Mendel Psychological Associates' blog » Therapy

Supportive therapy groups for teenagers with diabetes

Dr. Mendel — Tue, 17 Nov 2009 01:03:37 +0000

For over 20 years, I have been leading various groups: groups for kids whose parents have divorced, social support groups for kids with Aspergers Disorder, groups for kids who have lost a parent, groups for kids with ADHD and conduct disorders. One of the few things I have been doing even longer than leading groups is managing my blood glucose levels. I was diagnosed at age 22, with Type 1 Diabetes. Since that time, I have tested my blood sugar levels many times each day and given myself insulin shots or, more recently, used an insulin pump. Now, I have decided to put together these two parts of my life — group leader and diabetic – and start a therapeutic support group for teenagers with diabetes.
The feedback I have received from my diabetic clients, and from their parents, is that the fact that I have diabetes gives me an insight into their struggles that I would not and could not otherwise have. These children and teenagers often feel that I can understand what they are going through in a way that a non-diabetic simply cannot. I know firsthand the exhaustion and misery that come from high blood sugars, the confusion and inability to express a simple thought that come from extreme low blood sugars. I know all too well how desperately we diabetics wish we could – just for a day, just for a few hours! – stop being diabetic; how wonderful it would feel to be able to take a break from being aware of every bite we eat and its impact on us. At the same time, I know that many diabetics, particularly teenagers, are often all too adept at “pretending” they’re not diabetic. With an adolescent’s belief in his own invulnerability, a teenage diabetic may ignore the warnings he gets from his parents, his doctors and educators, and from his own body, and fail to manage his blood sugar levels adequately. And I know how painful, terrifying, and infuriating that can be for his parents.
For the past few years, I have been helping young diabetics learn to manage this disease and to cope with its psychological impact as well as assisting their families in dealing with this new reality in their lives. But I have been doing so one client at a time. I am so excited to announce that early in 2010, I will be initiating a weekly group for teenage diabetics. The group will be open-ended and non-time limited; that is, clients may join at any point and remain in the group as long as they benefit from it. The start date, day of the week, and time of day will be announced in the near future. I look forward to hearing from anyone interested in this group.

To Witness a Child Blossom

Kristin Vitko — Sun, 31 May 2009 22:41:00 +0000

I am grateful to be an Expressive Arts Therapist because to be a therapist is to be an artist.

As an artist working within relationships of growth and healing I know I am on the right path when I share remarkable moments with children, teenagers, and families. There are endless ways these moments coalesce to form deep connection, joy, understanding, and determination; in essence all the vital stuff of humanity.

The therapeutic theories and techniques that guide me have come through the careful observations and research of my colleagues and those who have come before me. Carrying out these understandings of human development, relationships, and healing through intentional creative processes is nothing less than the unfolding of meaningful experience.

Sometimes I think it is hard for parents to understand the far reaching effects of play therapy and the expressive arts. This confusion can lead to questions such as:

Is this really going to keep Johnny from hitting his sister?
Is Becky really going to get better grades by doing this?
I play with my child too, how is this going to help?

I welcome such inquiries because they come from parents who care, who want the best for their children. My response is a resounding YES, this will help.

As I engage children, adolescents and families we all have goals in mind, target behaviors to change, grades to raise, but we humans are not simple mathematical equations to solve. If we do A plus B then C will happen. Hey I admit, sometimes C does happen (thankfully) but usually not consistently over time. This is why creative collaboration and individual differences are so essential to therapy. Through creative therapies something deeper is happening. Long lasting fundamental moments of transformation are occurring. Over varying degrees of time these core changes begin to affect those most disruptive behaviors that have called out to us saying, “I need something more.” Johnny does stop hitting and Becky gets an A.

Many parents I see are already engaging with their children in creative ways each day. So I say, come in and let’s have the whole family play together. Let’s get more intentional about
play time and also weave creative methods that help into your every day routine. For developmental disorders, attachment issues, mood issues, and learning disorders the bottom line is the same, finding one’s unique path to human connection. There is no script for authentic human connection, although some explicit teaching is very helpful, when it comes down to cultivating fullness of life collaborating creatively is what leads to quality living.

