Blog

A child sitting with his parents while a educational professional performs a psychoeducational evaluation.

Children Teens April 1, 2022 By Jackie Haslam 0 Comments

Psychoeducational Evaluations 101

Have you been told that your child could benefit from a psychoeducational evaluation? If so, you might be wondering what a psychoeducational evaluation is, why your child might need one, and what’s involved with getting one. If you’re wanting to learn more about this kind of testing, we hope you’ll find this information helpful in deciding whether it’s right for your child.

The assessment team at Brentwood Counseling Associates strives to help parents understand their child’s patterns of strengths and weaknesses, identify barriers to success, and gain an understanding of their child’s unique style of learning. We currently offer comprehensive psychoeducational evaluations and attention-deficit/hyperactivity disorder (ADHD) evaluations for children, adults, and everyone in between. Psychoeducational evaluations are useful in that they highlight a child’s intellectual abilities (including verbal comprehension, visual-spatial reasoning, fluid reasoning, working memory, and processing speed) and reveal a pattern of how they learn in their own unique ways. They also include assessment of academic achievement to assist the clinician in ruling out learning disabilities such as reading disorders and dyslexia, writing disorders and dysgraphia, and math disorders and dyscalculia. This specific type of evaluation further includes assessment of the child’s social-emotional functioning and behavior to help identify disorders such as ADHD and those related to anxiety and depression.

Perhaps the referral concern includes issues such as difficulty focusing, poor concentration, or irritability. A teacher may report to a parent that they observe their student to be anxious about their school work or that it takes them longer to complete their assignments. A parent may notice that their child struggles with friendships or that they are argumentative. The family may report to their pediatrician that their child has been more withdrawn in school and at home and that they spend more time worrying. A tutor may observe that their student struggles with retaining information and with reading comprehension. It is through careful examination of the child’s presenting symptoms, developmental history, academic performance, and data collected in an assessment (including parent and teacher rating forms and questionnaires) that our clinicians can begin to tease out concerns and make a determination about differential diagnoses (e.g., ADHD versus a learning disorder). Psychoeducational evaluations can provide answers about what specific challenges children experience and can assist clinicians in guiding academic supports such as accommodations and/or modifications if needed.

Our comprehensive psychoeducational evaluations begin with a detailed interview with the clinician in which the family can express their concerns and provide helpful information about their child’s developmental, medical, social-emotional, and academic history. This interview is followed by approximately two hours of testing during the first session and three hours of testing during the second session. During that time, the clinician works with the child to gain an understanding about the issues and to make a determination about what tests are needed. An assessment battery generally consists of individually administered, standardized measures such as an IQ test, an academic achievement test, rating scales, and a child interview. Feedback sessions occur within two to three weeks in which the parents meet with the clinician to review a detailed, comprehensive report together and discuss recommendations and potential adjunct therapy referrals. The parent is able to ask questions, and time is spent with them to make sure they understand their child’s overall pattern of strengths and weaknesses.

Contact Brentwood Counseling Associates today if you’d like to explore psychoeducational evaluation for your child.

Therapy March 2, 2022 By Tara Hammonds 0 Comments

Is Teletherapy right for you? Pros and Cons

Prior to the pandemic, teletherapy was something that was available but not being utilized to the extent it is now. The rise of COVID-19 compelled us all to explore virtual access to meet a number of our needs. Now, many more individuals have had first-hand experience of the benefits and efficacy of teletherapy. In fact, many now prefer it. Below we will explore the pros and cons of teletherapy as well as discussing what to expect in order to help you decide if it is right for you.

The Pros:

Efficacy

Does it work? A very reasonable and common question is whether or not Teletherapy video sessions are as effective as in-person therapy options. According to the American Psychological Association research on teletherapy has been ongoing since 1960. Findings show that video teletherapy is as effective as in-person sessions in treating a wide variety of psychological disorders such as Anxiety, Depression, PTSD and Adjustment Disorders to name a few. Though research is ongoing, it is safe to say that psychologists agree in teletherapy being an effective form of psychotherapy treatment.

Convenience

Who doesn’t love a convenient option? Many people struggle with finding time to schedule sessions due to busy work days or school conflicts. Teletherapy increases access to many by eliminating commute times. Many people are able to find an hour in their schedule to make time for a session while avoiding the time commitment of travel time.

Access

Limited therapy access in your area? Rural areas sometimes have limited access to therapy services and are forced to undergo long travel times to find accommodations for themselves or their children. This can interfere with work and school responsibilities making the therapy process unnecessarily stressful. Unforeseeable instances of inclement weather or minor sickness can sometimes create barriers for therapy attendance. Teletherapy can provide a solution to these issues through creating access.

Comfort

Feeling anxious about your first session? While this is completely normal, feeling anxious about your first therapy session can sometimes be enough to cause people to forgo treatment altogether. Being able to curl up on your couch, with your dog and still have a session with a professional can make the process seem less daunting for some. As long as you are able to secure a private location in your home or office for an hour you are able to have a confidential and comfortable teletherapy session.

The Cons:

Therapeutic environment

You are responsible for creating your own therapeutic environment. Sometimes people are distracted during a session by their dog barking in the background, children coming into their room to ask a question, the load of unfolded laundry in the corner, etc. It can be tempting to multitask during sessions and this can unfortunately interfere with therapeutic connection and/or progress. These distractions can usually be problem solved however, for some, this a deal breaker no longer making teletherapy the right choice.

