Author Archives: Whole Person

Reaching Teenagers Effectively

If any group of therapists, counselors, or other caregivers of teenagers were asked if the pandemic has added to the mental health issues teens around us struggle with, most of them would reply with a resounding yes. The struggle of feeling alone presented by the pandemic has led many teens to question their reality, the adults around them, and their future. They are bombarded by social media influencers, the advertising industry, their parents and teachers, and their peers with conflicting messages that confuse and distress them. They haven’t had the everyday outlet of talking with their peers between classes, before and after school.

stressed teenage girl wearing a pandemic mask

By early May 2020, emergency department (ED) visit counts for suspected suicide attempts began increasing among adolescents aged 12–17 years, especially among girls. During July 26–August 22, 2020, the mean weekly number of ED visits for suspected suicide attempts among girls aged 12–17 years was 26.2% higher than during the same period a year earlier; during February 21–March 20, 2021, mean weekly ED visit counts for suspected suicide attempts were 50.6% higher among girls aged 12–17 years compared with the same period in 2019. (CDC, 2021)

Mental health professionals are tasked with creating programs and activities that will not only help but will be acceptable to a very difficult to engage group of people…teenagers. The average ratio of students to counselors is 311 to one. Only one if five high school students are enrolled in a high school with enough counselors. ( counselor%20ratio%20is,there%20is%20a%20sufficient%20amount%20of%20school%20counselors.) Now that schools have, for the most part, reopened, we are going to have to reach teens in large groups and hope that those in need will be helped or step forward and ask for more.

Given these parameters, how do we get through to teenagers in the situation described above, or even in a classroom of thirty who aren’t in the least bit interested in listening to someone they don’t know or trust rambling on about the state of their lives? Counselors need to develop unusual ways of catching the students’ attention. If we were all born comics, we could easily invent a plethora of activities ourselves. Since we aren’t, we tend to fall back on exercises we’ve been using for years and are surprised when they don’t have the anticipated impact. We search the internet and our own toolboxes for exercises that we feel might appeal to teenagers, make note of those that work, and use them in other settings. We network with our peers to find out what they are doing and how it is working. Are students responding? Are they reaching out for the help they need? Are they waiting weeks for their turn with the school psychologist?

The following worksheets are from Teens ~ Out-of-the-Box Coping Skills by Ester Leutenberg and Carol Butler, MS Ed, RN, C. The hands-on action and the visual aids foster anticipation, participation, and revelation. Download the Stress Less Kit to use with students and teenage clients, and see how it works.

*Download the Stress Less Kit from Teens ~ Out-of-the-Box Coping Skills here.

Coaching Alignment, Patience and Pacing

Being in alignment with our client can refer to both our cognitive and emotional congruence with them. Congruence, resonance, and even alignment itself are all ways of expressing being on the same page. This means clearly understanding the content of what our client is saying and being in touch with their emotional state and expression. This allows us to more easily and effectively provide empathic understanding, and results from the effort by the coach to relate to the client, understand them, and what they are communicating.

Alignment is achieved by a combination of effective coaching presence, a lack of judgment, active listening skills, and the way the coach creates a tempo for the session through the use of their own verbal skills. On this latter point, how is the coach matching or reflecting the speed of the client’s speech and how are they (the coach) influencing or regulating it? How fast is the client covering ground? That is, how quickly are they discussing subjects and processing? In other words what is the pace of the coaching session?

When coach and client are out of alignment, coaching, much like a car engine, tends to sputter. If the coach is ahead of the client, talking much faster, pushing an agenda, or trying to cover ground too quickly, the client may simply check out of the conversation, or struggle to keep up. The result could be awkward silences in response to questions, or a fits-and-starts type of interchange that is seldom productive.

If the coach is behind the client, we see insufficient energy being expressed by the coach and the client is setting a pace out of sync. At some point the client will notice how the coach is not keeping up either with content or with energy. The client may become frustrated or despondent, and could even decide to drop out of coaching. The consequences of being out of alignment with our client can be serious.

Being Out of Alignment – Causes

So, what can cause a coach to be so out of alignment with their client? What leads them to become out of synchronization with the coaching conversation?

  • Coach’s personality and anxiety. Some people are naturally faster talkers and processors. These coaches have to self-monitor their own rapid speech and processing with a determined effort at patience. There is also the anxiety that comes with being new to coaching.
  • Coach’s culture and background. Some people have simply learned to talk faster because of their family of origin, their own background, or even where they grew up. It’s a common observation to see the stereotypical New Yorker speaking rapidly.
  • Pressure from a coaching system the coach is working in. Coaches sometimes work for companies that expect fast results. Coaching sessions, even with limited time, don’t have to feel rushed but easily could.
  • The coach is too up in their head. That is, they are thinking too much about what to say or ask next and their listening is suffering as a result. The coach misses vital expressions of emotion or even content leaving the client feeling unheard. The client may be baffled by why the coach is asking about something that they spoke of earlier but from which they have already moved.

How to Be in Alignment with Our Client

  • Get centered. Being centered, grounded and more calm allows the coach to be as patience as they need to be. It allows the coach to be more present and better at observing all that is going on with their client. Doing what centers you in your life on a regular basis will allow you to come into the coaching session in a more centered way.

  • Psychophysiological self-regulation. What allows you to manage your own anxiousness? First is awareness that you may have gone beyond feeling energetic to acting frenetically. Become aware of the signs that your level of anxiety has become high. Anxiety is not always accompanied by worry. Are you jumping at sudden, loud noises? Are you breathing short and shallow? Have you exceeded the caffeine intake that you can handle without becoming wired? Practice breathing with more depth. Get enough sleep and rest. Consider using methods for deeper relaxation such as relaxation recordings, practicing Yoga or Tai Chi, etc.
  • Know yourself. If you are a person with a long history of very rapid speech (no matter where or how you learned it), your challenge is to accept the fact that unless you are matched with a very similar client, it just won’t work well in coaching. You will have to make a very conscious, concerted effort to slow down.
  • Pace with patience. Consider the work you are doing with your client as a whole, not just one coaching session. This is where coaching with a well-developed methodology that has significant coaching structure will allow you to have perspective. Such perspective will allow you to be more patient and not feel like you have to push to get steps accomplished prematurely.
  • Dance with some rhythm. Good and great coaching appears to be like a dance between two partners that have established a rhythm that they are in sync with. There is a great two-way nature to an effective coaching conversation. The coach is actively involved, not just passively listening for long periods of time while the client rattles on. This is where effective use of active listening skills throughout the conversation keep the coach involved and keep the client better focused. There is a rhythmic back and forth in the conversation that leads to productivity. A big part of dancing is also adjusting to the changes in the music. When your client shifts, are you able to shift with them? A change in mood, energy, or topic needs to be noticed by you and requires an adjustment. To keep your client focused you might bring the shift to their attention and ask them how they would like to proceed.
  • Self-reflect. Listen to recordings of your coaching. It is much harder to self-reflect in the moment. Your lack of synchronization with your client may become much more obvious when you can observe is afterwards on a recording.

It’s easy to become far too content-focused in our coaching. Yet, what is the content bringing up in our client emotionally and/or mentally? There is so much more going on in a coaching session. This is where our threefold task of awareness comes in:

  1. Awareness of our client.
  2. Awareness of ourselves.
  3. Awareness of what is happening in the coaching relationship. 

When we are in touch with all three, we will notice more about our pacing, our speed of speech, and the whole tempo of the coaching experience. Bottom line: trust the coaching process, relax, and enjoy!

Michael Arloski, Ph.D., PCC, NBC-HWC is CEO and Founder of Real Balance Global Wellness ( a premier health & wellness coach training organization that has trained thousands of coaches around the world. He is the author of Masterful Health & Wellness Coaching: Deepening Your Craft, available now through Whole Person Associates.

Stress Levels at Work

We all know that stress is not good for us. Newspapers and magazines publish articles telling us of the negative impact of continued high stress levels. When experiencing an average level of stress, blood pressure, heart rate, and body systems return to normal when the incident has passed, including the extra levels of cortisol produced during these times. If, after a dangerous event has passed, stress levels don’t return to normal, the body stays alert to address whatever danger it perceives. Folks with too much stress without a return to a calm state will find the high level of cortisol necessary for the body to process fight or flight, stays too high. For example, a stressful meeting at work followed by an unpleasant run-in with an employee in the hallway, and a huge pile of tasks lying in wait…the body can’t return to pre-stress levels. What follows is anxiousness, headaches, being more susceptible to heart disease, memory and concentration problems, as well as problems with digestion, sleeping, and weight gain. A pretty frightening list of potential health problems from something that seems innocuous. Just a little too much stress. It doesn’t have to be all from the same source, either. Work, family, finances, relationships. The list is endless ( No one’s body can handle it all. The solution: find an effective way to reduce or eliminate the stress encounter at work.

Stressed by Anger

Of course, if you are a therapist, a counselor, or another health professional you are well aware of the quagmire that results from dealing with too much stress. Both individual clients and professionals themselves tend to believe that they can handle it. It sounds easy. But no one can eliminate all stress. We know, and we tell our clients, some stress (eustress) is good for us, helps us feel alive and ready to shine. For example, performers often say that their stage fright heightens their ability to give a sparkling performance. They use it to their advantage. How do we teach our clients (and ourselves) to keep the good and get rid of the bad?

