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Archives for 2007

The Nutrition of Sleep

November 23, 2007 by Leave a Comment

The Nutrition of Sleep

Often when we ask our patients about sleep hygiene, we provide education on exercise regimens, lighting, and sleep conducive routines.  A new study from Northwestern suggests that we add discussing diet as well.  Joseph Bass and his colleagues discovered a connection between high-fat diets and the disruption of circadian rhythms in mice.  After only two weeks on a more fatty diet, the normally nocturnal mice had trouble sticking to their regular schedules of sleeping and waking.  This establishes that there is a two-way link between diet and circadian rhythms, a link we may want to point out with our patients whether they struggle with depression, diabetes, and/or obesity.

ADHD

Some interesting and hopefully reassuring research has come out for those of us who work with children diagnosed with ADHD.  The National Institute for Mental Health analyzed cortical scans in equal numbers of children diagnosed with ADHD and neurotypically developing children over a several-year-long period.  The results indicate that children with ADHD have up to a three-year lag in brain development, but have a normal pattern of cortex maturation.  This should reassure families that many children with ADHD outgrow the disorder, and see it as a form of neurological immaturity in many cases.  NIMH acknowledges that not all children with ADHD have equally good outcomes, and is now beginning to study why such differences occur.

Immigration Raids Hurt Youngest US Citizens

As you listen to the presidential candidates canvassing, pay close attention to their stance on immigration.  Researchers in three cities, including New Bedford, MA, recently interviewed 500 children whose suspected undocumented immigrant parents were recently detained in workplace raids.  The study, conducted by the Washington think tank Urban Institute found that the children faced mental health problems including PTSD, depression and separation anxiety.  Those who did have one parent remaining to care for them had compromised care due to the fact that that parent was often less accustomed to making decisions and/or the inability to access their spouse’s money.

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Autumn

October 8, 2007 by Leave a Comment

Autumn has rolled around, and yet, I have had to modify my practice of the old New England tradition of complaining about the weather.  The warm and sunny days have been great for apple picking and walks, but at last my inner cranky Yankee managed to put my finger on my discontent with the climate.  It happened when I heard yet another meteorologist cheerfully remarking on our “record-breaking highs,” our “unseasonably warm weather.”  I try not to get political in these blogs, but I have to point out that these changes fit Shakespeare’s quote, “Ill blows the wind that profits nobody.”  We are benefitting from a global warming trend that is no longer surprising or joyful, so let’s encourage the media to stop spinning it that way, shall we?  I have begun meta-complaining about the weather—how’s that for Yankee ingenuity?

The Postman Always Rings Twice

Although I like to encourage colleagues to take advantage of modern technology in our practice, I did want to pass on this article as a word of caution.   If you use email through Yahoo or Google (gmail) your email content is searchable and may be “trawled” for content.  It is an important reminder that your email is not just in your client’s and your computer, but also in the servers that each of you uses.  Keep emails brief and nondescript.  Having your client sign an informed consent around the internet is important, and will make sure you both understand what the limits and challenges of emails are.  Many clients will want to continue to use email for scheduling, but spelling out the risks never hurts.

Racial Stress and Prenatal Care

A recent study from Joint Center for Political and Economic Studies’ Health Policy Institute took a look at 600 African-American women and the impact of racism on their health.  The results indicate that reasons for their higher stress levels ranged from hearing white teachers’ comment on “those kids” to working longer hours to win acceptance from white co-workers.  Looking at the stress disparities across racial lines is nothing new, but this study looks at what causes the stressor with an eye to race, and finds that “rich or poor, well-educated or barely literate, African-American women were still more likely than white women, first-generation, poor Hispanic immigrant women and foreign-born black women to have premature and low birth-weight babies… and that when foreign-born black women had been in the United States for a generation they showed the same infant mortality rates as American-born black women.” (Lu, 2007)  This would indicate that addressing the psychosocial impacts of racism is an important part of prenatal care, and culturally competent practice.

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Research and Job Dissatisfaction

July 30, 2007 by Leave a Comment

20 Years in GLBT Youth Research

The NASW website “Help Starts Here” recently published an article I wrote that you or your clients may find of interest.  The article reviews selected literature from 2 decades of research on risk factors for gay, lesbian, bisexual and transgendered youth.  It compares those earlier findings to the two most recent Youth Risk Behavior Surveys done in Massachusetts.  Although the review of the literature is not exhaustive, it may be useful to clinicians and families.

