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GREAT BIG NEWS!!!! As many of you know, we’ve been working diligently to help our clients find someone who can manage their medications. After a long, exhaustive search, we’ve finally got that in place!
Welcome to our team Pat Jones, APRN
Pat will be working out of our Alpharetta/Roswell office beginning in February 2020 and will be closely affiliated with Alan Behrman & Associates, PC.
What does that mean? While Pat has been in her own practice for over 35 years, she’s graciously accepted an affiliation with us. While it may take the average person months and months to find and get a first appointment with with a psychiatrist, PA, or NP, our clients will now have quick access to scheduling.
Not only will our clients get priority access to scheduling for medication management, because Pat will be working out of our office, your prescriber and therapist can easily communicate with each other to meet your needs quickly!
Remember, this a special benefit for clients who are actively in counseling/therapy with any of therapists at Alan Behrman & Associates, PC regardless of which location they use.
www.alanbehrman.com 770-361-7864 [email protected]
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Turn Off, Tune Out, and Drop In, At Least Sometimes
A modus operandi for living in a screen time world.
When Timothy Leary uttered the infamous counterculture-era battle cry, “Turn on, tune in, drop out”, he did not have electronic devices in mind. He was urging people to accept cultural change and challenge societal norms, conventions, and hierarchies. Psychedelics aided this process, naturally. Nowadays the primary drugs are the electronic devices we turn on, tune in to, and use in order to drop out of society. Most people, on average, spend 3 hours and 15 minutes per day on their phones. Of the top 20% of smartphone users, average daily screen time is 4.5 hours or more. Countless studies warn of the detrimental impact excessive screen time can have on our health, productivity, social interactions, and just about every other facet of our lives. There is no question of the benefits and efficiencies these devices create, but as with many things in life, moderation is key. So in an effort to inspire even a modicum of change, I recommend a new modus operandi: Turn Off, Tune Out, and Drop In.
With technology becoming ever more omnipresent forces in our lives, it’s imperative we set aside time to turn everything off. This is especially true for infants, toddlers, and preschoolers. Recent studies have shown that those little ones who used screens for longer than the recommended one hour per day had lower levels of development in their brain’s white matter. This white matter is critical for developing cognitive, language, and literacy skills. Given that humans experience their most rapid brain development in their first five years of life, excessive screen time could prove detrimental to the futures of millions of children who come of age in this screen time generation.
Apart from brain development, studies have also linked excessive screen time to poor academic performance, impaired cognitive functioning, unhealthy eating habits, and an inability to pay attention and think clearly. Moreover, screens interrupt children who otherwise could be performing activities that enhance brain development, whether that’s interacting socially or problem solving. Screens promote physical isolation, plain and simple. Despite these risks, young parents often stress that there’s simply no other way to quiet their children, especially on airplanes or in restaurants. Quick, give them the iPad! But what happened to children simply learning to behave? In fact, they often follow the example set by their parents.
If parents succumb to every screen in sight, their children are likely to do the same. By not turning them off periodically, there’s almost no time to interact as a family. What long term effects this lack of interaction has on children is hard to tell, but it’s unlikely to cultivate social aptitude. And for people without kids, incessant screen time can stoke emotions of loneliness, isolation, and anxiety. There’s even a new term for snubbing someone for your phone — “ phubbing.” The people I know who excel at phubbing also happen to be some of the saddest people I know. They live in their own worlds. Even in public they engage you with a 50% attention span at best. You can witness their minds wandering to their social media drug of choice like a fiend searching for a hit, fumbling for their phone umpteen times as you try to converse. Phubbing’s alarming trend has led more people to retreat into solitude, with many now opting to engage friends and family through a screen instead of through the flesh.
It should be no secret that the screens delivering social media content are addictive. As one Harvard article put it, “platforms like Facebook, Snapchat, and Instagram leverage the very same neural circuitry used by slot machines and cocaine to keep us using their products as much as possible.” Like a casino or drug dealer, a social media company would not survive without repeat business and loyal customers. The companies that promised to change the world by connecting us online have made billions on reinforcing behavior that activates dopaminergic reward pathways. Namely, they tapped a clickbait cash cow of dopamine releasing social stimuli, as exemplified through the notifications that bombard us daily, whether it’s a text message, a Facebook post, or an Instagram “like.”
