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NEWS

This weeks focus: Victorian Bushfires and Trauma Support

Here at Ivanhoe Psychological Services we take this seriously and offer our support to all victims of the Victorian Bushfire victims and their families. 

Some of our therapists have, in the past, worked with Black Saturday victims and in the affected areas, as well as with  people affected by the traumatic incident/s.

Alternatively, we also offer our services to people who have families or friends affected and are in a state of grief or shock and require immediate trauma-intervention.

The Australian Government has released free therapy sessions  (without needing a mental health care plan) for those affected by the recent bushfires. At Ivanhoe Psychological Services we will be offering sessions face-to-face and/or via video-link or phone. 

Please see the Victorian  Government site for further information: 

https://www.health.gov.au/health-topics/emergency-health-management/bushfire-information-and-support/australian-government-mental-health-response-to-bushfire-trauma

Handout on surviving a traumatic event: 

APMHA

http://apmha.com.au/wp-content/uploads/Surviving-Traumatic-Grief-vol1.pdf

For Children: 

http://apmha.com.au/wp-content/uploads/Surviving-Traumatic-Grief-vol2.pdf

This weeks focus: Gender  Dysphoria in Children and Adolescence

 

Julia McCarthy has a keen interest in supporting young people and adults who are gender-diverse. At Ivanhoe Psychological Services we believe it is important that everyone receives support they are seeking in a safe place. The RCH and Kids Health Info have put together a great info guide explaining gender dysphoria. We have included it below for your information:

 

"Gender dysphoria

  • Gender dysphoria is the distress felt by people whose sense of being male or female differs from the gender they are assigned at birth based on their sex. For some people, the difference between their gender identity and physical characteristics can cause significant and persistent emotional distress.

    The terms ‘transgender’ or ‘gender diverse’ are often used to describe these identities. About 1.2 per cent of Australian school children (about 45,000 children) are thought to identify as transgender. Being transgender or gender diverse is seen as part of the natural spectrum of human diversity.

    Signs and symptoms of gender dysphoria

    Almost all children begin expressing their gender identity at two to three years of age through their preferences for particular clothing, toys and interests. Many transgender or gender diverse children will also express their gender identity around this time, and this may differ from what parents are expecting.

     

    It’s normal for children to experiment with gender roles. Many children will not desire any form of transition and will feel comfortable with their gender identity.

     

    For others, living in their birth-assigned gender role is extremely distressing. In these cases, it is important for families to discuss with their child or teenager what they need to do to protect their physical and mental wellbeing, and consider seeking professional assistance.

     

    For many transgender children and teenagers, the onset of puberty, with the development of secondary sex characteristics (e.g. breasts, changing voice) that don’t match their gender identity, is a particularly distressing time.

     

    Difficulties associated with gender dysphoria

     

    Being transgender or gender diverse is not a mental health problem. However, many young people with gender dysphoria also experience mental health concerns.

    • In younger children, this is often in the form of emotional and behavioural difficulties.

    • For teenagers, there are higher rates of depression, anxiety, self-harm and suicide attempts.

    A supportive family and school environment that affirms the child’s gender identity helps protect young people against these difficulties, and can improve mental health outcomes. 

     

    When to see a doctor

     

    Knowing when a child needs support can be difficult for parents and carers to determine. If your child or teenager has been showing ongoing distress about their gender, visiting your GP is a good first step to take in seeking professional help.

     

    In Victoria, The Royal Children’s Hospital (RCH) Gender Service will see children aged three to 17 years. You will need a referral from a GP. In other states, talk to your GP about what services are available.

    The RCH’s Gender Service team includes child and adolescent clinical psychologists or psychiatrists and paediatricians who specialise in gender identity. The team will work with your child to assess their gender diversity or gender dysphoria. Following the assessment, support and treatment pathways will be proposed and discussed with your family.

     

    Treatment for gender dysphoria

     

    Treatment for gender dysphoria depends on the individual needs of the young person and their family. Treatment aims to support individuals in affirming their gender identity, with a focus on physical and psychological wellbeing.

     

    Treatment before puberty

     

    For children who haven’t yet reached puberty, treatment focuses on gender affirmation through talking to the child and their family and providing support for home and schooling environments.

  • Treatment after puberty

    Once puberty has started, treatment options include the use of puberty blockers to stop the physical changes of puberty that the adolescent finds distressing.

     

    • Known as Stage 1 treatment, puberty blockers are used mostly in early puberty. Stage 1 treatment is reversible.

    • Stage 2 treatment involves using gender-affirming hormones (oestrogen or testosterone) to change the body to be more consistent with the teenager’s affirmed gender. Depending on the circumstances, this treatment can usually be started around the age of 16.

    • Stage 3 treatment involves surgery, which is not commonly undertaken before adulthood.

     

    Other support

    For all forms of treatment of gender dysphoria, your child should be monitored and treated for other medical and mental health difficulties that may occur. It is also important that families and schools are supported in maintaining a gender-affirming approach.

    Treatment focused on changing someone’s gender expression and identity to match the gender assigned at birth (known as conversion or reparative therapy) causes harm to the young person and is considered unethical.

