ADAA Professional Blogs

If you are interested in submitting a blog post for the professional or public communities, we invite your to read our blog post guidelines and submit today.

We also invite you to explore the many public facing blogs authored by ADAA members.

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In 2009 I decided to step out of my comfort zone and open a solo private practice. I’ve enjoyed the last 15 years in private practice, and looking back, there are some choices I made that were on point, some that were errors in judgements, but all were learning experiences.
Firearm ownership is undoubtedly a risk factor for suicide. While it is not the only risk factor, it is a significant one and certainly the most lethal. Firearms are a common method of suicide in veterans with high rates of gun ownership.
DEI can take up valuable time, as well as emotional and mental resources. This is particularly true for graduate students and trainees, who are simultaneously juggling research, clinical training, and personal transitions. Here are FIVE ways to ensure the important work you do, is also working for you.
To change societal perceptions towards OCD, we must first understand what those perceptions are. The purpose of this post is to share key takeaways regarding pre-service teachers’ (PSTs’) perceptions of and stigmas towards OCD, and how we can increase awareness within our schools and communities.
As the New Year approaches, many of us are drawn to the idea of starting fresh and making resolutions for positive change. However, traditional New Year's resolutions often focus on specific outcomes, setting us up for potential disappointment and loss of momentum.
Successfully treating obsessive-compulsive disorder (OCD) often requires primary psychotherapeutic treatment with exposure and response prevention (ERP) and pharmacological treatment with serotonergic agents, typically beginning with SSRIs; however, for a subset of patients with OCD, SSRIs alone do not effectively manage symptoms.
Youth OCD assessment and treatment is far more nuanced than a downward extension of adult OCD approaches, for good reason. What are some of the fundamental ways cognitive-behavioral approaches for youth OCD differ from their adult counterparts?
Someone you love or care for very much has shared with you that they want to “transition”. What does it mean and what do you do now?
The processes driving worry will vary for every individual.  Chances are good that it will not be one or another, but a proprietary blend of several processes which shape each person’s presentation of worry.  Our job as clinicians is to explore these processes and work with our clients to curate a blend of interventions uniquely suited to their experience.
As an ADAA member you enjoy many great benefits. But did you know that joining ADAA also enhances your professional growth?
Thinking, and even overthinking, is normal but when it becomes a mental health disorder, known as hyperawareness OCD, the person feels completely distracted and out of control.
Almost 75 percent of mental health professionals in the US today are white. That leaves roughly 25 percent as non-white, whether they identify as Black, Indigenous, persons of color or some other race or ethnicity.
Limit the depth of exposure to details. People can consume news in limited ways. In other words, learn what’s happening, then stop there. Avoid the urge for disaster voyeurism. If you have heard the story, you might not need to search for the images or the videos; if you have seen them, there is no need to revisit them over and over.

While treatment for OCD is highly effective for many, it can be hard work! It’s not an uncommon experience to lose momentum midway through treatment or even in the final stages. Below are some helpful tips from an OCD specialist to help you make it across the finish line!

1.    Watch out for assigning the hard work to your “Future Self”

The comprehensive behavioral treatment or the ComB model is a treatment protocol developed by (Mansueto 2019) that tackles the complexity of treating BFRBs. It begins with using a CBT assessment tool, a functional analysis.
It’s one thing to get an employee in the door. It’s another to retain them for the long-term.
It’s no secret that the healthcare industry is struggling to find and retain top talent. While the workforce landscape is competitive, recruiting talented employees is not impossible.
Whether we hear the term from a client, another provider, or our own classification of someone’s symptoms, “compulsions” tend carry with them some level of assumption – that this might just be OCD.
When an individual grapples with Obsessive-Compulsive Disorder (OCD), their brain perceives otherwise neutral situations, objects, or individuals as potential threats.
When a person seeks information about treatment for themselves or their loved one, the importance of connecting them with the appropriate level of care right from the start cannot be overstated.
My question to my fellow therapists who treat women with OCD is this: “How can we teach women to whole heartedly love themselves, when a mind that creates negative, intrusive, and terrifying thoughts is such a large part of us?”  
Check out our ADAA members' new books - CBT for social anxiety, an action mindset for teens and thriving with anxiety. Helpful resources to support your mental health journey.

City life is attractive to many people, but seemingly endless high-rises and gridlocked traffic leave little room for city dwellers to reap the benefits that green spaces may have to offer. In our rapidly urbanizing world, more than half of the global population have made their homes in cities. Unfortunately, as we migrate to urban areas, access to green spaces is dropping, which may actually affect our mental well-being.

