Group Therapy
Before you run off and sign up for individual consultations with me (or with anyone else), consider taking a series of groups first. You can learn basic information about your problem just as well (and maybe better) and get a head start on addressing the problem in a series of groups as in a series of one-to-one consultations. And it's a lot less expensive.
I offer group series on eleven different problem areas. See if any of them pertain to you or to someone you know.
Meeting other people who really understand what you are going through can be a great comfort. You won't feel so alone when you see how many other people are "in the same boat" as you. Other group members may also have information about books, articles, TV coverage, treatment programs and just plain old ideas that may be helpful to you.
A group gives you a chance to "put your toe in the water" before you decide whether you want to jump into individual therapy In group, you can play an active role by asking questions and sharing your own experience. Or, you can sit back quietly and just listen without participating if you wish. It's up to you. Either way, you are bound to get something out of it.
My groups include lectures, videos, question & answer periods, paper & pencil work and in-group exercises.
Some of my group series meet for a total of 20 hours, that is, ten 2-hour groups. Others meet for a total of 10 hours, that is, five 2-hour groups. One special group for children meets for five times for 1-hour each time.
You may attend any of the eight adult series of groups by yourself,
or, if you wish, you may bring a friend or family member for a small extra
fee. For the series on depression, you must bring a friend or
family member. (The reason will be explained later.)
How To Get Mellow
Around That Dentist Fellow
Five 2-Hour Experiential Groups To Get You To The Dentist On Time
Are you too embarrassed to smile because of your teeth? Are you putting up with pain and headaches because the fear of going to the dentist is a lot greater than your desire for pain relief? Is your fear of dental exams, cavity-filling and professional teeth cleaning so high that you'd rather risk being toothless at 50 than make and keep a dental appointment?
To be accepted into this group, you must first undergo an initial evaluation to make sure you are in good enough mental and physical shape to undergo the stress of being in it.
Stress? Yes! To overcome any phobia, you must expect to encounter some stress. This group is designed to keep the stress at a minimum and to give you skills to manage the stress at every level.
Still, you must be mentally and physically healthy before deliberately exposing yourself to any avoidable stress. You must get a clean bill of mental health either from me or from your own your own therapist (if you are seeing one).
How To Get Mellow Around That Dentist Fellow is based on well-researched psychological findings. There are three basic parts to it: First, you must understand both your fear reaction and the thing that you fear; second you must learn a number of effective "coping tactics" to manage anxiety; and third, you must allow yourself to face the very thing you fear, a little bit at a time, instead of avoiding it, through "gradual exposure."
Coping Tactics To face a fear, you need to have some "protection" from the anxiety that you will surely feel. You need to know that there is something you can do to keep yourself calm and make yourself go through with it.
"Coping tactics" or "CT's" do exactly that. CT's are specific actions you can take to reduce anxiety. Instead of just sitting there, gritting your teeth, white-knuckling it and telling yourself to "stop being ridiculous," you will now have the skills to help you manage your anxiety. CT's include factual knowledge about modern dentistry, deep breathing, muscle relaxation, humor and changing irrational thoughts.
Gradual Exposure At every point, you will be exposed to just enough anxiety to challenge you, but not so much that it would scare you into leaving. The five meetings take place in the waiting room and treatment room of a dentist who is a colleague of mine. (He doesn't actually make an appearance until the last group.)
Though you are urged to finally go through with a dental exam or teeth-cleaning, if you absolutely cannot, you can take the group series again without charge.
Once you do have a dental exam or teeth-cleaning, you will be rewarded with the confidence that now you can keep your smile and your teeth.
