As boredom sets in during this COVID-19 crisis, I have noticed the increased need for structure and a schedule.  So, the age-old question becomes even more pertinent: where do I begin?

I really can’t begin to label or quantify the value of good self-care.  Humans are equipped with amazing capabilities to self-regulate…if only we had the energy and desire to use them! In DBT, there is a skill (acronym) called the PLEASE skill, and I believe it is the answer to the question posed above.

I am going to focus on three components of PLEASE: Sleeping, Eating, and Exercising.

Sleep. Just do it, stop fighting it…put your Smartphone away and close your eyes.  Did you know that your brain cannot convert anything into memory until you are asleep? The Disney Pixar movie Inside Out had a lot of great content that helps drive this point home (it was quite factually accurate!).  In the movie, the main character Riley didn’t have her memory balls moved from short-term memory into her long-term memory until she slept! Our bodies are not machines; on a cellular level your body needs sleep to repair itself. Sleep allows time for the immune system to do its job and ward off viruses and bacterial infections.  During this time of illness-anxiety, sleep is a kind gesture you can do for yourself to maximize the immunity in your own body! Sleep will also help you reduce your overall stress level. So next time you want to watch the next episode on Netflix, play the next level on a game, or return one more e-mail, ask yourself what you need more: your health and sanity or screen time…

Eat. A balanced diet helps alleviate mood swings.  We (generalizing for Americans) live on a cycle of sugar highs and sugar lows. We have a habit of eating low quality breakfast (…if we eat any breakfast at all…) which floods the brain with chemicals and overwhelms our neuro-functioning; this results in you feeling hyper, a spike of motivation, and a burst of energy (yay!).  As a result of this flooding however; our bodies secrete insulin to suck up all the sugar like a vacuum leaving us feeling lethargic and moody (not so yay…).  This cycle repeats itself after lunch and dinner as well. Think about it…when do you reach for the candy bar? 10am, 2pm, 9pm…a few hours after each meal! Eating a balanced diet of carbohydrates, proteins, and fats ensures that our food (including a healthy amount of sugar) gets broken down over time and reduces that roller coaster of moodiness. While in quarantine, I want you to focus on mindful eating and try to keep it balanced and healthy!

Exercise.  I feel like this is a mute point in some ways. My goal is not to be preachy; it is to motivate you into action. The science behind working out is limitless and boils down to this: if you move your body your mind will feel better.  Physical exercise can helps your brain secret endorphins, adrenaline, and dopamine…all of which alleviate depressive symptoms.  Consider for a moment the cost of getting those chemicals elsewhere: prescription drugs, theme parks, extramarital affairs… Are those effective or realistic on a regular basis? Exercise also builds mastery. If you become fluent and experienced in a form of movement (yoga, running, lifting weights) it will build your confidence and overall satisfaction in life.  What can you do from home? I have seen a wide variety of online videos being posted on Facebook from different organizations, there are a seemingly limitless supply on YouTube, or you could go for a walk around your neighborhood.

For the full PLEASE skill, please refer to this graphic:

Temporarily Closing Our Offices. Telehealth Appointments Available.

Dear friend of Compass Point, 

Out of concern for the health of our clients and staff members, and in light of steps taken by the State of Ohio in the last few days to reduce the risk of transmission of the Coronavirus, we have made the decision to close our offices and to discontinue all in-person therapy sessions until we receive confirmation from regional health authorities that the threat of transmission has passed. This policy becomes effective Monday, March 16, 2020 at 8:00 a.m.
 
During this period, we will replace in-person therapy with telehealth sessions. Our telehealth platform is HIPAA-compliant, tailored to behavioral health sessions and user-friendly. Sessions delivered via telehealth are reimbursable by commercial insurance and Medicare at the same rate as in-person visits. And we are able to accept payments for sessions, deductibles and co-pays/co-insurances via credit card. All clients require for a telehealth session is a personal computer or a mobile phone with webcam and an Internet connection.
 
If you currently have a session scheduled at one of our locations, a member of our team will be contacting you to reschedule using our telehealth platform. Please be aware they are calling from personal phones, so the number may show up to as a blocked or restricted caller.

