Lindner Center of HOPE Doctors Among Best in Nation Ranking Places Four Lindner Center Doctors at the Top Locally

The Frances and Craig Lindner Center of HOPE is pleased to announce the following doctors were ranked among the best doctors in the nation and among the top specialists in the Tri-State as indicated by The Best Doctors in America 2017-2018 database. As selected by their peers, specialists from the Tristate will be included in the listing published in Cincy Magazine’s December 2018 issue:

Paul E. Keck, Jr., M.D., President-CEO, Lindner Center of HOPE, is a nationally renowned psychiatrist
and researcher in Bipolar Disorder and psychopharmacology. He authored over 700 scientific papers in leading journals and was the 7th most cited scientist in the world published in the fields of psychiatry and psychology over the last decade.

 

 

Susan L. McElroy, M.D., A nationally recognized researcher and educator, Dr. McElroy is internationally known for her research in bipolar disorder, eating disorders, obesity, impulse control disorders and pharmacology. As Chief Research Officer for the Lindner Center of HOPE, she currently oversees multiple ongoing studies in bipolar disorder, major depression, binge eating disorder and obsessive compulsive disorder.

 

This is the eighth consecutive year these doctors were included in this database. They hold faculty appointments with the University of Cincinnati College of Medicine and are part of UC Physicians.

Joining the list for the third consecutive year is: Brian P. Dowling, M.D., a highly regarded psychiatrist
in the Cincinnati area, who focuses on maximizing time with his patients in order to truly understand their individual stories attempting to offer them hope and a sense of possibility. Dr. Dowling is the Director of Medical Education at Lindner Center of HOPE.

New to the List:

Marie E. Rueve, M.D., serves as the Medical Director of the Sibcy House residential treatment program and as a staff psychiatrist at the Lindner Center of HOPE. She brings to the Lindner Center of HOPE’s Sibcy House an approach of integrated care to address each facet of a patient’s complex psychiatric history, focusing on their individual goals and expectations for improvement. She possesses not only an extensive background in psychopharmacology but also expertise in psychotherapy and a love of teaching. Her treatment philosophy centers on walking with patients through a comprehensive understanding of their illness and context, on to holistic, multi-disciplinary treatment approaches aimed at helping them live fulfilling and functional lives.

 

 

Angela Couch, RN, MSN, PMHNP-BC
Psychiatric Nurse Practitioner
Lindner Center of HOPE
University of Cincinnati College of Medicine

 

Suspected side effects are one of the most frequent barriers to medication compliance.Therapists are likely meeting with
the patient more frequently than the prescriber, and in some cases, may have better rapport with that patient. Sometimes the patient is more likely to open up to their therapist about problems with their meds, rather than the prescriber, particularly if they are afraid of disappointing the prescriber. Therefore, this puts therapists in an important position to be able to intervene in a constructive way.Symptoms that occur after the start of a medication may or may not relate to the medication. Several possibilities should be considered before attribution of symptoms is determined (Goldberg and Ernst, 2012). The natural course of illness may be responsible for symptoms; often symptoms of mental disorders may overlap with potential side effects of medications. Discontinuation symptoms may present upon stopping the previous drug, and may complicate the picture. Discontinuation symptoms may also occur when a patient’s compliance is spotty. Interactions between multiple drugs may be responsible
for an effect, versus an independent effect of a single medication. Medical comorbidities, substance use and compliance issues may also be implicated. Timing of onset of symptoms in relation to when the medication trial started is also important to evaluate. It requires careful assessment on the part of the prescribing clinician to determine whether an adverse effect is occurring, and what, if any, change to make.Many side effects may be adequately managed by simple changes to the regimen. A dose decrease may result in reduced negative effects but still maintain efficacy of treatment.Interested in touring Changing the schedule of administration can have significant impacts on side effects.

For instance, moving the dose from morning to evening or vice versa, or moving the dose in relation to meals could both
be helpful. Changing the schedule in relation to when another medication is given might be helpful.

Other medication side effects may require more complicated changes. These may include stopping the medication, changing to another medication, or adding a medication that may counteract the negative effects while allowing the patient to make use of the positive benefits. Much discussion may need to occur in cases in which many previous medication trials have been unsuccessful, or resulted in other more bothersome side effects. In those cases, the benefits of the drug may outweigh the level of discomfort from the side effects.