Individuals residing in cities are:

In the face of a perceived threat, your body often activates a fight-or-flight response. Heart in your throat. Butterflies in your stomach.
Parents of children with OCD are often not aware of how they can contribute to their child's behavior, or more specifically, how they unintentionally support the OCD through accommodating behaviors. This blog post explores the role of family accommodations in childhood OCD and provide strategies to help parents better support their child. 
Many of the themes common to OCD have a taboo or forbidden nature to them, making asking for help from treatment providers an anxiety-inducing experience.  Clinicians can be helpful by bringing voice to this issue, acknowledging and validating that anxiety is a natural part of asking for help. 
Although primary care physicians and other non-specialists in mental health feel comfortable managing less complicated anxiety-related disorders, OCD is a more complex diagnosis and ideally should be managed by a psychiatrist.  Before initiating medication, the psychiatrist will first do a thorough assessment to ensure that the diagnosis of OCD is accurate, and to determine the presence of coexisting conditions that may complicate the treatment.
Intensive programs for OCD can serve as a bridge between different levels of care, specifically as a step-up from weekly outpatient therapy or as a step-down from partial hospitalization/residential programs.
As we are experiencing heat domes across the planet, there is emerging evidence from recent publications that heat, among effects on many other human activities, can also have profound effects on mental health. - Martin Paulus, PhD
There can be confusion when differentiating between body dysmorphic disorder (BDD) and eating disorders (EDs). They both involve pre-occupying appearance-related thoughts and repetitive behaviours, but are treated differently.
According to the DSM 5, Body focused repetitive behaviors (BFRBs) are classified as obsessive–compulsive related disorders. But the question remains, how do we treat BFRBs?
The growing mental health crisis is indisputably affecting our youth. In fact, the pediatric mental health crisis has been called the “top patient safety threat” of 2023.
Check out our ADAA members' new books that offer help for the public and support for professionals.
Sensations of pain and illness in our bodies naturally grab our attention. This attention to pain and illness also naturally evokes emotional responses.
Dr. Widge presented at ADAA’s 2023 conference on how he believes “mental disorders are brain network disorders” and how treatments like Deep Brain Stimulation (DBS), Vagus Nerve Stimulation (VNS) and Transcranial Magnetic Stimulation (TMS) are quite possibly the wave of the future for certain mood and anxiety disorders, and particularly those that are treatment-resistant. 
Therapy can vary from patient to patient, clinician to clinician, but two ADAA members who presented at the 2023 Annual Conference believe therapy for SAD and other related disorders can benefit from an additional tool. Their conference session, Me Talk Funny One Day: Teaching Social Skills for Social Anxiety and Other Disorders, not only confirmed that belief but explained it.

The idea that mental illness and psychiatric disorders are afflictions that only affect the brain is now regarded as incorrect. We know that the brain controls the body and when the brain doesn’t function properly, the body suffers the consequences, and vice-versa. A Roman poet by the name of Juvenal understood this connection when he wrote “a healthy mind in a healthy body”, echoing the fact that the body and brain are intertwined, and the health or ill-health of one can affect the other.