Now that Compass Point has settled into Tele-therapy, we are hoping to serve our community with additional resources.

Things like; mental health tips, mindful minutes, activities to do with kids, etc.

If this is something you would benefit from, please comment below with a topic you would love to hear more about as well as what platform you would prefer to see it on (ie, our blog vsfacebook live.)

 Thank you for your flexibility during this time. We’re grateful to continue to serve the healthcare needs of our community.  

 Sincerely, 
 Your friends at Compass Point Counseling Services

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​What are comic strip conversations?Comic strip conversations are simple illustrations that show two or more people having a conversation using short sentences. Some children with autism learn better with visuals, so creating comic strips can be an effective tool. Constructing cartoon strips for kids is an enjoyable way for young people to communicate their thoughts and feelings while building the imagination.
What do Social Stories help with?Social Stories support kids with autism by:

• Teaching social norms
• Improving social skills
• Learning to empathize and have compassion with others
• Reducing anxiety

What are the components of a social story?

These stories are generally written in a sentence format. There are seven basic sentences that are generally used in its construction for children with special needs. These are:

• Perspective sentences – General descriptions of the internal state of another person like his/her knowledge, thoughts, beliefs, feelings, motivations, and opinions, as well as his/her physical condition. 

Example: “My brother likes to swim.”

• Descriptive sentences – Answers the “why” questions in a social situation or event. They are factual and observable sentences that are free from assumptions and opinions and are used to identify the most important factors in a social situation. 

Example: “Children go to school to study.”

• Directive sentences – Presents a response or choice of actions to a given situation or event in a positive way. 

Example: “I will brush my teeth after each meal.”

• Control sentences – These are written by the child who just heard the story. These are used to identify or remember the personal strategies or solutions that the child will use to recall and use information. 

Example: “I need to brush my teeth after each meal to keep them healthy.”

• Affirmative sentences – These sentences are used to support or reinforce the meaning of statements and may stress a shared value or opinion. These can be employed along with directive, perspective, or descriptive sentences. 

Example: “I will try to brush my teeth after each meal. It is very important to have healthy teeth.”

• Cooperative sentences – These sentences help a child understand the important role played by other people in a certain situation or activity. 

Example: “There are a lot of cars on the street. My dad and mom can assist me in crossing the street.”

• Partial sentences – These are sentences used to encourage a child with autism to determine the ideal response to certain situations. These sentences are recommended when the child has a significant understanding of social situations and how they are handled. 

Example: “My brother loves to play basketball.”
​
Some benefits to creating Social Stories for autistic childrenThese stories help kids learn how to respond to daily situations or events appropriately. A 2015 study of 30 children with autism, half of which went through Social Stories training, returned positive results. The experimental group who received a social story exhibited improved social interaction. 
Here are some benefits of developing Social Stories:

• Helps kids learn self-care and social skills
• Allows children with special needs to understand their behavior as well as others
• Assists autistic kids in understanding emotions such as anger, sadness, and happiness, and how to address them
• Helps children on the spectrum cope with various changes and everyday life transitions 
• Encourages kids to work on developing relationships and provides rewards for accomplishing social tasks
• Reinforces proper and/or accepted behavior 
• Teaches autistic kids how to join in activities, use their imagination, and play with others
• Provides the tools to teach kids with special needs to make and maintain friendships, as well as to join in group activities.​​

Get up to date on the Ohio State Board Requirements at Compass Point's Best Practices In Private Practice training. Be sure to pass a potential audit from The Ohio Board as well as get your Ethics CEUs by attending this training! Link below.

By Margarita Tartakovsky, M.S.

Research has shown that mental illness tends to disrupt people’s lives even more than physical conditions, said Dr. Mark S. Komrad, MD, a psychiatrist and author of the excellent book You Need Help! A Step-by-Step Plan to Convince a Loved One to Get Counseling.

“On average, a person with depression is at least 50 percent more disabled than someone with angina, arthritis, asthma or diabetes,” according to this report by The Centre for Economic Performance’s Mental Health Policy Group.

