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How Exposure And Response Prevention Therapy Can Help Families And Teens With OCD And Anxiety

Posted on by Carl Lovejoy

Unwanted or alarming thoughts creep into everyone’s head from time to time. Many people are aware of these thoughts and recognize that they are meaningless and temporary. People with obsessive-compulsive disorder (OCD) often experience these thoughts as intensely frightening and extremely real. As a result, they often develop ritualized responses or avoidance in order to lessen the discomfort and as a perceived way to decrease the chances of a feared outcome occurring.

For example, when a loved one leaves your home, you might think, “I hope they return home safely.” In a typical circumstance, you probably would not think much more about it. A person with a fear of harm OCD would likely experience that same situation very differently. They might experience an exceptionally intense fear that harm will befall their loved ones, a feeling that will be persistent and convincing that danger is imminent. They might even experience intrusive images in their mind of something terrible happening to their loved one. As a result, they may engage in checking compulsions, such as checking the weather forecast repeatedly or checking the news for stories of a tragedy involving their loved one. They might experience brief relief each time they refresh the weather forecast but the urge to check will quickly return. They might even call or text their loved ones to check on them, often repeatedly and urgently. This loved one might kindly reassure them that all is well, unaware that reassurance actually perpetuates and worsens OCD. This is where Exposure and Response Prevention Therapy has proven results.

Exposure and Response Prevention (ERP) Therapy provides deliberate and graduated exposure to situations that provoke obsessive thoughts, and the resulting distress while helping to prevent their compulsive responses. It also provides supported opportunities to learn new patterns of behavior without avoiding feared situations. This functions to increase an individual’s distress tolerance and opportunities to learn how to cope effectively. It also simultaneously allows someone with OCD to realistically test out the likelihood of a feared outcome and potentially develop a sense of self-efficacy about coping with a feared outcome. 

ERP leads to a change in one’s relationship with anxiety-provoking situations, thoughts, and intrusive images. Such change often leads to an eventual decrease in symptoms of anxiety and OCD, an increase in functionality, and an ability to engage in the world rather than isolate and avoid.

About the Author:

Brittany Little, LICSW, is a Clinician at Mountain Valley Treatment Center. Brittany has a BA in Music Therapy and her MSW from the University of North Carolina. She is intensively trained in Dialectical Behavior Therapy, Cognitive Behavioral Therapy, Exposure and Response Prevention and other evidence-based anxiety treatments.

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Utilizing Nonviolent Communication Skills in Teen Anxiety Treatment

Posted on by Carl Lovejoy

Nonviolent Communication (NVC) is a formula for communication that is meant to encourage compassion both with others and with oneself. The formula was devised by a renowned conflict mediator named Marshall B Rosenberg, who spent many years helping nations and individuals find peace between each other. NVC provides a framework to focus attention on what we are observing, feeling, and needing, rather than insulting, judging, and blaming. NVC is a “language of compassion,” as Rosenburg puts it in his book Nonviolent Communication: a Language of Life. Using NVC, we can unlock a deeper understanding of what is going on inside ourselves. It provides a way for us to develop empathy not just for other people, but for ourselves. This self-empathy can have a profound influence on teen anxiety treatment as it teaches young people skills that diverts their attention away from judging themselves and turns it towards their emotions and the needs that fuel them.  

 

Nonviolent Communication includes four components that can be applied to both sides of communicating: listening and expressing: 1) make observations without evaluations, 2) identify one’s emotions, 3) identify one’s needs and how they affect the emotions, and 4) make a request that would enrich life and get needs met. While the formula is simple, it is admittedly difficult to remember to go through these steps while conversing normally, let alone while talking to someone with emotions running high. It can be equally difficult to apply these steps when talking to oneself, which is something most of us do when we are angry and sad. It can be difficult, but with practice, these tools can become readily available even in the most emotional situations.

 

Imagine you’ve recently done something you regret. Maybe you were arguing with your mother; she told you that you need a new career path because you’re not making enough money at your job. But you love your job, so you got angry and yelled at her. Now, a few days have passed and you are berating yourself for being so mean to your mother. In this example, emotion has been identified: anger. Observation has also been made: you yelled at your mother. Making an observation and identifying an emotion are the first two components of NVC. The third component is identifying the needs that are affecting the emotions.  

