4105 S Carnegie Pl
Sioux Falls, SD 57106
Great Plains Psychological Services
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Psychological Services in Sioux Falls, SD

Adolescent Transitions

The transition from being a kid who goofs off with friends and doesn't worry about tomorrow to being an adult who pays bills and votes, is huge. Parents love keeping their kids' kids, but what happens when they graduate from high school? Do they get a job or go off to college? What college an adolescent goes to, how they study (or don't!) and how they choose the career their going to embrace as a young adult – it's all about transitions.

The shift from child to adult may be one parents and kids are not eager for, but it begins when adolescents enter high school. Many choices lie ahead. Most kids don't get this and don't realize that when they enter high school, their grades start really counting. This major life transition can be challenging – for parents and teens. Getting professional help can give teens a clearer view of the choices they are making.
Adoption Homestudies

An Adoption Home Study is done to approve prospective families/homes for an adoptive placement. This is only one part of a process which involves attorneys, agencies, state and possibly federal and international personnel.

The Adoption Home Study process includes:

  • A comprehensive interview with prospective parents, including background checks, reference checks, and a survey of the home.
  • A report is compiled with the findings and recommendation based upon the gathered information.
  • After placement of a child occurs, a six month post placement period begins where three visits will take place at one, three and five month intervals.
  • If placement is successful, a report is completed recommending adoption to the court.
Child & Adolescent Therapy

Despite a parent's best effort, a child may begin to have intolerable feelings of anger, rage, frustration, sadness, guilt or disappointment. Without intervention at this point, the child becomes a high risk for worrisome and destructive behaviors. When children are troubled, they generally behave in one of several ways:

  1. Acting Out: Abusive, violent, disruptive, aggressive, cruel behaviors.
  2. Withdrawal: Fears, depression, refusing to talk, acting younger than their age.
  3. Defensiveness: Lying, cheating, manipulating others, avoiding others.
  4. Disorganization: Out of touch, disconnected thinking or irrational behavior.

It's difficult to know for sure when a child is troubled. Here are a few warning signs to watch for:
  • Loss of interest in activities and relationships
  • Isolating
  • Feelings of hopelessness and despair
  • Changes in eating or sleeping habits
  • Declining performance in schoolwork and/or attendance
  • Angry acting out behavior such as hitting or fighting
  • Suicidal talk or action; other self harm
  • Lack of respect for authority
  • Drinking alcohol – using drugs
Critical Stress Debriefing

You have experienced a traumatic event. Even though the event may be over, you may now be experiencing or may experience later some strong emotional or physical reactions. It is very common, in fact quite normal for people to experience emotional aftershocks when they have passed through a horrible event.

Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. Sometimes they may appear a few hours or a few days later. And, in some cases, weeks or months may pass before the stress reactions appear.

The signs and symptoms of a stress reaction may last a few days, a few weeks or a few months and occasionally longer depending on the severity of the traumatic event. With the understanding and the support of loved ones, stress reactions usually pass more quickly. Occasionally, the traumatic event is so painful that professional assistance from a counselor may be necessary. This does not imply craziness or weakness. It simply indicates that the particular trauma was just too powerful to manage without help.

A CRITICAL INCIDENT STRESS DEBRIEFING promotes a more rapid recovery from incidents and aids normal integration back into work and home routines.

CRITICAL INCIDENT STRESS DEBRIEFING (CISD) is a confidential service using trained facilitators to help employees manage stress reactions to work related incidents occurring on or off-premises. The debriefing involves a confidential, non-evaluative discussion of the involvement, thoughts, reactions and feelings resulting from an incident. It serves to reduce the stress impact resulting from exposure to a critical incident through a venting of feelings along with educational and informational components. It is not a form of therapy or treatment. Typically a debriefing takes place within 24 - 72 hours of the incident and lasts one to two hours. Additional follow-up to the debriefing can be arranged, if needed. A CISD debriefing is not an operational critique or a formal inquiry. Some normal stress responses to Critical Incidents that may indicate a need for outside help include:
  • Changes in sleep patterns
  • Intestinal upsets
  • Anxiety
  • Flashbacks, nightmares
  • Difficulties concentrating
  • Changes in eating habits
  • Mood swings
  • Depression
  • "Startle" reactions
  • Feelings of anger or guilt
Individuals benefit from a CISD because it:

