About Counselling and Therapy Services (Burnaby/Vancouver)

As a Registered Psychologist I provide individual therapy and counselling services using the evidence based techniques of Cognitive Behaviour Therapy (CBT) and Rational Emotive Behaviour Therapy (REBT). Individuals are seen in both my Burnaby and Vancouver offices for a variety of issues including chronic pain, depression, anxiety, stress, panic, anger management, ADHD and work or relationship issues. 

I hold an Advanced Certificate in Cognitive Therapy from the Albert Ellis Institute in New York. If you are looking for a cognitive therapist you should ask what training they have in CBT, as many individuals claim they practice CBT after completing only a workshop or reading a book. The Advanced Certificate Program at the Albert Ellis Institute included extensive CBT readings, group and individual training and supervised practice of Cognitive Behaviour Therapy/Rationale Emotive Behaviour Therapy under the supervision of a licensed mental health practitioner. In addition to my practicum at the Ellis Institute I also focused on CBT during my graduate studies and post doctoral internship. Registered Psychologists undergo one year of of full time supervised practicum experience, as well as a year of post doctoral experience. Since graduation I have practiced counselling and therapy for over 20 years and have served as the program director and practicum supervisor in several hospitals, universities and community mental health centres.

FAQs:

Could you tell me more about Cognitive Behaviour Therapy (CBT)?

My primary mode of practice is rational-emotive/cognitive therapy. Cognitive Behaviour Therapy or CBT (including Rational Emotive Therapy) is a highly effective, research driven approach that helps people to combat and overcome such difficulties as high anxiety/stress, panic attacks, depression, anger, relationship problems, phobias, worry, obsessions, compulsions, addictions (food or drugs), social anxiety, sexual problems, ADHD and low self-esteem. The course of treatment is typically short-term (approximately 8-12 sessions), and people often enjoy rapid and enduring relief from their symptoms. I am also trained in other counselling and therapy techniques, and use these when and where appropriate. Overall I try to match  the skills and techniques to your needs. My office provides a supportive, caring and safe environment to work on change and focus on growth and future success.

I have heard about "Schema Therapy," what's that?

Schema-Focused Cognitive Therapy goes further, to help people address and break long-standing or particularly stubborn patterns of thinking, feeling and behaving that arise from deep-seated beliefs, such as “I’m unlovable,” “I’m a failure,” “People don’t care about me,” “I’m not important,” “Something bad is going to happen,” “People will leave me,” “I will never get my needs met,” “I will never be good enough,” etc. Remarkable results have been achieved via the Schema-Focused approach, even for people who have previously found other therapies to be ineffective. Results of course cannot be guaranteed, however, compared with other types of therapeutic intervention research has shown Cognitive Therapy to be effective.

Schema-Focused and Rational Emotive and Cognitive Behaviour Therapy do more than address symptoms, they address a way of thinking that causes you problems in life, work and relationships. In addition to individual therapy I often recommend readings which emphasize the personal growth aspects of cognitive behaviour therapy as well as those that focus on symptom relief.

Do you do any "Mindfulness" work?

In collaboration with other health related professionals I have recently (the past two to three years) begun to offer a longer and more intensive form of Cognitive Behaviour Therapy called Mindfulness Based Cognitive Therapy (MBCT). This method of therapy blends together features of two disciplines: Cognitive Behaviour Therapy (CBT), which aims to identify and alter cognitive distortions (irrational or inaccurate thoughts) and Mindfulness, which is a meditative (mental focusing) practice taken from Buddhism which aims to help people identify their thoughts, moment by moment, but without passing judgement on the thoughts. As with other medically based meditative interventions, this is not a religious oriented practice, but a scientifically supported methodology used in many medical and mental health centers throughout the world. This particular intervention is based upon Mindfulness-Based Stress Reduction (MBSR), an eight week program developed by Jon Kabat-Zinn in 1979 at the University of Massachusetts Medical Center. MBSR research has shown that this combined intervention method is enormously empowering for patients with chronic pain, hypertension, heart disease, gastrointestinal disorders, ADHD, as well as psychological problems such as anxiety, panic and depression.

