Category Archives: Insurance, Couples Counseling, Informed Consent , Affordable Care Act

Information regarding Insurance, Couples Counseling, Informed Consent ,and the Affordable Care Act

Attachment styles and your relationship?

Attachment styles and your relationships?  What is your attachment style in your relationship?

John Bowlby (British) and later Mary Ainsworth (Canadian ) pioneering research in developmental psychology, known for their work in early work in attachment.  Ainsworth research in attachment styles explored how a mother’s (ie. caretakers) and infants bond to each other.   She described  3 types of attachment styles in infants. Secure, Ambivalent and Avoidant attachment style.  Suggesting that these early attachment styles are learned from our primary care giver)s) in our early years.  We internalize them as road maps  to then later repeat as adults in our adult relationships.

Secure attachment style is of course the most stable style, yet only about 50% of population is able to create a secure attachment style.   This can create less than stable relationships and over all difficulty in long term relationships or marriage, if we do not fall into a secure attachment style. Secure attachment It is  stable, honest, intimate and manifests as a willing commitment to the other and to the relationship in the long run, even in hard times.

New research shows that attachment styles are both environmental meaning they can be learned by modeling and some speculate, some part might be inherent to us when we are born, as well. Also attachment styles  are now considered more fluid than before, where they were considered unable to change.  The new research shows that  if  some one can model a secure attachment style in a relationship or marriage to an ambivalent or avoidant  that is anxiously attached,  this person might in four or more years have a chance at being  able to change their style to a more secure attachment style.  How ever this is not a given and there are many other factors.

Ambivalent or Anxious attachments manifest with an inherent need to get a lot of affection and attentions, sometimes it never seems to be sufficient.  They are often insecure about  themselves and need a lot of affirmation form others.  They have a fear that their partner will some how  or abandon them, because they are not worthy  or they have a fear that their partner will cheat on them.  Worry seems to over ride trust, and they seem to pursue the other more.  They are usually uncomfortable alone and seek to be in a relationship at all costs even if it is not a healthy relationship.  Sometimes anxious attachment can manifest as a high need for control, or neediness vacillating with anger if unable to get needs met..  Having said that, all manifestations of control attempts of one partner over the other are not always just anxious attachment issues.

An Avoidantly attached person will feel suffocated with real intimacy or too much closeness and have the need for alot of alone time, a high need for privacy and possibly even stray to have other relationships.  They might find a securely attached person too regular and too boring.  Avoidantly attached individuals, like change and excitement they are not very emotionally vested in a relationship, and will be quick to end and restart another relationship without too much time in between.  Their focus is more on themselves and their work. They will be less interested in sharing intimate feelings/ Avoidant often will often leave their relationships when times get  difficult and they feel stressed.  Avoidant  have difficulty establishing a sense of “we” identity.

Newer research from Mary Main now points to fourth attachment style, the Disorganized Attachment style. This is created when the parent has unresolved abuse, trauma or loss, and disorientates the child growing up.  Parents are frightening or frightened and struggle with emotional regulation, the world is an unsafe place.  Disorganized attachment style is full of mixed messages, creating a very unstable environment for the child and later in adult their relationships. Often manifesting as a difficulty in managing stress and self regulation, poor social skills and trust issues.  The adult them will have difficulty with later parenting or in relationships over all.  People with disorganized attachment styles are less likely to feel they need help or to seek help. These styles can be explored in therapy as to how they impact the couple or the individual.

Once you are able to better make sense of what attachment style you developed as a child and how this map is still guiding your life today,  you will be able to gain insight and learn new skills.  Most people can learn to develop  a secure attachment style with time  and therapy or  a securely attached partner.   This information might be useful to know about yourself and your loved one when dating or when looking for a life partner.

 

What is Sensate Focused Therapy and who can it help?

What is Sensate Focused Therapy and who can it help? Can I increase intimacy in my relationship?

Sensate Focused Therapy was introduced by the famous sex researchers Masters& Johnson, and it is a therapy often used by marriage and family therapists or sex therapists that are trained in this procedure to increase a couple’s ability to increase a couples feelings of intimacy, sense of safety and non verbal communication. It starts with increasing one’s own sense of self awareness through intentional touching and observations and eventually after some sessions (usually 6-10) the work will lead to more intimacy, unity, and better sense of  harmony between a couple.  It is a fairly simple and most couples find the practice enjoyable to do. The practice is done at home in private with your partner.  Each couple has unique needs that are taken into account and other interventions might be suggested as the work progresses.