I am so thankful for all the moments I have shared with my Clients. One mother heard me and her son through the wall in the waiting room and said later, “I have not heard him laugh like that for so long!”

I recently asked a seven year old girl. “What can we work on together to make the things that are hard for you easier?” She replied wistfully, “Oh, there are so many things.” I am now the keeper of a folded up drawing she titled my problem. We will pull this problem out of my drawer next session and play it out, play beyond it, play from the deeper perceptions from which this problem emerged. Expressive arts therapy calls forth the expression of these deeper perceptions because they are the stuff of art. Expressive Arts Therapy is an immensely human process and a beautiful one at that.

Join Me for Expressive Arts Therapy

Kristin Vitko — Thu, 19 Feb 2009 00:51:14 +0000

Each expressive arts therapy session is as unique as the child, adult, or family I am working with. Imagine a space in which you are safe and inspired to explore your self through your own creative process. This is my office and I am here to support you. You determine the creative process that unfolds as I offer ideas and guidance for you to choose from. For many children this exploratory experience is very natural as they move easily from one creative activity to another and I support them in working toward developmental goals socially, cognitively, and emotionally, based on their growth areas and strengths.

When working with parents and families it is enriching to have visual art materials and drama therapy techniques, among other methods, available because it helps families relate in new ways. Engaging in creative activities simultaneously reveals difficult family patterns and allows families to find creative solutions as they relate in more authentic and spontaneous ways.

Come in and tell a story with puppets, make a collage, pretend to be someone else in your family, paint the sensation in your belly. Talk about a dream or how your day went. How about making a sandtray scene? If you don’t know what sandplay therapy is get started by going to: www.sandplay.org

I once worked with a wonderful ten-year-old girl whose father had suddenly died. The poem she wrote was entitled, I want a dad that will last forever. This is the power of art, to express one’s truth and be transformed.

Social Skills Groups: The Cure for Social Avoidance

Dr. Mendel — Tue, 17 Feb 2009 04:00:00 +0000

Craig had pretty much never had a friend. Every social interaction was torture for him. He had been a target of teasing, ridicule, and bullying from the time he was a very young child. He had been hurt so many times by social rejection that it had become the norm for him. He even began to welcome it, stating that he preferred not to have any of his peers in his life: it was better to be alone than to be continually hurt. It was clear to me, and to his parents, that a social skills group would be perfect for him.

But Craig felt differently. He adamantly refused to join the group. His response, in my experience, is fairly common. And it’s really not surprising. For kids like Craig, social interactions have always been sources of pain and torment. They assume that every group experience will be negative. Why in the world would they want to join a social group?

Yet, social skills groups are ideal for kids like Craig. They see very quickly that these groups are totally different than any social situation they’ve ever experienced: this is a place in which there is absolutely no teasing, insults, or humiliation. They also see that the group is filled with kids who have struggled with the very same things they have. These kids – often for the first time in their lives – feel a sense of belonging and acceptance. They start to develop friendships with the other members of the group. As these friendships grow, so too does the child’s self-confidence. Over time, his newfound social skills become increasingly strong and stable. Eventually, he starts to apply them in the social world outside of the social skills group. His social abilities improve and he starts to make friends. Finally, social interactions need not mean pain and misery, but can instead bring closeness, joy, and affection.

What is Expressive Arts Therapy?

Kristin Vitko — Tue, 27 Jan 2009 04:34:06 +0000

Maybe you have heard of art therapy, dance therapy, or drama therapy? These are considered single modality creative arts therapy approaches and each modality has it’s own professional credentialing process. This means that if you work with an art therapist he/she will use primarily visual art techniques therapeutically, and a dance therapist will use primarily dance and movement techniques to help clients. There are five main creative arts therapies specializing in: visual art, drama, dance, music, and poetry.