More about Cognitive Behaviour Therapy

Albert Ellis and the Institute for Rational Emotive Behaviour Therapy

In 1955 Dr. Albert Ellis developed  Rational Emotive Behaviour Therapy or “REBT”  which is an action-oriented therapeutic approach that stimulates emotional growth by teaching people to replace their self-defeating thoughts, feelings and actions with new and more effective ones. REBT teaches individuals to be responsible for their own emotions and gives them the power to change and overcome their unhealthy behaviors that interfere with their ability to function and enjoy life.

Today the Albert Ellis Institute is a world center of research, training, and practice of REBT, its founder Dr. Albert Ellis remains one of the most influential psychologists of our time, and authored more than 70 books and 700 articles all designed to help people overcome destructive, self-defeating emotions and improve their lives.  Later Dr. Aaron Beck developed what is commonly called Cognitive Behaviour Therapy (CBT) along the same lines as REBT. Today these two cognitive based therapies are very similar, although some specific techniques may differ in the two schools of practice. Both are referred to as Cognitive Behaviour Therapy. I have received both my Basic and Advanced Certificates in Cognitive and Rational Emotive Therapy through the Albert Ellis Institute in New York City. For more information you can click here:

http://www.rebt.org Albert Ellis Institute in New York City

What will I be learning in Cognitive Behaviour Therapy (REBT/CBT)

and Schema-Focused Therapy?

You will learn to:

1. Identify the themes and patterns in your thoughts, feelings and behavior that cause you emotional wear and tear;

2. Learn how to handle your thoughts and manage your emotions so that you feel better and cope more effectively;

3. Learn how to handle problematic situations to maximize positive outcomes and experiences;

4. Prevent maladaptive cycles of thinking, feeling and behaving from repeating over and over again;

5. Find ways to reach your goals and get your needs met rather than running up against the proverbial brick wall.

Could you say more about Schema-Focused Cognitive Therapy?

Schema-Focused Cognitive Therapy is the approach developed by Jeffrey E. Young, Ph.D., who was a protégée of Dr. Aaron Beck. Prior to his founding the Cognitive Therapy Centers of NY and Connecticut, as well as the Schema Therapy Institute, Dr. Young served as the Director of Research and Training at the Center for Cognitive Therapy at U. Penn with Dr. Beck, where he trained many clinicians in the application of CBT. In working with clients, however, Dr. Young and his colleagues found a significant segment of people who came for treatment but had perplexing difficulty in benefiting from the standard approach. He discovered that these people typically had long-standing patterns or themes in thinking and feeling—and consequently in behaving or coping—that required a different means of intervention. Dr. Young’s attention turned to ways of helping patients to address and modify these deeper patterns or themes, also known as “schemas” or “lifetraps.”

The schemas (listed below) that are targeted in treatment are enduring and self-defeating patterns that typically begin early in life, get repeated and elaborated upon, cause negative/dysfunctional thoughts and feelings, and pose obstacles for accomplishing one’s goals and getting one’s needs met. Although schemas are usually developed early in life (during childhood or adolescence), they can also form later, in adulthood. These schemas are perpetuated behaviorally through the coping styles of schema maintenance, schema avoidance, and schema compensation. Dr. Young’s model centers on helping the person to break these patterns of thinking, feeling and behaving, which are often very tenacious.

In formulating the Schema-Focused approach, Young combined the best aspects of cognitive-behavioral, experiential, interpersonal and psychoanalytic therapies into one unified model of treatment. Through Young’s work and the efforts of those trained by him, Schema-Focused Therapy has shown remarkable results in helping people to change patterns which they have lived with for a long time, even when other methods and efforts they have tried before have been largely unsuccessful.

Schema’s that REBT / Cognitive and Schema Focused Therapy Focus on:

Emotional Deprivation: The belief and expectation that your primary needs will never be met. The sense that no one will nurture, care for, guide, protect or empathize with you.

Abandonment: The belief and expectation that others will leave, that others are unreliable, that relationships are fragile, that loss is inevitable, and that you will ultimately wind up alone.

Mistrust/Abuse: The belief that others are abusive, manipulative, selfish, or looking to hurt or use you. Others are not to be trusted.

Defectiveness: The belief that you are flawed, damaged or unlovable, and you will thereby be rejected.

Social Isolation: The pervasive sense of aloneness, coupled with a feeling of alienation.

Vulnerability: The sense that the world is a dangerous place, that disaster can happen at any time, and that you will be overwhelmed by the challenges that lie ahead.

Dependence/Incompetence: The belief that you are unable to effectively make your own decisions, that your judgment is questionable, and that you need to rely on others to help get you through day-to-day responsibilities.