  • Reduces stress and feelings of isolation and abnormality resulting from a Critical Incident.
  • Prevents the onset of delayed psychological reactions and promotes well-being.
  • Provides peer support and education about stress reactions.
  • Improves coping skills for future incidents.
Education & Training Programs

The Staff of Great Plains Psychological Services is available for workshops, training seminars and speaking engagements. A variety of topics and formats are available. Some topics include the following:
  • Addictions and the Family
  • Assertiveness Training
  • Birth Position & Personality Development
  • Conflict Resolution
  • Critical Incident Stress Management
  • Eating Disorders
  • Effective Communication
  • Evaluation and Treatment of Sex Offenders
  • Grief and Grieving
  • Overcoming Depression
  • Parenting and Family Issues
  • Posttraumatic Stress Disorder
  • Sexual Harassment
  • Surviving Incest / Sex Abuse
  • Stress Management Skills for Today
  • Understanding
  • Women's Self-Defense: Physical Techniques & Psychosocial
  • Working with Emergency Personnel
  • Working with Resistive or Assaultive Clients
  • Youth and Suicide
Group Therapy

Group therapy uses the power of group dynamics and peer interactions to increase understanding and improve social skills.
Individual Counseling

Individuals seek counseling for a variety of reasons: depression, anxiety, low self-esteem, problems with family members, friends or other relationships.You may have behaviors you know are bad for you but you don't know how to change them. Perhaps you have a child or loved one you just don't know how to help. When the people you love are troubled, you feel troubled too.

Individual counseling can help you sort through the confusion to decide what's best for you to do. Our counselors can assist you identifying the specific aspects of situations troubling you and then explore changes you can make to help you feel more free and happy.

GPPS therapists commit to a strength-based and solution focused therapy which enables individuals to identify their needs, resources and abilities. It also empowers them to move towards creating positive and healthy change in their lives.
Marriage/Couples and Family Counseling

Families can be tough places to live, particularly if they don't know how to get along. Parents and spouses/partners are busier than ever with demanding jobs and tight budgets. Kids face an ever-expanding world of temptations and bad influences. If everyone loves each other, why is it so hard to be happy together?

Family and/or marriage/couples counseling can be helpful when conflicts between spouses/partners, siblings or between parents and children become disruptive to the family group. In this type of counseling, couples or the entire family come together for counseling, talking about the problems and concerns in the home. All participants are encouraged to give their point of view on the difficulties and say what they feel needs to change. Couples and family therapy focuses on helping the family function in more positive and constructive ways by exploring patterns of communication and providing support and education.
Play Therapy

Like adults, children have big worries too. Loss of a loved one, low self-esteem, abuse, an alcoholic parent or divorce in the family are all common issues that many kids struggle with. Young children don't always feel comfortable in what is known as traditional “talk” therapy.

Play therapy is a widely-accepted, very effective tool for helping children in problematic life situations learn to express their feelings and explore coping skills. Play therapy involves the use of toys, blocks, dolls, puppets, drawings and games to help the child recognize, identify, and verbalize feelings. The therapist observes how a child uses play materials and identifies themes or patterns to better understand the child's problems. Through a combination of talk and play the child has an opportunity to better understand and manage their conflicts, feelings, and behaviors.

