Promoting Mental Health – 3 Tips

#1  Build Confidence

Identify your strengths and build on them. Too many of us are great at identifying weaknesses and forgetting our strengths.  We all have strengths!

#2  Maintain Time for Family and Friends

Sharing joys and having someone to turn to when life gets difficult is important.  Make sure you save some time on a weekly basis to have fun with a family member or friends.

#3  Look After Your Physical Health

A balanced diet, some regular exercise and a good night’s sleep are important to maintaining good physical health.  Good physical health enables us to more effectively deal with life’s stresses.

Motivational interviews help patients with anxiety benefit from psychotherapy

People who suffer from severe anxiety respond much better to psychotherapy for anxiety if they receive motivational interviewing first to prepare them for change, a study led by York University has shown.

The study, published online in the Journal of Anxiety Disorders, offers hope for people who suffer from the most severe level of generalized anxiety disorder, a chronic condition characterized by excessive and uncontrollable worry.

Anxiety disorders are the most common mental health problem in North America, and chronic severe anxiety is the most difficult form to treat. The recommended treatment – cognitive behavioural therapy – focuses on finding ways to manage anxious thoughts and to reduce avoidance behaviours. However, it produces good results in only about half of patients and is least effective for the most severe type of anxiety, says clinical psychologist Henny Westra, a professor of psychology in York’s Faculty of Health and lead author of the study.

“People who worry all day every day are ambivalent about worry and may be reluctant to stop worrying. Worry severely interferes with their lives, but they also see it as something positive that motivates them, shows they care or prevents bad things from happening,” says Westra. “We used brief motivational interviewing prior to cognitive behavioural therapy to see if we could increase the success rate of therapy by helping clients to explore their ambivalence about worry and prepare themselves for change.”

The first controlled study or clinical trial of its kind, it randomly divided 76 people with a principal diagnosis of generalized anxiety disorder into two groups: those who would receive four weekly 50-minute sessions of motivational interviewing prior to eight weeks of cognitive behavioural therapy (14 hours), and those who would receive only the cognitive behavioural therapy.

The study found that 92 per cent of the group that had motivational interviewing prior to cognitive behavioural therapy responded very well, with normal worry scores following treatment, and everyone in the group improved to some extent. In the group that did not have motivational interviewing prior to treatment, 71 per cent responded well, but 21 per cent did not respond at all to therapy.

The effects were greatest for those patients with severe anxiety, where adding the brief course of motivational interviewing was “like doubling the effect of therapy”, Westra says. For those with the most severe symptoms, one year after treatment, 81 per cent of the patients who had received motivational interviewing sessions before cognitive behavioural therapy no longer met the criteria for generalized anxiety disorder. In contrast, 56 per cent of those who received only cognitive behavioural therapy were free from generalized anxiety disorder, which is consistent with response rates in previous studies for cognitive behavioral therapy alone. 

The study, “Adding a motivational interviewing pretreatment to cognitive behavioural therapy for generalized anxiety disorder: A preliminary randomized controlled trial”, was co-authored by Professors David Dozois of the University of Western Ontario and Hal Arkowitz of the University of Arizona.

Y-File 2009

Dr. Westra is a supervising psychologist at the York University Psychology Clinic.


When teen relationships go bad

“If you were to go into a high school and ask [students] how many have been in a relationship in the last six months where there’s been some aggression, the rate would be somewhere around 30 per cent, for both boys and girls,” says psychologist Jennifer Connolly, director of York University’s LaMarsh Centre for Research on Violence & Conflict Resolution, in the Toronto Star Aug. 13.

In our culture, kids start getting interested in the opposite sex in middle school, Connolly says. “The healthiest thing to be doing at that age is to be in groups of boys and girls, where they can observe how the other sex manages things and where the group itself ensures nothing too wild is going to happen,” she says.

The degree of abuse teenagers endure is usually less severe than the hard striking seen in domestic relationships, Connolly says. Teen aggression shows up as shoving, pushing, squeezing or controlling the movements of the partner. She warns, however, that such behaviour can escalate.

Connolly urges parents to stay alert to the signs their child might be involved in an aggressive relationship. Signals include concerns about offending the partner, secretiveness about the relationship, refusing to go to school, sadness and spending a lot of time in their room.

y-file 2009

Dr.  Connolly is a supervising psychologist in the York University Psychology Clinic.