The conundrum for our clients? Work is of central importance in one’s overall life, volunteer work, satisfaction at home, and general well-being. People who love the work they do, and who feel competent at their work, are more successful and satisfied than those who do not. A large part of their identification comes from the work they do and thus it forms a significant part of folks’ self-concept. The problem is that many workplaces have changed and continue to do so. In this “new” workplace, it is important to develop the requisite work skills and ability to handle added stress that supervisors expect from their workers in today’s world.

Furthermore, while specific knowledge and technical skills gained from formal education or on-the-job-training have been necessary for people in the workplace, work-related or work skills are considered as important as technical expertise. Supervisors are requiring a much broader skill set from their workers, thus increasing the demand for more well-rounded workers. It is estimated that workers in today’s workforce will go from school to school from school to work, from work back to school and then from retraining back to the workplace in an ongoing cycle of trying to learn the necessary work skills required in most positions and demanded by the ever-changing requirements of the fast-moving workplace.

It is imperative, then, for everyone to be responsible for managing their own skill development to keep up with the changes occurring in the workplace. The development of effective work skills in order to stay competitive is critical. Supervisors will expect employees to be able to do their work, and they also expect them to be able to apply knowledge of work skills. Adaptability will also be a key to employment success. Each person now needs to be a self-manager of their own skill and work development. Learning and practicing effective work skills never stops. Each of us, client and practictioner alike, need to be a lifelong learner of skills, including stress management skills, to be an effective worker regardless of the changes in society and the workplace (Essential Work Skills Workbook, Leutenberg and Liptak).

Stressed in the workplace
Stress in the workplace

Ability to deal with workplace stress should be at the top of the list. “People are asking me for answers,” says Sharon Melnick, Ph.D., a business psychologist and author of Success Under Stress. “Everyone feels overwhelmed and overly busy.”

In an article in Forbes Magazine ( by staff writer Jenna Goudreau, Dr. Melnick  gives suggestions for a dozen ways for all of us to cut down on high stress levels in the work place.

  1. Act rather than react – Identify what you can and cannot control. Perform impeccably on your parts of a project and let the rest go. Your skills and focus will shine through.
  2. Take a deep breath – One of the most effective methods of controlling stress is to breath properly. You can do a breathing exercise right in the middle of a stressful meeting without anyone knowing what you are doing.
  3. Eliminate interruptions – only answer emails and phone messages during certain times of the day and then close your office door. If you don’t have a door, turn your chair so your back is facing out, put up a sign that says when you will be available, and ignore those who come to see you. Your co-workers will self-train and eventually only come when they know you are available.
  4. Schedule your day so you can stay focused and on task – write a priority list before you go home in the afternoon, and then review it before you start your day. Should they be re-ordered? Did something change overnight that should be reflected in your plan for the day?
  5. Eat right and get enough sleep – provide your body with the right fuel, and sleep enough to reset yourself for a new day.
  6. Change the story – reinterpret the facts. Stressful reactions develop from looking at things through a certain lens. Change the lens. Don’t be a Pollyanna who doesn’t face facts realistically, but remember others’ opinions about you and your skill set are not necessarily negative.
  7. Cool down quickly – pull in air through your pursed lips and blow it out your nose. Done correctly you will feel a physical cooling off in your mouth that will inspire a mental coolness.
  8. Identify self-imposed stress ‒ change your focus from others’ perception of your work to the work itself. This has an added benefit: you’re more likely to impress those with whom you work.
  9. Re-order your priorities – Melnick says, “Focus on projects that will have the most impact and are best aligned with your goals.”
  10. Reset your Panic Button – learn about acupuncture points that will help you settle down. For example, Dr. Melnick suggests positioning your thumb on the side of your middle finger and applying pressure. This will instantly helps regulate your blood pressure.
  11. Influence others – in other words confront a stressful situation or employee as soon as possible. Don’t let the situation fester and grow in your mind. Help others to see things your way.
  12. Be your own best critic – internal negativity is as likely to stress you out as external negativity is. Pump yourself up! Encouraging thoughts will help you achieve at the highest levels and train others to think positively about themselves.

Here is an exercise to help you or your clients manage your workplace stress more effectively. It is from Leutenberg and Liptak’s workbook, Essential Work Skills Workbook.

The Power of Habit

Many times I’ve worked with clients who have made up their minds to change. They have determined that a change is needed and they have decided to change an old habit of their behavior that has been around for a long time (such as overeating, being sedentary or smoking). They appear motivated to change and vow to stop a certain behavior from occurring any more.

Before long they are disappointed that the behavior that they decided to end had resurfaced once again. Often the client would be disappointed not only that the behavior was back, but disappointed in their own lack of will power. They had thought, contrary to what we’ve seen Prochaska teach us, that change was an event (a decision) not a process. They made it about strength of character and gave their own inner critic plenty to berate them with.

Don’t underestimate the power of habit! Once we have adopted a new behavior there are actually neural pathways set up in our nervous system related to this behavior. Today’s neuroscience tells us that our habits are part psycho-physiological! Our bodies, as well as our minds, are in the habit of reacting a certain way, so no wonder changing a habit is not as simple as making a resolution.

Urge your client to consider these quick tips for changing habits.

  1. Practice patience. Research tells us that it takes as many as 180 days to truly drop an old habit and adopt a new one. So stay with it.
  2. No beating yourself up! Don’t put yourself down because you find yourself engaged in the old habit. Be compassionate with yourself instead.
  3. Celebrate catching yourself! Take the repetitions in stride. Realize that despite the old habit showing up again, you are committed to changing the habit. Instead of putting yourself down (“There I go again!”), celebrate the fact that you managed to catch yourself and become aware of it. As you catch yourself earlier in the practice of the old habit, you’ll have even more to celebrate!
  4. Use structures, as discussed on page 155, to help remind you of the new habits you want to adopt. Structures are little physical reminders that help you remember your goals. They may be little signs you print up for yourself reminding yourself to: “Wait to answer the call after 2 rings, not sooner!”; “Breathe!”; “Call a friend today!”;
    “30 min. of writing every day.” Another hint about structures—move them around, change the look of them so they don’t start blending in with the background again (out of habit!).
  5. Involve others in your goals. Let co-workers, friends and family know what you are working on changing. Enlist their support and possibly their awareness and feedback to help you stay engaged in the habit changing process.
  6. Get a coach! Working with a coach gives you someone to help you get clear about what behaviors you really want to change; give you support in the process and/or hold you accountable to do what you say you will do to change the habits.

Every man is more than just himself; he also represents the unique, the very special and always significant and remarkable point at which the world’s phenomena intersect, only once in this way and never again.

-Hermann Hesse

Every person’s path to and through change will be unique. As we strive to develop ways to help people make the lifestyle changes that will maximize their wellness we must remember that they are all just offerings we make for each person to examine for themselves.

-Excerpted from Wellness Coaching for Lasting Lifestyle Change, 2nd Ed. by Michael Arloski, PhD, PCC, CWP

How are we doing?

It is the last week of Mental Health Awareness Month in the United States. It seems to be a good time to take a look at how, in general, the mental health of the U.S. has fared over the last year. Perhaps we are more resilient than we thought…perhaps not. But tracking how we are doing is important to us all. These numbers will reassure us, or scare the heck out of us, depending on what they are. Let’s take a look at the findings of the CDC, one of our government’s watchdogs. Unfortunately, by the time statistics are gathered, processed, and reported time has passed and the situation “on the ground” has changed. This report covers information gathered from June 24 to 30 of 2020. Almost an entire year ago. Do they still mean anything? Can we draw useful trends and information for planning from something 11 months old? Yes, we probably can, as long as we look at current (April 2021 would be good) trends and factor them into our thinking.

The report indicates that adults in the U.S. reported their mental health was worse than it was last year, a fact that surprised no one. The numbers were worse for younger adults, minorities, essential works, and unpaid caregivers. They reported worse mental health outcomes, increased substance use, and elevated suicidal ideation (CDC, 2020). Again, nothing unexpected. Take a teen and take away all their friends, all their social circle, and all the spontaneous activity that takes place in school and it was likely that they would suffer higher rates of mental health issues.

Creating reports such as this one costs money, perhaps dollars that could have gone to treatment, to helping the homeless, to focusing more dollars to those who have been left out of the process until now. Many believe that the statistics in this report should have been foreseen without expensive polling and exhaustive research. However, today’s climate of best-practice, statistically driven action requires the facts on paper before we can send the boots where they are needed the most. (Retrieved from on May 20, 2022.

That was a year ago. Where are we now? Are we seeing any let-up in the rate of increase as we assess the position of the mental health of Americans?

According to the National Institute of Mental Health one light in the tunnel is that the expected rise in suicide ideation did not manifest itself (Gordon, 2021). Gordon goes on to say:

The mental health impacts of COVID-19 continue. From all that we know, it is clear these impacts will outlive the pandemic itself. Therefore, it is crucial that we work together to apply evidence-based strategies to support the mental health needs of all Americans and to make these strategies broadly available, especially in vulnerable communities.

Make sure that the vulnerable members of your client base are getting the help they need. Make a survey of what your area offers mental health patients that they can access on their own. Take heed of what the disabled population is suffering. While the majority of folks were in lock-down, deliveries, zoom meetings, visits to health care professionals via the internet, and other helpful services for those in lock-down soared. Let us make sure that we don’t let those much-needed services disappear now that the able-bodied population doesn’t have to rely on them.

Check into Maslow’s basic needs and make sure they are getting met. After all, a client suffering from a lack of food doesn’t have much energy left to seek care of their PTSD. If not, help your clients create a presence where they can get help, be it financial, social, or struggling with mental issues made worse by circumstances such as homelessness, chronic mental illness, or finding their next meal.