Some warning signs in young children:
  • Unable to separate from parents
  • Anxious or fearful
  • Refusal to comply with rules or expectations
  • Withdrawal and lack of interest in activities
  • Aggressive Behavior
Psychological Testing & Evaluations

Psychological testing and evaluations offer a formal way to measure traits, feelings, beliefs and abilities that can lead to people's problems. Some tests assess the presence of certain conditions, such as depression, anxiety, anger control or susceptibility to stress. Other tests measure general well being and provide an overall picture of a person's personality. A typical psychological assessment includes an interview with a psychologist and one or more formal psychological tests. The person may be able to complete some tests on his own; others may be completed with an examiner.

Upon a referral for psychological testing or evaluation, one should recognize that the intent is to gain a deeper, more complete understanding of the problem than can be gained from a brief office visit. Such a referral does not mean that the problem is particularly serious, difficult to understand or complex. It just means that additional information is needed before designing the best approach to address the problem.

If a referral for testing or evaluation is made, knowing why such a referral is being made is important to know. Becoming generally familiar with what to expect is also important. Often, an appointment for psychological testing and evaluation requires several hours of time to complete questionnaires or engage in face-to-face interviewing and paper and pencil testing.
Psychosexual Evaluation and Treatment

Psychosexual evaluations are conducted when there are concerns about a person's sexual behaviors. The sexual behavior or concern may be considered illegal and/or deviant, including, but not limited to: pedophilia or child sexual molestation; rape; exhibitionism or the exposure of one's genitals; fetishism, or the use of nonliving objects; frotteurism, or the touching of nonconsenting persons; sexual masochism or sexual sadism; voyeurism or the watching of unsuspecting persons for sexual purposes; problems with pornography in general or the use, manufacture or distribution of child pornography; obscene telephone calling; beastiality or zoophilia; excessive masturbation; other obsessive or addictive sexual practices.

Sexual behavior of concern may be seen in adults, adolescents and children. Psychosexual evaluations require an extensive clinical interview with the client (and also parent(s) or guardian(s) of minor clients), psychological and sexuality testing along with cognitive and mental status assessments. A review of collateral data should also occur, including but not limited to:

  • Court documents and Pre-Sentence Investigations
  • Law Enforcement Reports – Criminal History Data.
  • School Records to include: Grades, Disciplinary, I.E.P. and Psychological - Counseling Records
  • Previous Psychological Evaluations
  • Chemical Dependency Evaluations
  • Victim Statements

The psychosexual evaluation will help determine whether the presenting sexual behavior(s) of concern place the client and/or the community at high, medium or low risk of concern. Outpatient sexual counseling may be recommended for persons considered to be low to moderate risk when the person admits to having a sexual problem and reports they will commit to an active therapy plan designed to reduce their risk of recidivism. Residential treatment and/or incarceration may be recommended for persons viewed to be high risk for further sexual offending or for persons not willing to participate in recommended sexual treatment.

Psychosexual evaluations often require a full day of evaluation or multiple shorter assessment appointments. It is helpful to know ahead of time, when possible, if the client can read and write normally or whether they have problems in these areas.
Forensic Psychological Evaluations

Forensic Psychological Evaluations are designed to address psycho-legal issues. The most common forensic psychological referrals to psychologists are for competency to stand trial issues. Referrals are typically made by the Court or by an attorney.

Problem Addressed


Gambling, work, sex, internet, shopping and food – these are only a few areas where enjoyable interests and hobbies can become preoccupations and even compulsive. When any of these areas suddenly consume more of a persons time and life, or cause one to shift or compromise previous priorities in their life, it can be very disrupting to oneself, as well as significant others in their lives. Addictions and compulsions are often anxiety driven, act as a substitute for childhood or present day “voids” in ones life. Left unchecked, they can destroy a family, and often can lead to full blown addictions. Therapy can help an individual and family work together to keep addictions and compulsions form ruining their lives. The individual may need to work on emotional issues, while simultaneously committing to a re-structuring of their lives.
Anger Management

