At Woodhaven Counseling Associates there are several things we believe that you deserve as our client. Chief among those is your confidentiality, or privacy. We at Woodhaven commit ourselves to keeping your identity and the fact that you see a counselor very private. We will not tell callers or others that you are a client at Woodhaven. Most of the associates at Woodhaven will not even say “Hi!” to you in a public place for fear that some other person there will know you and recognize your counselor and suddenly understand that you have sought counseling. Overall, there are many other ways we at Woodhaven are very careful with any information about you, your identity, and the identity of family and others that might become known to your counselor. In case you know about HIPAA (the federal government’s laws about confidentiality), you might understand that Woodhaven counselors and staff are HIPAA compliant, and even exceed the minimums of confidentiality set forth in HIPAA. If you would like additional information about your confidentiality, ask any Woodhaven staff or associate or ask your counselor specifically.

There are ways that information about you, your case, and any progress you make can be made available to others if you wish, for example, your doctor. Ask your counselor about this if you need to allow others to know about your treatment by a Woodhaven professional. Also, there are local and state laws that govern your privacy. We at Woodhaven follow these laws. While Woodhaven’s clients are not usually affected by these laws, do not be afraid to ask your counselor for a complete explanation if it is a concern to you. Any of Woodhaven’s staff can help you make sure that your privacy remains protected, just tell us of your concerns.
Confidentiality is one of the “backbones” of what makes successful counseling possible. We take our responsibility to keep your confidence in us at Woodhaven as a very important part of our mission and trust. If we can serve you and your confidentiality needs in a special way, be sure to ask us and we will do all that we can within the laws to provide you with absolute security and privacy.

Q: I am going through a divorce. When is counseling necessary for my children?

A: When your children show signs of stress:

• acts younger than their chronological age
• fear of being apart from parent(s)
• moodiness
• acting out
• manipulation
• sadness and depression
• guilt
• sleep or eating problems
• change in personality
• academic and peer problems
• irrational fears and compulsive behavior

Q: I am going through a divorce. When is counseling necessary for me?

A: When you or your partner begins to:

• use the legal system to fight with each other
• put down or badmouth the other parent
• use the children as message carriers or to spy on the other parent (children feel caught in the middle)
• experience high levels of conflict and children repeatedly try to stop the fighting
• rely on the children for high levels of emotional support and major responsibilities in the home
• experience depression or anxiety

Q: Are there different kinds of losses?

A: People deal with many different types of losses in their life, not all related to death. One may grieve over a friend or sibling who moves away and one may also grieve over the break-up of an intimate relationship. Many people can feel strong grief if a pet dies.

Q: How should I care for myself?

• Be gentle with yourself and know that that grief is normal, you will heal with time.
• Eat right.
• Be with family and or friends to support you.
• Talk with someone when you feel ready.
• Write down memories, journal, or write poems to express your feelings.
• Cry.
• Exercise.
• Create a ritual or memorial for your loss.
• Join a support group.

Q: When is it time to seek a professional for my grief?

A: It is time to reach out for help if you continue to feel depressed (for four months or longer), you are unable to do your normal activities, you are unable to sleep and eat, you are beginning to have feelings of hurting yourself, and / or you are feeling that you do not want to continue to live.

Resources:

Ted E. Bear Hollow

Phone Number: (402) 502-2773
www.tedebearhollow.org/
A center for grieving children that provides support groups and camps.

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Woodhaven Counseling Associates, Inc., in conjunction with Jewish Family Service facilitates a parenting class called Parenting with Love and Logic.

Q: What Is Love and Logic All About?

A: The Love and Logic Institute and its sister company, School Consultant Services, are dedicated to making parenting and teaching fun and rewarding, instead of stressful and chaotic. They provide practical tools and techniques that help adults achieve respectful, healthy relationships with their children. All of their work is based on a psychologically sound parenting and teaching philosophy called Love and Logic.

Q: What Is Love and Logic?

A: Children learn the best lessons when they’re given a task and allowed to make their own choices (and fail) when the cost of failure is still small. Children’s failures must be coupled with love and empathy from their parents and teachers. This practical and straightforward philosophy is backed with 20 years of experience. Parents can apply it immediately to a wide range of situations instead of struggling with difficult counseling procedures.

Q: Who’s Behind It?

A:

Jim Fay – founder and former school principal – view biography
Foster W. Cline, M.D. – founder and psychiatrist – view biography
Charles Fay, Ph.D. – school psychologist – view biography

Q: Why Does It Work?

A:

• Uses humor, hope, and empathy to build up the adult/child relationship
• Emphasizes respect and dignity for both children and adults
• Provides real limits in a loving way
• Teaches consequences and healthy decision-making

Q: How do I get my child to help out around the house?

A: Chores make kids responsible

As a toddler, your child may have been eager to help you with everything, even when you did not want the help! Now that same toddler is older and is far less excited about helping out around the house and has her own busy schedule of extracurricular activities, homework, and friends. Although your child may not be thrilled about doing chores, giving her the responsibility will build her self-confidence and remind her that she is a contributing member of your family.

Tips for getting your child to chip in

• Make sure the chores you have your child do are safe and age-appropriate.

  If you would like your child to do a chore alone, make sure that is possible. For example, do not send a young child to take the trash outside by herself. If your young child cannot complete a chore by herself, you can do it together to help her learn until he is able to do it alone.

• Start young.

  Starting from when your child is in preschool, give him easy chores to do to get him in the habit of helping out and being responsible. For example, your 5 year-old can help clear the table, or even put away his/her clothes.

• Make your expectations clear and acknowledge hard work.