Enmeshment/Undeveloped Self: The sense that you do not have an identity or “individuated self” that is separate from one or more significant others.

Failure: The expectation that you will fail, or belief that you cannot perform well enough.

Subjugation: The belief that you must submit to the control of others, or else punishment or rejection will be forthcoming.

Self-Sacrifice: The belief that you should voluntarily give up of your own needs for the sake of others, usually to a point which is excessive.

Approval-Seeking/Recognition-Seeking: The sense that approval, attention and recognition are far more important than genuine self-expression and being true to oneself.

Emotional Inhibition: The belief that you must control your self-expression or others will reject or criticize you.

Negativity/Pessimism: The pervasive belief that the negative aspects of life outweigh the positive, along with negative expectations for the future.

Unrelenting Standards: The belief that you need to be the best, always striving for perfection or to avoid mistakes.

Punitiveness: The belief that people should be harshly punished for their mistakes or shortcomings.

Entitlement/Grandiosity: The sense that you are special or more important than others, and that you do not have to follow the rules like other people even though it may have a negative effect on others. Also can manifest in an exaggerated focus on superiority for the purpose of having power or control.

Insufficient Self-Control/Self-Discipline: The sense that you cannot accomplish your goals, especially if the process contains boring, repetitive, or frustrating aspects. Also, that you cannot resist acting upon impulses that lead to detrimental results.

Reference: "A Client's Guide to Schema-Focused Cognitive Therapy" by David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D.,

Cognitive Therapy Center of New York. 1999

Summary

I hope you have found this very brief introduction to Cognitive Behaviour Therapy useful. In the office we discuss these issues, practice understanding our “automatic” and often irrational thinking, and learn to apply cognitive behaviour techniques to stop and change these debilitating thoughts. Progress is made through a combination of in-office counselling/therapy, readings and homework during which you apply what you have learned and practiced in the real world. While CBT may often be the primary therapy technique we use I often also involve psycho-education (direct teaching about your mental health issues), behavioural techniques and sometimes use my skills in Systemic and Family Therapy to address issues you may have with relationships, family or at work.

Fees

EAP and EFAP consignment, crime victims assistance program as well as extended insurance and self-pay are accepted. Session fees are $175.00 per hour. There is a sliding scale available to those will lower incomes. I also accept credit cards through on-line PayPal.

.............................................

Psychological services (including assessment, testing and therapy) provided in my offices include (covered by most extended health care insurance):

ADHD (click here: http://www.relatedminds.com/adhd-attention-deficit-hyperactivity-disorder/

Anxiety and Stress (click here:) http://www.relatedminds.com/anxiety-stress/">http://www.relatedminds.com/anxiety-stress/

Autism and Asperger's Disorder (Click here:)  http://www.relatedminds.com/autism/

Individual Counselling (click here: ) http://www.relatedminds.com/individual-therapy/

Child Counselling / Therapy (click here: ) http://www.relatedminds.com/child-therapy/

Couples Counselling / Therapy (click here:)  http://www.relatedminds.com/couples-therapy/

About Dr. Roche

I am a Registered Psychologist and a Registered Marriage and Family Therapist (RMFT) in British Columbia. In addition to my doctorate in clinical Psychology (The Union of Experimenting Universities), I hold a master's degree in family therapy from Goddard college, a certificate of advanced graduate studies (CAGS) in school and educational psychology from Norwich University, and have completed two years of post doctoral studies in neuro-psychology at The Fielding Institute in Santa Barbara, California. I am also a certified school psychologist, certified teacher of special education (New York and California), and a Clinical Member of the American Association of Marriage and Family Therapists (AAMFT). Finally, I hold a doctoral degree in law (JD) with an emphasis in medical malpractice and education law. Beyond my academic credentials, I have completed two years of supervised clinical experience in both hospital and community based clinics and two years of post doctoral training in neuropsychology. I have served as director of behaviour programming for several school districts, as a consultant on autism for the province, and have held numerous academic positions including Clinical Instructor in Psychiatry at New York University and Bellevue Hospital in New York as well as being a faculty member at NYU, Brooklyn College, SUNY New Paltz, and Norwich University.