Now that telehealth and in-person services are available, what are important factors for clinicians, youth, and families to consider?
The headlines and the CDC report are indeed alarming, but they should serve as a wakeup call to all of us. Yes, we should think seriously about why we are seeing a steep decline in the mental health of teenage girls, but we have to come together now as parents, family, friends, educators, clinicians, providers, and as a society to support, enhance and establish more preventive measures for our youth.
ADAA had the chance to chat with the 2023 Donald F. Klein awardee, Emily L. Belleau, PhD, and the 2022 awardee, Sage E. Hawn, PhD, about the award and what it means to each of them. Speaking together, the two clinicians were an impressive duo, each with her own set of skills, knowledge and study, working on separate but incredibly meaningful and valuable research. Both Dr. Hawn and Dr. Belleau expressed the importance of being recognized by ADAA for their work and the significance of their studies.
We’ve all wished at times that we could have a therapist in our pockets. Digital mental health interventions are bringing us closer to making this a reality.
Working with Black churches to create a better today and a much better tomorrow in the field (literally) of mental health care for African Americans are three Black leaders in mental health who will present at the 2023 ADAA Conference. ADAA is excited to have Bernadine Waller, PhD, Atasha Jordan, MBA, MD and Kimberly Arnold, MPH, PhD discuss their work, research and findings in a presentation titled Implementing Evidence-Based Mental Health Interventions in Black Churches.
Cognitive behavioral therapy (CBT) for tinnitus has become increasingly popular following the publication of US and European clinical guidelines which designate CBT the only recommended treatment for tinnitus.
Starting an intensive outpatient program (IOP) can be a powerful step in helping individuals achieve lasting change in their mental health and well-being. However, for therapists, the planning and implementation process can be daunting.
Obsessive-Compulsive Disorder (OCD) can affect people of all races, color, ethnicity, gender, socio-economic status, sexual orientation and/or different cultural backgrounds, and culture can have a large influence on how someone might perceive or report their symptoms.
Obsessive-compulsive disorder (OCD) is a common condition affecting approximately 1-2% of the world population. Characterized by distressing intrusive thoughts, images or impulses and unwanted repetitive behaviors, OCD can have wide-reaching implications for both individuals with OCD and their families.
Subtypes are helpful in normalizing symptoms for OCD sufferers and even for diagnosing purposes.  And it is common for OCD sufferers to have multiple subtypes. 
As therapists, we know that OCD is no laughing matter. But that doesn't mean we can't use humour when fighting back OCD. In fact, as an OCD therapist the use of humour can be an integral part of the ERP experience.
For Jill, it was useful to know that the house wouldn’t burn down if she stopped checking; but it was more important to learn that she would still be a worthwhile human being even if it did.   
“Our first concern must be to assure that the advance of medical knowledge leaves none behind.”  A conversation with ADAA#2023 Conference Keynote Luci Baines Johnson
Athletes will continue to work hard, push themselves, and make their bodies do things many of us can only marvel at, but the attention and awareness to mental health in the field of sports gives them a fighting chance with conditions like anxiety and depression.
Throughout time, assessment and diagnosis in medicine have been key in the determination and identification of treatment for medical illnesses. No course of treatment will begin without diagnosis and understanding of origin of illness.
Yet another community is stricken with grief. In addition to those who are experiencing direct loss, such events also take a toll on others, including those who witnessed the shooting, first responders, people who were nearby and those who hear about it through the media.
We have seen an explosion of interest, questions, concerns and stimulating debate since the arrival of Inferential Cognitive Behavioral Therapy for OCD (I-CBT) in the USA. How do we distinguish between obsessional doubt and uncertainty in I-CBT? 
We anticipate a high-spirited, valuable and memorable ADAA 2023 Annual Conference in the nation’s capital and look forward to greeting you amidst the cherry blossoms in April!  
Thank You from ADAA Executive Director Susan Gurley.
Our website contains extensive resources for and from both professionals and the public—but do you know where to find them or what we offer? Here are some of the free evidence-based resources located on our website.
Inconsistent results across studies present a challenge not only for conceptual understanding of clinical symptoms but also for advancing treatment
These generous people lend us their voices, their stories and experiences, and help us shed light on underreported issues like male body dysmorphia and the traumatic effects on the family and friends of a person who died by suicide. Some even use their incredible talents in sports to reach individuals around the world. 

Are you a newly trained CBT therapist, wondering how to start your first independent practice?  Perhaps you want to join an existing group of therapists, or you dream of renting an office and having your own practice.  When I talk to our students and members at Anxiety Training who are working towards having a practice -- from those who are still deciding what degree is best for them to those who have started a practice and want help marketing -- I start by saying that I love my job.  I feel privileged every da

The ability to be ourselves with clients makes it so much easier to connect, to be real about how challenging treatment is, and enlist their help to ensure that whatever the exposure is, its something they can tolerate, trust in, and most importantly, begin to experience relief from their intrusive thoughts and the compulsions that may dominate their lives. 
There is no substitute for receiving mental health treatment and care from a licensed professional but in the crisis we find ourselves now, it becomes even more crucial for the health care ecosystem and all who touch it to take an interdisciplinary approach.
For the second year in a row, ADAA member David H. Rosmarin, PhD, ABPP, ran a fundraising campaign in conjunction with his Philadelphia marathon, raising a total of over $5,000 for ADAA. Dr. Rosmarin is raising awareness about depression and sat down with ADAA to talk about this mental health illness.
As the Executive Director of ADAA, I am always thrilled when we realize our work is making a difference and that we are reaching farther and wider. So, when the Hadassah Foundation, a mental health organization in Cameroon, contacted ADAA with a request to access our free member-created, publicly available, evidence-based resources, we not only acquiesced, we collaborated.  
An impressive trio: a successful psychiatrist, an accomplished social worker with a PhD, and an astute young doctor of psychology with a bright future ahead of her, are father, mother, and daughter, who also happen to be ardent supporters of ADAA and the field of mental health.
Please note that this is an opinion piece by an ADAA colleague member --    "...the conclusion of a study published in Molecular Psychiatry in July 2022 – that there is “no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations” – is not surprising, or even new. What is surprising is that popular media is interpreting the study’s conclusions to say that if serotonin is not the cause of depression, then antidepressants don’t work. Huh?   

At the Anxiety and Depression Association (ADAA), we value each and every one of our members and feel that all of them are a distinguished part of the ADAA “family”. But when we have members who are actually related – mother, son, father, daughter, uncle, aunt, niece, nephew (you see where we’re going here) – we can’t help but find a way to highlight not only the relationship that they have to each other but to ADAA’s work and mission. 