  Given that the purpose of chores is to help your child gain self-confidence, you want to make sure your child feels like she was successful in completing her chores. Try not to be too hard to please, or your child will be far less likely to want to help out in the future. Let your child know when the chore needs to be completed by, acknowledge that she has competed it, and let her know you appreciate her help by saying thank you. Try to avoid money as a reward for chores. Some children receive allowance each week or each month, but it is best not to make this a payment for chores done as children may begin to feel entitled to payment for any favor you ask of them, and the other values in doing chores might be lost. An occasional pizza or movie night at the end of the week or month to celebrate might be a good way to acknowledge chores being done.

• Make a family chore list.

  This will serve as a reminder to everyone of responsibilities, it will help your child know what is expected, and it can also be satisfying for him to ‘check off’ the chore when it has been completed. Mixing in a new and different chore once in a while can help keep your child interested in helping out. If you have more than one child, you could try rotating the chores on a regular schedule so each child is doing different chores each week. Also, try not to assign chores based on gender stereotypes. Anyone can help out with loading the dishwasher or taking out the trash.

Q: I am getting married soon. Is premarital counseling necessary?

A: Many young couples’ expectations of marriage revolve around the false belief that love will get them through rough times. While love is important, it won’t be enough if couples don’t have the basic attitudes and skills they need for a successful marriage. Lasting marriages require partners who respect one another, who have gained knowledge about what makes marriage work, and who have developed skills that will enhance the relationship.

Most couples face their most serious challenges during the first five years of marriage. The top ten problem areas researchers have identified are:

• Balancing job and family
• Frequency of sexual relations
• Debt brought into marriage
• Husband’s employment
• Finances
• Expectations about household tasks
• Constant bickering
• Communication with spouse
• Problems with parents or in-laws
• Lack of time spent together

Through premarital counseling, many of these issues can be discussed and plans can be made to handle them so they don’t become toxic to an early marriage.

When to seek professional help for blended families/stepfamilies:

Studies show that children of stepfamilies face a higher risk of emotional and behavioral problems. They also are less likely to be resilient in stressful situations. Although most parents are able to work out these difficulties within the family, they should consider counseling for their child(ren) when he/she exhibits strong feelings of being:

• alone in dealing with his losses;
• torn between two parents or two households;
• excluded;
• isolated by feelings of guilt and anger;
• unsure about what is right;
• very uncomfortable with any member of his original family or stepfamily.

Counseling might be appropriate for both the child and the family when:

• the child directs his anger upon a particular family member or openly resents a stepparent or parent;
• one of the parents suffers from great stress and is unable to help with the child’s increased need for attention;
• a stepparent or parent openly favors one of the children;
• discipline of a child is left to the parent rather than involving both the stepparent and parent;
• members of the family derive no pleasure from usually enjoyable activities such as learning, going to school, working, playing, or being with friends and family.

By devoting the necessary time to develop their own traditions and form caring relationships, stepfamilies can create emotionally rich and lasting bonds for each member. In the process, the children acquire the self-esteem and strength to enjoy the challenges that lie ahead.

Q: What is a parenting plan?

A: When parents separate there may be considerable advantage in formally agreeing how they will deal with the children. A parenting plan is a document which sets out the main issues in detail. Typically a parenting plan would include a contact schedule, the agreed positions in respect of contentious issues (i.e. health & safety, education and religion etc.), and specify how the plan would be updated.

Q: What are the benefits of a parenting plan?

A: When parents come to an agreement on a detailed parenting plan that reflects the overall best interest of their child they will often enjoy a more stable, predictable, and consistent schedule by reducing the amount of misunderstandings, conflicts, and legal costs often associated with litigation and the courts. A parenting plan is a document that is created in the context of a child custody matter to help the parents outline a parenting schedule, which may include a description of their timeshare with their child and each parent’s responsibilities to raise their child.

Q: How can parents and their children benefit from a detailed parenting plan?

A: Creating a detailed parenting plan can provide predictability in the parenting schedule for both the parents and their child. This allows the parents to make plans for their child and implement a regular and consistent parenting routine for him/her. A child who knows in advance which parent he/she will be with and what he/she will be doing can feel more secure, stable, and self-confident than a child who is left constantly worrying and wondering where he/she will go and what he/she will be doing.

Q: How can a detailed parenting plan reduce my legal costs?

A: Having a detailed parenting plan can reduce the likelihood of misunderstandings between the parents and the conflicts parents often face with ambiguous parenting schedules. Having a detailed parenting plan can reduce the potential for disagreements between the parents thereby helping the parents stay out of court and away from litigation. Over time, parents who have a detailed parenting plan in place typically experience lower legal fees and attorney costs, which are often associated with high-conflict child custody disputes and protracted child custody litigation.

Although a detailed parenting plan will generally benefit both the parents and children involved in a divorce and child custody dispute, you would be wise to consult an attorney to learn where you stand legally on your particular matter and to learn if a detailed parenting plan is the best approach for your situation before entering into any sort of proposed parenting plan agreement.

Q: How do I effectively communicate with my teenager?