 

To satisfy the third component, NVC asks “what needs were you trying to meet by yelling at your mother?” You’re pursuing a career that you find meaningful, even if it doesn’t earn a lot of money. Your mother, though, doesn’t seem to understand that. The unmet need in question here is “understanding from your mother.”

 

The ability to identify your unmet needs can be a big relief; it tells you that there was some rationale behind your behaviors. Understanding that there was some rationale behind our behaviors is a step toward self-empathy. Self-empathy is a crucial step toward growth, as it allows us to love ourselves. Loving ourselves can give us the sense of security we need to sit with anxiety and discomfort. 

 

Understanding your needs can help you move on to the fourth component of NVC and make a specific request that would get your needs met. By teaching NVC in anxiety treatment, the client begins to develop a strategy for difficult emotions. The self-empathy that results from acknowledging the needs is more conducive to growth than focusing on the difficulty at hand. To a teen suffering anxiety, this self-empathy can be life-changing. 

 

About the author

 

With a B.A in Environmental Studies, Nathan graduated from Prescott College in Prescott, AZ in 2014. Shortly thereafter he moved to Vermont and ever since has worked as a land steward, a youth mentor, an environmental educator, and an animal trainer. Additionally, he has served his local community by volunteering his time for restorative justice, animal rescue, and community dinners in the Upper Valley. Through all this work, he has discovered in himself an inherent desire to listen, be it to the land, the birds, or to the people around him. At Mountain Valley, he intends to use that desire to help the residents find validation, peace, and power.

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Courage & Perseverance at MVTC – Omar Shah, MVTC Psychiatry Fellow

Posted on by Carl Lovejoy
Omar
Rotating at Mountain Valley Treatment Center (MVTC) has been a great experience for me. It has brought to life, the theory I have read, regarding therapy for OCD (Obsessive Compulsive Disorder), anxiety and depression. No longer is Cognitive Behavioral Therapy just a theoretical tool to be used for me. It is practical and an effective method of treatment for severe mental health symptoms. On the surface, it appears patients are doing well and are merely having some dysregulation with their mood and/or anxiety. But under the surface, they feel they are drowning and they cannot function the way they want to any longer.

Like many psychiatric residents, I have read endlessly about the benefits of psychotherapy for mental illness. I have provided therapy myself to many patients. However, interning in a residential facility which hosts patients with few other options, has been a real eye opener for me. I have found that a tremendous amount of work goes into treatment here, both by providers and by patients. Interactions are intimate, subtle and profoundly meaningful. The power of active listening, emotional validation and eliciting information in a nonjudgmental manner is not lost on me. Therapy consists of sharing real life experiences, purposeful progression and encouragement every step of the way. After my experience here, I do not think it can be any other way. It seems a multi prong approach is necessary to fight the anxiety and depression the patients are dealing with. For example, OCD can be severely debilitating. It takes courage and faith on the patient’s part to tackle their compulsions. I’ve learned it is difficult to challenge OCD without a supportive environment and having good morale. It is not as simple as a quick fix with some medications and some exposure response prevention (ERP) treatment. There are lifestyle changes involved and perseverance is needed. The patient’s family support and academics are just part of the overall picture.

My respect for the patients and their providers has grown over the course of my rotation at MVTC. Treatment for the patients may at times feel slow or even futile because of the nature of the illness they are suffering from. But with vigorous therapy and positivity, it seems the illness eventually succumbs to the will of the patient. They learn to master their problems to the point of being able to live with them, if not completely getting rid of them. They regain the peace of mind and function they once enjoyed. It is truly humbling and joyful to see this transition taking place.

The experiential learning of various therapies for OCD, anxiety and depression has been very beneficial for me. When I read about these treatments or refer a patient for treatment, I am more appreciative of what that entails. I can visualize the frustration the patients might be having or the fear they may be experiencing, dealing with their mental illness head on. I am also more aware of the belief in themselves, they are leaning on, for the tasks in front of them. I feel I will be a stronger source of support for my patients now than I was before my rotation at MVTC.

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Inside One Teen Girl’s Struggle to Manage Anxiety during the Pandemic

Posted on by Carl Lovejoy

The pandemic has created challenges for all of us. People Magazine recently published a profile of our resident, Kaylie, who is one of the growing number of American teens who suffer from an anxiety disorder.

Her mom Lisa explains: ‘Mountain Valley was the first time Kaylie had to take care of Kaylie and do the hard work on her own.’

