ADHD and Childhood Bipolar Disorder

    Children misdiagnosed with bipolar disorder typically have serious difficulties that resemble some of the symptoms of mania. Such symptoms include distractibility, irritability, and talkativeness. These difficulties are well described in DSM-IV as the less serious and far more treatable diagnosis of ADHD. Most of the symptoms of mania can easily be matched to those of ADHD.  They are characteristically present most of the time and do not meet the criterion of being different form the patient’s usual self. Anywhere from 60% to 90% of children diagnosed with bipolar disorder are also diagnosed with ADHD, which is characterized by concentration difficulty and physical hyperactivity as well as difficulty controlling impulses. The ADHD diagnosis easily includes many of the behaviors described in the misdiagnosis of childhood bipolar disorder. It is common for children with ADHD to admit to racing thoughts, which is likewise the case for the bipolar disorder. The "increase of goal directed activity" of the child with bipolar disorder is similar to the ADHD symptom "often acting as if driven by a motor". The mania symptom "decreased need for sleep" is reported by parents of children with ADHD who explain that their child was always a poor sleeper and wanders the house at night. Although the ADHD diagnosis does account for several of the mania symptoms, it does not account for the angry behaviors, which are typical for children diagnosed with bipolar disorder. Anger, irritability, and aggression are not DSM symptoms of ADHD (Kaplan, 2011).


ADHD and Conduct Disorders (ODD/CD)

    Many studies have concluded that the most common comorbid disorders diagnosed with ADHD in children and adolescents are conduct disorder (CD) and oppositional defiant disorder (ODD). A conduct disorder diagnosis requires a repetitive pattern of behaviors involving violation of the rights of others through aggressive actions directed at people and/or animals (physical cruelty and fighting, destruction of property, vandalism, stealing, setting fires, or runaway behaviors). According to multiple studies the presence of ADHD is a significant predictor of conduct disorder in boys ages 8 to 17. In an inpatient group of ADHD children, those with a comorbid diagnosis of conduct disorder demonstrated greater degrees of psychopathology than other groups of ADHD children. Children with the joint diagnosis of ADHD and conduct disorder perform significantly worse in academic achievement than a similar group of conduct disordered children.
The ODD is less severe than CD and involves problematic attitudes rather than destructive behaviors. These children and adolescents display non-compliance, hostility, and stubbornness towards parents, teachers, and other authority figures. Barkley (1998) reported that 54% to 67% of children with ADHD meet the criteria for ODD. A comparative clinical study of oppositional only, ADHD only, comorbid, and a control group of boys, reported that the comorbid group was more impaired than the control group. Barkley and Anastopoloulos (1992), in a comparative study of ADHD adolescents with and without the oppositional defiant characteristics, reported that the first group displayed "greater than normal" conflicts, more anger, poorer communication, and negative interactional styles (Everrett & Evert, 1999).

Everrett, C., & Evert, S., (1999). Family therapy for ADHD. New York, NY: The Guildford Press, p. 26
Kaplan, S. (2011). Your child does not have bipolar disorder: how bad science and good public relations created the diagnosis. Santa Barbara, CA: Greenwood Publishing Group, p. 17-20.

Biser Rangelov, MA MFC, LPC
Biss-Ann Counseling Services
3001 W. 5th St. Suite 400
Fort Worth, TX 76107
E-mail:[email protected]
Phone: 817.372.1107

_    Why does a stimulant medication "SLOW" down the hyperactivity level of these children (adults) with ADHD and help them "FOCUS" their attention when it makes other children more active? Why does stimulant medication have this paradoxical effect on these children diagnosed with ADHD?

    Here's the core of the metaphor: The stimulant medication essentially speeds up the "lazy" frontal lobes of these ADHD children, providing them with the ability to filter out the extraneous stimuli in a way they could not do without the medication (unless there was an authority figure or structuring device helping them focus). They can now focus on their school work, rather than fidgeting because they feel pressure on their behinds, hear the sneezing, see the notes being passed, are thinking of dinosaurs and how big their teeth are and "ain't they neat they could eat you up so fast" . . . The filter is in place once the proper dose of stimulant medication is achieved.

    This medication has a therapeutic window. Too little, and the effect is poor. Too much, and the child can act dopey. Just right, and they can function much the way normal children do. Give it to children without ADHD and you may see them bouncing off the walls because most of the ADHD meds are stimulants---the opposite of what you’d expect for an already over-stimulated child, which is why the paradoxical effect of calming an over-active child with a stimulant medication is pretty good evidence that something wasn’t working right when the meds were first prescribed.