My offices in Burnaby and Vancouver serve Burnaby, Vancouver, Coquitlam, Port Moody, Port Coquitlam, New Westminster and Maple Ridge. Clients often come to my Vancouver office from North Vancouver, West Vancouver and even as far as the Sunshine Coast. For more information on the location of my Burnaby and Vancouver offices, please see my "Office Location" page, which contains a Google map.

Key words

ADHD | Anxiety and Stress | Autism and Asperger's Disorder | Individual Counselling | Child Therapy | Testing and Assessments and Learning Disabilities | Couples Counselling | Depression | The Angry Child | Anger Management | Pain Management and PTSD | Forensic Services | Attention Deficit Hyperactivity Disorder | Vancouver | Burnaby | Coquitlam | New Westminster | Maple Ridge | Port Moody | Child Psychologist | Psychologist | Learning Disability | Assessment | Testing | Psycho-educational Assessment | Neuropsychological Assessment

http://www.relatedminds.com

http://Therapists.PsychologyToday.com/rms/70682

http://www.therapistlocator.net/member?183420

http://www.bcpsychologist.org/users/jimroche

http://www.actcommunity.net/jim-roche.html

What is Different about Gottman Therapy?

Gottman Family Therapy is a science based form of couple's therapy. Information about Gottman Therapy, along with books, DVDs and audio books can be found at the Gottman Institute's website. Gottman Family Therapy is offered by both Registered Psychologists and Registered Marriage and Family Therapists in British Columbia. Please visit my website for more information on relational therapy that I offer: http://www.relatedminds.com

New Definition of Autism May Exclude Many

Usually, once a week, I teach a graduate class in diagnostics at a local college. Students are surprised to hear that the definitions of different mental health conditions such as ADHD or autism spectrum disorder can change. Any every few years, when the new edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) there are often changes. Most of these are brought about by new science, new understanding, experiments and research that helps re-define and make more specific how we make a diagnosis. This time around, as we prepare for the 5th edition, some people are concerned about the effects of many of the changes, especially those for Attention Deficit Hyperactivity Disorder (ADHD or ADD as it was once known) and autism spectrum disorder (ASD).

The proposed changes in the DSM for autism would, according to many, sharply reduce the skyrocketing rate at which this disorder has been diagnosed. And honestly, some days almost all of the calls to my office are from individuals who talked with a friend, read a newspaper article or saw something on the web that made them think they might possibly have autism. After talking with their family doctor, who usually has no idea how to make such diagnosis, they call me. Many want, more than anything, to get a diagnosis so they know what is wrong. But this is exactly where the new DSM is struggling. As a recent article in the New york Times puts it, "where to draw the line between the unusual and abnormal..." The new proposed guidelines are most likely going to exclude many people from the diagnosis who are "higher functioning" and move them from that the "category" of abnormal- or "diagnosable" to "unusual." Many people who are currently diagnosed as having Aspeger's disorder will most likely be left out.

currently at least a million children and adults have a diagnosis of Asperger syndrome (or disorder) or "pervasive developmental disorder-not otherwise specified- PDD-NOS - and endure many of the same social struggles and deficits that people with autism have, but they do not meet the criteria for ASD - autism spectrum disorder. The proposed changes to the DSM would put all three of these categories -PDD (Pervasive Developmental Disorder), Asperger's Syndrome, and Autism Spectrum Disorder (ASD) together, eliminating PDD-NOS and Asperger's from the manual entirely. Under the current criteria for a diagnosis a person can qualify for the diagnosis by exhibiting 6 or more of the 12 required observed or reported behaviours; under the new proposed definition a person would be required to exhibit 3 3 deficits in social interaction and communication and at least 2 repetitive behaviours, a much narrower definition for diagnosis. The problem is, especially in places like BC where a strict diagnostic procedure is enforced, kids may no longer qualify for a diagnosis of ASD (autism spectrum disorder) even though they have fairly significant behavioural and social deficits.  Some services are always driven strictly by a persons diagnosis.

Research shows that the new definition seems to have more of an effect on the "cognitively able" rather than the "classically autistic" child. Currently several studies are looking at how the new definition would effect diagnostic decisions. But if a diagnosis is suppose to guide treatment interventions, the real purpose of a diagnosis, then some changes really do need to be made. We will have to wait to see what the outcome is. No matter what happens, we do know the end result will be that some children (and adults) who currently qualify for a diagnosis will no longer qualify. Effort will need to be made to expand the criteria for getting help that even the "cognitively able" and "unusual" child needs to be successful.

