Category: <span>Mental Health</span>

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DBT Intensive Outpatient Program

DBT Intensive Outpatient Therapy Programme for Young Adults

What is Dialectical Behaviour Therapy (DBT)?

DBT is an evidence-based treatment programme designed to help people with  mental health conditions who have problems regulating emotions; It’s a third-generation Cognitive Behaviour Therapy (CBT). DBT was developed to treat people with borderline personality disorder, however, it is also used as a treatment for several other conditions, including people with substance use disorders, major depressive disorder, bipolar disorder, attention deficit and hyperactivity disorder (ADHD) and eating disorders.

People who may benefit from DBT: those struggling with emotional regulation, self-destructive behaviours and/or interpersonal difficulties.

During DBT, people are taught skills in four areas:

  1. Mindfulness skills help people focus on and accept the present moment without judgment.
  2. Distress Tolerance skills help people better tolerate and accept distress and pain. In DBT, people are taught that distress and pain cannot be entirely avoided in life, but by using certain strategies, they can be tolerated.
  3. Interpersonal Effectiveness skills include strategies people can use to assert themselves in social situations, including saying no, asking for what they want, and dealing with conflict in relationships. Additionally, these skills also emphasise in building new and maintaining existing relationships, as well as maintaining self-respect.
  4. Emotion Regulation skills help people better understand and control their emotions. In DBT, people learn several strategies to improve their emotion regulation, including identifying and labeling their current emotions, identifying obstacles that prevent them from changing their emotions, and engaging in positive events and experiences.

Our Intensive Outpatient Programme (IOP) will involve 11 hours of therapeutic services per week:

This is for young adults (18-30 years old) who are struggling with mental health concerns and need more support than a typical outpatient (i.e.: one hour per week) but not as much support as an inpatient placement.  It may also be appropriate for clients who are returning from overseas inpatient/residential treatment.  Groups will include 3 to 5 participants at a time.

  1. 9 Hours of DBT Skills Training (Group Therapy) per week: 3 hours, 3x per week (Monday, Wednesday & Friday 9am -12pm) where clients can process recent events and support each other as they learn new skills to increase effectiveness in daily activities and relationships.
  2. 1 Hour of Individual Therapy per week: All participants must also be engaged in individual therapy. This can be facilitated at OnCourse Cayman or with another provider in which case there will be regular updates between the group and primary therapist to ensure consistency of care and progress towards the client’s goals.
  3. 1 Hour of Family/Support System review per week: Group therapist will meet with each client and a family member or other support person once per week to review skills being worked on to increase support and generalisation of skills.

All sessions at OnCourse Cayman will be facilitated by Dr. Alexandra Bodden, Clinical Psychologist, who has had extensive experience working in IOP, inpatient and residential programmes for mental health and substance abuse concerns.  Dr. Bodden specialises in working with adults with a history of trauma, addictions and severe and persistent mental illness.

This DBT-informed programme complements much of the work being done by therapists providing individual therapy on island and should be considered if clients need additional support and/or new skills to be able to cope with daily activities.  An intake will be completed with each person prior to beginning the programme to ensure that they are a good fit.  All participants must have an individual therapist (whether at OnCourse or another clinic) throughout the program and a review by a psychiatrist prior to starting the program.

Group therapy session sitting on chairs

Evidence Base and Additional info: https://dbt-uk.com/stats-around-dbt-evidence-success-rates-and-impact/

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Men’s Health – What is Your ‘Check Engine’ Light?

We are designed to make, fix, create, provide, compete and win.  Many of us treat winning as evidence of strength magnified by normatively nice “things” or results.   Providing for our loved ones naturally follows when we compete well, sustained by rugged individual strength.  Chinks in the armor of performance are weakness, prompting us to lower our shoulders against the wall, push harder and find a way to make things happen.  This is our lot.  This is what we do as men.  This orientation to success and hard work has sustained relationships and cultural norms for millennia.

What happens when we protect this norm more than we protect our work tools?  In any line of work, men like tools, whether it is IT infrastructure, a band saw, a boat, or a truck.  We monitor mechanical limitations and maintain them in the most cost-efficient ways available to ensure that we can continue to compete and provide without interruption.

What happens when our striving for success exceeds biological limitations?  What happens when the weathering inside our bodily systems and cells collides with additional work responsibilities, unexpected delays, or roadblocks to obtaining a permit or closing a deal?  What happens when weathering collides with physical changes around 40?  Do we avoid the low-hanging fruit; decrease alcohol, stop smoking?  Do we implement preventative maintenance strategies to improve cardiovascular fitness with running, swimming, cross-training, pilates or yoga?  More often than not, we ignore these hassles and push harder into the same strategies to manage stress that worked in our 20s when we had less weathering, fewer skills, less understanding, fewer opportunities and fewer responsibilities to others in our growing spheres of influence.