[button href=”https://people.com/health/inside-one-teen-girls-struggle-to-manage-anxiety-during-the-pandemic/” target=”_blank” style=”primary” alignment=”center” color=”normal”]Learn More[/button]

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4 Tips for Choosing the Best Anxiety Treatment Center for Families

Posted on by Carl Lovejoy

Effective treatment for anxiety disorders is very specific and should be individualized for each client. There are many programs and treatment centers that add anxiety to the list of conditions they treat, but very few are utilizing evidence-based practices or have clinicians trained appropriately in the “gold standard”, Exposure and Response Prevention or ERP. 

Exposure and Response Prevention is a type of Cognitive Behavioral Therapy where the client gradually confronts the fear, worry or situation and eventually, the client learns that the fear, worry or situation does not produce the negative outcome they believe will occur, thus their relationship with that fear, worry or situation is such that their quality of life is improved. Getting to and through this process requires a skilled clinician, defined period of time, and a good rapport, trust and communication between the client and the clinician. 

A clinician supporting ERP is a key imperative for the process as is the ability of the clinician and other staff to provide education about anxiety, its impact on the body and senses, and terminology related to ERP. The staff must be able to provide this psychoeducation in such a way that the client understands based on their age and cognitive functioning. 

Over the past several years working with families and clients to determine if Mountain Valley Treatment Center is a good fit for their needs, I have found myself in a position of highlighting our program structure and educating families on what to look for when selecting an appropriate program. 

With all that in mind, here are 4 tips for choosing the best anxiety treatment center:

1. Look for an Anxiety Treatment Center Where the Clients Tend to Have Similar Presenting Issues

The center should have a population of clients with similar presenting issues, those being anxiety disorders, OCD and related disorders. Many anxiety treatment centers have clientele with a wide array of challenges such as substance use disorders, aggressive behaviors, and varying degrees of cognitive functioning. 

2. Make Sure the Anxiety Treatment Center Provides CBT & ERP Therapy

Do they provide CBT and ERP? A center that says they specialize in treating anxiety disorders must be providing sound exposure and response prevention therapy. ERP should also be conducted in a variety of environments and based on the client’s individual needs. 

3. Make Sure the Anxiety Treatment Center Provides Individualized Treatment Plans

Ensure that the center creates and updates specific, individualized treatment plans for each client. Additionally, there should be a system in place whereby the client, and family have access to the plan and sign them. Typically, an initial treatment plan will be developed upon admission and be based on information collected during the admissions process. Once admitted and after a period of time to gather information, the clinical team and the client/family will create a master treatment plan with goals and objectives. Treatment plans should also be updated as necessary and based on evolving progress in treatment.

4. Do They Have An Integrated Team Approach To Care?  

A clinically sound treatment center will follow best practices and have a multi-disciplinary team working with, monitoring, and documenting a client’s treatment and care. This team should be communicating with each other on a regular basis. A typical treatment team will consist of the individual clinician managing the client’s case, an individual representing the programming who can provide information about a client’s functioning outside of therapy such as during activities and after hours, and a medical representative who can contribute information in the area of medications or physical/medical conditions.

At the end of the day, everyone connected to the client wants them to have a successful treatment experience and get the help they need. Finding the right treatment center is one of the first steps.

If you found these tips helpful, and would like to learn more about treatment, and about Mountain Valley, contact us today.

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Anxiety, Instinct and The Senses

Posted on by Carl Lovejoy

As we all move (sweat) into July, I began thinking about our natural instinct in managing anxiety and its relationship with our five senses – taste, see, hear, smell and touch. We have all heard of the “fight, flight or freeze” instinct we are born with when responding to disturbing thoughts, feelings and events. Remember the Sabre-Toothed tiger story? My drive to work the other day got me thinking about how the senses can be impacted when we are fearful and worried.

As I wound my way down River Road on the way to campus, with windows down, passing the dairy farm (smell), with the sunlight reflecting off the Connecticut River (sight), sipping my coffee, purchased from the Starbucks ‘near’ campus – only 12 minutes away (taste), the wind blowing through my hair (hear), and feeling the heat of my seat heater on my rear-end (touch) – I had accidentally turned it on; I came up with the idea of asking some of our residents how their particular anxiety affects their senses. Later that day, I had the perfect opportunity during our new Elements Activity Therapy module. A group was preparing the hints and identifying locations around campus for the scavenger hunt later in the day. I asked the question. The three most common responses were (1) blurred or tunnel vision, (2) nausea, and (3) dry mouth.