Given that all of the most popular social media applications are free, there’s a race to the bottom for your time. I say the “bottom” because this incentive structure forces big tech companies to develop applications that control your attention and entice you to keep clicking. Advertising revenue would disappear otherwise. These companies then mine and monetize your data to the most optimal extent possible, with minimal concerns given to ethical, personal, or societal consequences (see Cambridge Analytica). In the end, what you’re using isn’t really “free” per se ( no such thing as a free lunch!). You’ve paid a potentially significant personal cost by just having a profile and interacting on these social media sites.
If that doesn’t persuade you to turn off your social media applications and electronic devices periodically, then consider these strange physiological effects. Yes, selfie elbow, texting thumb, and text neck are becoming real colloquialisms to describe musculoskeletal injuries associated with excessive screen time. So protect your body, mind, and personal data and turn your damn device off every once in a while.
Even if you succeed in turning off your personal devices, screens and sounds will try to follow you everywhere. Anyone with an office job likely stares at a computer for most of the day. And if you live in a city like New York, electronic billboards flash messages at every opportunity. Moreover, in this renaissance age of streaming media, countless podcasts, audio books, etc., companies tempt you to tap into content stimuli at any moment of downtime. It’s sensory overload.
I find myself falling prey to these temptations everyday. I listen to multiple podcasts regularly. After a long day at work, it’s dangerously easy to lay waste on the couch like a garbage monster and consume anything HBO, Netflix, Hulu, Disney+, or any sports app has in store. Don’t get me started with video games. While I consume, I often browse Twitter, Instagram, email, and news apps. If somebody texts me, stop everything! Suddenly it’s 10pm and I have to think about sleep before I do it all over again the next day.
I need to tune out. Forget devices. Ignore sounds. Meditate, practice mindfulness — anything to escape the incessant noise and commotion that the world blares at me for “free” everyday.
At this point in my early thirties most of my friends have either deleted Facebook or cut their use significantly. Any time I do go on to browse the mind-debilitating Newsfeed, I’m immediately greeted with numerous irrelevant notifications since my last visit. I don’t care what “Kelly” posted last week — what happened to the Facebook that used to send notifications only when something happened to me directly? All of the noise from randos I barely know anymore, not to mention the creepy ads that seem to track my entire internet existence, make me want to tune out for good.
But what can I do? I don’t want to lose touch with these randos completely. There have been moments when my only means of getting ahold of someone was through Facebook. What I’ve come to learn is that I need to fight back against the temptation to waste minutes of my day browsing a Newsfeed I don’t care about. So I deleted the app from my phone. The rest of my screen time battle I’ve turned into a game. Certain apps like Forest can even help you in this quest to take control of your screen time life. Their slogan of “Stay focused, be present” should be the societal ethos of the 2020s. The app challenges you to put down your phone and grow a virtual garden in the process. If you leave the app and look at your phone, the tree dies. Flip the incentive structure on the social media companies that have stacked the dopamine deck against you.
I also tune out by setting device free times and zones. An hour before sleep I leave my phone on the dining room table, far from the bedroom and my bed. I bought a real alarm clock to nullify the need for relying on my phone to wake me up. During waking hours I’ve significantly cut down on which apps can notify me and which can’t, along with specifying the types of notifications they can send. Some people even go as far as dumbing down their phones or adjusting their display to black and white so it’s not as enticing. I may not be that intense, but if you are, I commend you.
Turning off and tuning out of the electronic world allows you to drop in on what truly matters — your connection to family, friends, and yes, even yourself.
Some 200 years ago, Alexis de Tocqueville traveled from his native France throughout the United States on a journey to discover what made American democracy work (the French attempt had recently failed). Of course, some may question whether American democracy works today, but one primary observation de Tocqueville made in his magnum opus, Democracy in America, was that Americans maintained a strong sense of community through civil society and robust institutions. Whether it was the church, rotary clubs, sports leagues, or communal neighborhoods, Americans were uniquely skilled at building and preserving strong connections. Robert Putnam famously recognized the fraying of this social fabric of American life as civic institutions witnessed substantial declines beginning two decades ago.