 In true form, for OCD lovers like myself, I posed more questions than answers in the title.  That was intentional, to be funny, eye-catching, and thought-provoking.  Hopefully, I pulled off at least two of those.  These questions are often asked by clinicians, and sufferers alike.  How do I know if this is OCD or if this is social anxiety?  I’ll focus on answering this question as best as I can.   

As the old adage goes, there’s a first time for everything. In the field of psychiatry, we are cautiously celebrating a recent first-time recommendation by the US Preventive Services Task Force calling on primary care providers to screen all adults under the age of 65 for anxiety. Unlike screening for hypertension or diabetes, detecting anxiety can be a lot more challenging, and getting a valid and reliable screening tool is essential.
A newly published study on depression in the American Journal for Preventive Medicine reports that from 2015 to 2020 the prevalence of depression in the United States, particularly among adolescents and young adults in the nation, increased and that the pandemic contributed to a worsening mental health crisis.
With the emergence of I-CBT (which is not new, just new to many of us), we have additional options (for treating OCD). This does not mean we are throwing away other effective treatments like ERP and ACT. In fact, we are doing the opposite!  We have more tools  to provide clients to make sure they have the highest chance for success.
There is currently an unmet mental health need for women experiencing infertility. Embedded mental health care could help bridge this gap by providing access to care in the fertility clinic, a setting that may be more convenient and comfortable for women.
It was one year ago in the month of July that Aaron Beck, MD, the founder of Cognitive Behavior Therapy (CBT) passed away. I write this blog post as a memorial to one of the great minds of our times and to acknowledge the tremendous impact Dr.Beck had on the field of psychotherapy.
The digital natives we child-focused clinicians work with are simply incredible. Not only do they know their way around technology far better than many adults, but they’re also often fluid with their identity: openly embracing either their or their peers’ diverse ancestry, gender identity, sexual orientation, religions, family background, financial standing, as well as neurodivergence and disabilities in themselves and others.
“The ADAA conference provided me with a platform to continue my journey forward into greater understanding of how best to support and treat the patients that I have come to be so inspired by…,” Alex said, adding he is also grateful to his mother and the chance to continue her work into the next era of mental health as the field expands and improves. 
The recommendation most difficult to absorb by most clinicians is the suggestion that interventions that lower expectations of catastrophic or negative outcomes of exposure should be minimized in order to take advantage of the therapeutic effect of violating expectations. The question then arises as to how to motivate patients to do the exposure work while in the grip of serious anticipatory anxiety and suffering from the effects of their own anxiety sensitivity.
Nutraceuticals and herbal remedies are very popular in the United States and worldwide.  Reasons for their popularity include access without a prescription, and generally fewer side effects compared to prescription drugs.  However, the safety and efficacy products are less well studied and understood compared to FDA approved drugs. With growing use, we have seen more cases of serious side effects, toxic reactions, and interactions with other drugs.  Shopping for nutraceuticals can also be tricky because different commercial preparations may vary in purity and strength.  Finally, these treatments are not generally covered by medical insurance, so the consumer must pay out of pocket.
What would it be like if we approached mental health the same way we do physical health? If we normalized it. Everyone – every single human being with a human brain – needs to focus on psychological well-being.

This blog was originally posted on Ten Percent Happier on April 22, 2022 and is reprinted here with permission

I grew up in Brazil, in a little town called Governador Valadares.  Early on, my father left us, and it was my mom, my sister and me. Things were challenging. My mom did the best she could, she worked as hard as she could. But I remember how tough things were – there were times when we didn’t have enough to eat.  But we kept going.

1. Know the conference theme.

Every year, ADAA's annual conference has a theme. Be sure to consider how your submission may fit within the conference theme, and reference this in your submission!

2. Establish your target audience.

ADAA is my go-to conference as a therapist in a specialty private practice. I know I will experience useful and engaging clinical workshops that give me ideas for complex cases or exposures to new ideas. I can also obtain up to date reviews of the field and researching findings that are relevant to my practice. And especially, when in person, but even pretty good virtually, I can connect with colleagues or meet new ones.

Many members of BIPOC communities deal with stress and trauma that can stem from specific socioeconomic struggles that consciously and subconsciously impact the everyday lives of the community.

In a world that is constantly evolving, BIPOC youth are actively working to change the way their communities acknowledge and embrace mental health. Youth (defined here as those between the ages of 15 to 24) are redefining what mental health means and are trying to “unlearn” some of the negative stigmas that have been taught or demonstrated by older generations.  

The menstrual cycle is characterized by distinct changes in ovarian hormone levels, namely estrogen and progesterone. Emerging work suggests that ovarian hormones play a role in anxiety, depression, and trauma-related symptoms. However, their effects are quite complex.