An expressive arts therapist is trained in all five creative arts therapies and also learns how to combine them. For example, a client may create a drawing of an issue and then choose a part of that drawing to explore through physical movement, discovering inner resources to apply to the original issue.

The creative arts therapy field, including expressive arts therapy, has been evolving since the 1970’s in the United States and creative arts organizations and practitioners can be found world-wide. Former Senator of New York and now Secretary of State Hillary Rodham Clinton continues to advocate for the creative therapies. Below, I have posted then Senator Hillary Rodham Clinton’s letter to the president to initiate the first Creative Arts Therapies Week in 2003. This year Creative Arts Therapies Week is March 18 – 15th, 2009.

For more information regarding creative therapies, visit Arts in Therapy Network website’s What is section, www.artsintherapy.com. Also visit, National Coalition of Creative Arts Therapies Associations website’s Fact Sheet at www.nccata.org

For more information regarding Hillary Rodham Clinton’s support of the creative art therapies go to www.art-therapy.us/Hillary_Clinton.htm

June 3rd, 2003
Senator Hillary Rodham Clinton’s
Statement for the Congressional Record
in Recognition of
National Creative Arts Therapies Week
June 1-7th, 2003

Mr. President, the process of using the arts therapeutically to assist victims of illness, trauma, disability and other personal challenges, has historically been under recognized as a valuable treatment, yet the benefits of this treatment are far reaching. The Creative Arts Therapies, comprised of the fields of Art Therapy, Dance/Movement Therapy, Drama Therapy, Music Therapy, Poetry Therapy and Psychodrama, are disciplines that foster creative expression to promote health, communication, self-awareness, emotional, social and cognitive functioning. I rise today, to proclaim National Creative Arts Therapies Week, June 1st-7th, 2003 as a time to recognize this unique service.

Creative Arts Therapies have been practiced in the United States for over 50 years with people of all ages and problems. Such therapists work in medical hospitals, rehabilitation centers, mental health facilities, day treatment centers, nursing homes, schools, homeless shelters, correctional settings, and in private practice. Creative arts therapists have helped people who have undergone trauma, loss, acute physical and chronic illness, emotional disturbance, or struggle with depression, retardation, developmental disabilities and addictions. Their contributions during the aftermath of 9-11, assisting victims and the bereaved through trauma treatment and the alleviation of post-traumatic stress were invaluable.

I want to recognize and thank Creative Arts Therapists in America who are assisting the most vulnerable in our society with valuable therapeutic intervention. There are over 15,000 licensed clinicians who meet high quality standards of graduate education and practice. Various States, including New York have additional licensure requirements, which protect patients from fraudulent practitioners and maintain the quality of care to the highest standard. These credentialed clinicians constitute a vital force of mental health professionals in our country. However, many Americans are unable to access such services because awareness about their effectiveness and employment of such therapists is not sufficiently widespread.

The National Coalition of Creative Arts Therapies Associations is collectively celebrating the history and status of their profession. They will be showcasing workshops, presentations and exhibits throughout the United States to inform the public, healthcare practitioners, insurers and legislators about the therapeutic value and significance of this discipline.

I therefore proclaim National Creative Arts Therapies Week, June 1st – 7th, 2003 as a time to recognize the unique service provided by these clinicians. Further, I encourage my colleagues in Congress to support the Creative Arts Therapies fields and expand awareness about this form of treatment. Particularly at this time of heightened sensitivity to maintaining mental health, we should recognize the Creative Arts Therapies as a way to help those in distress through the power of the arts to heal.

Senator Hillary Rodham Clinton

Aspergers and Social Skills Group

Dr. Mendel — Fri, 09 Jan 2009 04:18:08 +0000

More often than any other question, I am asked to describe my social skills groups. I lead three groups, for upper elementary school students, middle school students, and high school students. While no particular diagnosis is required for a child to be in one of these groups, most have diagnoses of Aspergers Disorder or High-Functioning Autism. Others struggle with social anxiety or extreme shyness. What all the kids in these groups have in common is that they have trouble making friends and interacting comfortably with their peers. These are the kids who have always lived on the fringes of their peer group. They are teased, bullied, tormented, and ostracized.