The good news is that treatments for mental illness are highly effective. The bad news is that only one out of three people might actually seek help. And some research suggests that the people who need help the most are typically the least likely to get it.
People understand that you can’t treat a lump in your breast on your own, Dr. Komrad said. But that same understanding doesn’t extend to mental illness.

Self-reliance is deeply imbedded in our society’s psyche, he said. That becomes problematic when anything that’s the opposite of self-reliance — such as dependency — is viewed as weakness and something to be ashamed of.
People might worry about appearing weak if they seek counseling — and they might turn that stigma inward and see themselves as weak, Komrad said.
Another big deterrent is lack of insight. Many people with mental illness simply don’t think they’re sick.

That’s why it’s critical for families and friends to step in and help their loved one realize they need to seek counseling. Don’t worry about “meddling” in their lives, Komrad said. Rather, you have the opportunity and power to improve – and in some cases, save — their lives.
Warning SignsIn You Need Help! Komrad lists the specific signs — along with real-life examples — that signal an individual needs help. These are some of the signs:

• Behavior that scares you, such as a significant temper.
• Problems taking care of themselves or regulating their behavior, such as ignoring basic hygiene, engaging in reckless acts or drinking and acting aggressively.
• Problems with thinking, such as becoming disoriented, seeing or hearing things that no one else does or forgetting important facts.
• Intense feelings, such as profound anxiety about leaving the house.
• Problems interacting with others, such as withdrawing from the people they love.
• Inability to work, such as not holding down a job or diminishing grades or effort in school.
• Experiencing trauma, such as abuse or the death of a child.

​Ultimately, the key is to look for what Komrad calls “a change in baseline.” In other words, is your loved one acting differently in any area of their life, including work or home? Komrad said that it’s not unusual to see a person unraveling at home first.
Approaching Your Loved One in the Early StagesKomrad suggested the following ways to approach your loved one about seeking help in the early stages of mental illness.

• Let your loved one know that you need to have an important conversation with them. According to Komrad, this helps to focus their attention and implies they should take it seriously.
• Pick a good time and place. For instance, avoid talking during family gatherings or when you’re fighting.
• Approach them with empathy. You might say something like “I know this is really hard for you, but I’m talking to you because I love you. If I didn’t care, we wouldn’t be having this talk.”
• Be prepared for the person to be upset – and try not to get defensive.
• Use “I” statements, such as “I’m concerned about you.”
• Ask for a gift – literally. Ask your loved one to give you the gift of seeking help, whether it’s for your anniversary, a holiday or your kids’ birthdays. Here’s an example from Komrad’s book:“Getting a consultation with a psychiatrist about your mood swings would be the best thing you could do for our little girl’s birthday. It’s better than anything else that you could possibly give her. Please, do it for her. She, more than anyone, needs you to get some direction and proper help, more help than I know how to give you.”
• Facilitate the process by finding a professional and scheduling an appointment. Even if they refuse to go, see the practitioner anyway. Talk to them about helping your loved one. Komrad said that 15 percent of his practice is meeting with clients about their loved ones.
• Offer to pay for the appointment, if possible. A common excuse is that therapy is too pricey.
• Don’t use words like “crazy” or “abnormal.”

Taking Stronger MeasuresWhen your loved one has little insight into their illness – their “rationality is diminished” – or refuses to get help, you’ll need to take stronger measures. Komrad calls these strategies “therapeutic coercion,” which is akin to tough love.
An especially powerful tool, he said, is to explain to your loved one that families come with certain privileges – and responsibilities. For instance, if you’re a parent who’s financially supporting your adult child, leverage these privileges to get them to seek a professional evaluation.
If that doesn’t work and your loved one is a danger to themselves or someone else or is very ill, contact the authorities, Komrad said. Research your city’s laws on involuntary evaluation. And show up at every step of the process, he said.
“Don’t just call the authorities and wait.” Show up to the ER and the court hearing. “When you do show up, tell the story.” In fact, tell the ugliest parts, he said. Talk about the facts that substantiate the seriousness of the situation.
If you’re feeling unsafe for any reason, articulate that to the authorities. If you’re uneasy about bringing your loved one home, communicate that as well. As Komrad said, you don’t want to give the system an easy way out. You want to make sure they grasp the gravity.
Supporting Your Loved One Long-TermSupporting your loved one through treatment is “a long-term project,” Komrad said. Check in with them regularly about their treatment and how you can help.
Also, realize that “a change in them is a change in you,” he said. In other words, as they’re making changes in their life, you might want to seek professional help as well. You might even realize that your relationship is part of the problem. As Komrad said, “Sometimes relationships can be sick, too.”
As a family member or close friend, you have a lot of power in helping your loved one. Use it.

