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 »  » When Adjusting to Stressful Events in Life Isn’t as Easy as You’d Like It to Be
* ## When Adjusting to Stressful Events in Life Isn’t as Easy as You’d Like It to Be
  + Posted on May 21, 2024
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  *The Mental Health Program at Nutley Family Service Bureau (NFSB) provides counseling and psychiatric services for individuals and families. This article is part of an ongoing educational series focused on common mental health challenges, treatment techniques, and helpful tips.*
  Change can be hard, especially when that change is tied to a stressful event or experience. In many cases, you may feel sad or overwhelmed for a brief period, but the resulting stress is often temporary, allowing you to move on with minimal disruption to your life.
  However, you may experience more intense emotional or behavioral symptoms for a longer period of time, which could indicate an adjustment disorder. Adjustment disorders are fairly common but can be serious if they start to affect your quality of life. Let’s discuss the most common causes and symptoms and steps you can take to overcome an adjustment disorder.
  What Causes an Adjustment Disorder?
  Stressful life events, changes, and experiences, some of which affect everyone at some point, cause adjustment disorders, including but not limited to:
  + The death of a loved one
  + Divorce or the ending of a relationship
  + Job loss
  + A serious illness
  + The birth of a child
  + Moving to a new area
  “You may feel a little better a few months after a stressful life change, but an adjustment disorder can be a bit of a delayed, intense reaction that makes daily activity difficult,” said Staela Keegan, MSW, LCSW, LCADC, Senior Clinical Supervisor of the Mental Health Program at NFSB. “When a stressful situation happens, you might be in shock at first and struggle to get through the day. Then, when the dust settles, usually about three months later, the emotions suddenly hit you.”
  Someone dealing with an adjustment disorder can’t move forward on their own. For example, a person goes through a breakup or divorce and it’s constantly on their mind. They’re almost obsessed with sadness. They may find it difficult to get up in the morning and be productive.
  Adjustment disorders can affect people in all phases of life, from school-aged children, to adults in the middle of their careers, to seniors who are downsizing or may have lost their partner. The symptoms of an adjustment disorder go beyond everyday stressors in life and can include:
  + Persistent sadness, hopelessness, depression, or feelings of overwhelm
  + Nervousness or irritability that can’t be controlled
  + Withdrawal from social activities
  + Changes in sleep and/or appetite
  + Difficulty concentrating
  The symptoms of an adjustment order typically last no longer than six months after the stressful event or experience, unlike chronic anxiety and depression, for example, which tend to linger much longer.
  ## How Counseling and Coping Skills Can Help with an Adjustment Disorder
  Clients often come to NFSB for counseling because they need help processing and moving past the stressful event or experience that caused the adjustment disorder.
  “Initially, therapy often provides people with validation that what they’re feeling is normal,” Staela said. “Instead of feeling ashamed to talk about their mental health issues, they find comfort in having a safe space where they can talk openly and explore coping skills. Depending on the situation, like a relationship that ended, counseling can even provide an opportunity to explore patterns of behaviors to prevent a similar situation from happening in the future.”
  When a client comes to NFSB, we perform a biopsychosocial assessment. That’s a clinical term that involves discussing the client’s history, relationships, work history, trauma, and more. At this point, the clinician can typically distinguish between an adjustment disorder in response to a life event versus a depressive or generalized anxiety disorder.
  The next step involves developing a treatment plan with goals and action steps for addressing issues that the client is experiencing. The treatment plan may include self-care, such as getting enough sleep, eating healthy foods, drinking enough water, and spending time in nature.
  After the initial assessment and treatment plan, the therapist will review and update the plan every three months based on goals achieved and areas that need improvement. Once enough progress has been made, the therapist and client may decide to scale back appointments or even end therapy. With an adjustment disorder, counseling can be a short-term proposition.
  “When you open up with your therapist and learn about yourself and your relationships, you may feel comfortable discussing other issues that you’ve never addressed,” Staela said. “You learn to cope with stressful situations and bounce back a little faster.”
  If you suspect you’re dealing with an adjustment disorder, you can also practice coping skills that can help you process your feelings and return to the present moment. These include meditation, deep breathing, journaling, and practicing various forms of self-care.
  The sooner you recognize the symptoms of an adjustment disorder, and the sooner you seek treatment, the better your chances of seeing faster progress. Of course, it’s never too late to seek help. Everyone faces circumstances that require an adjustment, and there’s nothing wrong with seeking help to make the adjustment less stressful.