Pregnancy and childbirth can be a joyous time in a woman’s life but can also be a challenging one. Besides the physical changes that occur during pregnancy and postpartum, about 20% of women may experience mental health challenges. While increasing awareness of maternal mental health needs has led to various national efforts to improve maternal health care, Black mothers disproportionately face disparities in accessing and receiving appropriate health services.

Our growing understanding of the relationship between racism and health has enormous implications broadly and in relation to minoritized women. Black and Brown womanhood often results in the exposure to multiple oppressive and traumatic experiences uniquely dependent on the intersection among racism, sexism, and violence. 

“Polina came to our bedroom awakened by the sound of explosions. I didn’t know and still don’t know what to tell her. Her eyes today are full of fear and terror; eyes of all of us.”

Alina, a family friend who is a marketer and mother of two children from the Ukrainian capital of Kyiv – which is under seige by Russian forces – shared this reflection on her Instagram story. Her daughter Polina is 7 years old.

ADAA Executive Director Susan K. Gurley celebrates the mental health trailblazers within BIPOC communities.

If you're like me, this may be one of the first in-person professional conferences you've attended for the past 2 years! I am thrilled for the opportunity to reconnect with old friends, meet and network with colleagues in my field, and drink in all the latest findings in research and clinical work. I'm also eager to attend the poster sessions!

Many mental health professionals are now conducting patient visits virtually. I am one of the only psychologists left in my building who has stayed behind to continue in-person work while abiding by COVID protocols. Since our practice specializes in refractory OCD spectrum disorders and anxiety disorders a lot of the work done at our outpatient clinic requires in-vivo exposures, which cannot be replicated on Zoom.
Addressing health inequity requires a collaborative effort between many levels of the health care system (i.e., patient, community, provider, hospital, government). However, behavioral health providers and researchers can implement strategies that promote health equity at their level of care.
Many of us struggle with perfectionism and deciding on New Year’s resolutions can add stress to a process that’s supposed to be helpful. Fortunately, evidence shows that optimal goal setting promotes mental health when the goals are measurable, obtainable, psychologically safe, and prioritize health and wellness. 
Happy Holidays! I wanted to end the year by taking a moment to reflect on my tenure as ADAA president - which was served entirely during the COVID-19 pandemic. One of the highlights of these two years has been all that we were able to accomplish together despite the chaos of the world.
There is an area of social anxiety that is practically a universal experience for girls and women, yet rarely gets discussed: non-touch unwanted sexual attention.Such experiences happen to all people of all ages, and between all genders. For girls, the incidence is particularly alarming. From puberty to age 18, more than 90% of girls experience such unwanted encounters. 

ADAA’s conferences are incredible, offering unparalleled learning, networking, and engagement opportunities. However, for many attendees – both new and seasoned – the constant hustle can be overwhelming. As professionals, we want to gain the most we can from attending conferences, but the most effective way to do that can be elusive. One terrific tip we can take from mindfulness is to be present. Engaging in sessions and casual conversations can set off our minds about how we can take this information and best utilize it.

Science supports how consciously practicing gratitude can help you feel better, attain stronger mental health outcomes, and even curb anxiety.
In BDD, people are tormented by obsessive thoughts associated with a part or parts of their physical appearance being flawed in some way, yet these flaws tend not to be noticeable to anyone but themselves.
Read more on the strategies psychologists can use to discuss race in therapeutic spaces from ADAA Members Erika Vivyan, PhD and Katherine Martinez, PsyD.

When our family (KM) recently moved, my children discovered that in each of their new schools’ peers were using racist, sexist, and homophobic remarks, something they had not previously experienced. My kids were woefully unprepared - and it turns out this is not unusual. When it comes to these types of remarks, which we believe is a form of bullying, the research supports that while kids know what they are seeing/hearing is wrong, they often lack the skills to respond effectively1.

Congratulations on your poster acceptance to the ADAA conference! First let's take a moment to celebrate that accomplishment and the opportunity to present your work! This is a testament to the scientific contribution of your work and many conference attendees will be looking forward to seeing your poster at the conference.

As a new postdoctoral resident in 2019, I was nervous about the prospect of transitioning from a “forever-student” into an early career psychologist. After so many years on a prescribed path, it was tough to imagine forging into the job force without a clear plan. Searching for a tether of sorts, my supervisor recommended ADAA and the Alies Muskin Career Development Leadership Program (CDLP). Little did I know the impact this program would have in the trying times ahead!

During the fall of 2019 I was at a pivotal point in my career trajectory. I had just started my pre-doctoral internship year and was preparing to apply for post-doctoral positions – a last step in my training as I pursued a career in research. So, when I learned about ADAA’s Alies Muskin Career Development Leadership Award Program (CDLP) and its focus on providing early career researchers and clinicians with intensive mentoring and professional development opportunities, I knew I wanted to apply.

The current pandemic has unleashed unique stressors on our health care community. While many medical and mental health care workers have responded with resilience, our health care workforce is not immune to the trauma and suffering they face.