And something magical happens when they join the group. Quickly, they realize that here is a place where they will not be taunted or humiliated. Here, they will not experience bullying and social rejection. They see that there are other kids like them, dealing with the same struggles, sharing the same longings for social connection and a sense of belonging. For many if not most of these kids, group is the first safe peer setting they have ever known.

These children thrive in this environment. They form friendships with one another; together, they practice social skills that seem so natural to many of us: making eye contact, listening without interrupting, giving feedback, asking questions. After a while, I’ll hear from them and their parents that they’ve begun making friends outside of group. They start to carry their new skills outside of group and practice them in “the real world” of the classroom and playground.

For me, leading these groups – getting to know these wonderful children, seeing them blossom and flourish, watching their confidence and competence grow – is one of the most rewarding things in my life.

Use Your Imagination to Defeat Your Fears

Dr. Mendel — Sat, 22 Nov 2008 03:43:22 +0000

Over the years, I’ve worked with a lot of kids struggling with fears, phobias, and anxieties. Recently, I saw a nine year old boy who was having a lot of trouble getting to sleep because of night-time fears and bad dreams. This boy had one of the most vivid and creative imaginations I have ever come across. He uses his creativity to positive effect in lots of areas of his life, but when it came to sleep and night-time, the vivid images his mind came up with were so terrifying to him that he was unable to get to sleep. This situation was worsened and complicated by the fact that when he became scared, he went into his mother’s bed where he felt safe and was comforted to the point that he was able to sleep. Fortunately, his mother and father, who were recently divorced, were both fully on board in helping their son develop the skills and strategies he needed to be able to soothe himself to sleep.

My approach in working with this boy involved two main steps:

First, he needed to understand that the problem was “in his head.” That is, the things he feared and that were interfering with his sleep were not entities that he actually needed to be fearful of, but simply products of his vivid imagination. Fortunately, this boy knew this full well.
Second – and this is the key step – if imagination can cause the problem, imagination can cure the problem. I set this boy to work coming up with imaginary creatures that would be on his side and able to battle and defeat the monsters bringing him such distress. He created an intricate sequence of “blobs” able to outnumber and overwhelm the monsters of his bedtime.

The results were immediate: This boy and both parents reported that he was consistently sleeping in his own bed. Quickly, the frequency of his fears declined and he was able to dispel them rapidly when they did come on, with the help of his faithful “blobs.” To me, this approach was enormously gratifying for several reasons. The boy was able to defeat his imaginary monsters by himself rather than only through the presence of another person. This, I believe, will help him in many ways in his life, by strengthening his sense of competence and self-sufficiency. His belief that he was safe only in the presence of his mother, or of a protective adult, gave way to a view that he could be and feel safe even when he was by himself. Finally, rather than attempting to subdue or disparage his imagination – one of his great strengths – he was able to use his potent imagination and creativity to overcome this problem.

The Pain of Ending Therapy

Dr. Mendel — Wed, 06 Aug 2008 03:48:19 +0000

It’s easy to overlook or underestimate how attached kids can become to their therapists. This point was brought home to me in a very powerful way during graduate school, in my first year doing child therapy. I had recently told a very bright 4 year old boy with whom I had worked throughout the year that in the near future I would no longer be able to work with him, since I would be moving to a different internship (well, I didn’t explain it in quite those terms to him). A couple of sessions later, little Alan and I were playing Cowboys and Indians and he suddenly blurted out, “my therapy has been ruined!” I asked him why he had said that and he replied, “oh, that’s just an old saying that cowboys used to say.” Images of John Wayne spurring his horse on while calling out “my therapy has been ruined” rushed through my mind. But beneath the humor of the situation, and beneath Alan’s attempt to cover up his sense of pain and loss, lay his powerful feelings of sadness at the impending departure of his therapist. Since that day, I have tried my best to handle separations sensitively & patiently, recognizing that even in relatively brief therapeutic relationships, powerful bonds are formed and the severing of those bonds can be a very painful experience.