   *If you or a loved one is showing signs of an adjustment disorder, schedule an appointment at NFSB. English- and Spanish-speaking counselors are ready to help and we’ll always respect your privacy. Call 973-667-1884 extension 1.*
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 »  » Cognitive Behavioral Therapy: What It Is, Why It’s Effective, and How It Works
* ## Cognitive Behavioral Therapy: What It Is, Why It’s Effective, and How It Works
  + Posted on May 13, 2024
  + Comments Off on Cognitive Behavioral Therapy: What It Is, Why It’s Effective, and How It Works
  Did you know every mental health clinician at Nutley Family Service Bureau (NFSB) is trained in cognitive behavioral therapy (CBT)? CBT is the most common form of psychotherapy, or talk therapy, used by social workers, psychologists, and other counselors to treat mental health disorders.
  CBT is also among the most researched forms of therapy and has produced positive, evidence-based results in the treatment of a variety of conditions. Let’s discuss the definition of CBT, how it works, and why CTB is such a valuable tool for both counselor and client.
  ## What Is CBT?
  In the simplest of terms, CBT helps people identify and change unhelpful patterns of thought and behavior that are not serving them.
  “If we break it down into pieces, the cognitive part focuses on thoughts that automatically surface and influence how you feel or behave,” said Kelly Rivadeneyra, LCSW, Assistant Director of the Mental Health Center at NFSB. “These thoughts could be distorted or completely inaccurate. The idea is that the way you think about things affects the way you feel about things, and both might affect your behavior.”
  Behavior is the second piece. CBT helps you recognize certain patterns of behavior that might be contributing to your struggles. Once you gain awareness and understanding of these behaviors, you can learn to develop healthier, more productive ways of responding to stressors.
  **Conditions commonly treated with CBT include but are not limited to:**
  + Anxiety disorders
  + Depression
  + Bipolar disorder
  + Eating disorders
  + Phobias
  + Post-traumatic stress disorder (PTSD)
  + Anger management
  + Sleep problems
  + Low self esteem
  ## Progress Through Active Involvement in Treatment
  Perhaps the biggest reason CBT has proven to be effective is that it empowers you to take an active role in your own healing process.
  “You’re not just talking,” Kelly said. “This is a skills-based approach focused on learning actual tools, techniques, and skills that you can apply in your life when you’re dealing with difficult emotions. And CBT is very collaborative between you and your therapist. The therapist is simply a guide.”
  Bringing the relationships between thoughts, feelings, and behaviors to light helps you gain a sense of control. You learn to make a distinction between what your negative thoughts are, where they originated, and whether they are valid. Thoughts are often shaped by past experiences, and CBT helps bring you back to and focus on the present.
  ## The CBT Process
  CBT is frequently used when someone is struggling with some form of anxiety. They feel increasingly anxious and seek therapy when their anxiety is reaching a point at which it’s affecting their ability to enjoy life in the moment. Let’s take a look at a scenario involving social anxiety. You believe people are judging you. You’re afraid you’ll feel embarrassed and people won’t like you.
  “The first step is to work with the therapist to identify thoughts that are popping up in these specific moments where your anxiety is heightened,” Kelly said. “We go through a triangle process of discussing how thoughts and feelings are affecting behavior. The behavioral outcome could be that you just avoid these things altogether.”
  The second step is to start challenging these negative thoughts and beliefs. This could involve exploring evidence for or against these thoughts, almost like putting them on trial. You may find that there is an alternative explanation as to why someone might be acting a certain way that you could be misinterpreting.
  The next step involves behavioral experiments. The therapist encourages or recommends testing beliefs about what you think will happen.
  “In this scenario, you gradually expose yourself to social situations, paying close attention to people who are actually responding to you,” Kelly said. “This helps you gather evidence to challenge your negative beliefs. A big part of CBT is practicing coping skills for managing your anxiety, like deep breathing and mindfulness exercises.”
  Coping skills prevent you from becoming dysregulated while you’re practicing them. The goal is to start noticing these changes in your thoughts and behaviors. With ongoing practice and therapy, you can avoid returning to a place where you were experiencing a lot of stress.
  ## How Long Does It Take to See Results?
  Obviously, the amount of therapy required depends on the individual. That said, CBT is not considered a long-term therapy. In fact, CBT is often shorter than many other treatment techniques.
  CBT can produce meaningful results in 10-20 sessions. With consistent counseling and practicing of coping skills, sessions become less frequent. At that point, appointments are considered maintenance check-ins to reinforce positive coping skills.
  Keep in mind that CBT is not for everyone. CBT may not be the best choice for people struggling with complex or severe mental health challenges or learning disabilities. However, clinicians at NFSB have seen a tremendous amount of success using CBT to treat a wide range of conditions.
  “CBT is such a great tool to keep with you long after therapy,” Kelly said. “Once you learn it, you can apply it whenever you need it. CBT gives you something tangible that you can practice for the rest of your life.”