Agenda
Day #1
Video: Bill Cosby Himself (section on dentists) * Introductory information * Fear: The fight-or-flight response * Getting acquainted * Benefits (practical & emotional) of being able to go to the dentist * Costs (practical & emotional) of being able to go to the dentist * Preview the of rest of the groups * External triggers: sounds, smells, sights, touch, taste * Coping Tactic #1 (CT#1): Laughter overcomes fear (laughing in the waiting room, laughing in the dentist's chair)
Day #2
Anxiety checklist * Physical relaxation overcomes fear * Muscle tension awareness * CT#2: Body scan * CT#3: Progressive muscle relaxation (PMR) * Mental rehearsal * CT#4: Ki deep breathing * CT#5: Simultaneous PMR + ki deep breathing * Relaxing in the waiting room, relaxing in the dentist's chair
Day #3
CT#6: Knowledge: Information on modern dental treatment * Guest speaker: Dentist * Q & A * CT#7: Replacing "irrational beliefs" or "cognitive errors"with more realistic thoughts * CT#8: Mental rehearsal of dental treatment * Thinking realistically in the waiting room, thinking realistically in the dentist's chair
Day #4
Putting together your own personalized "Relax Kit" * Scripting your next dental visit * Choosing your preferred CT's * Mental rehearsal of your next dental visit * Dress rehearsal of your next dental visit
Day #5
group dental visit (teeth-cleaning or dental exam) * Using your own
personalized "Relax Kit" * Beautiful smile photo shoot
Keep It Down! (Your Weight And Your Dinner)
Ten 2-hour Intensive Groups For Binge-Purgers, Self-Starvers, Overeaters & Their Families
Also offered as a four-day marathon weekend.
NATURAL EATING...Eating when you're hungry and not eating when you're not hungry.
UNNATURAL EATING...Eating when you're not hungry and not eating when you're hungry.
You may have asked yourself, "Why can't I just eat?" You may already have some ideas as to why you binge, purge, diet or starve. Or maybe you are totally lost as to what's behind it all. In any case, it's still happening, and causing you a lot of distress.
You may have tried Will Power. ("I won't do it, I won't do it.") Or maybe you've made repeated New Year's Resolutions. ("After today, never again.") Maybe you've gone from one diet and weight loss scheme to another. Maybe you've even tried therapy. So far, nothing has worked.
Why? Because food is not the issue. But how could you think otherwise, what with so many diet clinics, diet books and diet experts steering you to "exert control" and focus on calories, portions and pounds!
This group will help you figure out the purposes that binging, purging, starving and worrying about weight serve in your life. How do these acts help you cope, get by and protect you from distress?
You will learn the ways in which you are keeping the emotional fuel level of your heart on low, and how this leads to filling up the stomach instead with physical fuel (food).
Once you understand this, you will see clearly what you need to do to overcome the binge-purge-starve cycle. (Hint: It has nothing to do with diets, food or willpower!)
Agenda
DAY #1
Getting acquainted * Expectations * Overview * What are eating disorders and do I have one? * Video: Today Show * Glamour Magazine Survey * Video: 20/20 * Q & A period
DAY #2
Families * Video: The Best Little Girl In The World * Control, Autonomy & assertiveness * Perfectionism * Family Do's & Don't's
DAY #3
Advertising & social pressures to be thin * Video: Waistland * Ladies' magazines * 3 body image exercises * The weight loss business * Sing-along protest song: Soft & Round
DAY #4
Biology & metabolism of eating and weight loss * Normal fluctuations in weight * 7 systems of the body: The chicken-and-egg trap * Anti-depressants & eating disorders
Day #5
External triggers for eating * Natural eating * 3 techniques for getting back in touch with your hypothalamus * Why diets don't work
Day #6
The top 40 emotional triggers for eating * 4 techniques for getting in touch with your emotional hungers * 2 techniques for learning what to feed the hungry heart * Video: Phil Donahue Show with Geneen Roth * Bruce Springstein's song: Hungry Heart
Day #7
Basic assertiveness & empathy training for sufferers & family members {Click here for more thorough assertiveness training.}
Day #8
Medical concerns * Finding & evaluating a medical doctor & dentist * How to tell your doctor or dentist
Day #9
Why you fight overcoming your eating disorder * What you will lose by overcoming your eating disorder * "Just saying 'no'" never works
Day #10
Designing your own personalized treatment approach * Finding & evaluating
a psychotherapist
An Ongoing Group For People Struggling With Bulimia, Anorexia & Binge Eating
This is an open-ended, on-going weekly meeting. You can come as often as you like. There is no "first" or "last" meeting. Family members and friends are welcome too. The meeting has no pre-ordained structure or agenda. It's whatever you make of it. You can tell your story, ask questions, see how others feel about things, make new friends, get ideas and share opinions on books, treatment programs and therapists. Most importantly, you can meet other people who understand and accept you in a way that many people who are not fighting this problem cannot.