How can you as the therapist help?

Do:
Ask your patient about compliance with each medication at each appointment. Poor compliance can often cause, or
be caused by, side effects.

Encourage your patient to talk to his/her prescriber if they have questions or concerns about their medications.

Remind your patient that most medications take several weeks of regular administration before they start exerting positive effects, and that dose changes MAY be required, so it is important to continue taking the medication even
if he/she is not seeing results, and communicate with his/her prescriber before making changes.

Contact your patient’s prescriber directly at any time if you have specific concerns or questions about the patient’s medication regimen, or you have a specific suggestion regarding the medication regimen.

Do Not:
Suggest to your patient that you believe they are on the wrong medication or make specific suggestions regarding medication changes directly to the patient. This can cast doubt on the prescriber’s ability and possibly impede their therapeutic relationship. Suggest to your patient that other patients have had bad experiences with a particular
medication. Instruct your patient to change the dosing of the medication.

In summary, patients benefit from good collaboration between prescribers and therapists, and the therapist can have a positive impact on a patient’s chance of success on medication. Reference: Goldberg, J.F., & Ernst, C.L. (2012) Managing the side effects of psychotropic medications. Arlington, VA: American Psychiatric Publishing.

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November is Family Caregivers Month.

A growing number of Americans are taking roles as caregivers for loved ones suffering with a variety of illnesses and disabilities. At least 60 million have a caregiving role – most caregivers are middle-aged adults.

Caregivers can be anyone doing a broad range of tasks for loved ones who are unable to perform everyday duties like picking up groceries, getting dressed in the morning, or driving to medical appointments. These caregivers are often unpaid and untrained.

By giving so much for others, it is easy to neglect self-care and caregivers often suffer burnout that leads to higher rates of mental illness like depression and anxiety. Exhaustion and fatigue can lead to more serious health issues. Recent studies show 40-70 percent of caregivers have clinically significant symptoms of depression and anxiety due to chronic stress associated with providing care

Some self-care strategies can include:

  • Eating right, exercising and getting enough sleep (7-8 hours) is always important
  • Make a self-care calendar and share that plan with someone else
  • Don’t base your identity on your care for others. Caring is acting, not being
  • Be mindful: Recognize how an activity reenergizes you and fully participate in it
  • Keep a victory journal
  • For more tips, view:  http://www.fox19.com/video/2018/11/16/national-caregivers-month/

The Lindner Center of HOPE has some of the nation’s leading physicians experienced in depression treatment and self-care. If caregivers are experiencing symptoms of depression or anxiety, they can schedule an evaluation at the Lindner Center of HOPE Rapid Access Service, which is an outpatient service for patients 18 and older, open Tuesday and Thursday afternoons from 12:30 pm to 4 pm. This service enables patients in need to have a scheduled appointment, within days of the call. The appointment includes a thorough outpatient assessment with a psychiatrist and social worker, a care plan, recommendations with referrals and a written after-visit summary. Call 513-536-0639 to schedule.

 

Chris Tuell Ed.D., LPCC-S, LICDC-CS
Clinical Director of Addiction Services Lindner Center of HOPE
Assistant Professor, Department of Psychiatry & Behavioral Neuroscience University of Cincinnati College of Medicine

In 1987, Francine Shapiro went for a walk. While on her walk, Francine was contemplating some very upsetting personal events that were occurring in her life at the time. But as she began to focus on this upsetting information, she noticed that her eyes began to flicker from side to side. More importantly, she noticed that the once upsetting information was no longer as upsetting. Shapiro felt that she had stumbled on some aspect of how the mind processes information. Eye Movement Desensitization and Reprocessing, better known as EMDR, was born.

For the past 30 years EMDR has become one of the most effective therapeutic approaches in the treatment of trauma. EMDR is not only approved by the American Psychiatric and Psychological Associations, but also by the United States Department of Defense and the Veterans Administration, as an effective therapy in the treatment of post traumatic stress disorder (PTSD). Dr. Shapiro believes that one of the major theories behind EMDR is the bilateral stimulation of both hemispheres of the brain. When we sleep at night, our brain continues to process information. This occurs during rapid eye movement sleep or better known as REM sleep.