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Mind Your Heart – Heart Health Month

Stress and change go hand in hand when our resources don’t create predictability.  Sometimes change happens too quickly, sometimes not quick enough, or sometimes change never stops. Our initial response is usually to stop or avoid some aspect of continuous change.  We experience this stress in our mind, our body and our heart.

Among the many ways to manage continuous change, during Heart Awareness Month we here at OnCourse invite you to focus on your heart as well as your brain.  As it turns out, one of the most effective ways to reduce stress and feeling overwhelmed is to learn how to access the intelligence of year heart.  We do this by shifting your heart rhythms that in turn send a different neural message to the brain.

As psychologists, we implement simple, practical, empirically supported techniques to teach alignment between the heart, physiologically not simply metaphorically, and the brain.  As you consider this shift, please recall a time when that deep physical sense that what we want, or are being asked to do, is probably not the best option or even possible right now. This lack of alignment, or incoherence, provokes somatic and emotional anxiety that we call stress.  Without active intentional skills to generate coherence between our heart and our brain, passive insight rarely makes us feel better. Coherence in our thoughts and actions and physiological responses allows our heart, mind, emotions and choices to align and work together harmoniously toward our own goals and shared needs.

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Psychological testing the cute little girl
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Intro to Psychological Assessment for Parents: What to Expect

Often I get questions from parents and other caregivers who are inquiring about assessments in our practice.  Most commonly, an assessment has been suggested by an individual working with their child, and parents are left scratching their heads wondering about what this means and what the benefits are.  In this blog post, I will seek to answer some of these questions and clear up confusion.

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Holiday depression and winter season anxiety
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Grief and the Holidays

Last week, we discussed dealing with difficult personalities around the holidays.  This week, we will be focusing on grief during the holiday season.  Grief comes in many forms.  Some folks may be experiencing the holidays following the passing of a dear loved one.  Some people (like me) are far away from their loved ones.  Some individuals grieve or become lonely because they do not have the stereotypical family or experiences featured on the overabundance of holiday commercials shown this time of year.  When it comes to grief, experts recommend: Read more

Santa Claus sitting on floor and looks frustrated
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Dealing with Difficult Personalities During the Holidays

Ahh, the holidays.  Christmas trees, Santa, Reindeer, the Three Wise Men, Snowmen, etc….

This time of year is supposed to be one of happiness, family, and festivity.  However, it can also be one of sadness, loneliness, and depression.  The holidays can be extremely difficult for a number of reasons.  For the next few weeks, we will be highlighting some helpful tips for getting through this season of cheer. Read more

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Growing Pains of Change

When my good friend and colleague Dr. Bodden asked me if I would like to contribute to our blog, I spent some time thinking about what I would like to discuss.  I have a lot of thoughts and a lot of opinions!  After thinking over topics for some time, I decided to discuss something close to home.  Dr. Bodden’s most recent blog post referencing embracing opportunities felt like the perfect jumping off point for this current blog post I am sharing.

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Suicide Prevention Awareness

September is Suicide Prevention Awareness Month.  Did you know:

  1. Worldwide there is 1 death by suicide every 40 seconds
  2. Suicide is the third leading cause of death for individuals aged 15-44 years old
  3. In Cayman , a PAHO report examining 848 students indicated that 22.6% of students had thought about suicide, with 57.9% of those youth considering a plan of how they would attempt suicide.

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First birthday celebration theme with cupcake candle
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OnCourse Cayman Turns 1!

We are proud to announce that we turned one on 31st July 2018! What an exciting year it has been! Thank You to our Clients, Colleagues and Supporters who have helped us to grow and develop our business and services in the past year! We are dedicated to providing the Cayman community with the best care possible.

We are the Private Practice of Clinical Psychologist, Dr. Alexandra Bodden. We offer Therapy and Psychological Testing for Children, Teens and Adults, Corporate Trainings and Workshops and Personal Development sessions with Horses!

DBT Intensive Outpatient Program

DBT Intensive Outpatient Therapy Programme for Young Adults What is Dialectical Behaviour Therapy (DBT)? DBT is an evidence-based …

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Cayman Community Resource List

Government/Free Services in Cayman: Department of Counselling Services **Free Services to anyone in Cayman** Additional Government/Charitable …

Man looking at broken down car.

Men’s Health – What is Your ‘Check Engine’ Light?

We are designed to make, fix, create, provide, compete and win.  Many of us treat winning as evidence of strength magnified …