A longstanding passion of mine has been exploring leadership opportunities and finding ways to develop my skills as a leader; in training, research, mentorship, and more. I love being able to interact with people, those similar to me and those different from me, and sharing my experiences and providing opportunities, tips, and support for their growth. I also happen to find leadership to be a very symbiotic relationship where I can learn and grow from those I “lead” - what better arrangement is there!

If you are attending ADAA's Annual Conference for the first time, welcome. With over 1,100 attendees expected and more than 100 engaging sessions anticipated, events, and networking opportunities, it could be easy to be overwhelmed. But we are here to help combat that feeling with a few helpful tips to make the most of your time!  And, don't forget - everyone was a new attendee at some point - me included!

Pace Yourself

The growing popularity of medical cannabis coupled with increased rates of anxiety, especially in relation to the COVID-19 pandemic, has reignited a long-standing conversation about the potential effects of cannabis on psychiatric symptoms.
According to the latest mental health statistics from the Trevor Project’s 2021 Youth Mental Health National Survey, 42% of LGBTQ youth reported that they seriously contemplated suicide during the pandemic. Additionally, these youth experienced elevated rates of anxiety and depression due to social isolation as many were unable to further their gender and sexual identity development and expression due to a lack of accepting and affirming environments that were open during the pandemic.

As summer heat waves break records across the country, many kids and teens have already started preparations for the upcoming school year. Given the many months of learning at home, virtual school, hybrid education, and socially-distanced classes (or some combination of all of these), students are in for another strange and anxiety-provoking back-to-school season. Here are a few things that parents and professionals need to know about back-to-school anxiety in 2021:

ADAA Member Amanda Baker, PhD, Daniella Levine, BA, and Donald J. Robinaugh, PhD author this blog post: Anxiety takes many shapes. Ecological momentary assessment (EMA) allows us a glimpse into the real-world experience of living with anxiety disorders.
ADAA members Sheila Rauch, PhD, ABPP and Carmen McLean, PhD - The past 30 years of research has seen vast leaps in our understanding of how the brain works in function and dysfunction.
For many of us, the pandemic and now the time we are moving into post-pandemic has created an unusual situation – life as an unbroken series of days that followed the same pattern.

Parenting is an increasingly complex job. It’s layered with important responsibilities one of which is raising anti-racist children. In addition to being a Registered Psychologist, I am also a parent, a white parent, who wonders what I can do to engage with this important work. I have learned that I can be doing more at home to raise antiracist children, and that the responsibility is mine and not that of the Black and Brown communities.

This blog post will share research surrounding the harms of such form of microaggression faced by Asian Americans: the “model minority” stereotype.

It can be challenging to control your weight. In today’s modern world, it is more convenient to order take out than to cook a meal and take the elevator instead of the stairs. Over time, a pattern of eating unhealthy foods and being sedentary can lead to excessive weight gain. While many of the factors associated with weight (e.g., genetics, metabolism, finances, lived environment, etc.) are not in our complete control, there are lifestyle factors that can be adjusted. In particular, nutrition and physical activity have the strongest evidence for maintaining a healthy weight.

"What if” thinking is not unique to Obsessive-Compulsive Disorder (OCD).  It is a feature to a greater or lesser extent in several other conditions.  Using what we know about Exposure and Response Prevention (E/RP) for OCD might improve treatment for these other conditions.[i]

The virus has upended the world as we know it, and kids are struggling.  Kids were not meant to live this way.  None of us were meant to live this way, but as a child therapist, I have a special focus on kids and their well-being.

Back in 1994, I applied for a poster presentation for the ADAA annual conference based on my observations that there is a certain group of patients whose onset of OCD began after a certain level of trauma/PTSD. ADAA's committee accepted my presentation for a symposium which was supervised and led by one of the leading experts in the world on OCD and PTSD: Dr. Edna Foa (also an ADAA member). 

Have your clients faced those situations where, in getting ready to make values-based exposure exercises, their minds come up with thoughts along the lines of, “It will be too much; I won’t be able to handle it; It will be a disaster; how do I know it’s going to work; Do I really have to do it?” And next thing they know, they’re in a battle with those thoughts, sometimes trying to prove them wrong, other times giving up and going along.

Anya, a 26-year-old, was in charge of organizing the schedule for the annual camping trip with her college classmates. She was excited and ready to make phone calls and gather prices for transportation, camping sites, etc. But in the middle of preparing for those errands, she noticed a red stain on the hardwood floor of her house. Quickly her mind came up with the thought, “Did I step on it? What if its blood? What if I get an illness?

As the COVID-19 pandemic continues, teletherapy is one of the only ways to continue receiving mental health services...but what happens when therapy must continue across state lines? 