• Remember that during adolescence, communication generally decreases and a child will confide less in parents. This is a fairly normal process and parents should not overreact.
• Listen to what is being said; that is, try to understand the teenager’s feelings and where she is coming from. Rather than thinking about arguments or retaliations, listen to her.
• Stop what you are doing and look at the teenager. Listen when she speaks to you. Be sure that you are giving her the proper attention and that she is not talking to a newspaper or to your back.
• Be sure most of your communication is positive, not negative. Don’t dwell on mistakes, failures, misbehaviors, or something they forgot to do. Give them positive communication and talk about their successes, accomplishments, interests, and appropriate behavior.
• Talk to them about their interests (e.g., music, sports, computers, dance-team practice, cars, motorcycles). Have conversations with them when you are not trying to make a point, to teach them something, or to impress them. Talk to them just to talk and to have positive verbal interaction.
• Avoid talking too much – giving long or too-detailed explanations, repeating lectures, questioning excessively, or using other forms of communication that will result in the teenager turning a deaf ear to you.
• Try to understand the teen’s feelings. You do not have to agree or disagree with him; just make him aware that you understand how he feels. Do not try to explain away his emotions. There are times when you do not have to fix things or make the youngster feel better. Understanding how he feels may be the primary comfort that is needed.
• Do not overreact to what is said. Remember, sometimes teenagers say things that are designed to get a reaction from their parents. In addition, do not say "no" too fast. Sometimes it is better to think about the request and give a response later. In other words, think before you open your mouth.
• Try to create situations in which communication can occur (driving the child to a doctor’s appointment, having the teenager help you with household tasks). You have to be physically close to the teenager for communication to occur. A television in the adolescent’s room can be an additional barrier to family communication. Whenever possible, the parent should try to do things with the teenager, rather than separately. Although the child may not frequently accept them, provide opportunities for him to do things with you.
• Try to avoid power struggles, confrontation, and arguing matches. Your goal should be to have the communication move toward a compromise situation, rather than a battle. When appropriate, involve the teenager in decision making and setting consequences for his or her behavior.

Q: How do I know if I need to seek counseling for my adolescent because of his or her behavior or moods?

A: There is a normal amount of moodiness and oppositional behavior as teens undergo hormonal changes and strive to assert their independence. However, there are limits where an adolescent’s mental health and behavioral changes become problematic. These are some situations when an adolescent would need mental health treatment or counseling:

• If your teen is feeling suicidal or homicidal.
• If your teen has been physically aggressive at school or at home.
• If your teen has engaged in self-harm behavior (i.e. cutting on themselves).
• If they continue to disrespect adults and rules despite consequences.
• If you suspect they are abusing drugs or alcohol (see substance abuse link).
• If they commit a crime.
• If they lose interest in school and activities.
• If their depression or anxiety is causing problems in their life.
• If they are disrupting the environment in your home on a regular basis.
• If they are associating with negative peers.

Q: How should I discipline my teenager?

A: Adolescents, like children, need consistent and specific consequences that are time-limited. Avoid grounding adolescents for indefinite periods of time, as the grounding will lose its effectiveness over time. It is helpful to pre-teach adolescents about your expectations and the consequences that they will receive if they do not meet them. Then there is no debating when a rule is broken. It may be helpful to make a list of expectations and rules and post them where the entire family can see them. It is also helpful to be creative with consequences, so the punishments do not lose their effectiveness. Try to make the consequences value-based, such as having them repair a hole in the wall that they made or writing an apology to someone they were disrespectful to. When giving consequences, present them in a confident manner and do not allow time for negotiation. It is also helpful to let your child know what the further consequences will be if they do not follow through with initial punishment. Finally, if there are multiple caregivers, it is important that they all be aware of the adolescent’s behavior and what their consequence is so there is not room for manipulation.

Resources:

www.OneToughJob.org
www.parentingteens.about.com
www.pediatrics.about.com
www.familyeducation.com
www.parent-teens.com

Q: Why are people with substance abuse problems often in denial?

A: Most people with substance abuse issues are the last to realize or admit that they have a problem, often because they are not ready or willing to stop their use. Other people often see the problem first. Family members, significant others, friends, co-workers, or even acquaintances may present concerns about your well-being and extent of drug or alcohol use. If this has occurred, or if you notice that your drug/alcohol use is interfering with your responsibilities, then it is recommended that you see a Licensed Alcohol and Drug Counselor (LADC) for a chemical dependency evaluation.

Q: What is the best way to approach someone who is in denial regarding their substance abuse?

A: Those in denial regarding their substance abuse are often defensive and difficult to talk to. They see the expression of concern as criticism and are not open to your feedback. It is important to not allow their defensiveness to cause you to question your concerns. It is also important that the abusers are held accountable for their actions. This is difficult as those with substance abuse problems may become increasingly argumentative and aggressive when they are given consequences. It is also important that they are encouraged to seek help for their problem in an assertive and supportive manner. It is also important that you acknowledge that their use is causing problems, so that you do not become an enabling individual to them.

Q: What is a chemical dependency evaluation?

A: The purpose of a chemical dependency evaluation is to assess a person’s level of substance abuse and make recommendations about an appropriate level of treatment. The evaluation takes approximately 1 ½ hours and consists of a face-to-face interview with the identified client and if possible one close family member or friend in order to obtain the person’s social history. The client is also asked to complete standardized tests and in some cases a urinalysis drug screen.

How can I tell if my child or adolescent is abusing drugs or alcohol? Adolescents who are abusing drugs and alcohol often demonstrate similar symptoms. Parents/guardians can look for the following signs:

• Teens smelling like alcohol or smoke.
• Your child’s eyes appearing glassy, red, or the pupils being abnormally small or large.
• Grades dropping.
• Increasingly disrespectful behavior.
• Secrecy
• Sneakiness
• Dishonesty
• Association with negative peers
• Your child not wanting you to meet their friends
• Loss of interest in school or activities
• Increased laziness
• Irritability
• Money (their or yours) being unaccounted for
• Your child not wanting to report their whereabouts
• The presence of drug paraphernalia
• Drastic change in eating and sleeping problems
• Depression and/or anxiety

Q: How can I tell if an adult is abusing drugs or alcohol?