Difficulty finding a private location

Similar to the issue described above, some feel anxious about having a private location to talk with their therapist virtually. Therapists are legally and ethically bound to comply with HIPAA privacy guidelines, which ensures they are the only party present in their location during your sessions. However, sometimes adults and teens feel as though they are unable to ensure their own private location away from listening ears.

Technology

One of the expected downfalls of internet communication is that there is always a chance of poor connection or even lost connection all together. This can definitely make it difficult to build rapport or work through therapeutic content when it occurs. Even if your telehealth therapist has a plan in place in case you do get disconnected, such as continuing over the phone or troubleshooting the issue, it can still be a frustrating barrier to treatment if it occurs consistently. Having a strong internet connection in general is a necessity to be able to participate in teletherapy services and should be considered.

May not be appropriate for all presenting issues

A very important item to note is that teletherapy is not appropriate for everyone who is seeking teletherapy services. Some psychiatric illnesses may be too severe or require more thorough monitoring making teletherapy insufficient to meet their needs. This is something that a teletherapist should be able to assess at the initial session in order to determine whether they can continue to see you based on presenting issues. At this point your teletherapist will be able to refer you to someone more appropriate to meet your needs.

What to expect in your first session?

The first step is to reach out to a therapist you’ve identified who offers teletherapy to set up an initial intake appointment.

In that first appointment your therapist will review confidentiality, potential barriers to teletherapy treatment and how to troubleshoot connection issues. The therapist will then begin getting to know you and gathering presenting issues, background information and what you may be looking for from treatment. This will ensure you and the therapist are a good fit.

Follow up appointments will be scheduled at the end of sessions and payment will most likely be collected at the end of the appointment. In some cases, a clinic manager may have already asked to place a card on file for you to aid in the convenience of payment.

If you are interested in beginning teletherapy services Brentwood Counseling Associates would love to assist you. We have a number of therapists offering both in person and teletherapy options. Whether you are seeking services for yourself or for your child it’s likely we have someone who can help. For more information or to schedule your first session please give us a call at 615-377-1153 to talk to our office manager, Jane Jenkins. Jane has been with the practice for more than 20 years and is great at helping you think through your needs and choose an appropriate therapist.

A woman standing on a dock overlooking a lake on a sunny winter day.

Anxiety Depression Grief & Loss Relationships Stress Therapy December 15, 2020 By Stephanie Insko, Ph. D 0 Comments

Maximizing Wellbeing During the 2020 Holiday Season

You might be wondering if that’s even possible. 2020 has been a challenge, to say the least. There’s no doubt that it’s left a lot of us feeling increased loneliness, isolation, worry, boredom, and frustration. Nothing about this year has felt normal, and most of us have had to make at least some adjustments.

Fortunately, it’s gone relatively well for some. But others have seen their mental health decline due to the lack of social support, fears about health and financial security, and the prolonged loss of our old way of life. And for those who’ve lost loved ones or jobs due to the pandemic, or have worked the front lines non-stop, things might be feeling particularly hopeless. Anxiety and depression are on the uptick, both for those who’ve wrestled with them previously, and for those who never have.

Under normal circumstances, the holidays can serve as a buffer against emotional struggles, offering folks the chance to spend meaningful time with family and friends and renew their hope and optimism for better things to come in the new year. But this time of the year can also be challenging for those who don’t experience joy during this season. For people who’ve suffered a significant loss, for example, or who are grappling with ongoing illness, addiction, or strained family relationships, the holidays only serve as a reminder of the things they don’t have.

Whatever the holidays mean for you under normal circumstances, you’ll likely have to adjust to a different – 2020 – version of them. If the year has already left you feeling stressed, you might be wondering how you’ll get through this season with your wellbeing intact. Here are a few ideas.

Connect with Yourself

When was the last time you checked in with yourself about how you’re doing? We’ve all been burdened with a keen awareness that things aren’t right this year, and the holidays will probably only serve to reinforce that. But how often do you examine and identify exactly what you’re feeling, and more importantly, allow yourself to express it? This kind of emotional catharsis is key to good mental health because it keeps things from building up and boiling over, or showing up in the form of depression or anxiety. It can also prevent unhealthy coping mechanisms such as addiction, which often arise through efforts to numb difficult feelings.

You might choose to deeply connect with your feelings on your own by journaling, or with a trusted friend or family member or a helping professional. Or you might find that you resonate more with an artistic form of emotional expression such as painting, singing, or dancing. However it is that you get in touch with your feelings and move them outside of yourself, try to prioritize doing it. And remember to take good care of yourself afterward. Emotional work is hard work, and you deserve to reward yourself. So make a plan to do something rejuvenating as a follow-up. This will replenish your emotional reserve, and make you more likely to engage in such emotional catharsis again.

It’s important to note that if connecting deeply with your emotions leaves you feeling in immediate crisis, please call the Tennessee Statewide Mental Health Crisis Line at 855-CRISIS-1 (855-274-7471).

Connect with Others

During this time of suggested isolation, it’s more important than ever to prioritize quality connection with others. You might not be able to physically be with family and friends this holiday season, so you’ll need to be extra intentional about making your virtual interactions meaningful. Whereas moments together in “normal” years might have been filled with small talk and shared activities where you’re not really connecting very deeply, consider packing your shorter interactions with more meaningful communication. A stronger emotional closeness such as this could go a long way in making the physical distance more tolerable.

For example, you might ask those you care about to share with you what they’ve truly been through this year; find out about their struggles and where they’ve found unexpected joy. Ask them if they consider this year to be the hardest one they’ve lived through, or if some other circumstance in their past was more challenging. Share with each other your coping mechanisms and explore what you wish you were doing a better job with.