There is a plethora of new resources to strengthen the coaching alliance as you work with clients face-to-face or online. Check out your favorite resource catalog and see what’s new, or what has been around for a bit, but is new to your practice. Look for a new way to teach coping skills, reduce the stigma of mental illness, or to find peace with the loss of a loved one. Series such as will help you dig down to what the real problem is and how you can help the client not just survive, but soar.

Sleep Problems – Is COVID-19 Keeping Us Awake?

Though sleep is called our best friend, it is a friend who often keeps us waiting.
~ Jules Verne

The events of the last year or so have impacted everyone in one way or another. One area of our lives that has been heavily hit is sleep patterns. Most folks no longer need to spring out of bed in time to get breakfast, kids to school, a quick workout at the gym, and catch the train/carpool/bus to work. The lack of structure has encouraged folks to sleep in more often and stay up later at night. For some, this has resulted in sleep problems.

In a recent survey conducted by the American Academy of Sleep Medicine (AASM), more than half of Americans have had increased trouble sleeping since the beginning of the pandemic.

A survey by the AASM of 2,006 adults, 56% of those questioned indicated they had increased sleep problems since the start of the pandemic. These issues are called “COVID-somnia.” Some of the symptoms are difficulty falling asleep, problems staying asleep, worse quality of sleep, and it isn’t just the elderly that are having these problems. “Those aged 35-44 had the highest rate of COVID-somnia sleep disturbances at 70%” (AASM, 2021).

As many can attest, the harder we try to fall asleep, the wider awake we become. In the same survey quoted above, the AASM found that 51% of those reporting problems were using sleep aids of some kind, while 68% of those already using sleep aids were using them more often. Only 5% of those regularly using sleep aids before the pandemic were using them less frequently. Dr. Fariha Abbasi-Feinberg, a sleep medicine specialist from Ft. Meyers, FL, reminds us that “Medicinal sleep aids should be used cautiously for people with sleep problems and should always be used in consultation with a medical provider.”

So, more sleep problems, but don’t use sleep aids and try to avoid prescriptions. What is the solution, or do we wait until the pandemic is over and hope we can catch up then? That’s not likely to work! Studies have shown that trying to reduce a sleep deficit by getting more sleep at another time doesn’t work. For example, a study found that sleeping in on weekends doesn’t reverse the metabolic dysregulation and potential weight gain associated with regular sleep loss (Depner, Current Biology, 2019).

Here are some ideas for overcoming sleep problems without resorting to sleep aids or trying to catch up later from the CDC COVID-19 site that might help (

  1. You’ll sleep better if your room is comfortable, dark, cool, and quiet.
  2. If it takes you longer than 15 minutes to fall asleep, set aside sometime before bedtime to do things to help you relax. Try meditating, relaxation breathing, and progressive muscle relaxation.
  3. Avoid sunlight or bright lights 90 minutes before you go to sleep, when possible. Exposure to light just before bedtime can cause you to feel more awake.
  4. Take naps when you have the opportunity.
  5. Eat healthy foods and stay physically active because it can improve your sleep.
  6. Before you go to sleep, avoid foods and drinks that can make falling asleep more difficult:

Other suggestions gleaned from the 2021 AASM survey include:

  • Turn off electronics at least 30 minutes before going to bed.
  • Use your bed only for sleep and sex.
  • Keep a consistent sleep schedule. Avoid the temptation to sleep late on days you don’t have to check in to work or on vacation. Choose a bedtime that will allow you to get 7 hours of sleep.
  • If you are still awake after 20 minutes, get out of bed.
  • Don’t eat a large meal right before bedtime. Try a light, healthy snack instead.
  • Avoid caffeine in the afternoon and evening.
  • Cut down on the fluids, including alcohol before bedtime.

(Abbasi-Feinberg, 2021)

Here are some exercises you can download from Coping with Sleep Issues Workbook by Leutenberg and Liptak to help you take a tangible step towards better sleep.

Reflecting on My Lack of Sleep will help you pinpoint what might be keeping you awake.

Sleeping Better will help you make small but helpful changes in your sleep environment.

A brief note about the AASM survey. The March 2021 AASM Sleep Prioritization Survey involved 2,006 adult participants in the U.S. The margin of error is +/-2 percentage points with a confidence interval of 95 percent. Atomik Research, an independent market research agency, conducted the survey. To request a copy of the survey COVID-somnia results contact the AASM at Retrieved from April 14, 2021.)

Helping Negotiate the Stress of Returning to School During the Pandemic.

“It was the best of times, it was the worst of times;” so said Charles Dickens in a Tale of Two Cities. To some extent, that is what parents and students are experiencing right now. Most parents are tickled that their children are returning to school and on-campus learning. Helping with online classes has been difficult. Keeping that Kindergarten student engaged, helping the Intro to Calc student master new skills, managing safe playdates and the like has been exhausting. Now we seem to see a light at the end of the tunnel. How do we negotiate the maze of information and find the right answer for the family?

First, parents have to decide if their kid should go back to on-campus learning. They struggle with weighing the danger to immune-compromised folks in their household against the need for their children to interact with the teacher, fill the void that has been left by in their social lives since schools went to online learning, and the myriad other benefits of normal classes.

Next, they must convince themselves that they made the right decision. Kids quickly pick up on feelings of ambiguity that parents try to disguise. Let them understand the decision-making process and be certain that they aren’t endangering Grandma or another loved one if they go back. Even little ones will be struggling with whether or not they want to return to class themselves. If they see you haven’t decided for sure that it is safe, their anxiety will skyrocket.

Let your children talk about going back and how they feel about it. Just because you had a good student with lots of friends doesn’t mean they won’t have conflicted feelings about the change. They will wonder if they will catch the virus. They will wonder if they are endangering Mom and Dad. They will wonder if it is wrong to be happy to leave Mom and Dad with whom they have been spending lots of time. They will wonder if it will hurt their parents’ feelings if they are excited about going back. Take the time to listen and discern what concerns they have. Don’t present a list of “Are you worried about…” questions. Let them tell you what concerns them and accept their reality. Don’t tell them not to be silly when they ask if it hurts your feelings that they want to go to on-campus classes or pose any other question to you. If they tell you they are worried, accept that the concern is of importance to them.

Work through “what-ifs” with them. Telling a student that they will fit in perfectly and all will be sweetness and light to a kid who has been ignored or bullied isn’t going to help him or her face what is coming. Explain their options carefully. Treat their issues realistically. Painting a rose-colored picture of what is coming…everyone will be friends, no one will bully you…when that hasn’t been the case in the past will not reassure them. It will simply reinforce the idea that parents don’t have a clue what really goes on once they leave the house.

Here is a list of suggestions from the Brain and Behavior Research Foundation to help.

  • Don’t be afraid to discuss coronavirus, but be age-appropriate and, As much as possible, try to project a sense of calm and control.
  • Help your child understand the importance of social distancing, handwashing, and wearing a mask.
  • Whether your child is going to a classroom, being homeschooled, or participating in virtual classes, try to help them focus on the positive aspects of the experience.
  • Make sure your child is eating well, getting enough sleep, and keeping physically active.
  • Try to maintain a structured daily routine at home.
  • Remind teenagers often that they are helping to protect others by following health guidelines.
  • If your child is participating in distance learning, create opportunities for them to socialize safely with friends, perhaps via video chats or FaceTime.
  • Reassure children about safety measures in place to keep students and teachers healthy. Remind children that they can also help prevent germs spreading by washing their hands with soap and coughing or sneezing into their elbow.
  • Consistently communicate with your child about your school districts and your families’ own back-to-school plans and listen to their concerns. It is important to encourage and remind children to be flexible as plans may change.

You can find more information from the Brain and Behavior Foundation at

One thing that can help both parents and children alike is to practice some of the stress coping skills that have worked in the past. Turn off the TV and all other devices. Sit in a relaxed posture where everyone is comfortable and tell a story that they have heard before. Suggest that they might close their eyes and imagine the background of the tale. Not the place, of course, for dragons and giants, but for happy children and pretty places. Begin deep breathing with them. Start counting breaths. In…1, 2, 3, 4. Blow it out, 1, 2, 3, 4, 5. Encourage them to imagine the breath coming from their toes, making room for a big, healthy inhale. Increase the length of the space between breaths. Encourage them to relax. When you think they are with you as you breathe, suggest that they imagine a favorite place the family has been together. A beach or a ski hill or a lake or a hiking trail or, for that matter, the family kitchen or living room. Walk them through the experience. At the end, suggest they continue deep breathing, and tell them they can open their eyes and return to the room. If they are in a good spot, begin to discuss the pros and cons of going back to campus. They will feel safe, and you might get results that would have been missed had you not prepared for the discussion.

Simple relaxation techniques such as deep breathing and progressive relaxation (where you begin relaxing at your toes and tighten and relax as you go up your body) will help all of your family settle down, ready for great interaction with each other.