Space is limited, so please phone or e-mail ahead of time to confirm that
you are coming.
Assertiveness For Wolves &
Sheep
Five 2-Hour Groups To Help You Act Like A Human Instead Of A Sheep Or A Wolf
Assertiveness is the middle ground between being too passive and being too aggressive. This group is for people at both ends of the spectrum.
If you let people walk all over you or if you stay silent when you wish you could speak up, this group can help you. If you let others take advantage of you or treat you rudely, then you will benefit from learning how to politely but firmly stand up for yourself. You'll feel better about yourself and you'll exert more influence on how people treat you.
On the other hand, if you lose your temper a lot or keep things inside until you explode, you probably regret it later. When you say hurtful things to people you love, you may feel awful about yourself once you've calmed down. If your anger sometimes gets so out of control that you get physical, this group can help you get back in the driver's seat.
Agenda
Day #1
The fight-or-flight instinct * Passive behavior * Aggressive behavior * Passive-aggressive behavior * Passive avoidant behavior * Consequences of each * The cycle * Real life examples * Questionnaire * Sheep or Wolf? * Assertive Behavior
Day #2
Real life examples of assertive behavior * Consequences of assertiveness * Blocks to being assertive * * Assertive Tactic #1: The model sentence * Round robin practice * Assertive Tactic #2: Broken record * Round robin practice * Assertive Tactic #3: Fogging * Round robin practice
DAY #3
Body language * Eye contact * Voice * Practice with coaching * Opening lines * U-turns * Rhetorical questions * Counter-offers * Practice with peer coaching
Day #4
Negative assertion * Negative inquiry * The right time, place and person * When not to be assertive * Practice with peer coaching * Goal for next group
Day #5 (One month later)
How'd it go? * Reaction of others * What got in the way? * Re-plays &
fine-tuning * Practice with peer coaching
Come Out From Under
The Cloud Of Depression
Ten 2-Hour Intensive Groups For Sufferers & Their Families
Are you sitting home, watching life pass you by? Have you given up on ever feeling better? Are you doing less and less each day? Is it getting too difficult to get out of bed, take a shower and eat properly? And does everything you do take more and more effort than it used to? Have even the things that used to give you pleasure lost their appeal? Are you thinking the world would be better off without you?
Depression makes you have tunnel vision and shrinks your universe. Depression is The #1 mental health problem in the U.S., striking about 17.6 million people a year. Depression costs over $23 billion in lost wages in a year and untold personal misery, sometimes ending in suicide.
You can get over this! With counseling and often with the help of medication, at least 70% of people with depression recover and return to their usual level of functioning.
To be accepted into this group series, you must bring a friend or family member to be your personal coach and support person. If you don't have anyone, I will help you find someone to do this with you. (Will explain why on Day #4.)
How To Come Out From Under The Cloud Of Depression is based on the seven most widely-subscribed to theories of depression, ranging back from Freud up to the more modern biological and cognitive-behavioral approaches. Each group focuses on one of these approaches, so that, by the last group, you can choose the combination of approaches that you think will work best for you.
