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NeuroStar TMS Therapy®

NeuroStar TMS Therapy®

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How Does NeuroStar TMS Therapy® Work?

Transcranial magnetic stimulation (TMS) uses a targeted pulsed magnetic field, similar to what is used in an MRI (magnetic resonance imaging) machine. While the patient is awake and alert, NeuroStar TMS Therapy stimulates areas of the brain that are underactive in depression.2

NeuroStar TMS Therapy is an in-office treatment that takes 37 minutes, is performed while the patient sits in a chair, and is administered five days a week, for up to four to six weeks.

Simple steps for NeuroStar TMS Therapy:

  • Step One: The patient reclines comfortably in the treatment chair, awake and alert
  • Step Two: A small curved device containing the magnetic coil rests lightly on the patient’s head
  • Step Three: The device delivers focused magnetic stimulation directly to the target areas of the brain
  • Step Four: The patient can immediately resume normal activities

During treatment, the patient hears a clicking sound and feels a tapping sensation on the head. The most common side effect is generally mild-to-moderate pain or discomfort at or near the treatment area during the session. When this occurs it is temporary, and typically occurs only during the first week of treatment.

There are no effects on alertness or understanding; patients being treated with NeuroStar TMS Therapy can drive themselves to and from their treatment sessions. Above information is taken from: https://neurostar.com/neurostar-tms-depression-treatment/

For more information on the rTMS treatment, please go to http://www.tms-singapore.com/ or call us at +65 63977309.

 

A Play in Psychodrama

A Play in Psychodrama

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As I mentioned in my first article, the phrase,”reverse roles” was very much what I heard at my first psychodrama workshop. As this was uttered by the group leader, two people on the stage switched places and began playing the opposite role. 

 “This is it! “, I thought as I began to think of how I could use it in my work. Get people to reverse roles and voila! Well I was sorely mistaken those many years ago. As I began to explore this fascinating form of group work I discovered several techniques that are used in Psychodrama. Here are two key techniques used and an example of how I used them. 

Role reversal

Here the Protagonist says a few words in the role of a particular ‘character’ or entity in their drama. The Auxiliary then says these lines to the Protagonist who is in the complimentary role. 

Concretization

In this technique, objects and people are used to represent the scenario the Protagonist wishes to explore.

A Drama using Role reversal and Concretization

Ken is aged 19, and has a serious problem with drugs and alcohol which he has managed to stop after going to the alcohol treatment centre. He had just come out of Rehab in the United Kingdom and was brought to my practice by his concerned father. His father has tried very hard to help him over the years and has now brought Ken to us at Promises. Ken is worried about going out for dinner with his Father and a family Friend, whom we shall call Andy, because he might be tempted to drink again.

I encourage him to enact a scene at dinner with his father and Andy, playing out what he expects to happen. He sets out the chairs and chooses two people in the group to be his Father and Andy. As he greets the two older men rather lethargically, his shoulders slouch and he speaks in a flat voice.

Reversing roles, Ken now plays the part of Andy. He perks up now, smiling and full of energy. ‘Andy’ says, “The last time I saw you Ken, you were a small boy. My how you’ve grown!” Playing the role of his tempter, he urges Ken to “have a drink now as a real man” holding a glass towards him.

Back to being himself after another role reversal Ken’s face reddens and he clenches his fists in agitation.  He speaks to me as the Director, saying that he is afraid he might have a relapse. I immediately ask him to take on the role of his father.

As his father, he sits with his arms crossed and says through clenched teeth, “It’s Ok, you don’t have to drink. I don’t want to cause a relapse.” As himself, Ken is at a loss for words. I ask the other audience members to do some modeling and try different responses in the role of Ken as he watches.

Ken cheers up as he sees the other group members rising to the occasion. Everyone is animated as they get a chance to act the part and try to tell Andy off. There is much laughter and hilarity as people do and say whatever they think might work. A sort of role training session is underway.

Ken is noticeably inspired by the group and he chooses one response. He stands tall with a cheeky smile and says to Andy, “I’m not drinking today, and I wonder why you are so determined to force alcohol on me!”  In role reversal as Andy, he changes the subject and backs down, no longer the magnanimous host. The drama ends. Ken is no longer a deflated doomsday worry wart. Instead he is positive about going out for dinner and knows what he can do later that night at dinner. The group has come to his aid and I once again marvel at the magic of Psychodrama.

In future articles, I shall illustrate more psychodrama techniques with dramas I have directed. It continues to be a privilege to be allowed into the lives of group members and I am continually amazed at the transformations that happen.

Written by Sharmini Winslow, Therapist.

At Promises Healthcare, we are committed to helping you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic on: +65 6397 7309 or email: clinic@promises.com.sg for inquiries and consultations.

What is Psychodrama?

What is Psychodrama?

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This is a series of article about the Action Method of Psychodrama by Sharmini Winslow.