A: Like adolescents, adults often demonstrate similar signs that show that their substance use is becoming a problem. Those around them can look for the following signs:

• Neglect of responsibilities at home (chores, bills, or caring for children)
• Neglect of responsibilities at work
• Secrecy
• Sneakiness
• Dishonesty
• Irritability
• Financial problems
• Tension in marital relationships
• Irritability
• Depression and/or anxiety
• Drastic change in eating or sleeping patterns
• Increase in amount or frequency of substance use
• Presence of drug paraphernalia
• Increased laziness
• Loss of interest in activities
• Money being unaccounted for

Q: What types or treatment are available for people with substances abuse problems?

A: There are different levels of care depending on the severity of the person’s substance abuse. A chemical dependency evaluation will provide recommendations about the most appropriate level of care. The least restrictive level of care is outpatient treatment. This is individual or group therapy that meets no more that twice per week. Family members are often included in the therapy sessions as well. The next level of care is Intensive Outpatient Treatment. This level of care includes 9-12 hours of group, individual, and family therapy per week. The next level is short-term residential treatment. These programs are inpatient placements that are approximately 30 days long. The highest level of care is long-term residential, which is an inpatient placement that can last up to one year. There are also detoxification programs for those who are under the influence and believe that they may experience several withdrawal symptoms when they initially stop using.

Resources:

www.hazelden.org
www.samhsa.gov
www.nida.nih.gov
www.nasadad.org
www.alcoholanddrugabuse.com

Persons diagnosed with major mental illnesses face some extreme problems in living their life. So do the people who love them and try to help them. We at Woodhaven have training and years of experience in working with individuals, families, and groups of persons with major mental illnesses. We are aware of and recognize all the various symptoms and manifestations of the various major mental illnesses. Additionally, all of our Woodhaven professionals have expansive knowledge about the medications used by psychiatric physicians, we have experience in helping sufferers of mental illnesses manage their medications and communicate with their physicians, and we know when the issues faced by a person can be benefited by medications. Yet, you should know that we here at Woodhaven do not prescribe medication, so we have no vested interest in seeing our clients use medications except when needed. The outcome is that at Woodhaven we view our clients as people who should first use their own personal coping and mental resources to get better before we suggest medical consultation and medications.

The major mental illnesses are problems that many people are afraid of, even deny to themselves and others. But the disturbance and even destruction of lives of people with major mental illnesses and those who love them is not a necessity today. We at Woodhaven take as our responsibility the duty to understand and respectfully treat individuals who suffer such illnesses as significant. We work easily with family, others, and other professionals involved in our client’s treatment, recovery, and maintenance. Mental health is our goal and our passion. Give us a call if you need help, wonder if you have a mental illness, or are just having problems understanding some of the ways you think, feel, or act. We will find the answers you need and do it confidentiality and as quickly as possible. At Woodhaven we do not discriminate against persons who have mental health problems, but we welcome you and do our best to be respectful and professional while keeping a focus on you, or your loved one’s, mental health.

The professionals at Woodhaven Counseling Associates have been trained to recognize and work with people who have had long-term problems in relationships and adjusting to life’s problems, often called “personality disorders.” We recognize each person’s unique set of problems as indicative of their personality and we strive to maintain each person’s uniqueness, yet improve their ability to cope with issues and make good decisions about life’s problems. This type of counseling often takes many sessions of counseling lasting over a longer period of time. However, we at Woodhaven are aware that this kind of “therapeutic work” can be a financial burden and so we have trained in the shorter-term methods of counseling for these kinds of problems. Ask your Woodhaven counselor about the details of this kind of work if you think it might apply to you.

Most people come to Woodhaven seeking help for an issue that is “bugging” them at the time that they call us. We will do our best to address the issues that are current and present, but we will also try to see if there is a pattern of these issues, and we will check to see if they might indicate a major mental disorder of some kind. Thus, Woodhaven works to allow our clients to understand all that they are facing. Comprehensive psychological testing and assessment are also available at Woodhaven if you feel that this might be helpful for clarifying the issues you are facing, including those of long-lasting patterns of problems adjusting to life’s ins and outs. When you call us, we will talk with you about your needs for counseling, assessment, and information about you and your personality. If you feel your problems are caused by a mental health disorder of some kind we will examine that as well.

Woodhaven’s professionals are experienced, focus on helping you change so that problems are less stressful, occur less often, and pass quicker, and we recognize the importance of how exhausting this kind of work can be. Give us a call and talk about your needs for treatment of who you are and how you work with all the major issues in your life.

Anxiety is a perfectly normal response to life’s stressors. Everyone feels anxiety. For example, it is normal for students to feel anxiety before tests. It is also normal to feel anxiety when one is making a presentation before an unfamiliar audience.

When anxiety interferes with one’s ability to function normally, the anxiety becomes an anxiety disorder. Examples would be students becoming so nervous that they are unable to take the test, or one becoming so nervous that (s)he is unable to make the presentation.

Anxiety disorders take many forms from an irrational fear of something specific to a state in which one is nervous most of the time. The fear of a specific thing is typically called a phobia. The continual presence of anxiety is called Generalized Anxiety Disorder. The disorder may be the result of psychological conditioning, a biological predisposition or both.

Anxiety is the most treatable of psychological problems. In many cases, it can be treated by short-term therapy. In some cases, it may be necessary to add medication to the treatment procedure. Woodhaven Counseling Associates, Inc. can help you develop and use the skills that will allow you to manage your anxiety disorder to the extent that it is no longer a problem for you.

Further information on Anxiety Disorders can be found at the following web site: www.adaa.org

People experience Gender Identity Disorders when they perceive a discrepancy between their bodies and their perception of their gender. In other words, a person with a male body feels that he/she is really a female or a person with a female body feels that she/he is really a male. Up until recently, we called this phenomenon Transsexualism because the person literally “crossed” genders. It is important to note that Gender Identity Disorders are real. It is also important to note that Gender Identity Disorders do not come about due to a person’s choice. The Disorder is simply there, and may have a biological basis.