At Mountain Valley we help residents develop skills to get in touch with how their body reacts to fear and worry. For example, practicing cognitive defusion so the thoughts don’t control the feelings resulting in the ineffective coping skills. As a result of this work, getting your senses back to where they can be appreciated in the moment to become aware of the positive things around you – like on my drive into work, will make for a more enjoyable life after Mountain Valley.

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A Much Needed Dose of Support from Lyme, NH Psychiatrist, Dr. Barbara Wilson

Posted on by Carl Lovejoy

Lyme, NH psychiatrist, Dr. Barbara Wilson, offers the Mountain Valley family a “daily dose of support” – My Version of Anxiety isn’t your Version of Anxiety!

In a previous life in outpatient psychiatry, I would frequently see patients who are struggling with social anxiety. A recurring comment from them was “every time I walk down the street it looks as though people are staring at me and are angry with me. I can see it on their faces.“ My reply to this would be, “have you ever considered the possibility that they are all constipated? “ In truth, it was likely far more probable that the majority of the people are walking down the street constipated versus thinking about how much they don’t like a person walking past them with whom they’ve never met.

And while I still stick to my “constipation hypothesis,”ᵀᴹ another possibility is that a lot of people are also walking around anxious. Their minds are racing, they’re not sleeping well, their necks and shoulders sore from the constant tension. Perhaps, they are also carrying the burden of their children’s anxieties or their grandparents’ anxieties or their coworkers’ anxieties or their patients’ anxieties. Perhaps their anxiety is constant; from the minute they wake up until the minute their head hits the pillow it is a whirlwind of “what if‘s” and “how do I plan” and “what might be.” Perhaps their anxiety sneaks up and bites them in the butt. One minute they’re doing well, staying focused, and dealing with the problem in front of them and the next they are scattered, emotionally labile and instantly exhausted. Perhaps they don’t think they have any anxiety at all and are confused by the new onset of jaw clenching, eye twitching, and headaches.

More often than not, anxiety is something that starts deep inside and rarely makes it to the surface for others to notice. However, in the new prolonged, uncertain reality that is COVID-19, my guess is that more anxiety is coming to the surface than ever before.

? How the hell do I know? I say that not because I don’t experience it but because it’s different for everybody. For me I eat less, I’m more irritable, and even more forgetful than my baseline walking advertisement for Vyvanseᵀᴹ. For you, your brows may furrow more, the corners of your mouth may turn down, and you may not be as good of a listener to your friends as you were before. You may even walk right past a friend, not because your eyesight is poor and 6 feet away makes them blurry, but because you are so lost in your own hamster wheel of thoughts and emotions you haven’t looked up to see the world around you.

I bring this up for you today because we are all guilty of jumping to conclusions as to why someone may be behaving the way they are. I’m giving you permission tonight to abandon my “constipation hypothesis”ᵀᴹ and assume that whatever behavior you’re seeing is likely their anxiety on the surface. And instead of starting your conversation with “is everything OK? “ or “what’s wrong?“ just assume you know what’s wrong and say “you know what, I’m feeling super anxious, too.“ It sounds like a funny way to start a conversation AND it instantly articulates the sentiment “       .”

You’re doing an amazing job. Has anyone told you that? Well I just did.

Dr. Barbara Wilson is a physician at Dartmouth-Hitchcock Medical Center in Lebanon, NH. To ready more of Dr. Wilson’s Daily Doses, follow her on Facebook at https://www.facebook.com/barbara.wilson.7777

 

 

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Reunions, Lunches, Emails, Cards, and Messages – Carl Lovejoy Offers a “Unique” Perspective

Posted on by Carl Lovejoy

I often cringe when people use the word unique to describe something that is clearly not one of a kind – yet when I meet with prospective families on our Plainfield campus or a school counselor on their campus, I find myself occasionally employing this mis-used adjective to describe Mountain Valley. Surely there are other fine programs, treatment centers and hospitals using the same evidence-based treatment modalities we do, but there is much about Mountain Valley that is, well, unique.

I have told this story countless times, but one of my favorite moments with an early group of Mountain Valley residents took place in my office in The Creamery on our original campus in rural Pike, NH. As was the case back then, kids would frequently head to my space during lunch time to raid my snack basket and escape the rigors of exposure therapy. On one beautiful summer’s day, four or five young residents squeezed together onto my old, red leather couch and started to tell me that they wanted to return to MVTC.