The brain processes the events of the day, keeping what is important (e.g. family, work, school, friends), and purging what is unimportant (e.g., What I had for dinner last Tuesday). How many times have we have been faced with a tough decision and resorted to, “I’ll just sleep on it,” only to awake the next morning with a better idea of what to do? But when a traumatic event occurs, the processing of this information becomes disrupted. The brain becomes unable to process and clear the event or information, resulting in the trauma experience continuing to occur as if it is happening all over again. In this playing-out, the right hemisphere of the brain, the part of our brain that experiences emotions such as fear and anxiety, continues to be activated by the unresolved trauma. The patient experiences this activation through intrusive thoughts, flashbacks, and disturbing dreams, the basic elements of PTSD.

EMDR involves the bilateral stimulation of both hemispheres of the brain while targeting the upsetting aspects of the trauma. In therapy, the therapist recreates what happens naturally during REM sleep, with the movement of the eyes as they follow the therapist’s hand, stimulating both hemispheres of the brain. Over the years, additional bilateral stimulation methods have been found to be effective (i.e., tactile, audio). This targeting involves, not only activating the image of the event, but also identifying the negative thoughts, emotions and sensations experienced by the patient from the trauma. During the reprocessing of the trauma experience, the logical, rational part of the brain, the left hemisphere, is integrated with the right emotional hemisphere. This results in the patient having a more adaptive response to the trauma. The patient may still have memory of the event, but the emotional aspects of fear and anxiety have dissipated. During EMDR, the left hemisphere of the brain, the rational, logical part, is integrated with the emotional right hemisphere of the brain, resulting in the patient feeling and knowing that, “The trauma is no longer happening to me now; The trauma is in the past; I am safe now.”

EMDR is not a wonder cure nor is it a quick fix. EMDR involves hard work by the patient and it takes a good amount of clinical skills in order to implement. This is not about touching the person’s forehead and he or she is better. The patient and therapist have to be responsible and work at this process, but it does appear to go much more rapidly than traditional types of therapy. If a trauma can occur within a few moments, why do we automatically accept that it has to take years to undo it?

More than 20,000 practitioners have been trained to use EMDR since its discovery. The use of EMDR has been found to be beneficial in other areas of mental health besides, PTSD. Areas such as panic disorders, anxiety disorders, grief, pain, stress, addiction, and abuse, have shown to be responsive to this unique therapy. One aspect of EMDR that I have found to be valuable is the fact that it is unnecessary for me, as the clinician, to know all the details and specifics of a patient’s trauma in order for EMDR to be helpful. Many individuals who have experienced trauma stay clear of therapy for fear of reliving the memories and feelings. The EMDR protocol allows for such traumatic episodes to be addressed and reprocessed without describing the details of the trauma. As a practitioner, I have found EMDR to be a valuable therapeutic tool in assisting patients in moving past one’s past.

For more information about EMDR: https://www.emdria.org

 

By Marcy Marklay, LPCC, Adolescent Therapist,
Lindner Center of HOPE

Technology has changed the way people bully each other. Cyberbullying via text messages and use of social media, as well as the more traditional forms of bullying,can occur in childhood, adolescence and into adulthood, even in college and in the workplace. Bullying is far from uncommon and needs to be addressed.

Reasons For Bullying
Bullying can occur due to someone being different. Elevating one’s social status can be a common motivating factor for bullying. Some bullies are motivated by obtaining power and control of others through fear. Some groups can gang up on someone, or another group, because of different beliefs, for example, being bullied for being lesbian, gay, bisexual, or transgender (LGBT).

How It Appears
Bullying can be subtle or overt, occur once or be persistent and chronic in nature. Bullies can use rumors or gossip and berate a victim and turn others against them in a deliberate attempt to sabotage their reputation. Chronic bullying takes a greater toll on the bullied individual, and can lead to mental, emotional, physical and social harm.