    Key points to remember

    • Children whose gender identity differs from the gender they were assigned at birth are known as transgender or gender diverse.

    • Gender dysphoria is the distress a child experiences about the difference between their gender identity and their physical body.

    • Treatment for gender dysphoria can take many forms, and is always tailored to the individual and their family.

    • After puberty has started, treatment may involve puberty blockers.

    For more information

    Common questions our doctors are asked

    Are stage 1 and stage 2 medical treatments for gender dysphoria reversible?

    Puberty blocking medication (stage 1 treatment) slows the development of sex characteristics (e.g. breasts, underarm hair, voice changes), while allowing time for the child to develop cognitively and emotionally. This treatment is reversible. Gender-affirming hormone treatment (stage 2), which initiates puberty in the teenager’s affirmed gender, is only partially reversible.

     

    What is the difference between gender and sex?

    Sex indicates whether a person is male or female, according to their sex chromosomes (female XX, male XY). These determine a person’s physical appearance (e.g. breasts, penis), internal organs (e.g. ovaries, testes) and hormones. Sex is not able to be changed with medication or surgery. Gender is how an individual identifies in society –  their innate sense of being male or female." 

    Developed by The Royal Children's Hospital Gender Service. We acknowledge the input of RCH consumers and carers.

    Reviewed September 2018.

This weeks focus:  Watch, Wait and Wonder Intervention

Laura Petrie is a psychotherapist trained in delivering the 'Watch, Wait and Wonder'  (WWW) intervention. WWW is an empirically tested intervention that is used with infants and young children who may have relational, behavioural, regulatory and/or developmental difficulties and parents who may feel troubled in their relationship with their child. Following assessment, and with the family's support, dyads generally attend weekly for 8-24 sessions [the research averaged 15 sessions]. Most often mothers are involved with fathers attending regular family review sessions. These decisions typically reflect the primary nature of the infant’s relationships at this early stage of development.

According to watch, wait and wonder site it is "a child led psychotherapeutic approach that specifically and directly uses the infant’s spontaneous activity in a free play format to enhance maternal sensitivity and responsiveness, the child’s sense of self and self-efficacy, emotion regulation, and the child-parent attachment relationship. The approach provides space for the infant/child and parent to work through developmental and relational struggles through play. Also central to the process is engaging the parent to be reflective about the child’s inner world of feelings, thoughts and desires, through which the parent recognizes the separate self of the infant and gains an understanding of her own emotional responses to her child. Because of the central role of the infant/child in the intervention and the relationship focus, Watch, Wait and Wonder differs from other interventions which tend to focus primarily on the more verbal partner, the parent."

To find out more information about this intervention Laura Petrie can speak to you directly. 

Feel free to read more on the wait, watch and wonder website

This weeks focus: Acceptance and Commitment Therapy

Our therapists at Ivanhoe Psychological Services are trained in Acceptance and Commitment Therapy (ACT).  ACT is an evidence-based psychological therapy that is highly effective in treating, anxiety, depression, life transitions, pain, psychotic voices and interpersonal difficulties. It is therapy modality that is creative and value-based and able to be adapted for all age groups.

According to Russ Harris (ACT guru):

" Acceptance and Commitment Therapy (ACT) gets it name from one of its core messages: accept what is out of your personal control, and commit to action that improves and enriches your life.

The aim of ACT is to maximise human potential for a rich, full and meaningful life. ACT (which is pronounced as the word ‘act’, not as the initials) does this by:

a) teaching you psychological skills to deal with your painful thoughts and feelings effectively – in such a way that they have much less impact and influence over you (these are known as mindfulness skills).

b) helping you to clarify what is truly important and meaningful to you – i.e your values – then use that knowledge to guide, inspire and motivate you to change your life for the better."

Russ Harris has a great website www.actmindfully.com.au full of free worksheets, videos and references. 

You might also be interested in reading more about ACT on Psychology Today, Good Therapy Steven Hayes  and Louise Hayes.

 

 

 

This weeks focus: EMDR

 

Some people may never have heard of Eye Movement Desensitization and Reprocessing (EMDR) until now. It is a highly effective trauma treatment that you are able to access at Ivanhoe Psychological Services.

 

According to the EMDR  Institute Inc. "EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.  Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal.  EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma.  When you cut your hand, your body works to close the wound.  If a foreign object or repeated injury irritates the wound, it festers and causes pain.  Once the block is removed, healing resumes.  EMDR therapy demonstrates that a similar sequence of events occurs with mental processes.  The brain’s information processing system naturally moves toward mental health.  If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering.  Once the block is removed, healing resumes.  Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.

More than 30 positive controlled outcome studies have been done on EMDR therapy.  Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions.  Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy.  Millions of people have been treated successfully over the past 25 years.

EMDR therapy is an eight-phase treatment.  Eye movements (or other bilateral stimulation) are used during one part of the session.  After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision.  As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level.  For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.”  Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes.  The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them.  Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies."

 You can read more about EMDR on EMDR Association of Australia, EMDR Institute and Psychology Today. You can also watch this brief clip  https://www.bing.com/videos/search?q=emdr+you+tube&view=detail&mid=2F1A68CD37584D76602F2F1A68CD37584D76602F&FORM=VIRE

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