“Return?” I questioned, feigning incredulousness. “You want to return?”

Knowing where they were going with this topic, but not wanting to let on, I continued my questioning while pointing my index finger at each of them – “You! You came through the door kicking and screaming – and now you tell me you want to return? And you! You sat in your car with the doors locked in the Creamery parking lot for five hours before I could convince you to give MVTC a chance. And what about you? You had to be transported here! And now you all tell me that you want to come back???”

“No, we don’t want to come back for therapy, silly.” they responded in unison. “We want to come back for a reunion!”

And come back they did. Eight families in October of 2012. 15 in 2013. Several of my colleagues with experience in residential treatment scoffed at the notion that kids would be interested in returning, but they did, for a four-hour event. And each subsequent year, more and more returned – from as far away as Alaska, Hawaii and Costa Rica.

We received numerous emails from disappointed residents who couldn’t attend due to school commitments, so we moved the Reunion from fall to summer – a Summer Celebration – and with the move from Pike to our gorgeous campus in Plainfield, our numbers grew exponentially – almost 250 former residents, their parents, siblings and grandparents, former staff and friends attended last summer for our 8th annual event – and there’s little doubt that we could have even more in attendance this summer.

Unique? Maybe, maybe not – but certainly special – and fun. We hope you will return on July 18th for our 9th Annual Summer Celebration, replete with the amazing Fire It Up pizza food truck, Mac’s frozen treats, the ginormous inflatable waterslide and the legendary bluegrass trio, The Sky Blue Boys w/Banjo Dan and Cookie!

In addition to organizing our reunions, my professional responsibilities at Mountain Valley include traveling around the country, stewarding relationships with former residents and their parents by meeting with them for dinners, lunches, coffee, ice cream cones, etc. I love doing this – especially when I get to see the amazing progress our graduates have made – and I cherish the feedback I receive about their MVTC experiences.

Similarly, I am always thrilled to receive emails, social media messages – and even notes left on whiteboards – sharing testimonials regarding the MVTC experience and the impact it had on them or their parents. The first time I heard “You saved my daughter’s life.” I knew we were on to something. Most recently, prior to a resident’s graduation ceremony – an experience that hasn’t changed much since our very first graduation in the fall of 2011 – the grateful grad wrote a heartfelt message on a Gallup House whiteboard for all to see, “I am Mountain Valley – Mountain Valley is my home.”

How fortunate I am – and we all are – to work at such a, I’ll say it – unique place – a place that gives residents back their lives and, yes, at times, saves those lives in a way that few, if any, other programs seem to do. And how fortunate I am to have had the opportunity to get to know these bright, talented, resilient young people – and their amazing parents who share them with us. We look forward to seeing many of you at this year’s reunion on July 18 – and hearing your laughter, enjoying your hugs, seeing your tears, and listening to your stories of strength and success.

Carl Lovejoy is Mountain Valley’s Associate Executive Director for Communications and Development and a member of MVTC’s founding team.   

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Dr. Tim DiGiacomo Interviews MVTC Residents Living with OCD, Anxiety and OC-related Challenges

Posted on by Carl Lovejoy

In the words of rock and roll titan Alice Cooper, “School’s out for summer!”  Well, sorry, Alice, but it’s that time of year again, summer is in the rear view mirror and most adolescents are back in school.  Actually, most adolescents have been back in school for a couple of months now, and many have, once again, hit the proverbial “wall,” and are refusing to go to school.   

As children, when my siblings and I felt nervous or upset before school, our mom would just tell us “eat a banana and get on the bus.”  She was a nurse, so we trusted that this was a legitimate cure and eating this magical fruit would miraculously make everything right in the world.  And, while this is not an evidence-based first line treatment, it apparently worked for us and got us to school and her to work.

So, what happens when you need more than just bananas (or prunes, for that matter – another magical fruit so familiar to Mountain Valley alums) to respond differently to your OCD or anxiety, live your life more fully and unburdened, and get yourself to school?

Well, I’ve recently read some interesting and informative blogs and articles related to the start of school and OCD and anxiety. There is a great deal of good information out there from professionals related to evidence-based treatments, but I also thought it would be useful to include some thoughts from those living with OCD, anxiety, and OC-related challenges.  So, I sat down with several gracious Mountain Valley residents to get their thoughts…

Awareness and Insight

 I was curious about awareness and insight into OCD and school-related challenges, so when I asked how Tommy* became more aware that challenges started to increase for him, he noted, “when little things became big problems…I had always loved school but then I started to hate school and then I started to think ‘what’s the point?’”