Addressing Bullying
Best practices in addressing bullying will include providing education about bullying as well as providing treatment interventions to those individuals affected or targeted by bullying. Education needs to include what to look for or ways to identify bullying, why bullying is harmful and unacceptable, and how to go about reporting it. It is generally a bully’s goal to disempower the victim. Teaching assertiveness skills are not the only interested in touring method to teach the target of bullying. More recently, utilizing bystander intervention has become increasingly helpful in combating bullying because it addresses the problem from a systems or group perspective. Bystander intervention involves enlisting the help of others in the school or community to assist in addressing and reducing the problem behaviors, by using a social norming campaign to teach students about appropriate behaviors. By adopting a community responsibility standard, bullying can be reduced in an environment where it is not acceptable. The number of individuals willing to confront bullying , whether cyberbullying , assault, threats, verbal abuse, or offensive behavior that can be humiliating, intimidating or threatening can be reduced more significantly in this way.

It is important to thoroughly listen to the victim of bullying’s story without quickly jumping to conclusions, and to explore possible options, such as what a treatment professional can provide, a victim can do for themselves, what a school or the police can do to help the victim. Narrative therapy is helpful in letting the victim tell their story. It can help them look at what is in and out of their control. It can externalize the negative experience of being bullied from the victim. In some cases a threat assessment is indicated to assess for the potential escalation of violence by the bully and retaliation from the person being bullied. Suicide prevention is also a concern, as some who are bullied may become suicidal and need crisis intervention. Victims can experience a wide range of symptoms due to being bullied, which are not limited to anxiety, depression, somatic complaints, falling grades, family stress, isolation. Victims often blame themselves. It is critical to focus on finding a sense of safety, addressing mental health concerns, and connecting the victim to a support system. Work on self-esteem and coping skills is helpful, and working to restore lost confidence is a goal. Victims may suffer from depression, anxiety, panic attacks, PTSD, acute stress disorder and even suicide. The victim’s primary relationships may suffer as a result of the bullying.

Help for victims
Helping those who have been bullied includes exploring ways to heal, examining realistic solutions to the problems, and prioritizing health. Encourage self-care and social support. Provide psychoeducation. Assist victims with finding resources. Keep a focus on the present and near future; focusing too much on the past does not give the goal-directed and strengths based approach these individuals need. Role playing and practicing and rehearsing coping skills in a safe space can be empowering. There is immense power in the act of listening to a victim of bullying. Parents are important in supporting the young person and can also benefit from internet and online safety training, and social media training along with their children. Many parents fear the internet and require their children avoid technology, which may help in the short term, but is not a realistic long term solution, as the internet is used for homework, employment and socialization. Teaching internet and online safety skills to both youth and parents is most effective. Parents then can become good role models for youth in using technology, enhance communication and develop a greater bond; this can result in personal empowerment for both youth and their parents.

Source
Cyberbullying: What Counselors Need to Know by Dr. Sheri Bauman; published in 2011

 

This month, Lindner Center of HOPE launched a digital content hub with the Business Courier as part of its commitment to increasing awareness of mental health issues. The hub is designed to educate employers and employees about mental health within the context of business. Articles cover topics such as the impact of mental health on business, suicide, perfectionism and addiction.

Visit the hub at:  https://www.bizjournals.com/cincinnati/news/partners/healthy-minds-healthy-workplace.

 Lindner Center of HOPE  provides excellent, patient-centered, scientifically advanced care for individuals suffering with mental illness. A state-of-the-science mental-health center and charter member of the National Network of Depression Centers, the center provides psychiatric hospitalization and partial hospitalization for individuals 12 years and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The center is also affiliated with the University of Cincinnati (UC) College of Medicine.

Amanda Porter, MSN, APRN, FN-C, PMHNP-BC, CARN-AP, Lindner Center of HOPE Psychiatric Nurse Practitioner, was honored on Tuesday, October 2 as a Rising Star Medical Leader by Venue Magazine and John D. Dovich & Associates, LLC.

Mrs. Porter is a triple-board certified Psychiatric Mental Health Practitioner, certified in internal medicine, psychiatry/mental health and addictions.

In her role, Ms. Porter offers patients psychiatric medication evaluation and treatment in addition to ongoing therapeutic evaluation and program support for Lindner Center of HOPE Professional Associates. She offers unique expertise in Integrative Mental Health.  Ms. Porter also supports the Mindful Transitions Partial Hospitalization Program.