Adult Asperger's Disorder Diagnosis / Testing / Assessment

Sitting in a coffee shop last week I heard an adult discuss how they were sure they had Asperger Disorder, or High Functioning Autism. "I read the symptoms and I have all of them!" he said. I've actually overheard several adults claim they have autism spectrum disorder, Asperger's or other forms of social cognitive deficit while trying to read, and they always have a story about how their doctor dismissed them, and they really know Asperger's is the cause of every problem in their life! All they need for happiness is a proper assessment and diagnosis of adult Asperger's. I honestly wish it were that easy.

The problem is that several factors complicate the diagnosis of Asperger syndrome (AS), an autism spectrum disorder (ASD). Like other ASD forms, Asperger syndrome is characterized by impairment in social interaction accompanied by restricted and repetitive interests and behavior; it differs from the other ASDs by having no general delay in language or cognitive development. But having social problems, not understanding, catching on or reacting properly to social cues does not in and of itself mean you have adult Asperger's. Those symptoms can mean many different things, ranging from simple "quirkiness" on your part, an "odd personality" to a serious personality disorder, mood disorder, anxiety disorder....or simple shyness. Matching the symptoms to your behaviour and experience is no way for an adult to be diagnosesed with Asperger's Disorder (Notice I sometimes refer to this this disorder as Asperger's Disorder, the most common name, and sometimes Asperger Syndrome, another common name. Both mean essentially the same thing.)

Further problems in the diagnosis of Asperger's, especially in an adult, include disagreement among diagnostic criteria, controversy over the distinction between AS and other ASD forms or even whether AS exists as a separate syndrome. Right now the plan seems to be to stop giving this diagnosis the next time the DSM (Diagnostic and Statistical Manual -  the "Bible" of psychiatric diagnosis, is published).  As with other ASD forms, early diagnosis is important, and differential diagnosis must consider several other conditions. If Asperger's Syndrome or Disorder is not diagnosed early much of the important information we need to make a final diagnosis becomes hard to obtain. We usually use parent reports, teacher reports and observations of play to make the diagnosis. This is hard to do for an adult!

Whena family medical doctor who you have been seeing dismisses your self diagnosis of adult Asperger's disorder or Syndrome it is often because the diagnosis requires that the impairments are "significant, and must affect important areas of function." Often a medical doctor who has seen you for a number of years and observed you makes a quick determination that your "impairments" simply are not "significant." Even though you might think they are. With a few simple questions he or she can, pretty much, rule out Asperger's as a major concern. So, no diagnosis of adult Asperger's for you.

Developmental screening during a routine check-up by a general practitioner or paediatrician should have identified these signs and symptoms, which we would expect would have had a greater impact on you when you were young. Because many individuals come to a physician or psychologist for a diagnosis of "adult Asperger's" when they are having trouble at work, school or other social situations they are very cautious about giving out the diagnosis. The issue often, for the family doctor, is one of severity of symptoms. Why do you need the diagnosis, and what good will it do you? Are you seeking treatment for adult Aspergers? Is there a problem at work? Home? What are the reasons for you coming in?

Many times the symptoms of adult Asperger's are the same as Anxiety Disorders and the treatment is often very similar. The likelihood they could make a diagnosis they might have to defend is small. And, as I've mentioned, many people seeking the diagnosis are have some sort of work or social problem.

There are some other reasons you are unlikely to get a diagnosis from your family doctor: "A comprehensive evaluation includes neurological and genetic assessment, with in-depth cognitive and language testing to establish IQ and evaluate psychomotor function, verbal and nonverbal strengths and weaknesses, style of learning, and skills for independent living. An assessment of communication strengths and weaknesses includes the evaluation of nonverbal forms of communication (gaze and gestures); the use of non-literal language (metaphor, irony, absurdities and humor); patterns of speech inflection, stress and volume; pragmatics (turn-taking and sensitivity to verbal cues); and the content, clarity and coherence of conversation."

Further, "Asperger syndrome can be misdiagnosed as a number of other conditions. Conditions that must be considered in a differential diagnosis include other pervasive developmental disorders (autism, PDD-NOS, childhood disintegrative disorder, Rett disorder), schizophrenia spectrum disorders (schizophrenia, schizotypal disorder, schizoid personality disorder), attention-deficit hyperactivity disorder, obsessive compulsive disorder, depression, semantic pragmatic disorder, selective mutism, stereotypic movement disorder and bipolar disorder[10] as well as traumatic brain injury or birth trauma, conduct disorder, Cornelia De Lange syndrome, fetal alcohol syndrome, fragile X syndrome, dyslexia, Fahr syndrome, hyperlexia, leukodystrophy, multiple sclerosis and Triple X syndrome."