A major reason for this decline today is somewhat ironic. It’s technology. Advances that were intended to build better social connections globally have compromised the very quality that made American democracy so recognizably unique to a foreign observer all those years ago. Local communities are dying in America and throughout the world as more people disengage in real life and hop into the digital realm. This desire is even more pronounced in younger generations (i.e., the toddlers growing up with iPads on airplanes so they’ll be quiet). The longer this trend persists, the less connected people will feel. Social unrest is inevitable — you can already see it in the current divisive state of American politics, with Brexit, in Hong Kong, and in the increasing rise of authoritarian regimes around the world ( Brazil, India, etc.).
“Using less social media than you normally would leads to significant decreases in both depression and loneliness. These effects are particularly pronounced for folks who were more depressed when they came into the study.” — Melissa Hunt, Ph.D., Psychology, University of Pennsylvania
We must drop back in as individuals, families, friends, and communities. While it would be helpful for governments to modernize the regulatory environment to better reign in technology and social media companies, we cannot wait for that time to come. If we promote social connections, meaningful conversations, and time spent with family and friends, we all stand to live happier, more productive lives. Anyone playing on their phone at dinner should be socially shunned. It should be taboo to “phub” someone. Screen time is undeniably a major part of our present and future lives, but cultural norms and mores must evolve so the technology designed to help and connect us doesn’t lead to our collective downfall.
In line with Timothy Leary’s battle cry of the 20th century, we need a new one to combat the forces that aim to hypnotize us into submission. We need to control screen time before it controls us. With the holidays in full swing and New Years resolutions beckoning, there’s no better time than now to turn off, tune out, and drop in.
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WASHINGTON, D.C. — People seeking treatment for mental illness and substance use disorders continue to pay more and face more barriers to accessing care than those seeking care for physical illness, according to a report released today from Milliman, Inc., and the disparity has worsened over the past two years.
Patients using commercial PPO health plans – considered “Cadillac plans” because of their “generous” coverage — are significantly more likely to have to pay out of pocket for mental health care compared to general medical care, according to the report, commissioned by The Bowman Family Foundation. When patients cannot find a physician in the plan’s network, they must go out of network and incur financial responsibility for a large portion of the bill. In 2017, 17% of behavioral office visits were to an out-of-network provider, compared to 3% for primary care providers and 4% for medical/surgical specialists. This disparity is a major financial obstacle to many with mental illness or substance use disorders.
These results are consistent with “secret shopper” studies the American Psychiatric Association has done indicating that provider directories provided by plans for mental health care are inaccurate and it is often not possible to obtain a mental health appointment in a reasonable amount of time because the plan discourages participation by mental health providers through discriminatory reimbursement rates.
In 2017, primary care reimbursements were about 24% higher than behavioral reimbursements. In 11 states primary care reimbursements were 50% higher than behavioral health reimbursements. To make that clear, if a patient sees their primary care provider for treatment of depression, the plan will pay that doctor up to 50% more than it would pay a psychiatrist – a medical doctor with four to five years of additional residency training in mental health care to treat that same patient for depression. This disparity is designed to discourage mental health professionals from participating in plan networks and to ensure that plan participants do not access care.
“The results of this study should set off alarm bells for all of us who care about our nation’s health,” said APA President Bruce Schwartz, M.D. “Discriminating against people with mental illness by restricting their access to care means that more people will suffer and some will die as a result of lack of access to life-saving treatments,” he said. “Given we are in the midst of an opioid epidemic and a public health crisis of rising suicide rates, insurers, states, law enforcement, plantiffs’ attorneys, and the federal government must do better to ensure people who need it can access care.”
“Many states are trying to enforce the Mental Health Parity and Addiction Equity Act, which would preclude these results and APA appreciates their efforts,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “But the problem is urgent and needs everyone’s attention. If a plan charges a patient for a product – access to mental health and substance use disorder treatment – and then ensures through its business model that there will be no providers to deliver that treatment – it is an unfair and deceptive trade practice.”
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Are you one of the hundreds of thousands of employees or business owners who travel all the time for work? Do you never know when you’ll be available for a free hour? Does all this keep you from engaging in the therapy or counseling or life coaching that you want so you can deal with your anxiety, depression, marriage and family struggles, addictions, or whatever else you have going on in your life? We have the answer.