This was the evolution of OCD and BDD-related challenges leading to depression-related challenges. This is what led to an increase in isolation and avoidance.  Tommy stated, “Just the thought of school was so distressing that I didn’t want to move.”  Having to avoid certain places and situations at school, due to the OCD-related stress, took a toll and despite his efforts, it was exhausting.  He was unable to consistently get to school and he fell farther and farther behind in school.

Similarly, Gina* noted that it’s important to remember that school is not just about academics, and that academics are not the only sign of difficulties.  She could keep up her grades fine for a time; however, prior to challenges with her grades, she noticed an increase in isolation and time trying to distract herself from distressing thoughts and situations, stating, “I didn’t want to spend time with my thoughts.”  She and her family began to notice a need for more help as she became more withdrawn and started avoiding school.  For Gina, as she returns to school, she plans to keep in mind that “it’s not just about academics,” but also overall health and living life in a meaningful and fulfilling way.

Reaching Out for Support

 Another important theme came out of these conversations; the importance of reaching out for support.  Both Tommy and Gina noted the importance of trusting others enough to share their challenges, but also noted that it was hard for them to understand their challenges enough to articulate them to others.  As such, it can be challenging for others to respond in a way that is helpful.  Sometimes, family, friends, and teachers will not understand what’s happening for someone living with OCD or anxiety and it’s challenging to talk about this.

Tommy noted that he didn’t feel shame in talking about his challenges, but also just did not know that he could talk with others about this, despite having loving and caring relationships.  Gina noted, “I didn’t want others to see how vulnerable I was, but I didn’t have the energy to cover it up either…so I just didn’t go to school.”  Both also noted that in the absence of sharing with others that it’s too easy to rationalize their challenges, minimize them, make excuses, or be overwhelmed with their obsessions and compulsions.  By bringing in others to the challenges, you’re able to get feedback and support.

 Get Creative with School and Treatment

 Tommy and Gina suggested using academic advisors, school counselors, family and friends for support and to tailor your OCD and anxiety treatment to school.  That is, to incorporate exposure therapy into your school day to address your OCD while still working on your academics and engaging in other school activities.  They suggested getting creative with school schedules, if possible, so that you’re able to attend school and achieve, while also still giving yourself time to recover and engage in treatment.  Gina noted that if you are really suffering and stuck, “It’s okay to sacrifice a semester or to take time out of school to get treatment.”  This, in reference to a more intensive level of treatment, more so than typical outpatient therapy.

You are More than your OCD

 A final overarching theme was to find ways to continuously challenge yourself to overcome your stuck points with OCD and also to continuously care for yourself.  It’s crucial to remember that you are more than your OCD and more than your OCD is allowing you to be during challenging times.  Living with OCD, anxiety and OC-related challenges is not easy and change can be difficult; however, you’ve got people like Tommy, Gina, and the staff at Mountain Valley to keep cheering you on.

  • Intrusive thoughts à distraction
  • Engaging in compulsions à distraction – can open you up to bullying and ridicule
  • Address the lack of understanding of OCD by educating school staff
  • Help your child find ways of explaining their OCD to their friends
  • Identify self-care to help your child continue attending school
  • Identify support people at school
  • Help your child understand their reasons for continuing to attend school and engage fully
  • Know that there will be ups and downs – some days are harder than others
  • It may be harder during the transition times and also when the work increases/becomes more challenging

*Names have been changed to protect confidentiality. Prior to MVTC, Tommy attended school and worked a part-time job on the docks.

*Names have been changed to protect confidentiality. Prior to MVTC, Gina attended school and worked a part-time job at a diner.