That's a lot to expect your medical doctor to do in a 15 minute examination. And if your symptoms aren't severe, it's unlikely you swill get a diagnosis in the first place.

So what can you do if you really do need a professional and comprehensive diagnosis as an adult with possible Asperger's Disorder (Asperger Syndrome)? Ask for a referral to a neurologist, or a psychologist. Counsellors cannot diagnosis Asperger's. Social Workers can not. Most psychologists do not have the training, experience or the tools to do the testing required. You need to find psychologist who has experience with Asperger's in children as well as adults. Here in BC ACT (Autism Community Training) could recommend someone with the experience and training (they have a list of approved MDs and psychologists). The psychologist looking into your possible "adult Asperger's Disorder" needs to be familiar with the most commonly used tools, the ADOS and ADI-R. The Ministry requires these tools, along with a psychoeducational assessment and functional behavioural assessment before approving an assessment of any child. If your going to a psychologist for an adult assessment of Asperger's, you really should see a practitioner who uses these instruments with children.

A comprehensive assessment of an adult for Asperger's takes two or three days of testing, totalling anywhere from 6-10hours, and can cost from $1,800-$2,600. This kind of assessment is not covered by MSP. Only occasionally will extended health care cover these costs. So it's really best to set up an initial appointment with a psychologist or neurologist and discuss the pro's and con's of undergoing an assessment for adult Asperger's.

..............................................

As a Registered Psychologist I provide diagnostic assessments for children, adolescents and adults for Asperger's Disorder, Autism Spectrum Disorder and related social-cognitive deficits. Please feel free to visit my web page: www.relatedminds.com or www.socialcognitivetherapy.com for more information.

This page is not meant to supply medical or psychological advice, or make any suggestions about diagnosis. If you have questions about disorders such as adult Asperger Syndrome or adult Asperger's Disorder, call and speak directly with a Registered Psychologist. The internet is not a good place for any medical or psychological advice!

Aspergers and Relationships: An Adult Love Story

Young adults with Asperger's or high functioning autism have very few resources here in BC. Autism funding is cut at age 19, and there are very few psychologists or other practitioners with experience with adults. In my own practice I see many of these young people as they try to navigate the new and complex set of relationships in college or work that are not as structured or supported as their high school experience may have been. Many young adults with high functioning autism or Asperger's disorder get into social trouble at work, refusing to sign a get well card, or making repeated social mistakes when others are trying to include them. Often the highly intelligent and skilled engineers or other professionals just can't navigate the twists and turns of "small talk." And relationships, which people with autism seek (in spite of what many think) are way beyond their reach without help. I use several books designed especially for young adults, as well as materials based upon the work of Michelle Garcia Winner, a leader in the filed of therapy with children and adolescents with Asperger's or high functioning autism. I also try to find good audio-visual resources, and the New York Times has just printed an excellent article on high functioning autism / Aspergers which contains a wonderful story about a couple and has some excellent and insightful video in it. I recommend it to teens, young adults with autism or Aspegers, and the parents, families, husbands and wires of those with high functioning autism or Aspergers.  Here is the information and link:

Navigating Love and Autism
By AMY HARMON
Published: December 26, 2011
For Jack Robison and Kirsten Lindsmith, both of whom fall on the autism spectrum, being in a relationship together has created a unique set of comforts and challenges.

http://www.nytimes.com/2011/12/26/us/navigating-love-and-autism.html

Dr. Jim Roche
Offices in Vancouver and Burnaby
http://www.socialcognitivetherapy.com

..............................................................................................