Agenda
DAY #1
Getting acquainted * Expectations * Overview * What is depression and am I really depressed? * Endogenous vs. exogenous depression * Suicide risk factors * Tips for families * Pro's & con's of hospitalization * Q & A period
DAY #2
Brain chemistry causes depression * The chicken-and-egg trap * Types of anti-depressant medication * How they work * What to expect * How to tell if medication is helping * Evaluating your psychiatrist
DAY #3
Loss & hurt cause depression * What losses are you suffering? * Anger turned inward * Forgiving yourself * How to commit to daily pleasures * Humor * Song & dance
DAY #4
Learned helplessness & hopelessness cause depression * Have you given up? * How to make yourself take action * How others can help
DAY #5
Thinking errors cause depression * The Dirty Dozen * Identifying your own thinking errors * Replacing them with more accurate ideas * How to reprogram your thinking
DAY #6
Lack of assertiveness causes depression * Basic assertiveness skills * Blocks to being assertive
DAY #7
Physical causes of depression * Poor nutrition * Illness * Other medications * Lack of exercise * Insufficient sleep * Drugs & alcohol * Lack of light (SAD) * What to do about each of these
DAY #8
Summing up * What are the causes of your depression? * Designing your own personalized treatment approach * What would get in the way of carrying out each part? * How to overcome these obstacles * Group brainstorming & support
DAY #9
What have you actually started to do? * What is getting in the way of doing more? * How to overcome these obstacles * Group Brainstorming & Support
DAY #10
Continued follow-up on what you have actually started to do * What is
getting in the way of doing more? * How to overcome these obstacles * Group
brainstorming & support * Finding & evaluating a psychotherapist
Fly Fear
Free
Ten 2-Hour Groups To Get You On That Plane!
There's a great big wonderful world to see! Have you passed up family holiday dinners, graduations and weddings because you just couldn't get on the plane? Have you given up on that dream vacation to Europe or the Orient or the West Coast because the terror of flying outweighs the pleasure of the vacation? Are you attending the local college because you panic at the idea of flying to the college that you really want to attend? Is your career being limited because you can't fly to business meetings or professional training conferences?
Fear of flying shrinks your universe. You're in good company. Over 25 million Americans are afraid to fly.
You can get over this! Fear of flying is a problem that is successfully overcome in 80% to 90% of people who enroll in programs like FFF. You don't have to continue living with this phobia!
To be accepted into FFF, you must first undergo an initial evaluation to make sure you are in good enough mental and physical shape to undergo the stress of being in the program.
Stress? Yes! To overcome any phobia, you must expect to encounter some stress. FFF is designed to keep the stress at a minimum and to give you skills to manage the stress at every level.
Still, you must be mentally and physically healthy before deliberately exposing yourself to any avoidable stress. You must be "cleared for take-off" by our own psychologist, by your own physician and by your own therapist (if you are seeing one).
FFF is based on well-researched psychological findings. There are three basic parts to it: First, you must understand both your fear reaction and the thing that you fear; second you must learn a number of effective "coping tactics" to manage anxiety; and third, you must allow yourself to face the very thing you fear, a little bit at a time, instead of avoiding it, through "gradual exposure."
Coping Tactics To face a fear, you need to have some "protection" from the anxiety that you will surely feel. You need to know that there is something you can do to keep yourself calm and make yourself go through with it.
"Coping tactics" or "CT's" do exactly that. CT's are specific actions you can take to reduce anxiety. Instead of just sitting there, gritting your teeth, white-knuckling it and telling yourself to "stop being ridiculous," you will now have the skills to help you manage your anxiety. CT's include factual knowledge about flying, deep breathing, muscle relaxation, humor and changing irrational thoughts.
Gradual Exposure At every point, you will be exposed to just enough anxiety to challenge you, but not so much that it would scare you into leaving. The first five meetings take place in a grouproom near the airport. The sixth meeting is held in a boarding area; the seventh, eighth and ninth in a plane sitting on the ground. The actual flight takes place in the tenth meeting.
Though you are urged to make the flight, if you absolutely cannot, you can transfer your airfare to someone else, or take the course again without charge and use your airfare the second time around.
Once you make your maiden flight, you will be rewarded with a celebration party, and most importantly, with the confidence that now you can go anywhere you want!
Agenda
DAY #1
Introductory information * Individual flying histories * Costs & benefits of flying * The fight or flight response * Coping Tactic #1 (CT #1): Humor
DAY #2
CT #2: Progressive muscle relaxation (PMR) * Mental rehearsal of flight
DAY #3
CT #3: Deep breathing * Mental rehearsal of flight
DAY #4
CT #4: Knowledge of facts of flight * Guest speaker: Pilot * Book: Fly Without Fear * Mental rehearsal of flight
DAY #5
CT #5: Identifying & replacing irrational beliefs or "thinking errors" with more realistic ideas * Mental rehearsal of flight
DAY #6
Mental dress rehearsal in boarding area, using all CT's
DAY #7
Dress rehearsal in standing plane (engine off), using all CT's
DAY #8
Dress rehearsal in standing plane (engine on), using all CT's
DAY #9
Dress rehearsal in taxiing plane (on ground only), using all CT's
DAY #10
Maiden flight to neighbor island, using all CT's * Lunch * Return flight,
using all CT's * Celebration & awards party!