“Reverse roles!”, the group leader shouted, and two people switched roles on stage and began enacting the opposite part. I was in the middle of my first Psychodrama workshop and all seemed chaotic and yet pleasantly therapeutic. What was going on? My desire to explore psychodrama had brought me here to a large room with a group leader and several very friendly people. Soon I was learning the ropes and I tried to make sense of things. 7 years later, I am still held captive by the magic of psychodrama.

Often people ask me,”what is Psychodrama?”, and I ask if they have 10 minutes to listen. It is a therapeutic action method that usually is done in groups. So here is a short description that will suffice for now.

Psychodrama, is the brainchild of Dr J.L. Moreno. It comes from two words, Psycho and drama. Psycho (not like in the movie where someone slashes you in the shower with a knife), is derived from the word ‘psyche’ which means the mental or psychological structure of a person. Drama refers to the enactment or action that happens in the session.

There are 5 instruments in Psychodrama

  • The Director

In the group, the therapist or group leader takes on this role and keeps the action flowing and gives structure to what evolves on the stage.

  • The Stage

This can be any space set aside for the enactments to occur. In a group, the stage is the space apart from where group members are seated. Moreno built a stage in New York specifically for psychodrama which had the audience seated at a different level. I had the privilege of directing a drama on the original stage.

  • The Audience

These are the group members who are not involved in the drama but who act as witnesses and can respond to the action on stage as a normal audience would, often yelling encouragement to the protagonist.

  • The Protagonist

This is the person who represents the main concerns of the group. Usually chosen by the group, the Protagonist gets to put into action a concern, a challenge or an event that they would like to have turned out differently. In psychodrama, past, future and present can coexist in the Here and Now.

  • The Auxiliary

The Auxiliary or sometimes called the Auxiliary Ego is the group member chosen to be a certain element or person in the drama, for example the protagonist’s Sister or maybe their addiction.

Each session has a warm up, an enactment phase and time for sharing. In the sharing segment, group members get to share something about their own lives that is connected to the drama.

So in Psychodrama the protagonist’s inner world gets “‘concretized” or made real, and the Director helps the Protagonist explore and work spontaneously to create new ways of being that are more helpful in living with whatever challenge was enacted. New perspectives are discovered; insights and conclusions made that bring healing and newness. The Protagonist and group members experience the wonder of being spontaneous and are positively energized!

*Psychodrama is used in group sessions run by Sharmini as part of her practice at Promises.

Written by Sharmini Winslow, Therapist.

At Promises Healthcare, we are committed to helping you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic on: +65 6397 7309 or email: clinic@promises.com.sg for inquiries and consultations.

Strategies to stick to your New Year’s Resolution

Strategies to stick to your New Year’s Resolution

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Have you ever wondered why it’s so tough to stick to your new year’s resolutions? According to Statistics Brain Research Institute, only 9.2% of Americans feel like they have achieved their resolutions in the past year. Here are some strategies from psychologist and behaviour change expert, Dr Paul Marciano, and the American Psychological Association to help you with sticking to your resolutions this year.

  1. Set realistic resolutions

Most of us are guilty of making impractical resolutions that we can’t keep. For example, we aim to exercise more regularly, from barely going to the gym once a week, to aiming for seven days.  Instead of setting unrealistic resolutions, you can try starting with something that’s small, practical and within your abilities. Rather than aiming for seven days of exercise, you could start with three or four. Josh Klapow, an Alabama-based clinical psychologist says, “It is far better to succeed at a smaller, more manageable resolution than to fail at a larger, loftier one.”

  1. Have patience

Bad habits develop over time. Similarly, it also takes time to substitute bad habits for good ones.  When making resolutions, we often overestimate ourselves and try to re-evaluate our lives.  We have to accept that development is rarely consistent and aim to change one behaviour at a time. Hence, having the patience to work through on resolution at a time will help you stick to them.

  1. Talk about your goals

Having support from your social group is vital. Sharing your goals with friends and family increases the chances of success. Rather than trying to achieve your goal alone, you could join a fitness class at a gym, join a support group to quit smoking, or even just have someone to check in on your progress (accountability partner). Having social support and people to share successes and failures will make the process less daunting.

  1. Be resilient

Resilience is vital in achieving your resolutions. When you slip-up and get discouraged, it is important to remember that it’s impossible to achieve perfection. Just because you were busy and didn’t manage to go for your gym classes doesn’t mean that you have failed and should give up your goal to be fit. What is critical is to bounce back from your mistakes and continue to work towards your goal. According to founder of MoneyCrashers, Andrew Schrage, it is useful to set targets throughout the year, so that you can keep yourself in check and your momentum going.

  1. Get support

When you’re feeling overpowered when trying to achieve your resolutions, it is important to remember people who can listen and care for you. Seeking professional help can reinforce your resilience and manage stress stemming from your resolution. For example, a psychologist can suggest ways for you to fine-tune your goals to make them more achievable.

  1. Make your resolutions more precise

Dr. Marciano recommends setting specific, measurable, achievable, relevant and time-bound (SMART) goals. Instead of just setting a goal to lose weight, you should be more specific and aim for a particular weight or body-fat percentage goal, or allocate a time every day to go for a run.