Treatment of Gender Identity Disorders is complex. The client is typically involved in a two-year process and is followed closely by the therapist during this time. A major part of the treatment transition involves surgery that will result in the client’s body becoming consistent with the client’s perception of her/his gender. Woodhaven Counseling Associates, Inc. can help the client enter and move through the treatment of Gender Identity Disorder.

Additional information on Gender Identity Disorders can be found at the following web site: www.athealth.com/Consumer/disorders/GenderIden.html

Q: How do I know if my spouse is depressed?

A: Often times the person who is depressed is the last to know how serious the situation is. Frequently the depressed person believes it’s situational, but the problem persists for long periods of times. Family members will notice that this person is irritable frequently, and often isolates from the rest of the family. Often family members report that this person is sleeping all the time or missing a lot of work due to illness. Children will report that this person no longer plays with them and takes no notice of what the child is doing in school.

Q: I worry about what living with a depressed person is doing to the rest of the family. Why won’t my spouse get help? Doesn’t he/she want to feel better?

A: It is common for the depressed person to lose all interest in usual activities, including healthcare. It takes all their energy to just get through a normal day. It is important that family members take charge and contact a mental health professional when a loved one is experiencing…

• depression that does not lift in a reasonable amount of time
• difficulty concentrating and making decisions
• social isolation
• loss of interest in usual activities
• changes in eating and/or sleeping patterns
• irritability
• frequent crying episodes
• thoughts or talk of suicide

Q: How can I help my spouse when I’m angry all the time at how I’m being treated?

A: It is difficult to have empathy for someone who is treating you badly. Family members often feel lonely and isolated as well. However, depression is a medical as well as mental health issue. It is important to remember that this person is not acting this way out of a choice. The symptoms listed above are a call for help. The benefit of utilizing compassion and empathy to get treatment will generalize to all the family once the depressed person improves. You may benefit from working with a mental health professional to address your personal issues as a result of living with someone who is depressed.

Q: I’m dating someone who at times appears to love me so much that I feel isolated and suffocated by all the attention. He/she gets extremely jealous over ridiculous things. Should I be concerned?

A: It may seem difficult to predict whether you are involved with someone who will be physically abusive. Jealousy, controlling behavior, quick involvement, unrealistic expectations, isolation, and hypersensitivity are only a few of the behaviors that have a strong potential for physical violence. If you are uncomfortable with the actions of your significant other, it may be helpful for you to contact a professional to help sort this out.

Q: I don’t know if I am being abused. This is all I’ve ever known. What are the signs?

A: Sometimes it is hard to recognize red flags. Often people in abusive relationships were raised in abusive homes. You live what you learned. Below is a checklist taken form the YWCA Omaha Women against Violence that may help determine if you need to seek help.

• I am afraid of my partner.
• I cannot express my ideas, thoughts, or feelings for fear of my partner’s reaction.
• My partner puts down my accomplishments and dreams.
• My partner uses intimidation and threats to get his/her way.
• My partner uses our children and pets to manipulate and punish me.
• My partner shoves, punches, kicks or strangles me.
• My partner pressures me sexually.
• My partner threatens to hurt or kill me.
• My partner makes me feel like there is “no way out” of the relationship.

Q: I have children. What can I say to them about why this is happening?

A: It is important to tell children that this is not their fault. Adults are responsible for their own behavior. It is important to tell children they are special and deserve to be safe. Children get angry, scared, depressed, frustrated, confused, sad, and hurt when adults fight with each other. You may need to get out first to be safe. There are shelters in your area that can provide that safety. You may need the care of a professional and/or support group.

Q: The police have been here several times. They say I need a protection order. I’m afraid of how my spouse will act. What should I do?

A: It is hard to take such a serious step. This is to protect you, your children, and even the offender from further damage physically and/or emotionally until you can get help. If you think the situation may become threatening or dangerous, you can stay with family or friends, go to a shelter or have another adult stay with you until the situation is under control. You don’t have to do this alone.

Resources:

YWCA Omaha
Phone Number: (402)345-7273
Internet Address: www.ywcaomaha.org

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Q: What can I expect in the first session when I see a therapist?

A: In the first session the client and the therapist will begin to get acquainted with each other and establish a level of expectations for the following sessions. The therapist will gather information from you and begin the process of working with you to set goals for therapy. The therapist will help you have a sense of hope for meeting your goals.

Q: Will a therapist attack my faith in God?

A: No. The therapist will respect your faith. We have found that faith can be a strong resource when a person is stressed or is having to make a serious life adjustment.

Q: How will I know if I need medication?

A: Your therapist will not be a physician and cannot prescribe medication. However, you can be sure that your therapist is experienced and will have good professional judgment based upon training and experience. The therapist working with you will advise you and can refer you to a physician who can prescribe needed medication. If medication is prescribed to you, you will continue to see your therapist as well as see the physician for checks of how you are progressing while on medication. Please remember, you are in charge of your therapy and your recovery. No one can force you to be on medication.

Q: Why won’t medication be enough to make me feel better?

A: Medication is often helpful. However, for many conditions medication is not enough, such as when there are underlying problems and you have ongoing life situations. Your therapist will work with you to encourage and help facilitate changes in your thinking and in your behavior. Therapy and medication can both be part of your recovery process.

A client asked one of our therapists, “Can you say in one sentence what you try to do in therapy?” After a moments thought the therapist responded, “I try to help clients empower themselves.”

Couples often come to marriage counseling because they cannot talk about important issues in their lives without arguing. Their arguments often go no where other than becoming more loud and hurtful. Typical reasons for arguments include; money, childrearing, sex, relatives, and communication styles.