Key words
ADHD | ADHD coaching | workplace coaching | Anxiety and Stress | Autism and Asperger's Disorder | Individual Counselling | Child Therapy | Testing and Assessments and Learning Disabilities | Couples Counselling | Depression | The Angry Child | Anger Management | Pain Management and PTSD | Forensic Services | Attention Deficit Hyperactivity Disorder | Vancouver | Burnaby | Coquitlam | New Westminster | Maple Ridge | Port Moody | Child Psychologist | Psychologist | Learning Disability | Assessment | Testing | Psycho-educational Assessment | Neuropsychological Assessment | Psychoeducational Testing

http://www.relatedminds.com
http://Therapists.PsychologyToday.com/rms/70682
http://www.therapistlocator.net/member?183420
http://www.bcpsychologist.org/users/jimroche
http://www.actcommunity.net/jim-roche.html
http://www.counsellingbc.com/listings/JRoche.htm

Autism Rates Increase...dramatically. Why?

According to the Centers for Disease Control (CDC), nearly one percent of U.S. children have some form of autism. This is 20 times higher than the rate of autism spectrum disorder found in the 1980s. In this NPR broadcast (link below) Alan Zarembo of The Los Angeles Times and clinical psychologist Catherine Lord discuss what’s behind the growing number of diagnoses. The explanations may not be as mysterious as some project.

Listen here: NPR

Aggression, Autism and Families

Dr. Jim Roche is a registered psychologist who provides diagnostic assessments for autism (ASD) and Asperger's Disorder as well as individual treatment and intervention for children, adolescents and adults with autism spectrum disorder in both his Vancouver and Burnaby BC offices. 


More information on Dr. Roche's autism related services can be found at: http://www.relatedminds.com  or at http://www.socialcognitivetherapy.com


A recent story in the LA Times about autism provides an excellent video about Jonah Funk, 13, who was diagnosed with autism nine years ago. His mother, Stacie, says she often describes herself as his eyes, his ears and his voice. "I want him to be treated fairly," she said. "I want him to receive the things he needs." The video is interesting in that it opens up this family's life from moment to moment, showing us both their successes as well as their ongoing problems. One of the issues that is evident in the video is Jonah's ongoing aggression. While appearing pretty mild, his parents are concerned about where this aggression will lead, as he disrupts the lives of his siblings and travel in the community becomes problematic.


What to do? Well, it's a good example of when professional help is necessary. A behavioural specialist is seen in the video, however this specialist isn't seen doing any real interventions. This is too bad, as it would be interesting to see what steps the intervention specialist, and Jonah's parents, are taking. From my perspective it's obviously well past time to conduct a functional behavioural analysis (FBA). This behavioural assessment will tell us what the function of the unwanted behaviour is, and we can then take two important steps towards dealing with it: 1) Teaching an appropriate alternative behaviour that meets the same function (know as a "FERB" or Functionally Equivalent Replacement Behaviour) and what environmental changes we need to make to reduce Jonah's need to engage in the behaviour.


Working with a highly trained behaviourist is important when trying to reduce these negative and sometimes aggressive behaviours. As a behavioural specialist in school districts for over the past 15 years I have relied upon one particular site for training materials: PENT California. The PENT site is a website provided for school based professionals working with all sorts of behavioural issues in the public schools. Their training materials are free, up to date and have withstood legal battles over the adequacy of an FBA. 


Working with a highly trained behaviourist is important when trying to reduce these negative and sometimes aggressive behaviours. As a behavioural specialist in school districts for over the past 15 years I have relied upon one particular site for training materials: PENT California. The PENT Positive Environment Network of Trainers) site is a website provided for school based professionals working with all sorts of behavioural issues in the public schools. Their training materials are free, up to date and have withstood legal battles over the adequacy of an FBA.  Completing a functional Analysis can be very difficult, and the individual completing it needs fairly advanced training and experience in behavioural theory. If you are having trouble with aggression, even minor aggression, I would talk with your school based team first. They may very well have someone who is an expert on these issues.  The next level would be the school psychologist who may have expertise on autism and aggression. After that, here in BC you might ask for a consultation from POPARD, the Provincial Outreach Program for Autism and Related Disorders. POPARD's professionals often have extensive training and experience in dealing with this type of low level behavioural issue. Finally, there are outside behavioural interventionists (usually approved by ACT: Autism Community Training, as a Behaviour Interventionist or behavioural specialist. At any rate, address these issues quickly. and start by having an FBA completed. These days we usually don't just use the term FBA, but instead use the terms FBA and PBSP, meaning "Positive Behavioural Support Plan," as the emphasis, as you can see from my description above, is not on punishment or control, but instead on skills development and environmental support. Usually that's all we need to change these low level aggressive behaviours before they become problematic.  

Click here to see the LA Times story: LATimes Video