  1. Track your development

Reflecting on your starting point and the developments you have made creates feedback loops. This allows you to track improvements during your endeavour and it will be an incentive to continue. It also enables you to reflect and adjust your strategies accordingly when you’re declining or when you’re not improving as much.

  1. Set aside time for your goals

Allocate time for your resolutions and make them a priority by putting them on your schedule. This way, you won’t have the excuse of not being able to find the time to complete something. If you’re trying to get fit, block out certain hours of the day to complete your run or schedule certain fitness classes into your calendar. Treating your fitness classes or runs as though they are scheduled appointments can help you stick to them.

At Promises Healthcare, we are committed to help you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic on: +65 6397 7309 or email: clinic@promises.com.sg for inquiries and consultations.

 

‘What is Forensic Psychology?’

‘What is Forensic Psychology?’

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Forensic psychology is as interesting as it sounds. People often imagine forensic psychologists running around in bullet proof vests catching criminals and solving crimes (think ‘Elizabeth Keen’ – forensic psychologist/FBI agent from hit television show Blacklist). Although real world forensic psychologists are more likely to be sitting behind a desk, there is still excitement, adventure, and risk in our daily lives.

What is forensic psychology?

Broadly, forensic psychology is the intersection of psychology and the law. This can include the practical application of clinical psychology in forensic settings. Forensic psychologists have specialised training in mental health and the law.

What settings do forensic psychologists work in?

Forensic psychologists work in a broad range of settings. The most common settings include;

  • Prisons
  • Courts
  • Inpatient mental health facilities
  • Government mental health departments
  • Private practice
  • Universities

Who does a forensic psychologist work with?

Forensic psychologists can work with both offenders and victims of crime, as well as those who are at risk of becoming offenders. People of any age, background, gender, ethnicity, race, and religion may become involved in the legal and/or mental health systems and therefore come under the scope of a forensic psychologist.

Forensic psychologists usually work with other professionals involved in the legal and mental health systems too. This can include legal professionals, law enforcement, government departments, prison staff, medical professionals, academics, and community organisations.

What does a day in the life of a forensic psychologist look like?

A day in the life of a forensic psychologist looks very different depending on the setting they work in. Here are the common functions of a forensic psychologist across most settings:

  • Forensic mental health assessment – this could be in a custodial setting (such as a remand center) or a private setting (such as a clinic taking referrals). The psychologist will assess a person to see whether they have a mental health concern, how it is linked to their legal issue, and make recommendations for treatment.
  • Forensic risk assessment – this can also be across a wide range of settings, but may be more common in a court setting, or inpatient mental health setting. The psychologist will assess a person’s risk of reoffending (violence, sex, stalking etc.) as well as their suicide risk, and make recommendations for risk management and reduction.
  • Court appearances – forensic psychologists working in any setting will often attend court to answer questions about reports they have written about a particular client. They may be asked to make recommendations to the court for the treatment and sentencing of an offender. Forensic psychologists are also asked to make recommendations to determine whether someone is ready for release from prison. Some forensic psychologists who have many years experience and specialisation in a particular niche become expert witnesses for the courts.
  • Group therapy – this can be in any setting. A forensic psychologist will conduct group therapy for a range of presenting problems. Common issues might be sex offender group therapy, violent offender group therapy, domestic violence group therapy, and group therapy for addiction recovery. The focus of group therapy is usually identifying the underlying causes for offending behaviour, and creating relapse prevention plans to reduce a person’s risk of reoffending.
  • Individual therapy – this can also be in any setting. A forensic psychologist can conduct individual therapy for a broad range of presenting problems. Individual therapy usually focuses on treating the underlying mental health problem that may be contributing to a person’s risk of reoffending. It can also include preparing a person for transition into or out of prison or inpatient settings, skill building, and motivating offenders to change.
  • Paperwork – we do spend a great deal of time writing case notes, scoring assessment measures, reading through collateral information, and writing reports.
  • Other things can include teaching, research, workshops, training, and consultancy.

Written by Leeran Gold, Psychologist in our Forensic Service.

At Promises Healthcare, we are committed to helping you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic on: +65 6397 7309 or email: clinic@promises.com.sg for inquiries and consultations.

3000 Pulses to Happiness?

3000 Pulses to Happiness?

TMS picture of Leeran on TMS

 

 

 

 

 

 

3000 Pulses to Happiness?… yes it is possible through TMS treatment!

Each of us has a different genetic make-up, which is why anti-depressants might be ineffective. Depression is a chronic mental illness that cannot be overcome by simple positive thinking. Many who suffer cannot lead a normal life and are often in isolation.

Promises Healthcare is the pioneer in providing rTMS treatment. rTMS stands for Repetitive Transcranial Magnetic Stimulation or repetitive magnetic brain stimulation (also called TMS). It is a non-drug alternative to anti-depressants and ECT without any of the side effects. The treatment requires 20-30 sessions lasting 40 minutes each. During each session 3000 magnetic pulses are delivered to the specific area of the brain that regulates moods.

For more information on the rTMS treatment, please go to http://www.tms-singapore.com/ or call us at +65 63977309.