We have 3 concierge style of appointments you can make.
Option 1: For $120/session, you can book a phone session within 24 hours (Monday-Friday). This gives you the option to be on the road, in the airport, in your hotel, or wherever and arrange a therapy session very quickly as soon as you know your schedule for the next 24 hours.
Option 2: For $150/session, you can pre-book your travel phone sessions like a normal in office counseling session. However, if something comes up and you need to cancel within the 24 hour period that would normally fall under the late cancellation fee policy, you would only be charged $75 for the no-show/late cancellation fee rather than the full session amount.
Option 3: Pre-paid, “all-you-can-eat” style. For $700/month, you can have up to 2 sessions per week and you’re guaranteed a phone session within 24 hours. You get 2 free late cancellations/no shows per month at no charge.
Here’s the benefit for our traveling clients: phone sessions/consultations predominantly at your convenience, minimal no-show/cancellation fees, therapy with a highly qualified, known therapist who will work at your convenience and that you can develop a relationship with overtime since you’ll work together on a regular basis.
Call us at 770-361-7864 or email us at [email protected] to set your traveling therapy appointment up now.
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If you’re a parent of a young child, chances are that someone on Facebook has sent you an alarming post about the “Momo challenge,” a game illustrated by a disturbing photograph of a woman, in which participants are blackmailed into completing increasingly dangerous tasks. Maybe that post says that Momo is the latest “trend.”
Momo was perfectly tuned to set off alarms in the mind of any parent: There’s something online that you don’t know about, and it’s about to kill or traumatize your child. Just one problem: There’s little evidence to confirm that the Momo challenge is real. Although multiple deaths are often attributed to the challenge in warnings about it, none has been confirmed.
The panic over Momo followed a familiar pattern established by other supposedly viral “challenges” — the condom challenge and Tide pod challenge, for example — that caused a lot of hand-wringing but few, if any, documented injuries. The viral spread of this kind of story may say less about the danger these challenges pose to young people and more about the fear that the Internet inspires in parents.
On Feb. 17, a parent anonymously sent in a warning about the Momo challenge to a Facebook group for the town of Westhoughton, England. “I’m deeply alarmed I have discovered when I collected [my kid] today … the teacher asked to talk to me. She said [my kid] had made three kids cry by telling them that ‘Momo was going to go into their room at night and kill them.’” The post contained a description of the challenge and urged other parents in town to talk to their kids about bad people online.
That post soon became an article in a local paper. It was then picked up by national tabloids like the Daily Mail and Daily Star. Many of those reports focus on a particularly dark detail from the legend of the challenge: that its ultimate goal is to persuade participants to kill themselves on camera. “Suicide game hits Britain,” read one of the Star’s headlines.
As word of the Momo challenge spread, the Mail followed up with stories advising parents on how to handle it.
As local police stations and parents began picking up on the viral warnings and issuing their own, more legitimate outlets like the BBCalso jumped into the fray. And then, the warnings spread to America. A Florida news station claimed Momo was “the latest trend on social media.” Kim Kardashian shared one of the posts going viral that warned about it.
Whatever their intention, the person who put up the anonymous Westhoughton Facebook post set off a chain of events that made warnings about the Momo challenge go viral — even if there’s little evidence to suggest that the disturbing prank is popular at all among the kids that concerned parents are now rushing to protect. As New York Magazine wrote in an examination of the latest panic, it’s “a little strange that we’re once again talking about Momo in 2019. Strange, but given the way the web works, not that surprising.”
Momo has spread online not as a viral threat to children, but as a panic-induced news topic about a perceived viral threat to children. And like many viral challenges, Momo has spread on kernels of truth about the real dangers of the Internet for young children, appended to a repeated pattern of bad reporting on dangerous viral trends targeting children — which often turn out to be not trending at all.
Last year, a viral panic about the condom challenge spread through Parent Internet, warning about a “trend” encouraging kids to snort a condom up their nose and pull it out of their mouths to get views on social media. The Post traced the origins of that story, which generated headlines across the country, to a presentation attended by a small group of San Antonio parents in March 2018.