If you need a refresher course on coping skills, take a look at Children and Stress published by Whole Person Associates,

Unpacking White Privilege: An Experiment in “Going There” with White Relational-Cultural Practitioners

Lisa Eible, DSW, MSW, LCSW

We were an informal group of educators, social workers, and therapists who felt deeply moved by ongoing race-related violence, and the difficulty in talking about race-related topics, even among RCT practitioners. We formed an informal group to examine our own white privilege and to address race-related issues and have been meeting for the past year and a half. As the poster describes, we are focused on further development of our personal and professional lenses in the application of RCT to racism (interpersonal and systemic). We seek to understand our individual and collective journeys and to further develop Relational-Cultural theoretical constructs related to racism. We expect and plan further work on this topic, as our group work continues. Lisa Eible may be contacted at

Transforming Community: Stories of Connection Through the Lens of Relational-Cultural Theory

From its inception and early beginnings, Relational-Cultural theory (RCT) has been characterized by co-creation. Jean Baker Miller strongly held to the notion that the work itself was “in relation”—that is, ever changing in a context of mutual learning and impact (Miller, 1976). In this rich collaborative tradition, a group of Relational-Cultural practitioners began working together on a personal, professional, and theoretical journey related to racism and white privilege after the 2015 Jean Baker Miller Institute (JBMTI) in response to yet another national race related tragedy—the Charleston, South Carolina church shooting. A call to action developed there for further RCT work specific to issues of racism and white privilege. Miller (1976) cited the importance of a “good conflict”; and authors such as Ayvazian and Daniel Tatum (1994), Daniel Tatum (2004), Jordan (1997), Tatum and Garrick Knaplund (2004), and Walker (2002) addressed racial issues. Our group thought there was another layer of “unpacking the knapsack” of white privilege which needed to be done (McIntosh, 1989).

A call was made for conference attendees and other RCT practitioners who were interested in working on issues of racism. It was decided that the group would be composed, at least to start, of those who identified as “white”. We observed, in the group’s conception, a need for “us to work on our own issues” and not place additional stress and expectations on our sisters and brothers of color to help us “get it”. This was a decision made in love and protection, not with the purpose of exclusion. It was also a place to start, not a forever decision.

Initially, two groups of social workers, therapists and educators from across the United States and Canada were established and began meeting in Fall, 2015, via on line meeting forums. While all group members identified as “white” and “female”, there was cultural, religious, and sexual orientation differences among group members. The initial goals were to raise each person’s individual awareness of their own privilege and to name how it impacted the lens through which they experienced the world. The longer-term goals of the group are to contribute to the Relational-Cultural theory literature as it relates to issues of race, diversity, and white privilege, as well as to develop some sort of individual or collective social action agenda. The two groups combined to form one group after the first series of meetings due to a smaller number of participants at that point, and has continued as such through April 2017.

A closed Facebook group was set up to share information that included materials such as worksheets, journaling, readings and videos (ex. Race—The Power of an Illusion, Wealth: America’s Other Racial Divide). Survey Monkey was used to gather data from the nine participants in the final group. In response to the question, Have you changed as a result of your participation in this group, participants answered:

• I feel more empowered to speak up on issues of privilege and racism…this group has provided connection and a safe learning place for my continued growth.
• I am angrier. In a good way.
• I am more knowledgeable about the history of racism and institutional privilege in the United States and more aware of how it has affected my habitual perceptions.
• I have become more conscious of my white privilege and have initiated numerous conversations with other white people about white privilege.
• I speak up in uncomfortable situations, whereas before I would be silent. Even if I don’t think I will change anyone’s viewpoint, I make it known that there are other perspectives.
• My self-awareness has increased though I know I have to keep learning. I also appreciate the access to resources…. I use and will continue to use these resources to expose others in my community. I see it as my responsibility to educate other white people.

In response to the question, What was your biggest learning/takeaway from this experience/group dialogue, they replied:

• I still have a long way to go with my understanding of privilege. This process is a marathon not a sprint.
• I was once again struck by the importance of taking time for the growth process to unfold, & to continue to hold the responsibility for learning rather than looking outward to people of color to educate me.
• How helpful it is to have an ongoing white affinity group to learn with.
• That I have the option to deal or not deal with racism and privilege, whereas others are confronted with it daily.
• We are all uncomfortable and will all make mistakes (embrace and acknowledge the mistakes).
• I would say becoming sensitized to the pervasiveness of my privilege. Once your eyes are open, it’s impossible to “unsee” things. And the group has given me courage to act.
• Hearing the complexity with which some of my colleagues describe their own growth in this area has helped me grow too.

When asked about their experiences and observations, they cited scheduling and technology issues as well as the emotional nature of the interactions. One participant seemed to summarize the emotional impact by writing: Several group members noted that the group provided support in tolerating the shame about unacknowledged privilege, opening participants up to greater consciousness and action.

Since the initial series of meetings, the group has continued to meet, and further published work is anticipated and planned.

*Excerpted from Transforming Community: Stories of Connection Through the Lens of Relational-Cultural Theory

Surprising Facts about Loneliness and the Pandemic

In “The Loneliness Pandemic” published by The Harvard Magazine in January 2021, written by Jacob Sweet, Associate Editor, some surprising insights have come to the surface. To make sure we are all defining loneliness in the same way: “Social psychologists define loneliness as the gap between the social connections you would like to have and those you feel you experience.” (Sweet, 2021)

In the past, there has been a stigma about admitting you are lonely. “People are typically embarrassed or ashamed about loneliness because they think it ties to some kind of inadequacy or deficiency on their part,” Sweet says. But COVID-19 presents obvious reasons for people to feel lonely—involuntary isolation, quarantining, etc.—”So what’s different about this loneliness is it actually has the potential to be unifying.” (Sweet, 2021) Perhaps this is a good time to look at how lonely we are, and if we need to find a solution to our feelings.

An article by Jamie Ducharme published in Time’s May 8, 2020 issue, discussed the difficulty in diagnosing which came first, the loneliness or a larger issue of depression. You know the vicious circle: you are depressed so you withdraw socially…you don’t see anyone, so you become lonely, which leads to a deeper depression. No matter which came first, chronic loneliness is a major contributor to dementia, depression, anxiety, self-harm, heart conditions, and substance abuse. Its impact is about the same as smoking 15 cigarettes a day (Ducharme, 2020).

Coping with Loneliness

In their workbook, Coping with Loneliness, Ester Leutenberg and John Liptak, EdD identify two kinds of loneliness. They posit that almost everyone will experience loneliness from time to time. Different forms of loneliness exist. (Excerpts from Coping with Loneliness, Leutenberg and Liptak.)

Situational Loneliness—people feel lonely due to a situation or experience. This is a temporary situation. An example would be moving to a new city where a person does not have any friends and has not made any acquaintances. Even though this situation brings on feelings of loneliness, these feelings will naturally disappear once the person has made new friends. This state of loneliness is usually a transient form of loneliness that changes as the situation or circumstances change.

(Leutenberg & Liptak, 2014)

When the pandemic began, if we felt more lonely than usual, we could find comfort in “this too shall pass.” Most of us didn’t have a clue we would still be experiencing lockdown and self-quarantine.

Leutenberg and Liptak go on to define chronic loneliness:

Chronic Loneliness – This is a form of loneliness that persists over time, regardless of the situation or circumstances. This chronic form of loneliness usually results from having a weak or non-existent support system, a lack of social skills, shyness, and/or low self-confidence. An example would be a person who lacks the self-confidence to initiate conversations when meeting new people, or a person who fears being alone. This type of loneliness often requires the person to take action and build a new set of social skills.

A specific type of this loneliness involves people with mental health issues. Even if they have a great support system and are surrounded by those who care, their issues cause them to feel alienated and lonely. They need to see a medical professional if it continues.

They suggest we be on the lookout for these symptoms of being lonely.

As loneliness becomes a bigger problem for people at all levels of society, it is important to distinguish the specific symptoms of loneliness. Because loneliness is an extreme emotional state in which people experience powerful feelings of isolation from others, it is accompanied by a variety of thoughts and feelings. People who are lonely will exhibit many of the following symptoms:

  • Crying a lot of the time
  • Feeling “hollow” inside
  • Feeling alienated from other people
  • Feeling as if you are alone, even though you are surrounded with others
  • Feeling as if you are not accepted
  • Feeling as if you are not as worthwhile
  • Feeling as if you are not loved
  • Feeling as if you cannot make friends or build stronger relationships with acquaintances
  • Feeling as if you do not have the same interests and values as those around you
  • Feeling as if you have nobody with whom to share personal concerns and experiences
  • Feeling cutoff or disconnected
  • Feeling damaged and unloved
  • Feeling empty
  • Feeling lost with no direction
  • Feeling physical pain akin to a “broken heart”
  • Feeling sad

Leutenberg and Liptak reinforce what we read from Sweet and Ducharme. The negative feelings of loneliness can lead to a variety of other health-related concerns and stress-related conditions including heart disease, high blood pressure and stroke. In addition, it is often related to addiction, various forms of anti-social behavior, disrupted sleep patterns and various mental-health conditions. People experiencing a long-term (chronic) form of loneliness are more susceptible to experiencing these wider effects of loneliness. If your clients are experiencing any of the effects listed above, suggest they see a medical professional.

If, on the other hand, you observe the general malaise that often accompanies mild feelings of loneliness this worksheet might help expand their areas of social interaction. Click here for a free copy of My Social Circle included in Coping with Loneliness, along with many other worthwhile worksheets and handouts for the professional to use when working with their clients.

Coping Styles Young Man Alone Loneliness

As we know, writing can be cathartic as folks struggle with many issues.  The following are suggestions from Leutenberg and Liptak for writing in a “Loneliness Journal”.  Click here for a printable version.

What would it be like to not feel lonely?

What could I do to change my attitude to be less lonely?

Why am I so lonely?

How can I take responsibility for being less lonely?

What steps should I now take to overcome loneliness?

Pandemic Grief

We have all been suffering from pandemic grief in one way or another. In an article “Grieving Life and Loss” by Kirsten Weir that was published by the American Psychological Association on June 1, 2020 (retrieved on January 15, 2021 from she states what we all have heard over and over: “The pandemic has led to a series of losses, from financial security to the lives of loved ones.”