Anger is a completely normal, usually healthy, human emotion. But when it gets out of control and turns destructive, it can lead to problems. The ability to effectively control or "manage" anger is essential in all phases of our lives. Whether as parents, employees, neighbors or responsible citizens, it is of critical importance that we can control angry feelings and avoid hurting others or ourselves. Feelings of anger can lead to rage and result in irreparable harm. For example, a perceived inability or unwillingness to control anger may result in:

  • domestic violence
  • child abuse
  • job conflicts
  • marital bickering or quarreling
  • road rage

Anger management counseling involves development of cognitive awareness of the thought processes that result in anger and loss of control, and learning self-control techniques to utilize when angry. Relaxation skills, stress management techniques and cognitive therapy interventions are used in combination to assist the individual with anger control.

Through the process of counseling, those who have been afflicted with feelings of anger and rage can begin to assume responsibility for their thoughts, feelings and behavior and can begin to live as healthy adults who are capable of controlling their behavior.

There are many factors account for anxiety disorders. Genetics, early childhood experiences, recent stresses in life, unrealistic expectations about yourself and others, relationship conflicts, alcohol, caffeine, poor coping skills, and other factors all contribute to the experience of anxiety. People are anxious about things that are personally relevant to their concerns. You may worry about being rejected, making mistakes, not achieving success, getting sick, or being abandoned. Furthermore, when you are anxious, you may avoid or leave situations that make you feel anxious or try to compensate by trying to be overly controlling, overly concerned about approval or by trying to be perfect.

Therapy will help you develop the motivation to modify your anxiety and learn how to distinguish between productive worries and unproductive worries.
Attention Deficit

Imagine living in a fast-moving kaleidoscope, where sounds, images, and thoughts are constantly shifting. Feeling easily bored, yet helpless to keep your mind on tasks you need to complete. Distracted by unimportant sights and sounds, your mind drives you from one thought or activity to the next. Perhaps you are so wrapped up in a collage of thoughts and images that you don't notice when someone speaks to you.

For many people, this is what it's like to have Attention Deficit Hyperactivity Disorder, or ADHD. They may be unable to sit still, plan ahead, finish tasks, or be fully aware of what's going on around them. To their family, classmates or coworkers, they seem to exist in a whirlwind of disorganized or frenzied activity. Unexpectedly--on some days and in some situations--they seem fine, often leading others to think the person with ADHD can actually control these behaviors. As a result, the disorder can mar the person's relationships with others in addition to disrupting their daily life, consuming energy, and diminishing self-esteem.

An attention-deficit disorder (ADD) is a developmental disorder characterized by developmentally inappropriate degrees of inattention, overactivity, and impulsivity. Symptoms are neurologically-based, arise in early childhood, and are chronic in nature in most cases. Symptoms are not due to gross neurological impairment, sensory impairment, language or motor impairment, mental retardation, or emotional disturbance.

Three main traits characterize ADD: (1) poor sustained attention or vigilance; (2) impulsivity or difficulty delaying gratification; and (3) hyperactivity or poorly regulated activity. Increased variability of task performance and problems complying with rules are often key features.

What are some signs of inattention?
  • Difficulty following instructions
  • Difficulty sustaining attention
  • Loses things necessary for tasks
  • Insufficient attention to details
  • Appears disorganized
  • Makes careless mistakes
  • Appears sluggish/drowsy
  • Appears forgetful
  • Often engages in daydreaming rather than attending
  • Appears apathetic, unmotivated to complete tasks
  • Appears "spacey," preoccupied
  • Appears confused, lost in thought
What are some signs of overactivity-impulsivity?
  • Difficulty awaiting turn
  • Interrupts/intrudes
  • Blurts out answers
  • Difficulty playing quietly
  • Difficulty remaining seated
  • Excessive writhing or squirming
  • Fidgeting
  • Excessive talking
In individual counseling, the therapist helps children or adults with ADHD learn to feel better about themselves. They learn to recognize that having a disability does not reflect who they are as a person. The therapist can also help people with ADHD identify and build on their strengths, cope with daily problems, and control their attention and aggression. In group counseling, people learn that they are not alone in their frustration and that others want to help. Sometimes only the individual with ADHD needs counseling support. But in many cases, because the problem affects the family as well as the person with ADHD, the entire family may need help. The therapist assists the family in finding better ways to handle the disruptive behaviors and promote change. If the child is young, most of the therapist's work is with the parents, teaching them techniques for coping with and improving their child's behavior.distinguish between productive worries and unproductive worries.
Bipolar Disorder