The COVID-19 pandemic and subsequent increased awareness of systemic racism have left me, a white psychologist, at a loss for words. I wanted to write a post for other anti-racist allies who are also struggling to voice and act in increasingly anti-racist ways both personally and professionally. Here are some things that I have been working on, and I thought that it would be a useful list for other white psychologists who aim to promote anti-racism in their practices.


As I was being discharged from the hospital after an 11-day stay, a friend texted me: “The hard part’s over!” In one sense she was correct – I’d completed the antibiotics for COVID, my sepsis was gone, and my pneumonia and kidney function were improving. But that was just the physical battle.

Body Dysphoric Disorder (BDD) is described as the disease of “self- perceived ugliness” or “self-imagined ugliness.” It is also seen as a distressing preoccupation with one or more physical non-existence “defects.” In the DSM-5, BDD is classified under Obsessive Compulsive and Related Disorders. Within the general population, 1%-2% have being diagnosed with BDD, which is nearly 5 million people in the United States alone. Additionally, about 70 % of cases indicate that the onset of BDD occurs before the age of 18.

In the midst of the ongoing COVID-19 pandemic, the killings of George Floyd, Ahmaud Arbery, Breonna Taylor, and many others shine a glaring light on the continued presence of systemic racism in the police system and many other U.S. institutions.

A new wave of high school dropouts is looming and the stakes couldn’t be higher. Dropping out of high school has been linked to higher instances of suicide attempts, substance abuse, and criminal activity.

Though none are immune to COVID-19, the rippling impacts of the current pandemic are unequal, due in part to pressing economic and social needs of minorities in the United States that are largely overlooked in response efforts.

In an already challenged, and often under-resourced mental health care system, the COVID-19 pandemic has led to an increase in mental health needs across the globe1,2. The World Health Organization’s models of pandemic impacts project a significant uptick in these needs both in the acute and long-term outcomes of this crisis3. To rapidly respond and continue the vital mental health services we need in the changing reality of wide-spread isolation measures, governments and insurance companies have rapidly aligned to adjust policy for telehealth.

The COVID-19 pandemic has caused significant disruption and stress for everyone.

The night of Sunday April 19, I stayed home with my dog Ritz watching TV and eating takeout from one of my favorite restaurants. Later that night I became very ill, surprising because I’d been eating at that place for a decade without issue. When my alarm went off Monday morning, I felt terrible and my temperature was 100.9°. When Ritz and I take our morning walk we usually go two to three miles, and Sunday had been no exception, but Monday morning I struggled to make it 100 feet. I knew something was wrong.

The use of positive behavioral strategies in the treatment of anxiety and comorbid behavior disorders is incredibly helpful during therapy sessions.  Whether the child is practicing exposures or destroying the therapy room, these strategies can help therapists to increase therapeutic time and decrease frustration for all involved.  Just remember the basic principle of consequences in operant conditioning (a la B. F. Skinner): 

Overnight the world changed. Public health terms have become common phrases; we hear people talking about flattening the curve and social distancing. Scientists have become household names, with Dr. Anthony Fauci not only appearing in press briefings but chatting with Stephen Curry. And people are staying home. Millions of people’s homes have suddenly become their workplaces. For many, that brings new challenges like learning how to join videoconference calls and not disturb family members.

In the early 2000s, patients started reporting a new worry to their OCD therapists: what if I’m gay? This thought was often prefaced by patients declaring that they weren’t homophobic, but the fear was still there. The theme was dubbed homosexual OCD or HOCD. However, around that the same time, patients who were gay had a very similar fear: what if I’m actually straight? The issue of sexual orientation creeping into OCD is a sign of the ever-evolving societal environment.

*With the pandemic creating untold new challenges for us all, many therapists have completely switched to video visits with their patients. For those of you who are new to telehealth, it may be useful to check out some of these links for technical and ethical guidance:

Before COVID-19 was declared a pandemic, many of us in mental health became aggressively helpful. We gave interviews to media outlets small and large and wrote content for wide distribution. Just before the World Health Organization made its declaration, some of us were already fatigued. We decreased our output and refused interviews. Much like medical experts had exhausted the limits of their advice—keep your social distance, cover your coughs and sneezes, do not touch your face, wash your hands for at least 20 seconds—we’d said all there was to say.

What is Trichotillomania (TTM)?

This consists of compulsive urges to pull one’s hair resulting in noticeable hair loss. Hair-pulling can be any part of the body like arms, pubic hair, eye lashing, legs, etc. 

Why do people do this?

What is OCD? OCD is composed of two components: obsessions and compulsions.  Obsessions are recurrent and persistent thoughts, impulses, or images. The thoughts, impulses, or images are not excessive worries about real-life problems. Individuals attempt to ignore, suppress, or neutralize such thoughts, impulses, or images. Typically, individuals recognize the thoughts, impulses, or images that are merely products of his/her own mind. For example, an individual might have a fear of being contaminated, losing control, or might focus on an idea excessively. 