Or tell someone who’s really important to you what you’re grateful for in your relationship with them. You might not often do this, but it can give definition to the more ambiguous good feelings you get when you’re with them. It will give them some insight into the special qualities they bring to the relationship, and help you understand the things you find essential in one. You’ll both likely learn a lot about yourselves and about your relationship, too.

With older relatives, consider finding out more about their childhood or what their lives were like when they’re the same age you are now. Or ask what their younger hopes and dreams were, or how they ended up following a particular career path or hobby. Find out if there’s anything they wish they’d known at your age or done differently. In learning so much about someone else, you might be surprised to find that you also learn something about yourself.

Cut Yourself Some Slack

Since there’s not been much normalcy this year, why expect the usual things of yourself? Especially during the holidays, it’s easy for our self-expectations to become perfectionistic in nature. Instead, strive toward making them as realistic as possible. And given that it is 2020, after all, perhaps even expect quite a bit of deviation from the norm. If old holiday traditions are scrapped, try to consider this year as an opportunity to develop new ones – and look forward to future years when you can reflect on this one and be grateful that you made it through.

Practice gratitude around the things you’re thankful are still a part of your life. Remember that this season of our lives is temporary. It’s easier to maintain flexibility when we have faith that at some point, things will return to normal. And break your forward-thinking into manageable chunks – get through one afternoon or day at a time instead of thinking in terms of weeks or months. You’ll feel much more accomplishment and much less overwhelmed.

And if you’re grieving a significant loss this season, allow yourself to feel the sadness around it. Remember to engage in plenty of replenishing self-care, and give yourself permission to do this holiday season differently than usual. Remain flexible, doing only the holiday activities you have the energy and emotional reserve for – not necessarily all the ones you’ve done in the past. And consider honoring the loss as part of your holiday tradition this year. Acknowledging it, as painful as it might feel in the moment, can be a significant part of your grieving process.

If you’ve tried everything you can think of and you’re still feeling burdened with the weight of 2020 this holiday season, don’t hesitate to reach out to someone in the helping profession. Our therapists at Brentwood Counseling Associates are currently offering both in-person and virtual counseling sessions to support you during this time. Sometimes it’s just too hard to do it all on your own, and that’s where we come in. So please reach out and let us know how we can help.

Anxiety Depression Grief & Loss PTSD Stress Therapy Trauma May 4, 2020 By Stephanie Insko, Ph. D 0 Comments

Mental Health and COVID-19: What’s Normal in the New Normal?

The new normal. Mental health and COVID-19. If you’re wondering how to optimize wellness during the current pandemic, you’re not alone. Over the past few weeks, many of us have shifted to working, learning, grocery shopping, exercising, and hair cutting from home. Instead of spending time in person with friends, family, and co-workers, we talk at our phone and computer screens to stay in touch. The days blend into each other now that we have no places to go or people to see, and we do our best to put some sort of structure to them. And in the time of COVID-19, we consider ourselves lucky if those are our biggest concerns. Some have experienced much more devastating changes due to the loss of jobs, health, and even life. They’ve lost everything, and fear for how much worse it will get before it gets better. This would have all seemed unbelievable just a couple of months ago, and yet, it’s where we find ourselves.

It’s safe to say that the COVID-19 pandemic has changed things for all of us, whether it’s simply the loss of our old way of life, or a much more tragic one. And during these times, it can be helpful to understand what we’re going through in the context of grief. When we think of loss in the traditional sense, we think of the death of a loved one or the end of a significant relationship. But our feelings and reactions to this pandemic are much like what we go through when we grieve. We’re grieving the loss of the way things used to be. And just as some people have a harder time working through the grief process, some folks are finding it harder to adapt to the loss of our old way of life. In this article, we’ll explore some of the normal, common reactions to our new reality, and identify some red flags to watch out for. We’ll also offer a few suggestions about how to grieve the loss of the old normal, and shift into the new one, in a healthy way.

Mental Health and COVID-19

Denial, Shock, and Disbelief

Much like a sudden and unexpected death, the drastic changes we had to make during the month of March seemed to happen overnight. We were caught off guard, and a sense of shock and disbelief set in. We were hopeful that schools and sporting events might start back up at best, in a couple of weeks, and at worst, maybe a month. In those first few days, we just couldn’t fathom that we might be in this for the long haul. The idea that this virus would be so contagious that we’d all need to wall ourselves off from the rest of society seemed like something from a blockbuster science fiction film, not from 21st-century America.

But it wasn’t unlike the denial phase of grief, when we find it hard to believe that a loss is real. Imagine the person, for example, who, soon after a breakup, holds out hope for a reconciliation. When a new way of being is too painful for us to bear, it takes some time to absorb the reality of it. And this denial phase of grief seems to have happened to a lot of us during those early days of quarantine.

But denying that things are different keeps us from doing the things we need to do to stay healthy – in the age of COVID-19, physical distancing, or washing your hands, for example. It can also delay our transition to a new normal, and keep us in a holding pattern of sorts that prevents us from developing new routines. Part of good mental health is having the flexibility to create new versions of our old routines when we’re forced to change our daily lives. For example, just because you can’t go to the gym for six weeks doesn’t mean you have to be a couch potato the whole time. Your new exercise routine might not look much like your old one, but the ability to find ways to approximate it is vital to transitioning into your new normal. Taking a flexible approach when shifting each part of your daily routine is one way to make the overall change seem less overwhelming.