Dr. Timothy DiGiacomo, Mountain Valley’s Clinical Director, is a licensed clinical psychologist with comprehensive experience treating children, adolescents and adults with individual, group and family therapy, including utilizing CBT-based modalities for anxiety, depression and trauma. Tim has treated individuals with anxiety, depressed mood, motivational difficulties, stress-related problems, learning difficulties, and trauma.  Tim has completed the International OCD Foundation’s Advanced Behavior Therapy Training Institute (BTTI) and is trained in Trauma Focused Cognitive Behavioral Therapy, Child Parent Psychotherapy, and other evidence-based treatments.  He has a particular interest in family therapy.  Tim enjoys meeting clients where they are at and helping them to learn the tools that they need to resolve their difficulties.  Tim takes a strengths-based and supportive approach to empower families to make positive changes that work for their family’s needs.
Dr. DiGiacomo oversees, leads and guides the clinical program and strategic development of our clinical services.  This includes, but is not limited to, ensuring the incorporation of the latest in Evidence Based Practices (EBP) for the treatment of OCD and Anxiety Disorders, overseeing Performance Measures systems including Outcomes Monitoring, research, and screening approval for prospective clients.  He also serves as the “Clinical Face” of Mountain Valley externally.  This includes, but is not limited to, developing and delivering local, regional and national conference presentations, supporting clinical outreach activities, liaison with external organizations and entities to the benefit of Mountain Valley and in the overall treatment of OCD and Anxiety Disorders.
Dr. DiGiacomo provides on-site clinical supervision of staff and systems including directly supervising the Senior Clinician and at least one therapist for both administrative/performance and clinical supervision and providing clinical supervision for the Associate Clinical Director.  He actively engages in and supports the marketing communications initiatives and branding to include, but not be limited to, identifying national accreditation for the Residential Exposure Specialist training, supporting the digital marketing program, and publication of the work we do.
During his time at West Central Behavioral Health in Lebanon, NH, Dr. DiGiacomo worked as a clinician, psychological assessment coordinator, Team Leader, and Acting Director of the Child Team.  He served as a Clinical/Adjunct Assistant Professor of Psychiatry for the Geisel School of Medicine at Dartmouth College, providing therapy and assessment supervision, and teaching seminars for psychology interns and post-doctoral fellows.  He has taught courses on co-parenting and alternative dispute resolution for the State of New Hampshire for families going through divorce.  He has also served as adjunct faculty for New England College and Franklin Pierce University, teaching at both the undergraduate and graduate levels.  He served as a psychologist and consultant for the Plainfield, NH and Lebanon, NH school districts.  Tim has worked in research at Yale University, in clinical roles at VA Medical Centers, and in various mental health facilities.
Dr. DiGiacomo graduated from the Virginia Consortium Program in Clinical Psychology and completed his internship and post-doctoral fellowship at Dartmouth Medical School.  He earned his Master of Arts in Community and Clinical Psychology at Norfolk State University.  He completed his B.A. in psychology at Fairfield University.

 

 

 

 

 

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Don Vardell Writes about The Importance of Traditions at MVTC

Posted on by Carl Lovejoy

Having and maintaining traditions are important both for families and organizations.  They are a vehicle for supporting positive aspects of an organization’s culture, spotlighting what makes the group unique, and make for great stories. Some of my favorite traditions from my family and my previous work experience include:  the ugly Christmas sweater passed down to other family members, monthly ice cream socials, making holiday cookies with Grandma, dressing up like your therapist at Halloween.

The best traditions are those that are organic – those that come from the bottom up.  At Mountain Valley we are filled with fun, unique and resident-developed traditions.  Here are just a few with their reason/purpose:

  1. The “Elder Stick” – a walking stick adorned with holiday lights and sayings from past residents.  The most senior resident (by number of days at Mountain Valley) is handed down the stick the evening after a graduation.
  2. The “Auction” – the evening before a graduation, the resident graduating auctions off specific items collected while at Mountain Valley.  Things like specific clothing, books, or crafts made in the art module are examples of the most common items.  Other residents make their “case” for why they want the item and the soon-to-be graduate awards items based on the case made.
  3. Graduation Day Meal – the resident graduating picks the lunch meal that will be served to the whole community, family members and staff.  Classic meals include sweat potato gnocchi,  pasta bar, and make your own ramen bowl.  All flawlessly prepared by our Chef, Pete Bayless.  During the graduation ceremony, ice cream from the local dairy, McNamara Dairy, is served.  Who is hungry?

Again, all of these have been resident-driven.  These, in addition to so many other things about Mountain Valley’s model are what make our treatment program special.  While being clinically intensive, we also strive to make a resident and families’ experience memorable and effective.  What are the traditions within your family or workplace?  I’ll bet they don’t include an ‘Elder Stick.”

 

Don Vardell, Mountain Valley’s Executive Director, is seasoned healthcare administrator and operational leader with experience at the helms of private residential treatment centers, therapeutic boarding schools and non-profit service organizations.

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