Take This Job…

Some interesting news came out of the outplacement consulting firm Challenger, Gray & Christmas.  They estimate that 25% of workers regret having taken a new job within their first year.  For those of us who work with clients dealing with work dissatisfaction, this statistic may de-stigmatize it.  It may also free them up to leave a job that providing them with the satisfaction and quality that work can and should bring.

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The Psychodynamic Strikes Back

June 9, 2007 by Leave a Comment

If your month has been anything like mine, the winding down of the academic year has not meant things are any less busy.  In fact, the duties of gardening have made the day even more packed!  Take comfort though, an hour of gardening burns off approximately 300-350 calories.

This June the American Journal of Psychiatry released an article which evaluated three yearlong treatments for Borderline Personality Disorder.  There were several things that were interesting about this study, one of the first to compare DBT with therapies partially or fully psychodynamic in nature.  First, all three groups treated showed marked improvement over the course of a year in the areas of anxiety, depression, and social anxiety.  Second, both DBT and transference-focused therapies were significantly associated with decreased suicidality.  Third, the psychodynamic treatments demonstrated more improvement in anger and impulsivity.  You may find this abstract and article of interest, especially when you are discussing with HMOs and others the importance of evidence-based treatment.

Dual Diagnosis—Best Practice

Although most of us are treating patients with co-occurring disorders, this article by John K. Smith highlights potential deficits in our training.  Beginning with a case study involving illustrating a dual diagnosis patient, Smith discusses the use of motivational interviewing during initial assessment and a dual diagnosis treatment model.  He then outlines some basic competencies for clinicians treating mental health and concurrent substance abuse issues.  You may find this article useful not only in terms of clinical practice, but as a framework for clinicians you supervise.

The iPractice

You may have all the materials you need to successfully and frugally market your practice for the information age.  From mining data to expand your network to preparing your digital credentialing library to developing a website, I can offer you some pointers individually or with group presentations.  If you would like to arrange a consultation on how you can use the latest technology to grow your practice, feel free to contact me.

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Talking the Talk… Or At least Understanding It

May 9, 2007 by 1 Comment

Anyone who has worked with adolescents for part of their practice has experienced the sense of speaking a language from an alternate universe, similar to yet quite unlike our own.  And anyone who has worked in the field of adolescence for a significant amount of time will from time to time experience a sense of being hopelessly “behind the curve.”  Fortunately, there is a resource out there for those of you who want to translate what your clients, or children are saying to you:  www.urbandictionary.com .  This highly nonclinical dictionary can definitely help, although like anything concerned with youth it is unconventional and preoccupied with some of the traditional categories of teen interest—sex, drugs, and music.  Nevertheless it contains just about every phrase, including text-messages, that you’ve ever heard about.

Peer Supervision

A peer supervision group is forming in Harvard Sq.  The group welcomes clinicians of various disciplines and theoretical backgrounds.  We’re looking for members with 5 or more years of clinical experience, an ongoing interest in learning, and a sense of humor.  Current members use psychodynamic, CBT, DBT, and systems theory in their clinical work, and are open to broadening their scope.  The group meets Mondays at 12:00 PM, please contact me for more details.

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Spring Fever, Etc.

March 28, 2007 by Leave a Comment

Recently the Archives of Pediatric and Adolescent Medicine published an article finding that children whose parents and families are experiencing stress tend to have more fevers and illness than other children.  The article, summed up in Medical News Today goes on to state that stress increases children’s immune functioning.  You may want to share this with your colleagues, as this time of year is particularly stressful for children and adolescents.  Between academic demands, increased testing, and gearing up for the “last stretch” of school, some children may be physically and metaphorically overheating!

Support for Bipolar Adults

In case you are not aware of this local resource, you and your patients may benefit from the services of the Manic-Depressive and Depressive Association of Boston.  While not a replacement for treatment, MDDA offers support and information for people with affective disorders, including support groups that meet at McLean.  These groups are a useful part of partial hospitalization discharge planning, especially with the increasingly shortened lengths of stay allowed by many insurances.

Insurance Update

I am happy to report that I have added Tufts Navigator and HMO Blue/Managed Care Behavioral Health to the insurances I accept.  I currently have availability most weekday mornings and afternoons, with a waiting list for evenings.  Please feel free to forward this information to whomever you’d like.  If you or your clients have any questions about the practice, the answers can be found on my site, www.mikelanglois.com .  Thanks to those of you who have made referrals, they are always appreciated.

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