How many times have you heard friends, teachers or coaches say, "Hey, just relax!" For some people who are born with with revved up nervous systems, it's not that simple. And for people who are sometimes faced with severe stressors in life (and who isn't?), it's hard to relax, at least as long as things are going badly. Everyone can learn to relax, consciously and deliberately. This group will show you how.
DAY #1
What relaxation is * What relaxation is not * Practical benefits of relaxation * Why people are reluctant to relax * Physical signs of tension * Rating your level of relaxation * Body scan * Body scan in motion * Five physical sensations awareness tactic * Mental awareness tactic
DAY #2
Review of relaxation tactics from DAY #1 * Fight-or-flight response * Four uses of relaxation * Deep breathing tactic * Deep breathing in motion * Progressive muscle relaxation tactic * Subtle muscle relaxation tactic
DAY #3
Review of relaxation tactics from Day #1 and DAY #2 * Simultaneous deep breathing & progressive muscle relaxation tactic * Passive relaxation * Why downers, alcohol and sedatives are not the answer * Physical pressure valve release tactics * Mental pressure valve release tactics
DAY #4
Review of all relaxation tactics * Choosing the ones you like * Making your own daily relaxation plan * Anticipating obstacles
DAY #5
Review of all relaxation tactics * Round-robin: How did your plan go?
* Brainstorming solutions to overcoming obstacles to relaxation
This group is for elementary, middle and high school students who have been labeled "hyperactive"(HA), "attention deficit disordered"(ADD) or "learning disabled"(LD). If you're a teacher, athletic coach or parent of such students, Thinking Out Loud (TOL) might help them concentrate more, learn faster and perform better.
The group takes place at your school, during regular group time or during after-school practice. The particular activities used to demonstrate and practice TOL depend on your subject (math, English, science, social studies, foreign language, athletics, music, shop, art, dance, home economics, etc.) TOL can increase students' ability to focus on the task at hand (whatever it may be), and to disregard distractions, whether these come from things going on around them or from internal thoughts, anxiety or other feelings. With better concentration, students will make fewer "careless mistakes" and will be more likely to catch errors before they occur.
Day #1
Who thinks out loud? * When do people think out loud? * No, it doesn't mean you're crazy * Examples * 4 steps of TOL * Warm-up: Counting Game * Using TOL while doing a card trick * Application of TOL to the particular group subject * Closing: The TOL handshake.
DAY #2
Warm-up: Counting Game * What's my strategy? (for undertaking visual-motor tasks) * Using TOL while doing mazes * Jam-up challenge * Using TOL while doing jigsaw puzzles * Using TOL to copy a picture * Using TOL to match things * Using TOL while assembling something * Using TOL when getting dressed * Using TOL to set the table * Application of TOL to the particular subject * Closing: The TOL handshake.
DAY #3
Warm-up: Singing Game * What's my strategy (for undertaking cognitive tasks ) * Phone number game * Using TOL to learn weird spelling words * Using TOL to memorize the multiplication table * Using TOL to solve math problems * Jam-up challenge * Using TOL to do crossword puzzles * Using TOL in Scrabble * Application of TOL to the particular subject * Using TOL when taking tests * Closing: The TOL handshake
DAY #4
Warm-up: Singing Game * What's my strategy (for undertaking organizational
tasks ) * Using TOL to organize (your room, your desk, your locker, your
essay, your homework, your day) * Using TOL to put things in the right order
(categorizing, sequencing) * Application of TOL to the particular subject
* Demonstration of your best TOL in the activity of your choice * Closing:
The TOL handshake
Overdoing
It
Ongoing Intensive Groups To Cut Down On Whatever You're Doing Too
Much Of
Sometimes activities that are usually harmless can get out of hand. Things like watching TV, surfing the internet, playing games on your DS/Wii/iPod/iTouch, sleeping, shopping, working, using credit cards pursuing a hobby, or watching sports. Other things which are meant to promote peace of mind (such as AA and religion) or strength of body (such as jogging or participating in other athletics) can do the opposite if carried to an extreme. Still other things may pose minimal danger if you do them in moderation, but can be harmful if you overdo them, such as drinking coffee, eating chocolate, drinking alcohol, taking prescription drugs and gambling. And we've all heard about the perils of cigarette smoking and street drugs.