Just as in individual counseling, progress involves work and commitment on the part of each spouse. The counselor cannot do the work for you. You can expect the counselor to give you a different perspective and insights into your marital system, as well as give you tools to aid you in making positive changes in your marriage.

Sometimes one spouse is disappointed when they expected the counselor to “take their side” in the counseling session. The purpose of the counseling is not to decide who is right or wrong, but to help each spouse to change themselves in order to enrich the marriage.

At times couples think they know each other when in fact they only know how the other spouse argues. Your marriage will improve as you stop trying to win conflicts and move toward understanding and appreciation of each other.

Our counselors also work with couples who have experienced infidelity and/or domestic abuse. These behaviors violate the trust and commitment in marriage. Sometimes the marriage cannot survive. There are times that persons are willing to commit themselves to change and their marriage can not only survive but become stronger.

When you are experiencing the pain of marital conflicts you do not have to face the pain alone. We have trained and competent counselors who can help you not only just survive your problems, but help you be empowered to improve your lives.

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Infertility

Q: How do I deal with my infertility?

A: Most people expect that they are going to be able to have a child. When this is unable to happen, people feel a huge loss of control and feel a great sense of loss. Adoption can fulfill the void of childlessness, but will never change the infertility issue. Even when people deal with their grief and loss of control, it may arise again in the future with the birth of a friend’s child or the loss of a parent. You may benefit from working with a mental health professional if you are experiencing…

• high levels of anxiety
• social isolation
• depression that does not lift
• difficulty thinking of anything except the infertility
• loss of interest in usual activities

Q: My marriage feels like it is falling apart?

A: Everyone goes through the stages of grief differently and at different times. Often there can be blame and guilt in a marriage if one spouse is responsible for the infertility. You and your spouse are also possibly overwhelmed with the medical terms, medications, and schedules. Couples counseling can be a good idea for a family dealing with infertility. It may be wise to go to couples counseling when…

• there is difficulty in communication
• making treatment decisions (i.e. medications, procedures, third party assistance)
• exploring adoption

Resources:

American Society for Reproductive Medicine
Phone Number(s): (205) 978-5000
Internet Address: www.asrm.org

Resolve: The National Infertility Association
Phone Number(s): (888) 623-0744
Internet Address: www.resolve.org

InterNational Council on Infertility Information Dissemination, Inc.
Phone Number(s): (703) 379-9178
Internet Address: www.inciid.org

The National Women’s Health Inforamtion Center
Phone Number(s): (800) 994-9662
Internet Address: www.womenshealth.gov

Q: Do adoptees have special needs?

A: A child who was adopted has to deal with their grief and abandonment issues. All children who are adopted have lost their birth families. Some children adopted internationally, lost their birth family, an orphanage, and the sights, smells, and language of their home country.

Q: Is it important for my child to talk about their birth family and know the whole truth about their conception?

A: The adoptee needs to be able to know the truth about their birth story and feel comfortable talking to their adoptive parents. The truth may be extremely difficult, but adoptees want the truth on every level. This may be the appropriate time to bring in a professional. Remember, adoption is a life long journey and the truth will help their personal growth.

Q: I am a birth parent, will I ever stop thinking about my baby?

A: Most birth parents will always think about the baby they placed for adoption. If you feel that it has turned into depression or you cannot do normal activities because you are thinking of him or her all the time, please call for counseling.

Q: How can I help my child grieve the loss of his or her birth parents?

A: There are a variety of ways to help deal with a child who has lost his or her biological parent:

• Keep a life book accessible to the child.
• Keep your home schedule free of constant activity.
• Give your child physical touch (i.e. hug, foot rub) throughout the day
• Continue contact with former foster parents.
• Remember to not feel rejected by the child moving through grief stages.

Resources:

Adoptive Families Magazine

Phone Number(s): (800) 372-3300
Internet Address: www.adoptivefamiliesmagazine.com

Nebraska Adoption Agencies Association

Phone Number(s): N/A
Internet Address: www.meadowlark.creighton.edu/naaa

Tapestry Books

Phone Number(s): (877) 266-5406
Internet Address: www.tapestrybooks.com

Nebraska Department of Health and Human Services

Phone Number(s): (402) 471-9331
Internet Address : www.hhs.state.ne.us/adoption

Q: What is attachment and what are possible causes of problems in attachment?

A: Attachment is the basic trust between a child and caregiver established in the first several years of life. This serves as a template for all future emotional relationships. Some major causes of disruption in attachment include:

• Physical neglect
• Abuse
• Emotional neglect
• Separation or changes in primary caregiver
• Traumatic experiences
• Maternal addictions to drug or alcohol
• Maternal depression
• Frequent moves or placements
• Inexperienced mother with poor parenting skills

Q: What are the signs and symptoms of attachment disorder?

A: A child who exhibits several of the following signs and symptoms should be evaluated by a licensed therapist:

• Superficially engaged
• Lack of eye contact
• Poor self-esteem
• Indiscriminately affectionate with strangers
• Lack of ability to give and receive affection on parents’ terms – not cuddly
• Inappropriately demanding and clingy
• Persistent nonsense questions and incessant chatter
• Poor peer relationships
• Extreme control problems—may attempt to control openly or in sneaky ways
• Difficulty learning from mistakes
• Learning problems—disabilities, delays
• Poor impulse control
• Abnormal speech patterns
• Abnormal eating patterns
• Chronic "crazy" lying
• Stealing
• Destructive to self, others, property
• Cruel to animals
• Preoccupied with fire, blood, and gore

Resources:

Attachment Treatment & Training Institute
Phone Number(s): (303) 674-4029
Internet Address: www.attachmentexperts.com

Love & Logic Parenting
Parenting Classes provided by Woodhaven Counseling Associates, Inc. and Jewish Family Services
Internet Address: www.loveandlogic.com

Association for Treatment and Training in the Attachment of Children
Phone Number(s): (866) 453-8224
Internet Address: www.attach.org

Q: What it Is and How to Prevent It

A: Sexual abuse of children is a grim fact of life in our society. It is more common than most people realize. Some surveys say that at least 1 out of 5 women and 1 out of 10 men recall sexual abuse in childhood. Parents need not feel helpless about the problem. The American Academy of Pediatrics provides the following information to help prevent child sexual abuse.