    It is important for those of us working with these children to report the impact of medication changes to family and physicians working with the children. Just because a child does not respond to a medication or responds too much doesn't mean it's the wrong medication (though it may be). I may just mean that it's not at the right dosage, or that the child may respond better to one of the other options available . . . everyone’s metabolism is different, and essentially, every trial of medications with an individual is an individual experiment. Many respond as the “average” child-patient did to the med-trials; some don’t. Some have very bad responses. The same is true for adults with ADD-ADHD.

    And, yes, as some of you will want to say: these children can often focus without medication when doing something they are highly interested in, just as we all do when something truly catches our attention. Again, the activity, if interesting enough or novel enough will provide a "structure" that normal day-to-day activities don't. It is the "extra energy" coming into the system that I mentioned earlier in this digression.

    One more thought about the ADHD issue comes to mind, this has to do with their behavioral issues more than their ability to focus attention.
    ADHD children have a form of executive dysfunction, which means that the frontal lobes of individuals diagnosed with ADHD are not as effective at monitoring behaviors and controlling impulses as are children (or adults) who don't earn this diagnosis.

    What this means is that many ADHD children who are not on the right dose of the right medication will often blurt out things when we want them to be quite or to conform their behaviors to classroom rules. They don't inhibit the kinds of comments most others do. If the thought comes into their head, it may just jump out of their mouth. While most of us think these things, we can keep the inappropriate comments to ourselves. ADHD children/adults have a very difficult time with this inhibition. They are, the word is, disinhibited compared to the norm.

    Again, the more activity around, the more stimulation they experience, the more difficult it is for them to conform their behaviors to norms that work for others.

    What this does to them as they hit school age is that they often become social outcasts because of their seemingly unsocialized behaviors. This leads them to not liking themselves because others don't like them. They form negative self concepts, and often then begin to act oppositionally, or in ways that reject the opinions of others. It is a vicious cycle of acting out, rejection, acting out, increased rejection, acting out, loss of friendships (except those which are often of the same ilk), and eventually, for many, leads to inappropriate social groups and behaviors that spiral out of control.

    Many ADHD children who are denied effective diagnosis and medical management develop significant behavioral problems in adolescent and adult years including increased substance abuse, impulse control and illegal behavior patterns.

    The research clearly indicates that taking medications earlier in life forestalls this pattern of downward spiraling misbehaviors. Long term outcomes of individuals with this diagnosis who have access to the medication are more positive than outcomes for individuals with the diagnosis who don’t receive this medical intervention. It is important to realize, though, intensive therapeutic interventions can also prove beneficial to both groups . . . though it is generally much more expensive and time-consuming to administer.

    Not understanding this effect and the downward spiral and treating it instead as "willful" behavior is an error that many educators, parents, and authority figures have committed. This lack of understanding is often an integral part of this downward behavioral spiral, and is frequently a potent magnifier of the already harmful impact of the disorder.

    I hope the "metaphor" and "analogy" offered above help you better understand ADD-ADHD.

Biser Rangelov, MA MFC, LPC
Biss-Ann Counseling Services
3001 W. 5th St. Suite 400
Fort Worth, TX 76107
E-mail:[email protected]
Phone: 817.372.1107

_    ADHD is a common mental health disorder for many boys and girls today. For the past six years I provided treatment and skills training for a number of children, adolescent and their parents both in my office and in their natural environment (home, school, and playground). I have heard different misconceptions and false beliefs from parents and teachers due to lack of knowledge and understanding about ADHD, which at times leads to refusal or non-compliance with the treatment. For example, children with ADHD can do math, read, write or control their behavior when a teacher or a parent provides individual attention and a question has been frequently raised as to whether there is “really” a disorder.

    It is very important for the counselor during psycho-education to explain ADHD in understandable layperson language. A while ago, I learned from Dr. Zwingelberg the following metaphor and analogy that I found very useful in helping parents, teachers and school staff members to understand this disorder.

The fact that a child with ADHD can behave and perform more effectively when a teacher stands over them than when they are left to their own direction is NOT a reason to believe that no disorder exists---though this is the argument you will hear from many parents and teachers who disagree with your diagnosis.