Getting Stuck

As we made the initial adjustment to our new routines, many of us found the extra time relaxing. No more drive time meant we could stay in bed a little longer and skip ironing our pants. Some of us even scrapped the professional look altogether and went straight to sweatpants and ball caps – relaxation at its finest! Hours upon hours at home also lends itself to binge watching TV shows or movies, often snacking while doing so. Downtime is a critical piece of optimal mental health, and many of us weren’t getting enough of it until now. There’s something to be said for our newfound comfort with presenting our “real” selves to the world – long, graying, messy hair, and all. Letting go of our old pretenses around image is a sign of vulnerability, which allows us to connect more deeply with others. Because we’re getting a glimpse into the real world of our colleagues, friends, and family members, we may end up feeling closer to them, because we can see that they’re much like us.

But what happens when the media binges go on so long that we miss sleep or meals, or fall down on the job? Or when one day blends into another so much so that we lose track of hygiene and stop showering or brushing our teeth? These patterns are easy to slip into, and are very common during the grief process. When we’ve lost a critical part of our old way of life, it’s not unusual to get stuck “waiting” for things to return to normal. But putting everything on hold is a signal that adaptation to the new normal isn’t going so well.

Having balance and structure to the seemingly endless days is crucial to maintaining good mental health during these times. You don’t have to create a down-to-the-minute schedule and stick to it; remember that the point is to be flexible during this time. But having some general expectations for each day isn’t a bad thing. It may be helpful to think about this, for example, in terms of physical health, work, and relaxation. A goal might be to aspire to include some work, some rest/relaxation, some movement, and adequate sleep and nutrition. This is just a starting place, though. Think about what’s important to you (spirituality is one example that comes to mind), and consider how that might fit into your daily plan around balance.

Going into Overdrive

What about when your problem is not doing too little, but doing too much? With calendars cleared of extracurricular and social activities, hours are suddenly opened up to devote to those long-delayed household projects. Backs of cabinets and closets have been cleaned out. Lawns are immediately immaculate. And pantries and desk drawers have been organized. Many of us have even taken up new hobbies or returned to old ones. It’s felt good that we’ve been able to make the most of these strange, scary new times by being productive. And there’s nothing wrong with that. But for some, along with all this new productivity came the expectation that they should be doing something fruitful with the extra time, all the time.

It’s not uncommon for people who are grieving to go to such an extreme after experiencing a significant loss. We see a lot of folks who throw themselves into work as a way to cope during the grief process. Staying busy is a way to distract ourselves from painful feelings about the loss. It’s also a way to feel like we’re taking back some control over our lives when it seems like everything has spun out of control. But that busy-ness itself can also spiral out of control, to the point that our mental health suffers. We can start using activities to push down our true feelings of sadness about the loss. Or we can start basing our self-worth on our productivity, feeling guilt and shame when we’re not getting enough done.

It’s important during these times to examine our motives for checking off to-do list after to-do list, and to check in on what emotions we might be using those activities to avoid. Such check-ins with ourselves and others about how we’re really doing with all these changes are vital to maintaining good mental health in this new normal. Don’t be afraid to identify and express whatever you’re feeling, whether on your own through journaling, for example, or with another person. If there’s not anyone in your life with whom you would feel comfortable doing this, please consider reaching out to a trusted professional. From counselors to clergy members, there are people ready to help.

Other Suggestions for Finding a Healthier New Normal

In addition to the suggestions given already, consider limiting time spent reading about the pandemic. It’s good to have information and be up-to-date on the latest recommendations. But given the tragic nature of much of the news these days, information overload can leave you feeling helpless, hopeless, and scared.

Not only can placing parameters on the time you spend consuming COVID-19 information help, but so can giving back. It can easily feel like our sense of control has been robbed from us these days. But helping others, and feeling like you’re really making a difference, can bring it back. Making masks, taking part in a quarantine birthday parade, joining in on a big round of applause for our health care providers, and donating money or food to a food bank are just some examples of ways people have been volunteering their time or resources.

And if you already struggle with stress management or mental health concerns such as depression, anxiety, or addiction, or if you’re going through an additional loss during this time, you’ll need to take extra good care of yourself right now. If you need help finding someone to talk to, please don’t hesitate to contact us at Brentwood Counseling Associates. We’d be happy to help you determine who’d be a good fit for your needs and situation. Whether it’s someone in our practice or somewhere else, we just want to be sure you’re getting the support you need during this time.

Premarital Counseling: Starting a Healthy New Relationship

Couples Therapy Marriage Relationships February 24, 2020 By Kris Lott 0 Comments

Premarital Counseling: Starting a Healthy Relationship

Congratulations on your engagement! Getting engaged is a thrilling first step toward a new life together with your partner. After the proposal, couples can become consumed with planning their perfect wedding. The details often become stressful and create new tension around wedding planning. There is a lot to consider: your dress, the invite list, who will be the best man, what song will be your first dance, what food should you serve, what is the budget, and more. One item, however, that should be on the top of your to-do list is Premarital Counseling.

Premarital Counseling is the first step to starting a new healthy relationship. This type of therapy allows the couple to discuss and work on strengthening communication skills, setting realistic expectations, and understanding what is important to each member of the couple. This is an opportunity to create a vision for the future healthy marriage. Below are 5 reasons why you should consider Premarital Counseling as your first step in your wedding planning.