Q: What Is Child Sexual Abuse?

A: It is any sexual act with a child that is performed by an adult or an older child. Such acts include fondling the child’s genitals, getting the child to fondle an adult’s genitals, mouth to genital contact, rubbing an adult’s genitals on the child, or actually penetrating the child’s vagina or anus. Other, often overlooked, forms of abuse occur. These include an adult showing his or her genitals to a child, showing the child obscene pictures or videotapes, or using the child to make obscene materials.

Q: Could My Child Be Sexually Abused? By Whom?

A: Boys and girls are most often abused by adults or older children whom they know and who can control them. The offender is known by the victim in 8 out of 10 reported cases. The offender is often an authority figure whom the child trusts or loves. Almost always the child is convinced to engage in sex by means of persuasion, bribes, or threats.

Q: How Would I Know If My Child Is Being Sexually Abused?

A: You hope that if your child is abused, the child will tell you or someone else about the abuse. Yet, children who are being abused often have been convinced by the abuser that they must not tell anyone about it. A child’s first statements about abuse may be sketchy and incomplete. He may only hint about the problem. Some abused children may tell friends about the abuse. A child who is told about or sees abuse in another child may tell an adult.

Parents need to be aware of behavioral changes that may signal this problem. The following symptoms may suggest sexual abuse:

• striking, exceptional fear of a person or certain places,
• an uncalled-for response from a child when the child is asked if he has been touched by someone,
• unreasonable fear of a physical exam,
• abrupt change in conduct of any sort,
• sudden awareness of genitals and sexual acts and words, and
• attempts to get other children to perform sexual acts.

Physical signs of abuse include sexually transmitted diseases, such as gonorrhea or herpes. In an exam, a doctor may notice genital or anal changes indicative of abuse.

Q: If My Child Reveals Sexual Abuse, What Should I Do?

A: Above all, take it seriously, but stay calm. Many children who report abuse are not believed. When a child’s plea is ignored, she may not risk telling again. As a result, the child could be victimized for months or years. Millions of children have had their lives torn apart by ongoing sexual abuse.

Make sure you help your child understand that the abuse is not his or her fault. Give lots of love and comfort. If you are angry, don’t let your child see it – you do not want the child to think the anger is aimed at her. Let the child know how brave she was to tell you. This is most important if the child has been abused by a close relative or family friend. Then, tell someone yourself. Get help. Talk to your child’s doctor, a counselor, a policeman, a child protective service worker, or a teacher.

Q: Can I Deal with Sexual Abuse in My Family Without Contacting the Authorities?

A: It is difficult for parents to stop sexual abuse without help from experts. The hard but healthy way to deal with the problem is:

1. Face the issue.
2. Take charge of the situation.
3. Work to avoid future abuse.
4. Discuss it with your pediatrician, who can provide support and counseling.
5. Report abuse to your local child protection service agency and ask about crisis support help.

Talking about sexual abuse can be very hard for the child who has been told not to tell by a trusted adult. It can be just as hard for adults if the abuser is close to them. Still, the abuse should be reported to your local child protection agency or your doctor. It is the best thing to do for both the child and the family.

Q: What Will Happen to the Child and the Offender If Sexual Abuse Is Reported?

A: Cases are checked by the police or a social service agency that looks into reports of suspected child abuse. With the help of a doctor and/or the police, a social service agency will decide whether sexual abuse has taken place. Sometimes, the police will let social services handle the case. This may occur if the child is not physically abused and the abuser is a family member. When a child is abused by an non-family member, the matter is usually handled by the police.

After the case is reported, what happens depends on the circumstances. The degree of risk of additional abuse to the child is of first concern to the authorities. The offender or the entire family may be required to attend a treatment program. In some cases, the offender may face criminal charges. If the child’s safety is in question, he may be removed from the home. In any event, the child and family will need a great deal of support from relatives and friends.

Q: What Can Parents Do to Prevent Sexual Abuse?

A: Stay alert to sexual abuse and teach your children what it is. Tell them they can and should say NO! or STOP! to adults who threaten them sexually. Make sure your children know that it’s OK to tell you about any attempt to molest them – no matter who the offender is.

• See if your child’s school has an abuse prevention program for teachers and children. If it doesn’t, get one started.
• Talk to your child about sexual abuse. This should be an ongoing dialogue which constantly enforces the child’s right to say "no" and to tell.
• Teach your child about the privacy of body parts.
• Listen when your child tries to tell you something, especially when it seems hard for her to talk about it. Don’t always presume you know what your child means. Ask for more information.
• Give your child enough of your time so that the child will not seek attention from other adults.
• Know with whom your child is spending time. Be careful about letting your child spend time in out-of-the-way places with other adults or older children. Plan to visit your child’s caregiver without notice.
• Tell someone in authority if you suspect that your child or someone else’s child is being abused.