    Think of driving an automobile on a freeway when you are very tired. You can fight sleep, but you keep nodding off. This is what it is like having ADD-ADHD. You can fight it, but it takes a lot of effort. Now back to the car. It is two in the morning; you nod off, but awaken yourself, still fighting sleep. You awaken your friend who is sleeping in the passenger seat and say, "I'm falling asleep all the time, talk to me, make noise, help me focus." Your friend does just that. And what happens?

    You find it easier to stay awake and to continue driving without the insistent need to fall asleep. Why? Because you have had an external focus of attention delivered to you. It is as if you have been given extra energy to accomplish your driving task, which in fact you have been given. You now have the energy of another person helping you accomplish the task at hand. You have, essentially, an external conscience, as well.

    This is essentially what happens with ADD-ADHD children given attention by adults or others to help them stay on task and perform, to help their behaviors conform.

    Essentially, and here's the metaphor, ADHD children's frontal lobes are working too slow to filter out extraneous stimuli. As you read this you are likely sitting down. Until you read this next sentence you are unaware of the facts I'll mention in a moment, but the instant I mention them you will note what I say. Your frontal lobes are filtering out extra stimuli at this moment. An ADHD child's (or adult's) frontal lobes are not as effective as yours at doing this.

    Here's what you are filtering . . . as you sit there, reading, you have pressure on your behind. You can feel it now, but until I mentioned it your mind was filtering out the sensation. Now it senses the "feeling" of sitting. You likely also can hear some sounds around you, or smell something, or feel a draft of air, a fan, or even taste something or feel hungry or thirsty or . . . any number of sensual things are occurring that you have weeded out until asked to become aware of them.

    The frontal lobe filters of individuals with ADHD don't filter as effectively. More impulses are coming into their brain and they have to react to them. In a one-on-one situation, such as when a child is tested by a lone psychologist in a quiet office, such stimuli are minimized. When they have an authority figure standing over them, they have extra energy to manage their behaviors . . . much as an individual with kleptomania will not likely steal something when a police officer is standing next to them. This is that external conscience, again.

    In a classroom, or around activity, color, noise, movement, etc., the individual with ADD- ADHD is bombarded with sensory input you and I easily filter out. They struggle with this "filtering" because, essentially, their frontal lobes are working "slower" (part of the metaphor I'm setting up here). This is why it is most difficult for these children to behave in crowded classrooms or where there is a great deal of activity. In class, they hear the pencil sharpener, and must look to see who's there; they hear the sneeze at the back of the room, see the kids passing notes, hear the whispers of kids playing around, are distracted by their own flow of consciousness thoughts . . . and are continually distracted---unlike those with good frontal lobe filters who can weed these things out of their environment and consciousness.

To part II

Biser Rangelov, MA MFC, LPC
Biss-Ann Counseling Services
3001 W. 5th St. Suite 400
Fort Worth, TX 76107
E-mail:[email protected]
Phone: 817.372.1107

_
Healthy Body:

    As counselors, we help our clients work through emotional, mental, spiritual, and relational issues. Often times, we forget to integrate physical well-being.  We need to inquire about the client’s diet, sleep, and exercise.  Also, make sure the client has had a physical within the last year. We remind the client that we are not MDs or dieticians, and the purpose for inquiring about one’s physical habits is so we can better help the individual work towards goals and improve overall lifestyle.


Diet:

    With all the fads and trends, how does a counselor know what is the best approach to helping a client make wise decisions regarding diet? You want to look for diets that enhance the brain. Dr. Daniel Amen, Dr. Mark Hyman, and Dr. Nicholas Perricone work from the philosophy that what you eat either enhances your brain or hinders it. They are more concerned about one’s overall health and brain function than they are with tricks and gimmicks. Dr. Amen provides a list of the top 50 brain foods along with practical suggestions to help a person begin introducing healthy foods into their lifestyle. Remember, when you are working with clients, the focus is on a healthy lifestyle rather than focusing on a particular diet. Inquire about when the client had his or her last meal and what he or she ate. Sometimes clients might say they feel sluggish or grumpy to discover that they haven’t eaten all day.  Or, clients may feel jittery and you discover that they drank 62 oz of Mountain Dew. You want to help the client be aware of how he or she is treating one’s body and mind. Again, you want to remind the client to consult with a physician prior to changing diet plans.