This type of work is great to rekindle and reconnect intimacy in a couple, even for those who for whatever reason feel like “sex” might not be an option for them anymore.  Please call me if you have any questions about Sensate Focused Therapy or if you feel like your couple could benefit from increasing your sensual and intimate connection. I would be happy to talk further and see if it might be beneficial for your couple.

Can fathers have Postpartum Depression or Baby Blues?

Postpartum Depression or Baby Blues? Can fathers have them too?

Post partum is a time with many transitions.  Finally healthcare workers and the populations at large are coming to understand post partum depression or :baby blues: in women.  More and more women are not suffering in silence but asking for help with this.  According to the Mayo clinic  http://www.mayoclinic.org/diseases-conditions/postpartum-depression/basics/symptoms/con-20029130

“Postpartum depression symptoms for the mother may include:

  • Loss of appetite
  • Insomnia
  • Intense irritability and anger
  • Overwhelming fatigue
  • Loss of interest in sex
  • Lack of joy in life
  • Feelings of shame, guilt or inadequacy
  • Severe mood swings
  • Difficulty bonding with your baby
  • Withdrawal from family and friends
  • Thoughts of harming yourself or your baby Yet what about the changes that might take place in fathers as well?
  • Parenthood transition appears to be a time of higher risk of fathers developing depression, compared. Coming to terms with a new identity and a changing relationships and the responsibility of financial consequences of starting a family are all factors to consider.
  • Untreated, postpartum depression may last for many months or longer.”

Might dad be experiencing any of these symptoms of paternal postnatal depression, or baby blues risk factors? Might you have some or all of these?

  • having a partner with postnatal depression
  • history of depression
  • marital discontent
  • low self-esteem
  • doubts about parenting role
  • first time parent
  • sickly or irritable Baby

There is no manual that comes with parenting. The earlier you address these issues of change and transition, the faster you and your wife can get your family back on tract and feeling better. If you are experiencing any of these baby blues symptoms, help is available now.

Let me know if I can help.

Insurance, Couples Counseling & the Affordable Care Act

Insurance, Couples Counseling & the Affordable Care Act

There was a time where insurance companies and your employer knew a lot less about what you did in your health provider’s office.  Now with the Affordance Care Act more and more people will get insurance and more mental health services are being covered.  Sometimes couples counseling is covered as such, sometimes one of the people in the couples session must be the “identified patient” for insurance billing purposes. Many clients do not know this.  If you use your insurance to covers your mental health services one of you probably will get a diagnostic code in order for you or the mental health care provider to be able to get reimbursement from the insurance company. No diagnosis code, no reimbursement. You may or may not be told or know what your diagnosis that you are being billed for.

Depending on the diagnostic code that might determine how many sessions you will be allowed, sometimes it can vary depending on your needs. Often time’s insurance company or employer will need an update as to your progress on your diagnosis, in order to determine if more sessions will be given.  All this information about you and your diagnosis is given to the insurance company and sometimes as to your employer.

In the past health care information would be kept for five or seven years.  In the paper days, this information would be kept by your health care provider, perhaps shared if referrals were made and then later destroyed. These days it is being most likely stored in the cloud for ever. This information will follow you along with the rest of your medical records, probably for life.  This should  clearly be explained to you.

This is one reason why many people still prefer to keep their mental health care outside of the insurance providers reach.  Having to meet insurance deductibles, having a high co pay and needing an “identified patient” for diagnosis makes using insurance less than appealing for some people.

A more attractive alternative model for many is to have an affordable, non diagnosis model as far as their mental health care. Many people thus prefer to keep their mental health information out of their employers or insurance company’s hands by not using their health insurance.

Remember that if you do use your insurance, be sure to inquire about the following contract details to make a better informed decision as a consumer as to which choice is best for you:

  • Is outpatient mental health covered? Is Couple’s counseling specifically covered? Or only individual?
  • Any preauthorization requirements before you begin?
  • What is your co-pay?
  • Is there a deductible that must be met yearly, before benefits will begin? What is it?
  • What credentials are required of the therapist? There are many types of mental health credentials; will my particular therapists be covered?
  • Will it be in either in network or out of network?
  • How many visits will be given per year?

Ask your therapists to explain your diagnostic code that they are using for insurance billing purposes, it could be one or several codes.  If you have any questions or need clarification ask.  It is important to be fully informed and protect your confidentiality. You have a right to know and make an informed decision.

 

 

Carmen’s Blog

CarmenThank you for stopping by and welcome to my blog. I hope to share useful information and experiences with you here.