This is a form of a depressive disorder that also includes periods when the individual is “manic” rather than depressed. Mania includes symptoms such as lack of need for sleep, inflated self-esteem, excessive irritability or hostility, inability to sit still, racing thoughts, easily distracted, and inappropriate or highly risky behavior.

Patients and their families can cope better if they learn more about the nature of bipolar disorder. No one “chooses” to have bipolar disorder—so educating families about the genetic basis of this problem can be very helpful. Also, family members can learn how to respond to the patient's mood fluctuations –such as sadness, irritability, exuberance, and hopelessness—without being critical or controlling. Psychotherapy, along with medication, is very valuable and effective in treating this illness.
Blended Families

Nationally, nearly three out of five families are raising children from another parent, different marriages and different families. Blended families include adopted children, divorced families raising children together and children from other marriages or relationships. An increasing number of grandparents are raising their grandchildren. And foster parents are raising their own children with the children of other parents. Parenting in a blended family is a challenge with unique problems.

Children grieve, let go and move on in different ways and over different time frames. Blending a family may be necessary for practical and financial reasons, but doing so can be stressful and will raise many uncertainties for children. Life goes on, but ignoring stress when blending a family can produce emotional and behavioral problems. Children tend to act out their feelings when they are under a lot of stress. Family counseling or advice may be helpful and even necessary if children are having difficulty with an early transition into a blended family.
Career Counseling

People spend a significant chunk of their lives working, but many find themselves unhappy and frustrated in their careers. Career counseling can help pinpoint the best jobs for specific individual strengths. Different jobs are perfect for different people. To determine a person's best work situation, counselors will utilize such instruments such as the Myers Briggs Type Indicator and The Strong Interest Inventory. These instruments describe personality attributes and help focus academic or career efforts. All jobs have some drawbacks, but a career that fits individual needs enables us to feel productive and happy.
Chemical Dependency

Dependency with alcohol or drugs can often begin as a temporary solution to physical or emotional pain. For some, it can quickly develop into a way to cope with on-going emotional and physical pain. When this happens, the focus often becomes more on the “relief” from the pain than on solving the problem. Dependency occurs when someone has developed a tolerance to a substance and needs increased amounts of a substance to achieve “relief” from the pain, or finds the substance no longer achieves the desired effect, and they can experience any or all of the following:

  • withdrawal symptoms
  • an inability to cut down or stop using the substance
  • excessive focus and time spent on getting more of the substance
  • negative impact on job, school, relationships and interests
  • ultimate worsening of physical or psychological problems

Ongoing abuse/misuse of substances for recreational purposes can also develop into a dependency problem A counselor can help you identify if these warning signs are present, develop a plan to address them and put things back in order in your life. It's never too late to address dependency problems. If you are in a relationship or family where someone you care about has a dependency problem, a counselor can also help you to develop the necessary skills to keep another's substance use from hurting yourself, often called co-dependency or enabling. Sometimes helping yourself is also the first step to helping your loved one.

Depression has a variety of symptoms, such as loss of energy, loss of interest in activities and in life, sadness, loss of appetite and weight, difficulty concentrating, self-criticism, feelings of hopelessness, physical complaints, withdrawal from other people, irritability, difficulty making decisions, and suicidal thinking. Most depressed people feel anxious as well. They often feel worried, nauseated, dizzy and sometimes have hot and cold flashes, blurred vision, racing heartbeat, and sweating.