The presentation mentioned the condom challenge as an example of a dangerous viral teen challenge. Educators in San Antonio gave the same presentations for years. But on this date, a local news crew was present. Their report on the presentation was then aggregated by news outlets across the country, who focused in on the condom challenge and deemed it “every parent’s worst nightmare,” “the latest dangerous social media trend” and “trending” among teens.
It wasn’t trending. Instead, The condom challenge was briefly popular on YouTube in 2013, thanks to a couple viral videos of people attempting it. The Post found no evidence that anyone on YouTube had tried the challenge for years. Instead, search results were full of videos warning about it. The same pattern has been repeated with the Tide pod challenge, the deodorant challenge and, to some extent, the Bird Box challenge.
Momo is similar: It is true that an extremely creepy image of a woman with bulging eyes and black hair has become a modern monster of online culture, one that has been in and out of the news cycle as reports and warnings pop up about the challenge. But the details that bolster its legend as something parents should be worried about don’t hold up. As The Post reported in September, when the challenge previously made the news, three deaths are often attributed to the challenge, but none of those reports has a proven connection.
Another warning, posted first to Facebook and then reposted to Twitter (where it has tens of thousands of retweets) claims that videos showing Momo are rampant on YouTube and YouTube Kids: “It doesn’t come on instantly so it’s almost as if it waits for you to leave the room then comes on in mid show. It’s been seen on Peppa Pig, LOL DOLL, those surprise eggs, and a few others.” But when The Post attempted to find any of these videos, we came up short. Instead, several popular YouTube videos warned about the possibility of a Momo scare in videos targeting kids. In others promising to show “proof” the rumors were real, the proof was often less than convincing.
But this warning, too, feeds off real concerns about what children are exposed to on YouTube. The Post reported earlier this week on parentswho were finding disturbing, violent clips spliced into videos targeted to children on the platform. But there’s no evidence that Momo videos trying to trick children into self harm are viral on YouTube or YouTube Kids. If they exist at all, they’re extremely hard to find. In a statement, YouTube also denied that Momo was spreading across their platform.
“After much review, we’ve seen no recent evidence of videos promoting the Momo Challenge on YouTube,” the statement reads. “Videos encouraging harmful and dangerous challenges are clearly against our policies, the Momo challenge included. Despite press reports of this challenge surfacing, we haven’t had any recent links flagged or shared with us from YouTube that violate our Community Guidelines.”
YouTube also announced that it would demonetize (or prohibit ads on) all videos about the Momo Challenge, including those from news organizations and YouTube creators commenting on the spread of the panic, the Verge reported.
As the Guardian noted, one of the more disturbing things about Momo’s viral spread as a warning to parents is the seriousness of the underlying topic of suicide. Samaritans, a Britain-based suicide prevention organization, told the Guardian that they were concerned all the coverage of the Momo challenge was “raising the risk of harm” for vulnerable people. “These stories being highly publicised and starting a panic means vulnerable people get to know about it and that creates a risk.”
According to the Centers for Disease Control and Prevention, risk factors associated with suicide may include mental disorders such as clinical depression, previous suicide attempts, a barrier to accessing mental health treatment, physical illness and feelings of hopelessness or isolation. Those who need help, including children, can call the National Suicide Prevention Lifeline at 1-800-273-TALK.
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Both Kelly Hindman and Lisa Ibekwe are now open for scheduling appointments in our new Alpharetta/Roswell office.
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We have officially got a second location in the Roswell/Alpharetta area. We will be accepting new clients for February 1, 2019! We will be conveniently located near Avalon, Wellstar North Fulton Hospital, Roswell HS, Centennial HS, Blessed Trinity, Alpharetta HS, and a variety of middle schools and elementary schools. The new location is:
1041 Cambridge Square, Suite B
Alpharetta, GA 30009
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First, we’d like to thank all of our clients and referral sources for having the trust and faith in us to serve you well. You all have referred to us and trusted us SO much that it is almost overwhelming. So with that in mind, we’d like to announce that we are NOT moving, but rather we are ADDING a second location to Alan Behrman & Associates, PC. We will be adding more spectacular therapists to our already amazing staff. We do have an area in mind, but we aren’t disclosing that just yet until we have all the details finalized. We are shooting for a late winter/early spring opening date. The location will be in Fulton County and we will start taking appointments for that location hopefully by early January.
