documentation.


 

Be Prepared

Pack, pack, and pack! Pack even if you are just traveling a short distance or you are not traveling at all. Have reinforcers, toys, books, and snacks available at all times. These can be lifesavers at a holiday gathering. It is also important to bring any behavior plans, coping skills charts, token economies, and communication assistance devices. If you child engages in dangerous behavior (e.g., eloping, unsupervised cooking, fire playing, etc.), make sure to have preventative measures in place in each new setting. Your child will still need support (and maybe a little extra support) when celebrating with family and friends.


 

Explain

Decide in advance how you would like to communicate information about your child and his/her needs to friends and family. Your doctor may have brochures you can share, depending on how detailed you would like to be. It is helpful to let other individuals know what modifications may be made and how your child may respond. Many families find it helpful to work out a plan in advance for responding to challenging behavior, should it occur in the presence of new people or people your child is not with very often.


 

Have Fun

Even though the holiday season can be stressful, remember to “be” (see November’s blog). Have fun with your child. Let them know they are loved and will be safe and you are both prepared to handle challenging situations.


 

Remember, you will never be able to predict everything. Sometimes a monkey wrench is tossed into the situation. Model good coping skills when this happens. Change can be OK and growth may even occur when challenges are experienced.


 

Warm Wishes for a Happy and Healthy Holiday Season!

The Day Trip for Families: Friend or Foe?

Posted on August 19, 2013 at 9:45 PM Comments comments (0)


Taking a trip to a new place with a child can be exciting and terrifying. You pick a day. You pick a place. You pick the people to join you. You pick what to bring. What you don't get to pick is your child's mood that day. You don't get to pick the prices. You don't get to pick if anyone is going to be sick or healthy that day. You don't get to pick the weather. This is all OK.


I recently took two day trips (or 1/2 day trips) to child friendly locations, an ecology center and an aquarium. There were many families at both. Both settings involved animals or other living creatures. Both settings were crowded, involved walking, were unpredictable, and included outdoor and indoor activities. Some adults have difficulty when faced with situations that have these qualities. Many children also experience a level of discomfort mixed in with excitement for traveling to a new place and seeing cool species. Now imagine a child with special needs. How is he/she feeling and dealing with the unpredictability of animals, shows, and events? How is he/she coping with being surrounded by lots of strangers, tall people, little people, strollers, wheelchairs, and animals? How is he/she managing the energy and perseverance of walking great lengths in the hot sun? The answer? It depends. There's that phrase again (in case you missed my last blog post, read through it and "it depends" will make more sense to you). A better question might be- how are mom and dad handling these factors? Are they comfortable or distressed? Are they laughing when they read a schedule wrong and missed an event, or are they yelling because their child is unable to sit for 20 minutes to wait for the next showing?


Children look to the adults and others around them for cues about how to think, feel, and act. This can be very useful, or it can be unhelpful and even hurtful. Parents can model appropriate coping skills and behaviors for their children in these difficult (even though they are fun) situations. Children with special needs may need some additional support. Consider calling the locations in advance and find out what accommodations they offer. These may include preferential seating or parking, use of headphones, early entry/exit, and reduced waiting times. You may want to consider bringing snacks, toys, and coping items (book, blanket, picture cards, etc.) with you for your child to use during stressful situations. If your child uses a communication device, bring it with you and allow your child to have access to it at all times. Remember, this is their voice. Listen to your child. Ask a relative, close friend, or professional to take the trip with you. This may help the child and parents feel more successful and relaxed when additional eyes, ears, and support are available. Prepare your child about the upcoming experience and let them know that there may be some unpredictability and this is OK. We can call these events "monkey wrenches." Adults-this is for you too. Sometimes life throws you a monkey wrench such as rain on the day you wanted to go to the beach or get that yard work done. The point is-change is all around us and it can be good. Part of preparing your kids for what to expect to reduce unpredictability is actually preparing them for change and monkey wrenches!


Have fun during the rest of summer (it's not over yet!) and plan a trip to take in the next few weeks. Just be sure to actually have fun and don't stress about the monkey wrenches. If you have fun, you're kids probably will too.


 

#DrLauraVSH #SpecialNeeds