Exercise:

    Exercise is beneficial and a necessity for everyone. Exercise boosts blood flow and keeps the brain healthy. We have more energy and a positive outlook on our situations when we engage in regular exercise. We feel better about ourselves, which helps us with our work, relationships, and spirituality. Discuss your client’s exercise regimen. Find out the type and frequency of their exercise routine, and make sure they are keeping hydrated.  Remind the client to consult with a physician prior to beginning a new exercise program.


Sleep:

    Sleep rejuvenates the brain, which means we need to practice good sleep habits. Adults need at least 8 hours of sleep. Inquire about your client’s sleep environment: is it free from clutter and distractions; comfortable room temperature, is the room dark, and is the TV off. You also want to inquire about sleep habits. For example, does the client wash one’s face before going to bed; meditate/pray; stretch muscles for about ten minutes to relax the body. You want to make sure the client avoids caffeine, alcohol, vigorous exercise, and eating heavy meals before bedtime.  Dinner should be eaten at least three hours before bedtime. Also inquire if the client has a regular sleep schedule. Sleep is critical to overall well-being, and we need to educate our clients on the value of sleep.


Breathing:

    Breathing is so basic, and yet often overlooked in counseling sessions. Breathing is involved in everything we do. When we are tense, stressed, and anxious, our breathing becomes shallow, and we breathe from our chest. We need to teach our clients diaphragmatic or belly breathing. Have your client sit comfortably and have him place one hand on his abdomen and one hand on his chest. Inhale through the nose and exhale through the mouth. Tell the client to breathe deeply into the abdomen and feel it expand to the count of five and pause to the count of one. Client will exhale slowly to the count of five. Repeat at least five times. Watch to make sure the client’s chest has minimal movement and that his muscles are relaxed. The breathing should be smoothed and relaxed throughout the exercise. You will also instruct the client to think of positive thoughts or emotions while doing this exercise. 
As counselors we need to demonstrate to our clients the value of having a healthy mind and body. If we want God to use us as His instruments then we need to take good care of ourselves so we can better serve His Kingdom.

Malinda Fasol, PhD, LPC, NCC
Focus for Living
Website: www.focusforliving.net

_Recommended Resources:
    Amen: Change Your Brain Change Your Life
    Amen: Healing Anxiety and Depression
    Amen: Change your Brain Change your Life Cookbook
    Hyman: The UltraMind Solution
    Perricone: The Perricone Promise and The Perricone Prescription
    www.amenclinics.com
    www.drhyman.com
    www.heartmathstore.com

_ Healthy Mind:

    Our thoughts are powerful, and can impact our mood and behavior. According to Dr. Daniel Amen, when we have positive thoughts (ie; kind, joyful, hopeful), our bodies release chemicals that help calm our deep limbic system and calm our bodies.  We tend to think clearer, have a positive outlook, and are able to view other options, solutions, or possibilities. Our thoughts and emotions are proactive rather than reactive. Scripture is clear about what we are to think on: “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things” (Philippians 4:8 NIV). Additionally, the body tends to reflect a healthy mind. We relax our muscles, smile more often, and breathe slower. We are more aware of nutrition and exercise. We tend to respect the temple in which God has given us.

    In counseling, the clients typically demonstrate faulty or distorted thinking. Their minds are clouded with countless thoughts assumed to be true. Their emotions, behaviors, and physical well-being reflect negative thinking. Every time we have negative thoughts, the brain releases chemicals to the deep limbic system that cause the body to feel bad (Amen,2003). They feel depressed or anxious, engage in unhealthy behaviors, and display muscle tension. Through cognitive therapy and other techniques, counselors help clients examine distorted thinking, core beliefs, and identify common themes or messages. Clients learn to replace faulty or negative thinking with positive thoughts. As counselors, we need to also address the clients’ physical well-being by educating them on proper nutrition, exercise, sleep, and proper breathing.


Healthy Mind and Body - part II

Malinda Fasol, PhD, LPC, NCC
Focus for Living
Website: www.focusforliving.net

_
Models of the Mind

    In order to comprehend how hypnosis works, it is important to understand the 3 different levels of the mind. They consist of unconscious, subconscious, and conscious. The key aspect of these models is that all of its components are best understood as functions rather than physical parts.


Unconscious Mind

    Even though it is called unconscious mind, it is a very active level of consciousness. The unconscious mind works automatically to take care of functions that are associated with Autonomic Nervous System (ANS). Some of the bodily functions that are associated with the unconscious mind are breathing, physical/emotional responses, heart rate, and protective functions such as reflexes and immune system.