Premarital Counseling creates space to make sure you are both on the same page. Stress and fears can create a lot of tension for new couples. This stress could develop from wedding planning, tension between what the new in-laws expect, or what type of ceremony you each want to have. Stress could also surround the budget or how the new couple will handle finances or debt. Beyond stress, couples carry fears into any new relationships. The “what ifs” (Is he going to always love me? What if she does not want children? Can I trust him again? How can I deal with her family?) often linger in the back of your mind. Premarital Counseling offers the couple a safe place to voice their fears and stress and help the couple begin to understand how each person copes with stress and what they need from their partner.

Premarital Counseling helps the couple know what each person is bringing into the marriage. Some of the most important work a new couple can do is understand how growing up in their own family creates norms and expectations that will influence the new marriage. Couples need to study each person’s family of origin (How was affection shown growing up? What about discipline? How did your family define success? What are important traditions of your family and how does it compare to your partner’s family traditions?). While you are not tied to live just like your family of origin, the past may influence you in how you view the family or marriage. In Premarital Counseling, a trained therapist can help the new couple navigate these past themes and create discussion on what the new couple values from their past.

Communication and the couple’s “rules of engagement” need to be a part of any Premarital Counseling. In Premarital Counseling, you can grow your communication skills and learn to identify your conflict cycle. Together, you will explore what are the common areas of conflict, and what does each partner need for a positive outcome. The goal is for the new couple to develop their own “rules of engagement” as well as begin to see the conflict cycle before it starts.

Premarital Counseling also explores the relationship for strengths and growth areas. Couples will learn where they currently excel as well as areas where they can improve. This focus will help a couple set and manage expectations and roles in the relationship. It is important to explore how each person in the couple views marital roles. Premarital Counseling also allows time for the couple to name roles they enjoy and roles where they are uncomfortable. This discussion will aid in setting a couple’s expectations about how decision making and responsibilities will be shared.

Creating a new vision. Premarital Counseling is a time for visioning and exploring what the couple is looking forward to and dreaming. Beyond their favorite traditions and expectations from their family of origin, Premarital Counseling offers space to voice shared goals and hopes for the new relationship. Premarital Counseling can be a fun time to dream big, name new traditions you hope to start in the new marriage, and name values your healthy marriage will stand on.

Click here for more information about premarital counseling at Brentwood Counseling Associates.

Anxiety Stress December 20, 2019 By Tara Hammonds 0 Comments

Gift Giving: Beat the Stress and Maintain the Joy of the Season

Stressed to find the best gift during the Christmas season?

Christmas is a holiday of joy and cheer. Many of us use it as an opportunity to express how much we care for their family and friends through warm wishes, gatherings, and gift giving.

The holiday season is supposed to be the most wonderful time of the year, but it can easily go from Christmas cheer to Holiday stress. Finding the perfect gifts, attending all of the festive activities, and trying to fit it all in our holiday budget can take a toll.

So how do we prevent our joyous giving from turning into overspending pressures and longing for the season to be behind us?

Why do we enjoy giving?

Let’s look into the psychology behind the pressures to give and why we are so compelled year after year to immerse ourselves into finding the perfect gift, even if it brings on unwanted stress.

According to research we give for many reasons. We give to show gratitude, empathy, and love. We also give to increase relationship connections and because it makes us feel good.

Dave Ramsey says that the act of giving causes our brain to release ‘feel good hormones’. He mentions the phenomenon of the ‘giver’s glow’ which is that feeling of joy we get from showing generosity toward other people. Generosity comes with so many advantages; not only to those on the receiving end, but to those doing the giving too. Generosity has also been shown to reduce stress and help counteract depressive symptoms, says Ramsey.

There is a great sense of satisfaction when seeing the expression on the face of someone you’ve given a gift to. Its a way to express feelings when you can’t find the words. Giving is a way to say, “I’m thinking of you and you matter to me.”

When gift giving gets stressful

Even though giving makes us feel good, there’s definitely a tipping point. What happens when we start to lose the joy in giving and it becomes a stressor?

Gift-giving can be a mood booster and create balance. However, it can get stressful when you’re struggling to find the perfect gift for friends and family. It’s difficult when trying to find a gift that’s an affordable, thoughtful gift and within our holiday budget. I think the pressure is also surrounding the fact that we recognize gifts are symbolic, so we tend to obsess over the meaning we are trying to convey.

How to maintain the joy and pleasure in gift giving

Here are some helpful tips to remain mindful of what’s important about gifting and how to maintain joy this Christmas season.

Keep it simple

Not all gifts have to have a huge monetary value. If you enjoy spending extra on someone, go for it. Although, before you make a large purchase ask yourself, “Am I buying this because it’s more expensive or because I feel it’s what they would truly prefer?” The most meaningful gifts are sometimes homemade. In a society obsessed with commercialism, it can be refreshing to offer something more personal. Some example may be handmade cards, homemade essential oils, fresh baked goods, or wooden toys. If DIY-ing isn’t your thing, you can always gift your time such as a car wash or free babysitting.

Create some giving boundaries

For many of us, this is the season to splurge and indulge. However, it can be helpful to create some boundaries as it relates to giving to maintain our sanity and our bank accounts. So, be realistic but stick to your holiday budget as much as possible. Things like setting a budget for individual gifts and tracking your spending can be helpful.

Practice gratitude

Gift giving is not the only way we can show appreciation to others during the holiday season. Write a gratitude letter. This letter can be written to a significant person who made a positive difference in your life. This can have the same effect as a holiday gift letting them know “I am thinking of you and you matter.” Describe in specific terms what the person did and why you’re grateful.

Remember what’s important

According to an article by The Society of Happy People, when people are asked what makes them happiest about the holidays, most said connection with family and friends. So, let yourself off the hook a little bit. If you are able to spend some quality time with your loved ones, know that your presence is just as valuable as a gift.