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Originally posted and written by Dr. Joe Accardi:
Drum roll please! Congratulations, you have decided that the time to change your life has arrived. No more low self-esteem, problem relationships, or feeling out of control. You have made the decision to take charge of your life, to shake things up, to change. You are going to begin therapy.
You have found a psychotherapist, psyched yourself up, and are ready to begin, or so you think. Butterflies begin to set in. Questions arise. Is this something you really want to do?
Are you really ready to open up your life up to someone you don’t even know? What will they think of you? What if therapy doesn’t help? It’s all new and maybe even a bit embarrassing. You may ask yourself, “What have I done?”
Take a deep breath and relax, as you prepare yourself for your first time in psychotherapy it is quite normal to wonder what the experience will be like. And there are plenty of examples to draw upon. From the comical to the serious, we’ve all heard or seen depictions of characters being involved in therapy. It is a favorite topic of many stand-up comedians, interview shows, and other venues. How close to reality are they? Let’s take a look.
Your First Time
At some point anyone going into therapy must start somewhere. That initial first step is always the same: finding a therapist. Information on this important topic is covered in another article but suffice to say your first session will depend on who you have selected. Beyond that, there are some general things you must take care of when you have your first appointment. These include:
- Where your therapy will take place: As silly as this may sound, many clinical practices may use satellite offices for therapy. It is never wrong to know where you are going.
- Type of therapy; group or individual: This should have been discussed during your initial intake. If not, ask. There is nothing more disappointing than to expect an individual session with your therapist and then walk in to a group session.
- Appointment time: Obvious, right?
- Completing necessary paperwork: Be sure to bring copies of the information the office needs. Ask them in advance what it is they will want.
- Cancellation policy: Just in case.
- Completion of other items
- Allow an additional 15 minutes before your appointment to complete everything.
- Try to relax.
- Use the restroom.
- Bring a bottle of water with you.
Behind Closed Doors
There you sit, wondering to yourself if anyone else in the waiting room recognizes you. You hope not. Then the door opens and your therapist invites you inside. He or she then gently close the door behind you inviting you to sit down, and makes sure you are as comfortable as possible.
Again, you may be given the opportunity to clarify any questions you may have or even ask new ones. Thus the dance begins. As it is with most new relationships you will probably react in one of two ways. You will be quiet and reserved, answering only those questions you are asked. Or, you may be like others. In an effort to break the ice you may just start talking a mile a minute. Not to worry, your therapist has seen it all, and is fully prepared to let you get settled in.
The goal for most first sessions is to establish what it is you and your therapist will be focusing on. Depending on your issues this exploratory time may be completed during the first session, or in some instances it can extend beyond that time into another session.
Your therapist may take notes or even tape your time together. If they do tape your time you can expect them to ask your permission to do so. These notes serve as reminders to the therapist of your thoughts and reactions to certain things. In addition, most professional therapists are required to maintain a record of some kind that covers your interactions, treatment, and progress. These records are always private and shared only with your permission.
All of this, and it is only the first session.
Let the Therapy Begin
Although many people do not recognize it, all of the goings on during that first session serve an important therapeutic end. That is to establish your comfort level, to get you involved, and to begin to build a level of trust between you and your therapist.
Depending on the direction of the type of therapy used by your therapist several options may occur. Mot therapist will begin by asking you what are known as open ended questions. This method involves the therapist in shaping a question that asks you to tell a story about an event or people in your life. For example, the therapist may know or suspect that as you experienced your childhood the dynamics of your family played an important role. They might as you this, “Tell me what it was like for you growing up?”
Many clients may be hesitant to say too much, but a good therapist will soon put your mind at ease and encourage you to let the words flow. What your therapist is looking for are:
- Self-descriptions of your experiences
- Opportunities for additional insight on your part.
- Clarification of issues.
The steps described above are very general in nature, but do point out that the work you do in therapy is a process. While it may not always the most comfortable of directions, never the less it can be an exciting process of self-discovery. As you and your therapist dig deeper there will be discoveries made about how and why you react in certain ways as well as offering you the opportunity to try reacting differently.
For however long it takes you to achieve your goal you and your therapist will continue to work on you getting it right.