Subconscious Mind

    The subconscious mind is who you really are. All the developments from our experiences that make up our personality store permanent memory into the subconscious mind and it is limitless as to how much they store. During hypnosis, all of your experiences that are held in the subconscious can be revealed. The more important or more emotionally packed a particular event is in your past, the more easily it can be found and revivified. However, there may be some challenges on the revivification if the event is blocked by a protective function which can make the retrieval more difficult. Some of the functions of the subconscious mind that makes up your personality include habits, beliefs, imagination, and protective functions (resisting incoming information that is inconsistent with previously accepted information).


Conscious Mind

    The conscious mind focuses on the current state of mind; however, the conscious mind can easily be refocused on the past and create imagination of the future or into a complete fantasy. Unlike the subconscious mind, the conscious mind is limited to how much it can hold. The functions of the conscious mind consist of protective thought process, logics, and interact with the critical factor which resides between the conscious and subconscious.

    It is important to understand that hypnosis does not cause someone to lose consciousnesses. Hypnosis is not a state of unconsciousness, but rather a stated of focused consciousness.

_
Gina Ahn, PsyD, CH

Email: [email protected]
Phone: 469.733.6092

_What is hypnosis?

    Hypnosis means a heightened state of suggestibility. An individual who is hypnotized may look as if he is sleeping but the person is fully awake and understands what is going on during the process. Hypnosis is common and I am sure that everyone has already experienced it without even being aware that they were hypnotized. For instance, one type of hypnosis is called highway hypnosis. Highway hypnosis is when you experience time distortion or momentarily wonder which causes you to miss your exit. Another example of hypnosis is when a person focuses on a task so much that he induces self-hypnosis. At this point he becomes unaware of the surroundings and is only focused on this particular task. Although people do not realize it, hypnosis is common and you would not even realize you have been hypnotized until you understand what hypnosis is all about. If fact, anyone of normal intelligence who is willing to follow instructions can be hypnotized.


The benefit of hypnotherapy  

    Hypnotherapy is a unique type of therapy that I like to consider “express” therapy.  Unlike any other therapy method, hypnotherapy can overcome client’s issues in as short as 5 to 7 sessions.  It is a life-changing therapy that helps clients overcome bad habits, increase motivation, become disciplined, confident, develop happiness, and many more.  In addition, hypnotherapy not only targets the mind but also manages or eliminates physical components of chronic pain, stress and anxiety as well as child birthing.


Recommendation

    I would recommend hypnosis to those who have not experienced it. I personally found the experience to be eye-opening and realized that after my sessions I have changed into a person who is more confident and motivated. I believe that hypnosis works and it can make a huge difference in your life as well.


Hypnotherapy - part II

Gina Ahn, PsyD, CH

Email: [email protected]
Phone: 469.733.6092

_    After retiring from the Marine Corps after 20+ years of active duty service, I began a second career in mental health counseling. After working several years in inpatient psychiatric and substance abuse/dependence treatment facilities, I began to wonder if the current bias toward medications interventions was the most effective way to treat those suffering with mental illnesses and substance use disorders. During my masters and doctoral studies, I was introduced to brainwave biofeedback, initially for treating symptoms related to ADHD in children, and later, in remediating the symptoms of mood disorders and PTSD in adults. After a few years of investigating psychophysiology while working toward my PhD in psychology, I concluded that adding neurotherapy to talk therapy was a better approach than medications alone, or in combination with talk therapy.

    Psychophysiology is not a new field. Hans Selye, an endocrinologist, described a theory of stress that he called the general adaptation syndrome in 1936. Stress is an interactive process involving psychological appraisal and physiological response.  The psychophysiology of stress and anxiety is well understood, and a number of behavioral interventions, to include gradual relaxation, guided imagery, heart rate variability, and diaphragmatic breathing, are routinely used in psychotherapy to manage stress.  The German psychiatrist Hans Berger experimented with EEG recordings in the late 1920’s, and noted the prominent sinusoidal rhythm of the brain, which he called the alpha rhythm, was prominent in the posterior regions of the brain when the eyes were closed. In the 1950’s, psychologist Joe Kamiya began training people to produce alpha rhythms using the EEG. In the late 1960’s M. Barry Sterman, a psychologist at UCLA Medical School, used operant conditioning to train cats to produce 12-19 Hz beta in the sensory motor cortex, making them resistant to seizures when exposed to hydrazine. Sterman called this EEG pattern along the sensory motor strip, sensory motor rhythm (SMR). Hydrazine, an ingredient in rocket fuel, had been causing seizures in air force personnel during refueling operations. Sterman applied the SMR training to human subjects with epilepsy and found that SMR training reduced the frequency, duration, and severity of their seizures, often controlling the seizures permanently. In the late 1970s, Joel Lubar at the University of Tennessee, used operant conditioning to train the theta : beta ratio in children with ADHD. Joel and his wife Judith have used theta : beta ratio training to  successfully assess and train children struggling with ADHD for over 30 years.