It would be an unusual person who said that he never felt “depressed'. Mood fluctuations are normal and help inform us something is missing in our lives and that we should consider changing things. But clinical depression is much worse than simple fluctuations in mood. Clinical depression varies from mild to severe. For example, some people complain of a few symptoms which occur some of the time. Other people may complain of a large number of symptoms which are frequent, long lasting and quite disturbing.
Divorce Adjustment

Divorce is one of the most traumatic events in anyone's life, but it can be devastating to children. Divorce adjustment counseling can assist adults and children in this difficult transition. Children often react with depression, anger, behavior problems in school and lower academic performance. Younger children frequently regress, and parents observe behavior more common at a much younger age. Some recently toilet trained children begin wetting the bed again, other children resort to talking in baby talk. All of these symptoms are a reflection of the trauma being experienced by these children. Psychological counseling can help children and adolescents to adjust to the changes of divorce, and to minimize the negative impact. Counseling can also help parents to understand the best way to mange their children during this transition period.

Adults frequently need counseling to manage divorce as well. This is particularly true for the spouse who does not want a divorce, but is forced to accept it. Depression and anxiety problems are common results, and treatment is designed to minimize the negative impact of the divorce, and help the individual manage the changes thrust upon him/her.

Parent-child relationships often change during divorce, and parents need help learning how to cope with new responsibilities. Custodial parents often feel overwhelmed by the increased responsibility of being a single parent, and also experience considerable anger toward their spouse, which sometimes is translated into interference with visitation. Non-custodial parents may have to manage their children alone for the first time in their lives. Some tend to withdraw, rather than face the responsibility, while others simply do not know how to care for young children. All of these issues are appropriate for counseling and psychotherapy.
Eating Disorders

Eating Disorders generally develop during adolescence. Binge-eating, common in bulimia and compulsive overeating, often involves an excessive intake of food, usually high calorie foods, in a short period of time. It can be understood as an attempt to dull or escape anxious thoughts and feelings by creating a “trance-like” or “mindless” state. These periods of overeating are usually preceded by a period of fasting, producing excessive cravings for food, and often followed by purging through excessive exercise, self-induced vomiting or laxative misuse. Many bulimics hold perfectionistic standards for themselves which produce excessive self-criticism (e.g., “I'm disgusting”, “No one will ever want me”). Treatment involves:

  • Establishing an appropriate eating plan (three meals and snacks) toreduce the risk of excessive cravings that often lead to bingeing. A consultation with a licensed nutritionist is strongly recommended.
  • Detailed self-monitoring of the frequency, amount, situations, thoughts and emotions associated with bingeing.
  • Using response delays (allowing some predetermined amount of time to pass or engaging in an alternate activity - choosing to wait 20 minutes before bingeing, calling a friend, washing laundry, etc.) or response prevention (trying to tolerate the urge to binge without bingeing).
  • Cognitive thought monitoring to identify and challenge the unpleasant thoughts and feelings you become aware of as binge-eating decreases (e.g., “I can't stand feeling so bloated”, “I have to get rid of this feeling immediately”).
  • Relaxation and positive body imagery training.
  • Assertiveness, communication and problem-solving strategies as needed.
Gambling Issues

Problem gambling is gambling behavior which causes disruptions in any major area of life: psychological, physical, social or vocational. The term "Problem Gambling" includes, but is not limited to, the condition known as "Pathological", or "Compulsive" Gambling, a progressive addiction characterized by increasing preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, "chasing" losses, and loss of control manifested by continuation of the gambling behavior in spite of mounting, serious, negative consequences.

Warning Signs
  • Do you hide the rent or food money because your loved one gambles it away?
  • Is your loved one away from home or unavailable for long periods of time due to gambling?
  • Does your loved one sincerely promise to stop gambling, begging for another chance, then continues to gamble?
  • Have you noticed a personality change in your loved one as the gambling continues?