We gain happiness around the holidays from spending time with loved ones by giving gifts, sharing meals and attending holiday festivities. It helps to remember that the holiday season is about being with the people we care about, not about giving gifts, unless giving gifts is what makes us happy.

Explore ways to turn teen anxiety into resilience at Brentwood Counseling Associates.

Anxiety Teens Therapy August 9, 2019 By Kris Lott 0 Comments

Teen Anxiety: Why It Can Be Necessary and What Can Be Gained

Every living creature experiences anxiety. Anxiety is necessary for survival and adaptation. Normal teen anxiety is common, and generally short-lived. In today’s fast paced world, however, we live in a culture that suggests any anxiety is bad and a person who struggles with it, including adolescents, is weak or faulty. Society is so eager to diagnose a person with an official disorder.

Teenagers have been taught the need to be perfect. They have received participation trophies for their whole lives. Social media is used as a tool to present an edited/photoshopped sense of perfection. Many students get to retake their test in school to increase their GPA. We have created people who have never experienced failure. When one has been protected and has never struggled to achieve, they are often unequipped to handle the smallest mistakes later in life. These first failures can be crippling and can lead to catastrophic feelings once the safety nest of parental protection is removed.

Yet there are many positives once you learn to embrace your anxiety or face your nervousness. Studies have shown how the power of facing adversity can create resiliency. Resiliency is the ability to overcome challenges of any kind. The mastery of resiliency takes time and training. It is especially important for teenagers to have safe places where they can experiment with failing and facing their fears/anxieties.

3 Proven Ways to Deal with Teen Anxiety

SHARE INTENTIONALLY – Create a space for teenagers to share both successes and failures as well as opportunities to see others (more importantly adults) talk about their ups and downs. This expands a teen’s view of normal anxiety and overcoming failure, and can take place at the dinner table, a small group setting, or during prayer time.

HIGHLIGHT STRENGTHS – Find ways to highlight a teenager’s gifts. Too often, teenagers can overly magnify their smallest perceived flaws. Highlighting strengths over weaknesses, teens learn how to overcome anxiety and stress brought on by a hyper focus on the negative. We all have many different talents that are unique to each of us. Helping a teenager name their gift(s) allows them to see more than the negatives. The second part of this step is to brainstorm with them ways for the teenager to use these gifts in their everyday lives. Be specific. Challenge them to find ways to engage with their gifts daily and celebrate them when they do use them, even if it does not work out as planned.

NORMALIZE & FOSTER MENTAL TOUGHNESS – Remind teenagers that it is okay to have bad days and being mental strong is not about having it together all the time. Help them see past our society’s unhealthy need for perfection to learn that anxiety can be seen as an opportunity to grow rather than a threat or personal flaw. Mental toughness and resiliency are strengthened by learning to embrace anxiety/uncomfortableness and take action anyway. The more often a person steps into their challenges, the stronger and more confident they can become.

Ready to schedule an appointment? Contact Brentwood Counseling Associates and connect with one of our experienced therapists.

Children Teens Therapy July 29, 2019 By Tara Hammonds 0 Comments

Signs Your Child May Need Counseling

So, you’re wondering if your child needs a therapist and are asking yourself, “Is this (fill in the blank) normal?” I completely understand. There are a lot of worries surrounding parenting and wanting the best for your child. I want to start by saying, parents, you are the expert of your child, no one knows them better than you. Often times, parents will come into my office saying that they can sense that there is something going on with their child but they just aren’t sure if it’s normal or if it’s something they should be concerned about. I will acknowledge that sometimes it is hard to say because there can be a fine line between normal and “let’s get some help with this.” Let’s briefly talk about the definition of a “normal” child and some signs your child may need counseling from a professional therapist.

So, what’s normal?

There’s no perfect child or parent and there is some normalcy in having fluctuations in mood and behavior that are part of normal child development. Children do break the rules sometimes. I know how frustrating it can be to have your child not follow directions but testing limits is how they learn who they are and how the world works. This also creates the opportunity for you to teach them valuable lessons while they are still within your safety net and can receive your guidance and support. Sometimes, however, persistent behavior problems can be a sign of something more serious. Another thing that can be normal is changes in appetite and sleep. Have they been on a school break recently? Are they off their routine? Sometimes changes in routine can affect things like sleep and appetite. However, these changes should be monitored and if they persist beyond a couple of weeks it could be an indication that something is up.

Here are some common experiences that may trigger signs your child may need counseling with a professional therapist:

Life Transitions – Sometimes change is inevitable and not all change is bad. However, sometimes kids struggle when they experience too many life changes all at once. What could be a small change for you could be having a more difficult impact on your child. Did you and your child recently move? Or did they have a change in school? It can be normal to see a brief change in your child’s behavior when they are going through life transitions. As adults, even for us we need time to adjust and get our bearings after a recent move or change in job. However, if changes in sleep, appetite or mood persist for more than a couple of weeks it could be an indication they are having difficulty handling things.
Household chaos – Every family has some sort of dysfunction. Parents are people too and sometimes may have disagreements with one another, other adults, or even their children. These disagreements don’t always have a negative effect on children, but they can. Problems arise when children witness highly emotional arguments between parents, or between parents and other individuals, physical violence (pushing, hitting, shoving, etc.), someone important to them leaves the household.
Separation from parent – Separations from your child can occur for many reasons (divorce, changes in custody, parents traveling for work), some reasons aren’t controllable, it doesn’t always mean it’s going negatively impact your child. There may be times in which you are not always able to be with your child. As children get older and are gaining autonomy, this is quite normal and appropriate. However, until they reach middle school children are heavily reliant on parents to meet their emotional, physical, and basic needs. I believe what is important is that children are able to maintain healthy access to parents as much as possible. It’s important to keep a close watch on how your child is handling separations from you. Problems can easily arise if a child feels their ‘safe place’ is being threatened.
Death of a family member or friend – Loss is a normal part of life, and grief is not pathology. Children are able to process the death of a loved one effectively if it’s talked about and handled appropriately. Problems arise when they don’t understand what they’re feelings, have been given untruthful information or they feel its unsafe to share their feelings. Regardless, it can always be helpful to have assistance from a counselor to foster a healthy grieving process.
A frightening life event – When most people think of traumatic experiences, they immediately think of things such as abuse (physical, emotional, sexual) or neglect. In these instances, counseling is always recommended regardless the presence of symptoms.
But what if it’s not abuse or neglect? Can other things be traumatic for children? The quick answer is yes. Again, it’s important to hold in mind the perspective of a child. Something could be scary to your child that isn’t scary to you: a traumatic doctor visit, a car accident (even minor), sickness of a parent, experiencing a major natural disaster, experience with death like attending a funeral, to name a few. Young children are highly susceptible to the ‘emotion in the room’. Were other people stressed, upset or crying? If so, this could have been a traumatic experience for a young child who doesn’t understand or isn’t able to express the event’s impact.
Bullying – Parents, you are unable to protect their children from everything and unfortunately, most people will have experienced some form of bullying within their life. Most of us are able to overcome this experience with support. It’s important to engage in regular check-ins about peer relationships to create the opportunity for healthy conversation with your child. This also creates the opportunity for your child to gain skills from you on how to handle stressful situations. However, sometimes, bullying is persistent. Persistent experiencing of threats to physical safety or criticism can lead to feelings of low self-esteem or worthlessness. In these cases, if can be helpful to have support from a counselor to work on healthy ways to problem solve and cope.

If your child has experienced one or more of the above it doesn’t necessarily mean they will need additional support. However, it is always a good idea to monitor your child when they are going through these experiences so you can identify warning signs your child may need counseling. Some of these signals can be:

Difficulty managing emotional outbursts
Behavior that does not respond to discipline
Persistent difficulty falling or staying asleep
Persistent increase or decrease in appetite
Behavior that interferes with school
Behavior that interferes with social interactions
Self-injury or talk about suicide

How can a therapist help?

Therapy can look different depending on the age of the client. With young children its often a misconception they cannot benefit from therapy because they aren’t able to understand or articulate their feelings. Research search tells us that children are able to express themselves through ways other than verbal expression. A common way is through play or other expressive activities like drawing. Children communicate their perception of the world through play and its therapeutic for them to share their feelings in this manner. It is necessary for parents to participate in therapeutic process. This creates opportunity for therapists or parents to assist the child in labeling his or her own feelings and experiences. Incorporating emotional identification and healthy coping strategies can be extremely effective in supporting children who have had stressful experiences. Being understood and having support increases the efficacy for behavior changes and overall positive functioning. As children get older, therapists are able to incorporate more verbal processing and problem solving. However, regardless the age a therapist can be an integral part of aiding in healthy development and overcoming difficult experiences.

Armed with a little more knowledge, the signs that your child may need counseling might be a little more evident. Ready to schedule an appointment? Contact Brentwood Counseling Associates and connect with one of our experienced therapists.

ADHD Children Teens May 8, 2019 By David Elkins, Ph.D. 0 Comments

ADHD Testing

Testing for ADHD can be as brief as a school or pediatric screening; or, if a learning disability is suspected, it may be as comprehensive as a full psychoeducational evaluation or neuropsychological assessment. Typically, the protocol is somewhere in-between. At Brentwood Counseling, experienced psychologists and educational consultants help evaluate Attention Deficit Hyperactivity Disorder in children, adolescents and adults using the following protocol:

Parent Interview and Review of History
Parent Rating Scales (ADHD, Developmental History, Behavior/Psychological)
Teacher Rating Scales
Self-Rating Scales (older students and adults)
Consultation with referring therapist or physician (when appropriate)
Extensive Clinical Interview with child, adolescent, or adult (typically requires two sessions)
Observation of child in classroom (when appropriate)
Psychological Screening to help rule out other concerns (e.g., anxiety, depression, behavior disorder)
Written report
Feedback session with parents to review results and recommendations for treatment, etc.

It is important to remember that ADHD is not a binary (yes/no) diagnosis that a certain score on a specific test can identify. Rather it is a continuum disorder that presents in varying degrees as a deficit in some aspect of self-regulation (attention, focus, hyperactivity, impulsivity). An ADHD diagnosis requires concerns in childhood that continue to have a negative impact over time in more than one setting (e.g., school, relationships, family, work). Even well-trained professionals can disagree as to causes of these problems with self-regulation, but basic symptoms are outlined in the Diagnostic of Statistical Manual (D.S.M.-5) and provide helpful guidelines for clinicians with the evaluation process. If a diagnosis is made, treatment options include behavioral/psychological interventions, environmental changes, parenting modifications, school accommodations, neurofeedback and, at times, medication.

If you are in need of ADHD testing, contact Brentwood Counseling Associates and connect with one of our experienced therapists.