    Neurotherapy (EEG biofeedback, or neurofeedback) uses electronic monitoring equipment to provide moment-to-moment information to an individual on the state of their neurophysiological functioning. During therapy, sensors are placed on the scalp and then connected to sensitive, computerized electronic equipment that detect, amplify, and record specific brain activity. This information is fed back to the client through visual, auditory, and tactile (the sense of touch) means. Software is used by the clinician to adjust how and when feedback is provided to the client with the understanding that changes in the feedback signal(s) indicate whether or not the client’s brain activity is within the range(s) designated by the clinician. Based on this feedback, the brain’s ability to learn guided by the clinician’s input, changes in patterns of brain functioning occur and are associated with positive changes in physical, emotional, and cognitive functioning. Often the client is unaware of the mechanisms that underlie the changes as they are occurring, although many report acquiring a ‘felt sense’ of the positive changes after the session.

    Neurotherapy is distinguished from other forms of biofeedback by its focus on the brain and central nervous system. Neurotherapy takes into account behavioral, cognitive, and subjective aspects of individual function as well as brain activity. Neurotherapy challenges the brain to function better. This powerful brain-based technique is not new; it has been successfully helping clients around the world for over 30 years. It is a non-invasive procedure with dramatic results for a multitude of symptoms. Neurotherapy does not involve surgery or medication, nor is it painful or injurious to the client. Neurotherapy sensors and equipment are passive - they only detect, amplify, and display the electrical activity of the brain. Clients generally do not experience negative side-effects. 

    Neurotherapy is preceded by an objective assessment of brain activity and psychological status. A variety of assessment techniques are employed by our clinical staff in the assessment to include interviews, assessment instruments (some are computerized, others are paper and pencil, and some may be completed on the Internet), and Quantitative Electroencephalogram (qEEG). The qEEG, MICROCog computerized test of neuropsychological functioning, computerized continuous performance tests, and the clinical interview are the most commonly used assessment tools employed by the clinicians at Focus for Living.

    After the assessment, the clinician will go over the results with the client and recommend a treatment plan to address the problem(s) identified in the assessment and the symptoms identified by the client. Think of Neurotherapy sessions as personal training for the brain. Training the brain to function at its potential is similar to the way the rest of the body is exercised, toned, and maintained. Brain training exercises the neural pathways that allow the brain to function optimally in a variety of areas.

    During a standard session we will observe brain activity charting the several brain wave frequencies and measures of brain function. Depending on the specific area of the brain being exercised, we will train brain activity by inhibiting some activity while rewarding other activity, or by encouraging the brain to move toward normal performance across a number of performance measures, thereby creating shifts toward a more appropriate and stable brain state. The process occurs gradually over the course of 20-40 sessions of 30-50 minutes each. With newer approaches, such as LORETA neurofeedback, the course of training can be reduced to as few as 10-20 sessions. 

    Neurotherapy is used to treat a variety of symptoms associated with a broad range of neuropsychological problems. Neurotherapy has been found to be effective in retraining the brain and remediating, and often resolving, the symptoms of the following conditions:
   
    Attention Deficit/Hyperactivity Disorder
    Autism Spectrum Disorders
    Post-traumatic Stress DisorderSubstance Abuse Disorders
    Depression
    Bipolar Disorder
    Anxiety
    Obsessive Compulsive Disorder
    Compulsive Behaviors including Compulsive Sexual Behaviors
    Migraines and headaches
    Bruxism (grinding of the teeth)
    Learning Disabilities
    Chronic Pain
    Mild Traumatic Brain Injury

_
Wesley D. Center, PhD, LPC (Board Approved Supervisor), NCC, BCPCC
Focus for Living
Website: www.focusforliving.net
Email: [email protected]
Phone: 817.295.8708
Seminar: AACC 2011 Therapy with the Brain in Mind PowerPoint