Problem gambling affects the family as a whole, as well as each and every member. It disrupts family life through its negative financial consequences, the deterioration of basic trust between the gambler and other family members, and the loss of the problem gambler's ability to carry out his or her normal family roles and responsibilities. These developments in turn produce social, emotional, and even physical changes in the family's well-being. In adjusting to the impact of gambling addiction, family members may become increasingly isolated from each other and from their community. Family members often need help to recover from the impact of the problem gambler's behaviors as well as support in building a family environment that supports recovery for all family members.
Grief / Loss and Treatment

Suffering from the loss of a loved one can be excruciating. Whether through death or divorce, people struggle when a significant relationship is ended. The process of grief is very personal, following no specific time table. Feelings of guilt and regret may seem overwhelming. Sometimes, individuals do not know how to go on with their lives. Doing so can even seem like a betrayal of the loved ones, as if they didn't matter.

But prolonged, disruptive grief is harmful, not only to the grieving individual, but to those who love and depend on him or her. Grief Recovery counseling can help people work through the natural stages of loss – the anger, denial and despair. Working through this painful transition allows individuals to become happier, healthier people without trying to deny or bury past loves.
Obsessive Compulsive Disorder

People with Obsessive Compulsive Disorder (OCD) are afraid that if they let themselves think their feared thoughts without doing any compulsions they will get more and more anxious and they won't be able to stand it. They often worry they might go crazy.

Cognitive-behavioral treatment is aimed at helping you learn that you can control your anxiety without compulsions. You will learn coping strategies like relaxation exercises and ways of thinking that can help you feel less anxious. Your therapist will help you gradually face the things that you fear the most, until you are confident that you can handle your fears without compulsions.
Oppositional Disorders

Oppositional defiant disorder (ODD) is a behavior disorder, usually diagnosed in childhood, that is characterized by uncooperative, defiant, negativistic, irritable, and annoying behaviors toward parents, peers, teachers, and other authority figures. Children and adolescents with ODD are more distressing or troubling to others than they are distressed or troubled themselves.

Most symptoms seen in children and adolescents with oppositional defiant disorder also occur at times in children without this disorder, especially around the ages or 2 or 3, or during the teenage years. Many children, especially when they are tired, hungry, or upset, tend to disobey, argue with parents, or defy authority. However, in children and adolescents with oppositional defiant disorder, these symptoms occur more frequently and interfere with learning, school adjustment, and, sometimes, with the child's (adolescent's) relationships with others.

Symptoms of oppositional defiant disorder may include:

  • frequent temper tantrums
  • excessive arguments with adults
  • refusal to comply with adult requests
  • always questioning rules; refusal to follow rules
  • behavior intended to annoy or upset others, including adults
  • blaming others for his/her misbehaviors or mistakes
  • easily annoyed by others
  • frequently has an angry attitude
  • speaking harshly, or unkind
  • deliberately behaving in ways that seek revenge

A child psychiatrist or a qualified mental health professional usually diagnoses ODD in children and adolescents. A detailed history of the child's behavior from parents and teachers, clinical observations of the child's behavior, and, sometimes, psychological testing contribute to the diagnosis. Parents who note symptoms of ODD in their child or teen can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.

Further, oppositional defiant disorder often coexists with other mental health disorders, including mood disorders, anxiety disorders, conduct disorder, and attention-deficit/hyperactivity disorder, increasing the need for early diagnosis and treatment.

  • Do you feel like you don't know what to do, or where to turn, to make the situation better with your child?
  • Has your child become difficult, rebellious, irritable, or angry?
  • Are you afraid to set limits with your child?
  • Do you find communication with them almost impossible?
  • Do things just seem overwhelming at times?