The COVID-19 pandemic is an epidemiological crisis, but also a psychological one. While the situation provokes anxiety, stress and sadness, it is also a time of collective sorrow, says Sherry Cormier, PhD, a psychologist retired from private practice who now focuses on grief training and mentoring. “It’s important that we start recognizing that we’re in the middle of this collective grief. We are all losing something now.”

Many people are confronting the loss of a loved one to the novel coronavirus—a challenge made even more difficult by physical distancing orders that prevent them from saying goodbye in person or gathering with others to mourn. Deaths aren’t the only losses that people are reckoning with, however. Millions of people are facing loss of employment and financial upheaval as a result of the pandemic. Yet even p­eople who haven’t lost anything so concrete as a job or a loved one are grieving, Cormier says. “There is a communal grief as we watch our work, health-care, education and economic systems—all of these systems we depend on—destabilize,” she says.

Pandemic Grief

Everyone’s pandemic grief is different. Those who are lucky enough to still be working, who live with supportive family members, who are financially able to keep a reasonable facsimile of their former life in place, feel that they shouldn’t be grieving as they are much better off than many friends and family members. Ester Leutenberg and Fran Zamore in GriefWork (2008) refer to grieving as

…A long, winding path that curves back on itself, traverses hills and valleys, and has many obstacles. It is a path that is challenging to negotiate, time-consuming to travel along and may provide opportunities for personal and spiritual growth. Grieving is a part of the human experience. A person attached to someone will mourn the loss of that relationship and miss that person’s physical presence. We understand this as a simple truth. Remembering this truth does help some people cope with the loss because they are able to be somewhat philosophical….

Added to this list are, of course, all the losses we have experienced because of the pandemic. According to the Mayo Clinic article Coronavirus grief: Coping with the loss of Routine during the Pandemic…

Efforts to prevent the spread of COVID-19 have affected people’s jobs, where people work, the way kids go to school and play, and the ability to gather in person with family and friends. These measures have also changed how people shop, worship, exercise, eat, seek entertainment, and celebrate holidays and special events. As a result, the pandemic has had a major psychological impact, causing people to lose a sense of safety, predictability, control, freedom and security. Retrieved January 15, 2021 from

The following story and worksheet* are excerpted from The GriefWork Companion, by Fran Zamore, LLSW, IMFR & Ester R.A. Leutenberg.

How Do You Handle Adversity?

Are you a Carrot, an Egg or a Coffee Bean?

A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up. She was tired of fighting and struggling. It seemed as one problem was solved, a new one arose.

Her mother took her in the kitchen. She filled three pots with water and placed each on a high fire. Soon the pots came to a boil. In the first, she placed carrots, in the second she placed eggs, and the last she placed ground coffee beans. She let them sit and boil, without saying a word.

In about twenty minutes, she turned off the burners. She fished the carrots out and placed them in a bowl. She pulled the eggs out and placed them in a bowl. Then she ladled the coffee out and placed it in a bowl.

Turning to her daughter, she asked, “Tell me, what do you see?”

“Carrots, eggs and coffee,” she replied. Her mother brought her closer and asked her to feel the carrots. She did and noted that they were soft. The mother then asked her to take an egg and break it. After pulling off the shell, she observed the hard boiled egg. Finally, the mother asked the daughter to sip the coffee. The daughter smiled, as she tasted it and noticed its rich aroma. The daughter then asked, “What does it mean, Mother?”

She explained that each of these objects had faced the same adversity – boiling water. Each reacted differently. The carrot went in strong, hard, and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior, but after sitting in boiling water, its insides became hardened. The round coffee beans were unique, however. After they were in the boiling water, they had changed the water.

“Which are you?” she asked her daughter. “When adversity knocks on your door, how do you respond? Are you a carrot, an egg or a coffee bean?

Think of this: Which are you? Are you the carrot that seems strong, but with pain and adversity do you wilt, become soft and lose your strength? Are you the egg that starts with a malleable heart, but changes with the heat? Do you have a fluid spirit, but after a death, breakup, a financial hardship, or some other trial, have you become hardened and stiff? Does your shell look the same, but on the inside are you bitter and tough, with a stiff spirit and hardened heart?

Or are you like the coffee bean? The bean actually changed the hot water, the very circumstances that bring the pain. When the water gets hot, it releases the fragrance and the flavor. If you are like the bean, when things are at their worst you get better and change the situation around you. When the hour is the darkest and trials are their greatest, do you elevate yourself to another level? How do you handle adversity? Are you a carrot, an egg or a coffee bean?

Pandemic Grief – Limits of Control

It is important to realize the limits of what you can control. Especially during this difficult time, remember, we have control only over our own responses and reactions.

After completing the activity, journal about your thoughts.

*Click here to download the worksheet “Control” from The GriefWork Companion.

Resiliency in Kids and Teens: A survival tool for Covid-19.

Leutenberg and Liptak tell us in their book Teen Resiliency Building that resiliency is the ability of a young person to interact with the environment, handle stresses that occur, and bounce back from stressful events. It is the process by which well-being is promoted and protection factors are activated against overwhelming feelings of stress. Kids who have developed resiliency are able to bounce back from the negative impact of difficulties. Resiliency, or a positive behavioral adaptation, is critical when people encounter any type of trauma. The Covid-19 pandemic has placed us in a traumatic situation unlike any we’ve experienced before.

How can we help our kids come out on the other side of the pandemic as the healthy, strong young folks that we knew last March?

Research indicates that resiliency can be built through skill development by enhancing communication, developing an optimistic outlook, building a greater sense of control, creating a more realistic sense of self, and learning how to effectively deal with change. We can inspire out kids to a more optimistic outlook even under these unique circumstances.

Explain to your kids in language that they will understand that an optimist, regardless of transitions, setbacks, disappointments, or Covid-19, looks at the bright side and sees the possibilities life has to offer. Optimists expect good things to happen, expect to be able to solve problems efficiently, and plan to accomplish their goals. They go through life with positive outlooks and are content most of the time. Optimists maintain a positive view of the world. Pessimists think negatively and cynically (littler kids might need to know that cynically means to be concerned only with one’s own interests and typically disregarding accepted or appropriate standards to achieve them) about the world.

Then discuss the following questions with them:

  • Which are you, an optimist or pessimist? Why do you believe this?
  • How long have you felt like an optimist or pessimist? What brought this on?
  • Think of a time when you viewed a situation as bad, or negative, and yet, something good, or positive came out of it?
  • How can you begin to view the world in an even more positive light?

Make sure your younger children understand the concept of positive and negative.

Hope is an important part of an optimistic outlook.

Explain that hope can be described as a mindset consisting of a positive or good and happy view of the future for yourself and others. Remaining hopeful over the course of your life is at the core of resiliency and the ability to bounce back while facing problems and the stresses that go along with the pandemic. Having hope will guide you with resiliency while you achieve your goals and dreams.

Discuss these points with your kids. Be sure they understand the questions.

  • Did the pandemic cause you to stop hoping?
  • Where do you believe your sources of hope, or lack of hope, come from?
  • How has your environment affected the amount of hope you currently have?
  • Where do you look for hope in your life?
  • What are three things you hope for?
  • How have your hopes changed?
  • How has hope, or a lack of hope, affected choices you have made?
  • What needs to happen before you have more hope in your life?

Here are links to generic, non-Covid-19 specific worksheets on the material above designed for teens. They are both from Teen Resiliency Building by Ester Leutenberg and John Liptak EdD: Hope and Life Outlook Worksheets

Making sure your kids are optimistic and hopeful about the future is a good start to helping them through the pandemic. Remember the other suggestions that will help them develop resiliency:

  • Enhance communication
  • Build a greater sense of control
  • Create a more realistic sense of self
  • Helping them to effectively deal with change.

Why Can’t I Sleep? Do I Have a Sleep Disorder?

Sleep Disorder

Most people, at one time or another, have experienced trouble falling asleep or staying asleep. Inability to sleep occasionally is normal and is often the result of some sort of stress in life. However, when sleep problems become a regular occurrence and begin to affect one’s ability to function in daily life, the person may have developed a sleep disorder.

Do I Have a Sleep Disorder?

A lack of adequate sleep may not seem like a big problem, but it can seriously affect one’s performance at school or work, ability to concentrate, ability to control emotions, and ability to handle stress. Lack of sleep is a challenge to one’s own general health and well-being.

Adequate sleep is a great buffer that helps to protect people from everyday stress. Sleep is a vital support for one’s ability to rejuvenate the mind and body.

Any type of sleep deficiency can seriously increase one’s vulnerability to a variety of physical disorders and to a host of negative feelings, emotions and behaviors:

  • Anger
  • Anxiety
  • Frustration
  • Irrational thinking
  • Irritability
  • Sadness

Inadequate sleep:

  • A reduction in the amount of sleep one experiences. This occurs when people find that they are not sleeping enough hours each night.
  • A reduction in the quality of sleep one is receiving. This occurs when people find that they are having a hard time falling asleep, often awaken, and then may have difficulty going back to sleep. This reduction causes a dramatic break in the sleep cycle.

What is the Sleep Cycle?