Depression Grief & Loss April 24, 2019 By Stephanie Insko, Ph. D 0 Comments

What Might Have Been: A Nontraditional, but Significant Kind of Loss

Ah, spring. The time of year when a sea of gold descends upon us here in Nashville. And no, allergy sufferers, it’s not just the pollen. It’s the jersey-clad, rally-towel-waving, banner-flying, Nashville Predators fandom that takes over the city during the NHL Stanley Cup playoffs. And it was never more rabid than during the team’s Cup Final run in the spring of 2017. For a couple of months that year, it was unlike anything Nashville had ever seen. And we believed that team could win it all. But suddenly one night in June, it was over. It wasn’t supposed to happen that way. Not to a team that had been the last to make the playoffs, a team whose players had suffered injuries galore, and still had somehow made it that far. And yet, it just wasn’t meant to be. If you were around that spring, or if you’ve ever rooted so long and so hard for something that didn’t come to pass, you’ve probably experienced the same kind of heartsick letdown that followed that Game 6 loss. To be clear, sports championships aren’t exactly the stuff of life and death. But they illustrate a type of loss that isn’t talked much about: the loss of what might have been.

When we hear that someone has experienced a loss, or is grieving or mourning, we usually make the assumption that they have lost a loved one or something vital to their happiness and well-being, such as their home. It’s long been that way in our culture, though more recently we’ve expanded our notions of loss to include experiences such as infertility, miscarriage, and the death of pets. However, just like in the hockey reference described above, what happens when something that we expected to happen, doesn’t? This type of loss often goes unrecognized because it doesn’t fit into our culture’s traditional definition of something that is “worth” mourning. And when we (or others) don’t recognize something as a loss, we don’t feel like we’re allowed to grieve. But when grief goes unresolved, it can morph into something else, like depression or anxiety. In fact, unresolved loss is often the “root” of the problems that bring people into therapy. Let’s take a look at some common nontraditional forms of loss around what might have been.

In my experience, one of the most common nontraditional losses of this kind occurs in close relationships, when there is grief about what a relationship could have been. This type of loss can occur in friendships, relationships with siblings, and romantic relationships. But its impact seems to be felt most strongly when it happens in the parental relationship. Most mothers and fathers strive to parent in the most effective way possible, and don’t intentionally set out to hurt their children. But certain circumstances can lead to an ineffective, often outright hurtful parenting style. Those who struggle with alcoholism, for example, parent while under the influence, when they’re usually not at their best selves. Or those who grapple with severe depression parent while being unable to function at the most basic level, let alone at the level that healthy parenting requires. Regardless of the reason, parents do sometimes become unable to offer the unconditional love, support, and acceptance that their child needs. And just because a child reaches adulthood doesn’t mean that that need goes away. This is why most people with this kind of loss report that they continue to try to please their parent, despite having been met with rejection their whole lives. They’ve become tired of trying, yet may be reluctant to accept the loss of hope that their parent will ever truly approve of them. They often enter therapy when they just can’t try anymore. And the grief work done in therapy involves deciding whether to continue to expect anything from the parental relationship, and how to make peace with what it could have been.

Another “what might have been,” nontraditional form of loss occurs around career paths. This kind of loss can occur anytime during a person’s career. However, I’ve noticed it coming up so frequently among college and university students that I’ll use that population to illustrate it. Maybe more so than ever, students these days begin thinking about their career paths in high school, or even earlier, as they discover their talents and passions and start focusing on a particular educational track. Maybe they’ve got a knack for numbers, and they’re encouraged to pursue accounting. Maybe their talent lies in science, and they decide to shoot for medical school. Or maybe their athletic prowess has paved the way to a full scholarship and talk of professional play. But what happens when there’s a bump in the road and those plans don’t come to fruition? Consider the mathematically- or scientifically-minded student who runs up on some required classes he can’t pass. Or the star athlete who has a career-ending injury. Not only are these students left to redirect their course and find a new career path, but they’re left with the loss of what might have been. And if well-meaning parents, friends, and advisors emphasize the importance of finding that new path, the student can draw the conclusion that the loss wasn’t worth grieving. But when unresolved grief is suppressed, it can make it difficult for such students to move forward. College is stressful enough without also having to rewrite your life’s career path. But therapy can allow students to process the emotions surrounding the loss of their original career expectations, begin to heal the pain of that loss, and start writing their new career story.

Finally, let’s consider losses that alter a person’s lifestyle. These kinds of losses are often physical in nature, having to do with significant illness or other changes to the body or mind. For example, let’s say a person’s spouse develops early-onset dementia. Shifts must be made not only in the couple’s daily lifestyle, but in their expectations about the long-term. What happens to their plans of traveling abroad after they reach retirement age? Or to all those hopes and dreams they had about being grandparents together? There might also be regrets about not having gone after those hopes and dreams earlier. Or guilt about acknowledging the sadness and unfairness of the curveball life’s just thrown them – after all, the last thing the wife wants to do is blame her husband for getting sick. But it’s crucial that she give herself permission to mourn the loss of her old reality, as well as the loss of what might have been. If she doesn’t, it could complicate the grief she experiences when she faces the impending loss that will eventually come with the progression of her husband’s disease. Talking with a trusted professional in counseling can ensure that all the facets of loss, both traditional and nontraditional, are acknowledged and honored. And difficult though it is, doing the work of grief goes a long way in ensuring that it doesn’t shift into something more.

If you have experienced or are currently experiencing this kind of loss, and are struggling with the emotions associated with your grief, contact Brentwood Counseling Associates and connect with one of our experienced therapists.

5200 Maryland Way

Monday - Friday: 9am - 6pm