It has been said that parenting is the most difficult job, and the most important responsibility, you will ever have in your life. Unfortunately, you receive little or no formal training in parenting, yet you are constantly criticized for every mistake you make. Usually, we either do what our parents did, or we do the exact opposite, depending on our opinion of the parenting we received.

No one provides us with clear guidelines about the right way to parent. There are no classes in school, and childbirth preparation focuses almost entirely on the birth process. After having a child, hospitals provide some basic instruction on the care and feeding of a newborn, but no one teaches you how to nurture, support, guide and educate your child to become a responsible adult. Most of us muddle along on our own.

Developmental psychologists have done research on different parenting styles, the effects of discipline, and how children respond to various people and life events, such as divorce, stepparents, abuse, sibling conflict, poor academic success, bullying, or parental substance abuse. This knowledge has allowed counselors to develop effective treatment interventions for children and families in crisis. But, it also provides a basis for teaching parents how to manage their children's behavior effectively, and how to intervene with specific child and adolescent problems. Counselors can help parents understand what children need from adults to foster their emotional and intellectual development.

We are here and ready to help. We have parenting solutions from early childhood dilemmas to the complex issues of trying to parent adult children.
Post Traumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD) is a common reaction to very stressful or traumatic events, including car accidents, rape, being a victim or witness of crime, physical or sexual abuse, disasters such as fires and tornadoes, or seeing someone else die.

People with PTSD have three main problems or symptoms:

Re-living the trauma. This can include memories that you can't control, nightmares, and flashbacks that make you feel as if you are living the event all over again. Often memories happen when something you see or hear reminds you of the event. Avoiding, because it is upsetting to remember what happened, people with PTSD try not to think about it. They also stay away from people, places or things that bring back memories. Often they feel numb or detached from people. Some turn to alcohol or drugs to dull the pain. Signs of physical stress. These can include trouble sleeping, feeling irritable or angry all the time, trouble concentrating, and feeling tense or on guard.

Therapy can teach you ways to cope with the feelings and tension that come with the memories. It will also help you face the memories and develop a sense of peace.
Premarital & Marital Issues, Relationships

In today's world of high stress, careers, mothering & fathering, and juggling multiple activities, relationships suffer. We can easily take our partner for granted, project unresolved childhood emotions such as anger and blame onto our partner, expect our partner to change and be the way we want, and simply not put quality time into our relationships. We may also chronically feel unhappy, empty or lonely in our marriages.

No matter the cause, distress in a relationship can create undue stress, tension, sadness, worry, fear and other problems. You may hope your relationship troubles just go away on their own. But left to fester, a bad relationship may only worsen and eventually lead to physical or psychological problems, such as depression. A bad relationship also can create problems on the job and affect other family members, such as children, or your friendships as people feel compelled to take sides.

You don't need to have a troubled relationship to seek therapy. Counseling can also help couples who simply want to strengthen their bonds and gain a better understanding of each other. Counseling also can help couples who plan to marry — ironing out differences before a union is sealed.

Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we re-adjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it.

Our goal is not to eliminate stress but to learn how to manage it and how to use it to help us. Insufficient stress acts as a depressant and may leave us feeling bored or dejected; on the other hand, excessive stress may leave us feeling "tied up in knots." What we need to do is find the optimal level of stress which will individually motivate but not overwhelm each of us.

Signs that stress has become too much to ignore or handle alone include:
  • restlessness
  • extreme fatigue
  • argumentativeness
  • increased alcohol and/or drug use
  • apathy
  • loss of pleasure in life
  • angry outbursts
  • general feelings of emptiness and futility
A professional counselor can help those affected by stress identify the sources and learn effective strategies to effectively cope with or eliminate stress and its' unpleasant results. There are many strategies that are useful in the management of stress, including (but not limited to):
  • guided imagery
  • improved nutrition
  • exercise
  • conflict resolution
  • critical problem solving
  • time management
A professional counselor can help an individual discover their major stressors and plan effective interventions that promote a healthful sense of renewed self-assurance and control.