Sleep is an altered state of consciousness in which brain waves pass through distinct stages that keep cycling between REM (Rapid-Eye Movement) and Non-REM sleep. This is referring to the sleep cycle, and this is how the sleep cycle works:

There are four stages of sleep: Stage 1, Stage 2, Stage 3, and REM. These stages do not always occur in order. In fact, they rarely occur in order. The sleep cycle begins with three Non-REM phases that people typically go through before reaching REM sleep:


This stage between asleep and awake is almost always first. It may be just a minute or so long, but is usually less. It is just a transition from awake to Stage 2 where one spends about seventy-five percent of the night. Typically, a person will drift straight through Stage 1 for a minute or two, and be in Stage 2 for some time. One’s eyes are closed, but it’s easy to wake the person up.


This is a light sleep. One’s heart rate slows and one’s body temperature drops. The body is getting ready for deep sleep.

Stage 3 – DEEP SLEEP

This stage is tricky. Deep sleep is also called delta sleep. It is the restorative sleep for the body, when the brain secretes growth hormones, and when our breathing is most regulated. Children have a long period of delta sleep. As we age, the amount of delta sleep that we have decreases by a certain percent each year, so that by the time we reach ages 60 to 70 we have little to NO delta sleep. Men begin to bypass the delta sleep stage sooner than women. So, it is likely that in an adult population, a researcher will not see delta when studying a normal night of sleep. There will be a night here and there when an adult will have an instance of some delta activity, but it is not a stage that they go through on a nightly basis. It is harder to rouse one during this stage, and if someone wakes one up, one would feel disoriented for a few minutes. During the deep stages of Non-REM sleep, the body repairs and re-grows tissues, builds bone and muscle, and strengthens the immune system.

The Sleep Cycle now moves into deep REM sleep: Usually, REM sleep happens approximately 90 minutes after one falls asleep. The first period of REM typically lasts 10 minutes. Each of the later REM stages gets longer, and the final one may last up to an hour. One’s heart rate and breathing quicken. One tends to have dreams during REM sleep. The cycle then begins all over again. The last REM cycle is the longest and most restorative and awakening during this cycle can leave one feeling disoriented.

Common Types of Sleep Disorders

Many different types of sleep disorders are listed below. Check if you think any of them might apply to you.

Delayed Sleep Phase Disorder is a disorder in which a person’s sleep is delayed by two or more hours beyond the conventional bedtime. This delay in falling asleep causes difficulty in waking up at a desired time.

Insomnia is the most common type of sleep disorder. Some of the symptoms of insomnia include difficulty getting to sleep, waking many times during the night, and often waking before it is time to actually get up. Insomnia can affect normal daytime activities. Insomnia is most often caused by stress, anxiety, certain medications, depression and/or inadequate sleep habits.

Narcolepsy occurs when people feel excessively sleepy in the daytime. The sleepiness felt with narcolepsy is overwhelming. Some people with narcolepsy have uncontrolled sleepy periods that can occur regardless of what they are doing, while others have constant sleepiness throughout the day. The person has this feeling for a period of time longer than three months, and it is accompanied by a higher than usual percentage of REM sleep.

Nightmares are frightening dreams that occur during deep, REM sleep.

Periodic Limb Movement Disorder is the movement of hands, arms, feet, and legs during sleep that frequently causes arousals and disturbs the sleep cycles. Whether the person remembers waking or not, the brain often shifts from sleep to wake in a response to the jerking of the limbs causing the sleep cycle to be disrupted and worse excessive daytime sleepiness.

Restless Leg Syndrome occurs during wake hours and is often worse in the evening and before bedtime, which can lead to sleep onset insomnia. This discomfort can come in the form of an urge to move one’s legs and feet to get relief. People find themselves experiencing excessive and rhythmic movements while they are sleeping.

Sleep Apnea occurs when soft tissue covers the airway, either partially or completely, causing a cessation of breathing for ten seconds or longer repeatedly through the night. This can cause frequent arousals and disruption of the desired sleep cycle. These disruptions cause those suffering from sleep apnea to be very tired during the day.

Sleep Talking is a sleep disorder defined as talking during sleep without being aware of it. Sleep talking can involve complicated dialogues or monologues, complete gibberish, or mumbling. The good news is that for most people it is a rare and short-lived occurrence.

Sleep Terror Disorder occurs mostly in children but can be found in adults. Night terrors are frightful images that appear in a person’s dream but are often difficult to remember upon awakening.

Sleepwalking is a disorder that causes people to get out of bed and walk while they are sleeping. It usually happens when a person is going from the deep stage of sleep to a lighter stage, or into the wake state. The sleepwalker can’t respond during the event and usually does not remember it.

My Self-Care Sleep Habits

Sleep habits are often dependent on wellness habits that you display during the day. Think about some of your wellness habits and how they may be negatively affecting your ability to sleep at night. In the chart on the attached worksheet, write about how you can make positive change in your wellness habits.

Click here to download the My Self-Care Sleep Habits worksheet.

This material was excerpted from Coping with Sleep Issues by Ester R.A. Leutenberg and John J. Liptak, EdD.

World Mental Health Day

Saturday was World Mental Health Day. Whole Person Associates would like to present the following in response to the reminder that we all need to care for our mental health.

Some people are more optimistic than others and see the glass as half-full rather than half-empty. The half-full folks are optimists. Their ability to look at the world in an optimistic manner helps them maintain their mental health.  As an optimist, regardless of transitions, setbacks, or disappointments, the person looks at the bright side and sees the possibilities life has to offer. Optimists expect good things to happen, expect to be able to solve problems efficiently, and plan to accomplish their life and work goals. They go through life with positive outlooks and are content most of the time.

What is your outlook on life?   Answer these questions to find out.

  • Do you believe yourself to be an optimist or pessimist? Why do you believe this?
  • How long have you been an optimist or pessimist? What brought this worldview on?
  • How did your childhood affect the way you view the world?
  • How can you begin to view the world in an even more positive light?
  • Think of a time when you viewed a situation as negative, and yet, something positive came out of it?

Click here for a link to a printable version of this exercise, Life Outlook.

Can you change your attitude on life? Try these suggestions or click here for a printable copy of Reconstructing My Attitude.

When you find yourself getting stuck in a cycle of negative thinking, what is one method you can try to restructure your thinking from pessimistic to optimistic?

Consider the situation, as an example, of going back to school.

  • When you feel yourself becoming negative, identify your negative thoughts: “I’m not good enough,” “I’m not smart enough,” “Everyone will be much younger than me,” “I have not been to school in such a long time.”
  • Think about the accuracy of your statements. What is the proof they are accurate? When you look at them objectively, what do you learn?
  • Think of positive ways to restructure these thoughts. “If other people can go back to college so can I,” “I will be more experienced than many of the other students,” “It’s never too late to learn,” “I deserve the benefits of going back to school.”
  • Take action: “I will go to the school on Friday and pick up an application. I will complete it over the weekend and search online for information about financial aid.”

The article and exercises above were excerpted from The Building Resiliency Workbook by Ester Leutenberg and John Liptak, EdD.

There are signs to look for if you or someone around you is showing evidence of early signs of a mental health problem: 

  • Eating or sleeping too much or too little
  • Pulling away from people and usual activities
  • Having low or no energy
  • Feeling numb or like nothing matters
  • Having unexplained aches and pains
  • Feeling helpless or hopeless
  • Smoking, drinking, or using drugs more than usual
  • Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared
  • Yelling or fighting with family and friends
  • Experiencing severe mood swings that cause problems in relationships
  • Having persistent thoughts and memories you can’t get out of your head
  • Hearing voices or believing things that are not true
  • Thinking of harming yourself or others
  • Inability to perform daily tasks like taking care of your kids or getting to work or school

Retrieved from: on 10/10/20.

What should you do if you notice these signs in yourself or someone else? Click on the link above for some helpful information.

Romantic Intensity Versus Intimacy

Intensity Versus Intimacy in a Romantic Relationship


  • Gaining clarification between deep connection and passing infatuation
  • Maximizing enjoyment and minimizing the downside of dating

The beginnings of an intense romantic relationship can be exciting and fun. Being clear about the difference between intensity and intimacy, and knowing what you want from a relationship can help you stay balanced and avoid disappointment.


Studies show that falling in love activates areas of the brain associated with gut feelings and euphoria. The frontal lobe area, associated with higher thought, is not especially active. So how do you keep your feet on the ground when you are attracted to someone?

Answer these questions to help boost your intimacy IQ. Intimacy involves closeness, comfort, familiarity, trust, and acceptance.

Mindfulness for Emerging Adults Book Release
  • Can I talk openly to my partner about my fears?
  • Can I talk openly to my partner about my hopes and dreams?
  • Can I talk openly to my partner about my past?
  • Can I accept my partner’s past?
  • Can I listen and support my partner in conversations about fears, hopes, and dreams
  • Do I feel safe with my partner?

If you answered yes to most of these questions, you are on your way to establishing intimacy.

Intensity usually involves feelings of euphoria and preoccupation.

  • We have been physically close, but I really don’t know much about my new partner.
  • My partner doesn’t really seem to be interested in things that are important to me.
  • There has been a lot of “love bombing” – Heavy doses of romantic gestures and flattery, but not a lot of authenticity.
  • Does my partner try to change me?
  • Do I try to change my partner?
  • Does my partner often disappoint me by changing plans or otherwise being inconsistent?

If you agree with or answer yes to most of the above statements, you may be in the throws of an intense romantic and physical relationship. There may be nothing wrong with this! Just make sure that you are on the same page about the direction of the relationship.

-This exercise is excerpted from Mindfulness for Emerging Adults

Relax Away Your Stress

Physical distancing and isolation measures, [and] the closure of schools and workplaces, are particularly [challenging for] us, as they affect what we love to do, where we want to be, and who we want to be with,” said Dr. Hans Kluge, the WHO’s (World Health Organization) regional director for Europe, in his opening remarks.