There are clear treatment standards for the treatment of obsessive compulsive disorder (OCD) which offer impressive outcomes and allows individuals to return to high-levels of functioning. Exposure with response prevention (ERP) and a combination of medication are the gold-standard treatment for OCD and through a goal-oriented treatment approach, individuals with OCD (across severity levels) can significantly reduce their overall symptomology, learn tools for relapse prevention and enter the maintenance stage for their diagnosis. 

This blog post is presented by the ADAA 2020 Conference Gold Sponsor VistaGen Therapeutics.

My newest way to explain OCD to a patient and family.

I love trying to come up with new ways to explain OCD to new patients and families. In my 20 years of treating OCD, I like to think that I have honed in on it pretty well, and thought I would share it with all of you. I would appreciate your feedback and would love to hear if you use it with your patients and how it went.

Here we go.

Prior to joining the Stress, Trauma and Anxiety Research Clinic (STARC) at Wayne State University (WSU), I did not know much about the refugee community, aside from what was publicized as a political point of contention during the 2016 election. I now see it as the crisis that it truly is. The STARC team, directed by of Dr. Arash Javanbakht, had found a high prevalence of anxiety and depression in both Syrian and Iraqi refugee adults and children, with symptoms shared between mothers and their children. While watching a CNN report on this research work, an art therapist at WSU, Dr.

I presented a complex case recently at the Anxiety and Depression Association of America that challenged my clinical skills, but more importantly, deeply affected the quality of life of the person I was treating. It is always an honor to walk alongside my clients on their journey to living well with anxiety and OCD. This particular person struggled from a trauma he experienced when he was young and from there he developed severe OCD with themes of harming, responsibility, and perfectionism. I am happy to say he is living his life fully now.

You may already feel overwhelmed by reading the title of this blog! How do I keep up with the changing trends and use social media effectively to promote myself? It’s easy to use social media as a form of entertainment, to post personal pictures and videos, and to connect with others who have similar interests. But, when it comes to having a professional presence on-line, it can be difficult to know where to start.

In this blog post we will provide a description of Problematic Internet Use, describe screening measures existing in the field and key unanswered questions, provide clinical patients examples, introduce COST project, suggest a design of an upcoming study, describe applications (“apps”) available for intervention, and will seek patient advocates feedback for the proposed study design, screening measures development and feedback on different digital apps available.

Postpartum mood disorders are among the most common and debilitating mental health problems in the U.S. (1-2), with the capacity to interfere with maternal function, infant health (3-4), and maternal-infant bonds (5). There are unique concerns that clinicians and patients should know to recognize and treat these conditions. In my recent ADAA continuing education webinar, I discuss the structure and techniques of an effective behavioral intervention for perinatal depression.

1. What makes an application “wow” you? And the converse, what makes you want to stop reading an application on the spot? 

1) Certainly experience is a major factor in making a job application impressive. However, two factors that are particularly appealing are the applicant’s ability to convey eagerness to learn and genuinely communicating a desire to be involved in the prospective employer’s work. Applicants who communicate in a diplomatic fashion that they are familiar with your work while simultaneously highlighting good experience and a desire to take their own program of research and practice to the “next level” are particularly ideal.

Kids and teens often react with anger to the prospect of facing their fears. Doing things like engaging in exposure therapy or going to school when they are feeling panicked or overwhelmed, can trigger fight-or-flight responses, in which anxious children not only experience a desire to avoid things but sometimes actively fight or resist when we try to push them.  

On average, it takes 17 years for an evidence-based treatment to reach the community, and because of stigma, it may take an additional 10 years before a person suffering from mental illness actually receives treatment. The goal of implementation science is to address this gap between science and practice, helping the most vulnerable people to access high quality care. Providers and researchers are both crucial to bridging research to practice, especially in community settings.

Focal brain stimulation techniques are potentially powerful tools for the investigation and treatment of neuropsychiatric disorders. These approaches include transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation among others. In general, focal brain stimulation applies electrical stimulation to a discrete region of the brain to generate neurophysiological effects.

We have all felt afraid.  Fear makes some feel unique, alone, embarrassed, or ashamed, while others may become angry, defensive, or hostile.  Socially, group experiences of fear of the unknown and xenophobia can drive negative political movements and mass hysteria.

Elizabeth Spencer and I just finished giving an ADAA continuing education webinar called, The Magic of CBT for Anxiety and Depression. We have found, from our workshops, that many master level clinicians have never learned the foundations of cognitive behavioral therapy. This is unfortunate in that it becomes difficult to understand some of the more advanced concepts of CBT with ERP if you don’t know the basics. We were thrilled with the number of participants in this webinar.