Prevention measures to safeguard your children should begin early, since a number of child abuse cases involve preschoolers. The following guidelines offer age-appropriate topics to discuss with your children:

• 18 months – Teach your child the proper names for body parts.
• 3-5 years – Teach your child about private parts of the body and how to say no to sexual advances. Give straightforward answers about sex. Empower them about their bodies.
• 5-8 years – Discuss safety away from home and the difference between safe touch, unsafe touch, & confusing touches. Encourage your child to talk about scary experiences.
• 8-12 years – Stress personal safety. Start to discuss rules of sexual conduct that are accepted by the family.
• 13-18 years – Stress personal safety. Discuss rape, date rape, sexually transmitted diseases, and unintended pregnancy.

Your child’s teacher, school counselor, or pediatrician can help you teach your child to avoid sexual abuse. They know how this can be done without making your child unduly upset or fearful. For further information on child sexual abuse and other forms of abuse, write to the National Committee for prevention of Child Abuse, P.O. Box 2866, Chicago, IL 60690.

Your pediatrician understands the importance of communication between parents and children. Your doctor is trained to detect the signs of child sexual abuse. Ask your pediatrician for advice on ways to protect your children.

This digest was adapted from the flyer Child Sexual Abuse: What it Is and How to Prevent It, copyright 1988 American Academy of Pediatrics.

Q: My child seems very angry. How did this happen?

A: It is very stressful to observe anger in your children. When we were young, many of us were taught that anger is “bad,” and this influences how we deal with anger with our own children. The goal in helping children cope with anger is not to repress it, but rather to accept the feelings and to help them learn to cope effectively with it.

We also need to help determine what may be underlying the anger. Often, anger is associated with sadness and depression. It is sometimes related to anxiety about situations over which the child has no control. It may also be a symptom of low self-esteem and feelings of isolation. Understanding why your child is angry or aggressive is the first goal in finding ways to help him/her.

Q: How can I help my angry child?

A: The most important thing is to let them know that you accept all of their feelings, including anger. Next, we must be clear with what we expect from our children, and teach them acceptable ways of coping with their anger. A mental health professional can help you use the following techniques to teach your child to handle anger effectively:

• Catch the child being good
• Deliberately ignore inappropriate behavior that can be tolerated
• Provide physical outlets and other alternatives
• Manipulate the surroundings
• Use closeness and touching
• Be ready to show affection
• Ease tension through humor
• Appeal directly to the child
• Explain situations
• Use physical restraint
• Encourage children to see their strengths as well as their weaknesses
• Use promises and rewards
• Say “NO!”
• Tell the child that you accept his or her angry feelings, but offer other suggestions for expressing them.
• Build a positive self-image
• Use punishment cautiously
• Model appropriate behavior
• Teach children to express themselves verbally

Resource:
www.childdevelopmentinfo.com

Q: What is a Pervasive Developmental Disorder (PDD)?

A: Pervasive Developmental Disorders refer to a broader group of neurobiological conditions, known as autistic spectrum disorders, that are characterized by delayed development of communication and social skills. Children with these disorders often have trouble relating and communicating with others, and have noticeable difficulty in using and understanding language. They may also exhibit unusual play with toys and other objects, including flicking or shaking toys in nontraditional manners, repetitively spinning toys, and lining up toys instead of playing with them. These children often have extreme difficulty with changes in routine.

Q: What is Asperger’s Syndrome?

A: Asperger’s syndrome is a PDD, but is different from other PDDs because the child’s early development is normal and there is no language delay. Children with this syndrome frequently have peculiarities in speech and language, such as speaking in an overly former manner or in a monotone, or taking figure of speech literally. The most distinguishing symptom of AS is a child’s obsessive interest in a single object or topic to the exclusion of others. These children have extreme difficulty in having successful peer interactions. They also typically have problems with non-verbal communication, including the restricted use of gestures, limited or inappropriate facial expressions, or a peculiar, stiff gaze. Eye contact is often poor. Finally, Asperger’s children often present with clumsy and uncoordinated motor movements.

Q: What is Autism?

A: Autism is a developmental disorder of brain function. People with autism often have impaired social interactions, problems with verbal and nonverbal communication and imagination, and unusual or severely limited activities and interests. Symptoms appear during the first three years of life and continue throughout life. Eye contact is very poor, they may flap their arms or engage in other self-stimulatory behaviors, or they may say the same sentence again and again to calm themselves down.

Q: What should I do if I suspect my child might have a PDD?

A: If a child has difficulty with social interaction and communication, and exhibits repetitive behavior, he or she may need to be evaluated for a PDD. Medical professionals and psychologists frequently work together to help determine if a PDD is present, and how to treat a child. Treatment often involves such things as speech/language therapy, educational and behavioral interventions, occupational and physical therapy, and medication. It is best to start these treatments as early as possible.

Resource:
www.childdevelopmentinfo.com
www.aspergerfoundation.org
www.usautism.org

Q: How do I know if my child has ADHD?

A:Children with ADHD begin to exhibit symptoms of inattention and/or hyperactivity before the age of seven. Characteristics of ADHD children include being easily distractible, difficulty concentrating or paying attention, impulsivity, hyperactivity, and emotional instability. A pediatrician or a child mental health therapist can help determine if your child is ADHD.

Q: If my child has ADHD, will he/she need medication?

A: Your pediatrician and therapist can help determine if medication is right for your child. Medications such as stimulants have long been employed for the treatment of ADHD. These medications improve functioning in various areas of the brain involved with attention, concentration, and self-control. Other treatment strategies include:

• Parent Education
• Behavior Modification Programs for Home and School
• Relaxation Training to Improve Emotional Control
• Cognitive Behavioral Therapy to Improve Motivation, Problem Solving Skills and Self-Esteem
• Social Skills Training

Resource:
www.add.com
www.ldonline.org
www.chadd.org