“It is absolutely natural for each of us to feel stress, anxiety, fear, and loneliness during this time. At [the] WHO, we consider [effects on] our mental health [and] psychological well-being as being very important consequences of COVID-19,” he added.

Everyone seems willing to acknowledge that the pandemic and its consequences are stressful. To make it even more difficult to endure, our usual contacts with health professionals of all kinds has changed dramatically. We now have virtual appointments which are helpful, but not the same as a face-to-face visit with someone we trust to help.

Recently, to add to the cares and worry of the pandemic, there is civil unrest in the United States and throughout the world as the issue of systemic racism again raises its ugly head.

What can we do, pretty much on our own, to combat these stressors? Is there a magic wand out there we can wave over our heads to allivate this sense of drowning in stress? Of course not. However, there are some steps each of us can take that will help.

Kat Hounsell is a leadership coach and mental health first aid instructor, and founder of everyday people, says, “Be kind and patient with yourself and those around you.” She also stressed the importance of maintaining other healthful habits — such as eating regularly and sticking to a healthful diet — because these are, in themselves, a cornerstone of mental health.

In the same article, business neurolinguistic programming practitioner and mental health trainer Tania Diggory, founder and director of Calmer, said, “[w]hen working from home, prioritizing your mindset and well-being at the start of the day is essential.”

Of course, sounds simple. Anyone can do that. We can, but do we do it daily…not always. Try this, it will help.

Before you sign off for the day make a list of tasks for your next session. Prioritize them and refer to it first thing. Break things up into manageable units. Just saying, “Get final budget proposal for the company” isn’t going to work. Break down the tasks needed to accomplish large goals. You will find crossing off small tasks almost as satisfying as deleting big ones, and, when you eventually can cross off that giant budget approval that seemed so difficult and far off, you will not have driven yourself into the ground with frustration because you can’t see progress being made.

When you take a break at work, go to lunch, on your commute, take along headphones and listen to a relaxation script. There are several types of relaxation…their formal names are not important. Below is a link to a free script from Natural Tranquilzers, an excellent compilation of different types of relaxation. Remember: being able to relax on command is a muscle skill. Wayne Gretsky, the best hockey player ever, had to learn how to handle the puck and shoot at the goal just like any other 5 year-old Ice Mite did. Van Cliburn, pianist extraordinaire, wouldn’t have learned to play with the beauty and artistry he exhibits if he hadn’t trained his muscles to know where the notes were on the keyboard, practicing scales. You, when you first try to relax using a time-honored relaxation technique, will need to train your muscles, too. Many people find that at around the seven to ten day mark their muscles begin to relax on command and they see the benefits begin to accrue.

Schedule time to wind yourself down. Even at work, you can take 5 or 10 minutes to listen to your favorite relaxation MP3 file. Click here for a link to download Calm Down, a free relaxation script track from Natural Tranquilizers, one of our relaxation audio products. Practice it for seven to ten days. The trick is teaching your muscles to respond to the music and words you are hearing without you having to consciously tell them to do so. It works!

Pandemic Anxiety: Mental Health Awareness Month

May is mental health awareness month. Many of us are experiencing more anxiety than usual with the pandemic and all of the uncertainties we are facing. Pandemic anxiety can feel overwhelming at times.

Stressed by Anger
Intense anxiety isn’t always obvious.

If you are suffering from depression, if you can’t keep up your usual activities, if you have been sad for weeks and can’t seem to recover as usual, please contact a mental health professional right away. If you are feeling anxious, unable to function in your usual ways call your local mental health clinic. Even insurance companies are recognizing virtual appointments during the pandemic, and, most of the time, covering the cost. Of course, check with your insurer, but don’t put off getting the help you need. 

The conversations that go on in our own heads during the pandemic can be a contributing factor to our levels of pandemic anxiety. Click here to download the Worry Self-Talk exercise from the Managing Intense Anxiety Workbook, by Ester Leutenberg and John Liptak, EdD.   

In an article published in the March, 16, 2020  Psychology TodayDr. Deborah Serani gave five suggestions for dealing with pandemic anxiety and panic.  

1. Ground yourself in science. Resist viewing or reading sensational news or social media, where facts are often blurred or exaggerated. Instead, reach out to your local health or state department of health for up-to-date information on COVID-19. Science-based facts will help ground you in a reality where truth, hope, and interventions exist.  

2. Isolate but stay connected to others. Protect yourself with social distance and homebound activities. But make sure to keep your attachments to friends, family, and loved ones by calling, texting, using FaceTime or Skype.  

3. Think locally, not globally. Focus on what is happening in your local community and what you can do to keep yourself and neighbors healthy and safe. A sense of community is vital for moving through traumatic situations and builds resilience in children and adults. 

4. Practice self-care and make sure others do too. Be mindful of eating well, keeping a healthy sleep cycle, exercising, and other soothing self-care behaviors. Make sure to avoid using alcohol or drugs to cope with stress. And limit caffeine, as it heightens anxiety and irritability. 

5. Fight helplessness by finding purpose. The uncertainty that COVID-19 brings can leave many of us feeling unspeakably helpless. Finding purpose can alleviate restlessness and anxiety. Choose things you can control, be it shifting negative thoughts into positive ones, deciding what to cook for lunch, reading a good book, picking what movie you and the kids will watch, or other activities you have power over.  

Moodiness and Depression

As the pandemic drags on and on, more of us are struggling with depression, moodiness, and other mental health issues. In a March 20, 2020 article in US News and World Report, it was reported that “Fear of the unknown and uncertainty over how long we’ll have to resort to limiting our daily lives, fear of contracting the coronavirus or even worry about how this will affect one’s financial situation are legitimate concerns.”

Often, we are afraid to bring these concerns up to our families. We struggle on alone, chiding ourselves…we have so much, how can we be so sad; we are still managing to get up in the morning and go to bed at night, things can’t be all that bad; we lost our job, but unemployment is there and so helpful; I really miss the interchange between me and my coworkers (even though I used to complain about them to my partner all the time.) I ran short of food, but the food-shelf was there to step into the breach. I even saw my supervisor standing in line. It isn’t like my family is going without, why should I be so sad. My granddaughter asked if I ever smile anymore. I could have told my daughter how depressed I’ve been, but I didn’t want to put down my “Grammy can handle anything” reputation. Besides, I didn’t want to burden her with something so “silly” as being depressed. So why do I still feel so sad, depressed, lost?

Our unwillingness to act on our feelings of depression and sadness might well be based in the stigma that still haunts mental health issues. The stigma of experiencing depression or moodiness is often more damaging than the experience itself. Although we have come a long way, the acceptance of mental health issues is still a long way off. Learning to cope with your moodiness and the stigma that surrounds it will be helpful. If you would like help dealing with the stigma of mental health issues click here for a worksheet that will help: Focus on Your Strengths Worksheet

If you are one of the people like those in the first paragraph who minimize your depression or moodiness you might find this helpful: Ways I Try to Minimize My Moodiness Worksheet

Managing Moods Workbook

People become sad for a variety of reasons including disappointment, grief, frustration of not being able to accomplish a project or not getting what’s desired, experiencing despair during the pandemic, etc. When these feelings of sadness last for hours or even a couple of days, they may not be a cause for concern. They may be part of the normal “ups” and “downs” of life. It is common for people to feel blue or down, become frustrated and/or experience a sense of emptiness from time to time.

However, a sad mood which won’t let up can change the way people think and feel and may be a sign of a more serious problem. When people find themselves for several weeks taking little joy in activities they have previously enjoyed, appear irritable a majority of the time, and feel fatigue and a general loss of energy, they may be experiencing the symptoms of more serious problems.

These more serious mood or depression problems stretch far beyond the usual limits of disappointment, loss, frustration, and joylessness. They can be accompanied by an inability to cope with everyday life issues and stressors. Rather than temporary feelings of down in the dumps, these extreme feelings tend to last for more than a few hours or days. They tend to affect all aspects of a person’s life and leave the person feeling empty, unable to move, and hopeless for weeks, months and even years.

People who experience problems in maintaining a balanced and healthy overall mood are often incapable of functioning well in daily life. They often experience extreme emotional states, negative feelings, and self-defeating moods that are inconsistent with what is happening in their environment. People struggling with these mental conditions find that they are unable to overcome their moodiness in the workplace, at home, with family and friends, at school, and in their community. People who experience depression and moodiness may have problems in interpersonal relationships, ability to work effectively, study and concentrate, and in the ways they eat, sleep, relax and live their daily lives.

Much of the material above is from Managing Moods by Ester R.A. Leutenberg and John J. Liptak, EdD.

Oh Happy Day! Optimism Is Good for Your Health

Optimism during crisis

Photograph by Deb Lutkevich

During this time of crisis, when normal seems long gone, will those who are optimistic fare better? Will they cope with the change brought on by the pandemic better than their pessimistic cohorts? Does a magic wand sprinkle fairy dust over those who believe, no matter what, that things will work out for the best? Even if that optimism is unfounded in reality? It turns out optimistic folks do better than those who are more pessimistic in their outlook.  

In an article in Psychology Today, July 2016, Utpal Dholakia Ph.D. said, discussing dispositional optimism, or how much folks believe that things will have positive outcomes for their family, support systems, even for the economy and the entire world. “More than five decades of research have found that optimism is a potent health tonic. Optimistic people remain healthier and live longer.” (Dholakia, 2016)  

Dr. Dholakia believes there are four reasons that dispositional optimism leads to healthier people.  