Mrs. Porter, along with other honorees, were recognized at a reception on October 2nd.

Lindner Center of HOPE  provides excellent, patient-centered, scientifically advanced care for individuals suffering with mental illness. A state-of-the-science mental-health center and charter member of the National Network of Depression Centers, the center provides psychiatric hospitalization and partial hospitalization for individuals 12 years and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The center is also affiliated with the University of Cincinnati (UC) College of Medicine.

Representatives from Lindner Center of HOPE were invited as special guests to the second meeting of the Tri-State Local Government Collaboration on September 12, 2018, held at the Great American Tower.

The purpose of the invitation was to give mental health a voice in front of elected officials and discuss what kind of action is needed to become leaders in the country for addressing the mental health needs of our community.

Josh Gerth, President, Anderson Township Board of Trustees; Kris Knochelmann, Judge Executive, Kenton County and Jim Thatcher, Commissioner, Dearborn County brought the group together for this important discussion.

Founder and Chairman of the Board of Lindner Center of HOPE addressed the crowd, sharing the journey to opening Lindner Center of HOPE. Mike Glen, Vice President, Business Development and Innovation, Lindner Center of HOPE also made some remarks.

Free Community Education Series Offered the Third Wednesday of Every Other Month

The fifth session of a free education series to help community members increase awareness of mental health, substance use disorders, treatment and strategies for coping is October 17, 2018. Megan Schrantz, EdD, Lindner Center of HOPE, will present The Impact of Trauma on Child Development and Wellbeing Throughout the Lifespan.

This session will cover how adverse experiences impact development and how trauma-informed treatment can help reduce the negative effects.

Lindner Center of HOPE with the support of Manor House in Mason, Ohio is once again offering a Free Community Education Series to increase awareness of mental health issues and substance use. The series offers expert discussion of Mental Health, Substance Use Disorders, Treatment and Strategies for Coping for community members seeking information.

The series is held at Manor House, 7440 Mason-Montgomery Rd., Mason at 6 p.m. the third Wednesday of every other month.

Register by calling Pricila Gran at 513-536-0318. Learn more by visiting lindnercenterofhope.org/education.

Lindner Center of HOPE in Mason is a comprehensive mental health center providing excellent, patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, outpatient services for substance abuse through HOPE Center North location and co-occurring disorders for adults and research. The Center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The Center is also affiliated with the University of Cincinnati (UC) College of Medicine.

Lindner Center of HOPE was a special stop during the Walk Of America expedition taking place between June and September 2018 during which six wounded veterans (three U.S. and three U.K.) will walk 1,000 miles in 12 weeks from the West to East Coast.

The visit to Lindner Center of HOPE on Aug. 27, 2018,  provided much-needed awareness and acknowledged the significant mental health challenges faced by veterans. A shared vision was voiced to raise awareness of the invisible injuries.

“We are extremely grateful to the Lindner Center of HOPE for their support; it provides a unique opportunity to gain insight into the extraordinary work they are doing and to take learnings back to the U.K. to better serve those who have served us,” said Ed Parker, Co-Founder & CEO of Walking With The Wounded.

 Also present were representatives from the Bob Woodruff Foundation (BWF), a U.S.-based nonprofit sponsoring this week of the walk. BWF has invested more than $55 million to Find, Fund and Shape™ programs that have empowered impacted veterans, service members and their families.

“We’re proud to join Walking With The Wounded and the Lindner Center of HOPE to honor this incredible team of veterans, and help shine a light on the collaborative work being done in both of our countries to improve the lives of those who’ve served,” said Anne Marie Dougherty, Executive Director of the Bob Woodruff Foundation.

 The evening, took place in the center’s gymnasium/conference center and included, remarks from Lindner Center of HOPE President and CEO, Paul Keck, Jr., MD and a message read by  L. Thomas Hiltz from Mitch McConnell, United States Senator. Eighth United States Secretary of Veterans Affairs, Bob McDonald, also offered a special address. Moving stories from the six walking wounded were also shared.

To learn more about the expedition or participating veterans, visit www.walkofamerica.com