Few things in life have the power to stir our emotions and evoke compelling responses in the way art does. In all of its various forms, art is a powerful tool for expression. Through visual means, an artist is able to communicate and connect with others in a way that transcends words, and art therapy utilizes this connection to strengthen recovery.
The compelling quality of art makes it an incredibly useful tool in psychotherapy and counseling. Creative activities, in the form of art therapy, become a type of language that allows people to communicate thoughts and feelings that are too difficult or painful to put into words.
WHAT IS ART THERAPY?The formal definition of art therapy is “the application of the visual arts and the creative process within a therapeutic relationship to support, maintain and improve the psychosocial, physical, cognitive and spiritual health of individuals of all ages.” Put more simply, art therapy is a type of psychotherapy that uses art and artistic mediums to help people explore thoughts and emotions in a unique way.
Art therapy is facilitated by a trained, qualified professional with a knowledge of visual art—drawing, painting, sculpture and other art forms—and the creative process, as well as human development and counseling theories and techniques.
From the patient’s perspective, art therapy does not require experience or special talent. The work is not criticized or judged for its artistic quality, precision or beauty. The methods used, along with the resulting artwork, are more about the emotions expressed and felt throughout the process.
HELPING TEENS EXPRESS THEMSELVESThe use of nonverbal expression can be especially beneficial for adolescents who are navigating the difficult waters of their teen years. Normal developmental changes, family tensions and social challenges may be further complicated by symptoms of mental illness, which affects 20 percent of all youth ages 13-18.
Teens often see art therapy as a nonthreatening form of treatment. The artwork they produce helps the therapist gain a better understanding of the their concerns and life circumstances, especially those situations that are too risky to reveal or too personally embarrassing to relate. This awareness better equips the therapist in efforts to protect and support them.
In art therapy, teens are able to express themselves in a context of gentle guidance that assists them in self-discovery and growth. The creative process helps them develop an understanding of their own inner voice, establish an identity, examine values and morals, question authority and plan for the future.
BENEFITS OF ART THERAPYThe positive results of art therapy are broad ranging and provide benefits for anyone wishing to learn more about themselves or explore the creative arts as a means of self-expression. But art therapy holds specific benefits for those suffering from a wide spectrum of mental illnesses.
Under the guidance of a trained expert, art therapy can help improve various mental and physical symptoms, bringing significant relief and promoting recovery from debilitating mental disorders. In addition to addressing specific symptoms, art therapy offers many general benefits, such as:

• Offering a nonthreatening way to express inner feelings that can be difficult to put into words
• Fostering a feeling of being understood, relieving frustration
• Providing a safe outlet for feelings such as fear, guilt, pain, rage and anger
• Gaining skills and a sense of achievement, providing ownership of successes
• Building trust, which is encouraged in a safe environment
• Increasing self-esteem and self-respect
• Developing objective perspectives on conditions, challenges or difficult life circumstances
• Experimenting with change that can be applied outside therapy
• Encouraging realization of existing personal strengths and the confidence to use them
• Improving social skills, especially for someone who may be withdrawn or shy

Art therapy can help teens understand, express and improve their mental and emotional conditions. Since it can raise the quality of life for many, art therapy is definitely worth considering as a catalyst for healing mental illness.