  • Dr. Dholakia says that optimistic people know more about their health conditions and how to improve them. If you know what to do to be healthy and overcome health challenges, you are ahead of the game. Optimistic people are willing to study their conditions and find ways to do what is best. Compliance is high. 
  • Optimistic folks behave in a healthier way than those who are not optimistic. These behaviors lead to feeling better, which then lead to the continued practice of healthy lifestyle choices. They live longer and better than those who aren’t so optimistic. Dr. Dholakia says, “Optimists’ healthier actions lead to more positive health outcomes.” These, in turn, promote healthy activities, producing a virtuous cycle for good health. 
  • Optimistic people have better coping skills. When faced with a setback, they know how to deal with it. They believe that if they follow their time-honored skills, all will be well. 
  • Optimists believe they have better support systems both in and outside their family circle. Because they are usually likable folks, they often do have a larger group of supporters to call upon in times of need. They also believe that their support system will enjoy helping them deal with whatever difficulty they are facing. 

“Choose to be optimistic, it feels better.” – the Dalai Lama 

Retrieved from on April 20, 2020.  

-Written by Peg Johnson

For resources that promote optimism and support uplift, see our Self-Help section and titles like:

The Grief Experience

One of the important aspects of grieving that has been largely overlooked is the relational aspect. Each person’s grief is unique because he or she: 

  • Had a unique relationship with the deceased (loving, ambivalent, challenging)
  • Brings a unique personality and coping mechanism to the situation
  • Has a particular world view which will impact how he or she enters the process
  • Has ongoing relationships which may or may not be helpful
  • Has a unique relationship with death
  • Came to this particular loss with a unique history of dealing with earlier losses
  • Has particular expectations about what dealing with the loss means and wonders how dealing with the loss “should” proceed
GriefWork Resources

The grieving process can occur in many types of losses; although we focus on loss by death, the concepts presented can be applied to other losses.

We view the grieving experience as a long, winding path that curves back on itself, traverses hills and valleys, and has many obstacles. It is a path that is challenging to negotiate, time-consuming to travel along and may provide opportunities for personal and spiritual growth. Grieving is a part of the human experience. A person attached to someone will mourn the loss of that relationship and miss that person’s physical presence. We understand this as a simple truth. Remembering this truth does help some people cope with the loss because they are able to be somewhat philosophical.

The process may be more complicated when the relationship with the deceased was either ambivalent or challenging. The reality, for most people, is that relationships are not easy to put into these categories. Most long-standing relationships are at times loving, at times ambivalent, and at times challenging. The degree of challenge will likely add to the complex feelings that the person who is grieving will experience. Along with the death of the person, the bereaved may also grieve the reality of unmet needs represented by the relational difficulties.The death of a loved one is a major life event. When assessing the progress of a grieving client, the facilitator must be aware of that person’s level of functioning in all domains prior to the loss.


BEREAVEMENT refers to the experience of the loss of someone through death.
GRIEF is the reaction to bereavement. It is a universal response to any loss.
MOURNING refers to the expression of grief in culturally specific ways.
LOSS refers to no longer having somebody or something.

Kinds of Losses

Loss is a part of everyone’s life at some point. Each person reacts to a loss in a personal way. As well as the emotional response, loss also has physical, intellectual, behavioral, social and philosophical dimensions. Response to loss is varied and is influenced by beliefs and practices.

People’s losses, no matter what, are important and often devastating to them. They represent the disappearance of something or someone cherished.

Some examples of loss: 

  • Addiction
  • Death
  • Divorce
  • Failed business venture
  • Faith
  • Financial security
  • Home
  • Independence
  • Mental ability
  • Pet
  • Physical health
  • Plans, hopes and dreams
  • Relationships
  • Role in life
  • Sense of safety/security
  • Status
  • Treasured possessions

Many of the handouts in this book will apply to some of the losses and to most people. Carefully choose the handouts given to each person. If handouts are being distributed to everyone in a group, instruct participants to complete only the parts applicable to them.

-From the Introduction to GriefWork: Healing from Loss by Fran Zamore, LISW, IMFT and Ester R.A. Leutenberg

Use the Coupon Code GRIEF2020 at checkout prior to June 1st, 2020, and receive 30% off of the following workbooks (print and/or PDF eBooks) from our GriefWork Series:

About Caregivers

During the pandemic we are making our book, The Complete Caregiver Support Guide, available at a reduced price to help more therapists add this valuable resource to their library. Find the coupon code at the bottom of this blog post.

Former First Lady Rosalynn Carter stated,

“There are four kinds of people in this world: those who have been caregivers, those who currently are caregivers, those who will be caregivers, and those who will need caregivers.”

This includes virtually everyone!

A Brief History of Caregiving

In past generations, it was customary for people to have large families. Members of an extended family often lived within a few miles of each other. Few women had jobs outside the home, so the elderly and infirm were cared for within the family. Both the primary caregiver and care-receiver had the support of nearby relatives, friends and community.

Circumstances are different today. Families are typically smaller and are often scattered across the country and around the globe. A much larger percentage of women work outside the home. People live longer, often with chronic illnesses. These factors make caregiving much more complicated than it was in the past.
The early stage of caregiving is often handled by family members or by friends who live near the person needing help. They begin by simply doing what they can and often, as time passes, assume the caregiver role without realizing it – caregiving isn’t a job that many people choose to sign up for.

The tasks caregivers perform can vary widely, from transporting a child with disabilities to school each day, to doing someone else’s laundry, to helping with medications, to dealing with insurance companies. Caregiving can be temporary, as when someone is recovering from an accident, or long-term, as when caring for a person in need of significant ongoing support.

In an attempt to define family caregiving, the National Family Caregivers Association (NFCA) developed a list called “Caregiving Is.” The text below was inspired by that list.

Caregiving is as diverse as the individuals needing it. It can be 24-hour care for persons who cannot manage daily tasks of living or are suffering a significant level of cognitive loss. It can be preparing for an uncertain future because a spouse has a progressively disabling disease, even though that person is still able to function quite well. It can be temporary, last several years or last a lifetime.

Caregiving means being a person’s healthcare advocate. It requires learning to work with doctors and other health care professionals and to navigate government healthcare programs. It can also be learning what it means to die with dignity and making sure that the care-receiver’s wishes will be honored.

Caregiving is stressful work. Most people have had no training or education regarding the many aspects of caregiving when they begin helping their care-receiver. They discover that caregiving is assuming tasks they never dreamed of undertaking. It can be learning about medications, wheelchairs, lifts and gadgets that help struggling fingers button a shirt. It can involve doctor visits, calls to 911 and long days and nights in a hospital waiting or emergency room.

Caregiving challenges people to go beyond their comfort zone. It is having conversations on topics most people hope they will never need to address. It is grappling with questions that often have no easy answers. It is loving, giving and sharing. It is accepting, adapting and being willing to keep on going.

Caregiving forces individuals to deal with change. They are often required to re-evaluate finances, living conditions and/or their personal work situation. They will need to make compromises and readjust again and again as the circumstances change.

Caregiving is an endless search for balance. It is seeking the middle ground between doing too much for the care-receiver and doing too little. It is trying to find time for personal needs – and hopefully, even wants – while providing for another’s needs. It is recognizing that one cannot do it alone – one can and should ask for help, respite care and time off for a vacation to recharge through activities that help maintain a sense of self.

Caregiving is a strain on relationships. Even the best of relationships can be challenged by the stress of caregiving. The demands on one’s time and energy may leave family members or friends feeling neglected. Moving a parent into a family home – or moving into the parents’ home – can be a source of contention between couples, and between parents and their children. Finances and other emotionally charged issues can also cause tension between adult children of an ailing parent.

Caregiving can be a lonely world. While the tasks and experiences of caregiving may be similar in nature, surprisingly they are not what unites family caregivers. According to the National Family Caregivers Association, the common bond of caregiving is the emotional impact.

Those caring for others often feel lonely, isolated, and unacknowledged for all their work and sacrifice. They can experience anger and resentment toward family members and others who carry on as usual, while they of necessity give up much of their normal life. They grieve the losses in their own lives as well as and the loss of the person their care-receiver once was as they watch him or her decline. They often experience depression, sadness, pain, the need for normalcy and regret for what they might have done had circumstances been different. They also may feel guilty because they sometimes wish it were over.

Caregivers can find comfort in learning that such feelings are perfectly normal and in finding ways to cope with them in support groups and within these pages. They can also find hope in the possibility of connecting on a deep level with their care-receiver and creating closer bonds with family members. In fact, discovering positive meaning in the tasks of caregiving is crucial for the emotional health of everyone involved.

Caregiving can also be moments of joy and fulfillment.

  • Happiness when seeing one’s child with a developmental disability learn a new skill.
  • Joy when a spouse’s face lights up, expressing thanks for being his or her partner on a difficult path.
  • Closeness during nighttime conversations about love, life, death, and what’s most important.
  • Satisfaction in the knowledge that one has provided something for the care-receiver that has made life better.
  • New recognition of one’s inner strength and determination.
  • Gratitude for simple things, for each new day.

-From the Introduction to The Complete Caregiver Support Guide, by Ester R.A. Leutenberg and Carrol Morris, with Kathy Khalsa, OTR/L

Use the Coupon Code CARE2020 at checkout when you order The Complete Caregiver Support Guide before June 1st, 2020, and receive 30% off the workbook. This code can be applied to your purchase of the print workbook and/or the PDF eBook.