How do you know when you're overdoing it? If you answer, "Yes," to any of the following six questions, it's time to consider cutting back:
(1) Is it harming your physical health? Can it do so in the future?
(2) Is it jeopardizing your financial stability? Can it do so in the future?
(3) Is it interfering with your ability to work or go to school (or whatever it is you do)? Can it do so in the future?
(4) Is it causing problems (upset, anger, alienation) between you and the people you love? Can it do so in the future?
(5) Is it disturbing your own peace of mind? Can it do so in the future?
(6) Is it shrinking your universe? (Is it taking over everything else in your life and becoming the most important thing or maybe the only important thing?) Can it do so in the future?
To be accepted into this group series, if your aim is to cut back on coffee, cigarettes, alcohol, prescription drugs or street drugs, you must be in some other regular treatment (not necessarily with me). This is because caffeine, nicotine, alcohol and many drugs are chemically addictive substances that make it harder for you to cut back than other habits which do not involve such chemicals. Although this group series can help you cut back, it will probably not be enough, by itself, to set you free of the addictive power of these chemicals. If your aim is to cut back on a habit that does not involve these chemicals, you are not required to be in other regular treatment.
Overdoing It is an open-ended, on-going group. You can come as often as you like. There is no "first" or "last group." You will be expected to commit to at least three groups.
Each group meeting follows the same format:
The group opens with an overview of how the groups are structured, so that newcomers will know what to expect.
Next, I ask, "Who would like help first with his or her habit?" Everyone gets a turn during each group, unless of course, you choose to "pass."
For new group members: If you choose to participate, you will get to sit in a special, designated "helping chair," and to tell what it is you are "overdoing", how much and how often. How did it start? How long has it been a problem? Throughout this, other group members will be invited to comment.
Then you will be asked to talk about whether and how overdoing it has harmed your physical health, finances, relationships, peace of mind, ability to work or study. How has it narrowed your universe? What negative consequences have occurred? What has it caused you to miss? What do you think is keeping it going? Is your aim to cut back a little? Cut back a lot? Or eliminate it entirely? Again, other group members will be invited to share their own experiences and opinions.
Now comes the really good part: group members will be asked to brainstorm ideas about what you might do to stop "overdoing it." These are written on a board for all to see. I too will contribute my suggestions. I will also share with you what I know about the different schools of psychology and how you might utilize their principles to achieve your goal. ( From the"behavioral school", this includes the principles of positive and negative reinforcement, habituation, satiation, immediate and delayed reinforcement, emotional conditioning.) Between the ideas of other people who are in the same boat as you and the ideas of a psychologist (me!), you will end up with a list of very useful things to do to stop "overdoing it."
Now comes the really odd part: The group members will be asked to brainstorm ideas about why you will probably not take any of their suggestions. "Huh?!" you might be asking. "Why would I not take suggestions? That's what I'm here for! To find out how to stop overdoing it!" I too will contribute my guesses about this. Please click on My View Of Behavior now and read my comments about Resistance.
Finally comes the most important part: The group members and I will brainstorm ideas about how you might overcome the obstacles that get in the way of your carrying out the suggestions.
For returning group members: When you take your turn in the "helping chair," you can update everyone on how you've been doing with your habit, since your last group. Did you actually use any of the suggestions? What helped? What didn't? How come? Do you need more ideas on what to try? Do you need more ideas on how to overcome your own resistance to trying the ideas that have already been suggested?
Overdoing It involves everyone helping everyone in a supportive, non-threatening atmosphere. To borrow a phrase from internet chat rooms, no "flaming" will be allowed.
Nada Mangialetti, Ph.D.
DrNada@KapoleiCounseling.com
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