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Assessing for Pediatric Mania | Part 1 of 2

by Dr. Himanshu Agrawal, MD.   Disclaimer: This blog is merely a personal opinion about psychiatric issues.It does not equate to a psychiatric consultation and does not imply doctor-patient relationship. In my humble opinion, in the world of Child Psychiatry, there is nothing murkier than the answer to this question “What does pediatric mania look like?” It seems that there are several differing opinions endorsed by different schools of thought spread across USA.

Using Dialectical Behavioral Therapy (DBT) Principles in Daily Life | Part 3 of 3

by: Kira Yanko, MS, LPC  |  Northwest Passage III Therapist Don’t Have a Cow?! For therapists like me, thankfully DBT is highly structured.  There are times in every clinician’s work that we are challenged and these difficulties lead to self doubt.  In addition to hashing this out through consultation, DBT’s stages and targets allow for grounding and focus in session.  They provide a framework to approach clients and guide treatment.  This is especially important when working with clients who are emotionally dysregulated because often they will enter session with a new “COW” (Crisis Of the Week) that they would like to discuss.  Often these are chaotic and crisis ridden problems that are loosely related to the overall goals of treatment.  As such, it would be easy to spend each week addressing these COWs and never get to the gestalt, to the greater pattern of underlying distress, and the need to build a live worth living.  Avoiding COWs is a term I heard in a training several years back.  In my own practice, I tend to refer to these as “shiny objects” because it is easy to become super distracted by them in session.  The stages and targets of DBT help provide a framework to make COWs or “shiny objects” less clinically alluring.  They also offer guidance to what problems areas

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Using Dialectical Behavioral Therapy (DBT) Principles in Daily Life | Part 2 of 3

by: Kira Yanko, MS, LPC  |  Northwest Passage III Therapist Nurtured and Nudged… The first and foremost principle of DBT is dialectics, hence the name.  This is the idea that two concepts that seem to be completely opposite from one another can both exist and be true at the exact same time.  A person can both love and hate someone.  They can seek independence and dependence at the same time.  A client can be doing the best that they can and simultaneously need to do better.  This isn’t a new idea (and Marsha doesn’t suggest that it is…after all it is the basis of the serenity prayer written in the late 40’s, early 50’s), but for the first time it was encapsulated and formalized it into a therapeutic approach.  It is often the belief that only one truth exists that leads to both internal and external turmoil for our clients.  If we interact with any of our clients purely from one static vantage point, we present them with opportunities to “power struggle” and this can destroy our alliance – the key aspect of any therapeutic relationship (and I’m not just referring to therapeutic relationship in terms of therapist and client, but in terms of any relationship between two people that can have therapeutic value).

Using Dialectical Behavioral Therapy (DBT) Principles in Daily Life | Part 1 of 3

 by: Kira Yanko, MS, LPC  |  Northwest Passage III Therapist A Rather Loose Metaphor… In the world of mental health, Dialectical Behavioral Therapy is all the rage.  It’s the Channing Tatum of psychotherapies…can you tell I’ve worked with adolescent girls for the past eight years?!  Although starting primarily with clients diagnosed with Borderline Personality Disorder who possessed a high suicide risk, research has shown DBT to be an effective treatment for any client whose underlying struggle is rooted in emotional dysregulation.   Just as Channing has proved he is here to stay in the cinematic world, any early concern that DBT was simply a “buzz word” in the therapy world or a passing fad has long been laid to rest.  Also like Channing, DBT is easy on the eyes…so to speak.  DBT’s popularity amongst clinicians (aside from its efficacy, of course) comes from how it took aspects of behavioralism, CBT, mindfulness, and emotional regulation and added some “zhush” transforming it into a package that is more palatable by clients leading to greater adherence and success in treatment.

Cognitive Disabilities | In-Home Recommendations for Parents (part two)

Part 2 of 2: by Melissa Gendreau, MS, LPC – Child and Assessment Center Therapist In part one, we introduced several environmental factors that can be helpful for parents – part two will expand upon additional strategies. Read part one here.  Utilize emotion charts- Make a poster with multiple facial expressions on it to help the child identify what emotion he is having. This can be even more useful when incorporating pictures of the child’s various emotions as well as the parents. Validate his emotional distress and then work to help problem solve the situation. Making statements like “I can see you’re angry right now” “Let’s figure out what you can do until…”

Cognitive Disabilities | In-Home Recommendations for Parents (part one)

Part 1 of 2: A child’s environment is vital to his/her future health and success. For the parents of children with a cognitive disability, the task of creating an appropriate environment can be daunting.  Children with this diagnosis require an environment that is calm, predictable, and supportive.  Children with cognitive disabilities require simple, concrete behavioral expectations in their environment.  In addition, they must experience immediate, consistent, non-shaming consequences (that are appropriate for their individual level of functioning) for not meeting those expectations.  Short-term behavior goals matched with equally short-term consequences may be the most effective method for children with cognitive disability.  The important aspect to remember is to ensure that it is a realistic goal for the individual child. Incorporating all of the above aspects is no small feat. These children often require intense supervision and structure in the environment.  They often do best in their environment when they came to understand the schedule and routine of the day.  Parents with children who function at an intellectually disabled level often find their child will require multiple parenting and teaching strategies for him/her to be more successful.

Lifestyle, Mental Health and the New Year’s Resolution Syndrome

by Dr. David Ammend  As a general pediatrician by training, I have been taught to try to look at children as a whole when attending to their health needs.  In my role as Medical Director of Northwest Passage residential treatment programs over the past 18 years, my practice has been focused on the health of children with a very particular set of problems, and there can be a tendency for me to pay insufficient attention to children’s general health as we are sometimes faced with a child and family in extreme distress due to mental illness.  However, my ability to keep the “whole child” in mind has been sharpened by the growing recognition that it is exactly the issue of “lifestyle” in its broadest sense has a profound impact on mental health.  Here I would like to discuss some of the challenges that anyone involved with the care of children face when trying to promote a “healthy lifestyle”. Over the past 5-6 years I have been working with some of my Northwest Passage colleagues to better understand the role of a healthy diet and physical activity in promoting mental health, and to use that knowledge to inform our work with the kids we serve.  What has become increasingly clear to me over that time is that there is a large

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Ice Cave Adventures

“Ice Caves Go Viral” by Kaitlyn As fleeting as they are iconic, the ice caves of Apostle Islands National Lakeshore are considered an endangered national park experience.  With spring around the corner, the ice caves will soon be a memory, with no guarantee of their accessibility in winters to come. But the young women of Northwest Passage Prairieview (previously known as Northwest Passage III) are among the lucky ones.  Braving the biting cold of a couple weeks ago, they trekked across the big lake to experience–and capture–these elusive cathedrals.  Enjoy their photos below.    

Diagnosis Versus Identity

This bit of reflection is dedicated to a beautiful soul who left this world much too early. I have been searching for a way to honor the footprints she left and this blog seems to be an appropriate stage. My experience walking…

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