While each therapeutic setting has its own set structure and goals, the following characteristics of DBT are found in group skills training, individual psychotherapy, and phone coaching:

• Support: You'll be encouraged to recognize your positive strengths and attributes and develop and use them.
• Behavioral: You'll learn to analyze any problem or destructive behavior patterns and replace them with healthy and effective ones.
• Cognitive: You'll focus on changing thoughts and beliefs, and behavior, or actions that are not effective or helpful.  
• Skill sets: You’ll learn new skills to enhance your capabilities.
• Acceptance and change: You’ll learn strategies to accept and tolerate your life, emotions, and yourself as well as skills to help you make positive changes in your behaviors and interactions with others.
• Collaboration: You'll learn to communicate effectively and work together as a team (therapist, group therapist, psychiatrist).

​Acceptance & Mindfulness
 
Take a moment to think of the last difficult situation you were in.
 
Did you say statements like “this isn’t fair”, “it should not be this way”, or “why me”?
 
What emotions did you have during this time?
 
Now think about the statements above. What emotions do you feel when you think of these?
 
Perhaps frustration, anger, sadness, or feelings of being stuck. Wishing things were not the way there were creates a lot of difficult emotions. Our mind often travels to the past of what was and then spirals to future anxiety of what is to be. We begin to ping-pong from the past to future and lose touch with the present.
 
When we push back against reality, we are choosing not to accept the present moment. When we do not accept the present moment, we create more pain.
 
 
Leaning into Acceptance…
 
No one wants to experience pain.
 
If you take a look at our society…we tend to avoid pain at all costs. One way to avoid it is to wish the present situation was not happening.
 
The irony behind this method of avoidance is that we are actually creating more pain for ourselves.
 
When we push back on the reality of the present moment…we create more pain.
 
When we refuse to accept the truth of a situation, we deny the present. When we deny the present, we are disconnected and feel both the pain from the situation AND the pain from wishing it was different.

This not to discount the pain that comes from a difficult situation. Rather, acceptance invites us to acknowledge the truth rather than staying stuck in wishing it was not this way. Failure to accept the present moment as is can cause a greater intensity of emotional pain.
 
 
…And How Mindfulness Can Help Us Do This
 
Mindfulness has become quite the buzz word in our culture along with many different ideas of what the practice is. Jon Kabat-Zinn, Founder of Mindfulness-Based Stress Reduction, provides us this definition:
 
“The awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally” (Kabat-Zinn, 2015)
 
Simply put— mindfulness is to experience the present moment fully awake.
 
This means we are not ruminating in the past nor letting the mind wander to the what ifs of the future. We are fully embracing the present moment for what it is.
 
Pay attention to where our thoughts wander…are you in the past or future? Or are we fully in the present moment?
 
What is the story we are telling ourselves? When we begin to live awake in the present moment and accept what is, we can lessen painful experiences.
 
 
Acceptance ≠ “I Agree”
 
Let me confirm that true acceptance DOES NOT mean agreement. It is extremely difficult to accept a situation that is painful AND we can choose to accept the present moment.
 
True acceptance does not mean agreement. We can both disagree with a circumstance and agree that it is reality.
 
When painful experiences happen in our life it is human to wish circumstances were different. It is when we lean into full acceptance of the current situation that we arrive to freedom.
 
While we cannot discount the pain and difficulty a situation may bring us…there is freedom in acknowledging the reality.
 
It is when we push back at the present moment when circumstances become more painful.
Once we fully acceptance the present moment for what is it we can then navigate the new reality.
 
Bringing awareness to your thoughts on the situation – what is the story you are telling yourself? Start by noticing your thoughts. When they wander to “this is not fair” or “I can’t deal with this”, acknowledge them nonjudgmentally.
 
We Have a Choice
 
It takes a LOT of energy to fight reality. Acceptance can place us in control of our emotions. Acceptance AND mindfulness of the present moment gives us freedom.
 
Life can guarantee pain. It is our choice how we respond to it.
 
Acceptance gives us the ability to be mindful in the present moment. When embracing acceptance accompanied by mindfulness of our thoughts and feelings…pain is lessened.