Staff Spotlight: Valerie Luxon

imageValerie Luxon, Psy.D joined Inner Door Center in March of 2015 as the Clinical Program Director. Valerie graduated from Illinois School of Professional Psychology and as a Licensed Clinical Psychologist has worked with children, adolescents, adults and families since 2003.

When asked about why she chose to be a psychologist, Valerie explained that she has always been intrigued by the multiple layers and complexity of mental health. She wants to be able to help other people back those layers and create a better quality of life.

Originally from Michigan, Valerie moved back home from Chicago, IL where she previously worked at Alexian Brothers Health System, for the opportunity to work at Inner Door Center. Although she enjoyed her time at Alexian Brothers Health System, she spoke about how much she enjoys working at Inner Door Center because of the flexibility and creativity the center gives that makes it more beneficial for the staff and the clients.

Inner Door Center’s yoga based center and Valerie’s long going passion for working with eating disorders is what made the choice of wanting to work at Inner Door Center an easy one.  Every day at her job is different; Valerie sees patients, works with administrative development, conducts assessments with clients and develops new programs and trainings.  Her favorite part of the job would be interacting with the clients, seeing the progress they are making and creating new ideas for programs Inner Door Center.

Valerie is right where she wants to be with her career. She really enjoys her job and everything she does and her focus now is to keep moving forward with community outreach programs, workshops and new trainings.  The last thing that Valerie was asked in her interview was who inspires you the most and she stated beautifully “Watching the clients I work with persevere through difficult life challenges to find inner acceptance and knowing that they have allowed me to be a part of that journey is really inspiring.  I gain so much strength from so many of the clients I work with.  It truly is just as beneficial to me.”

If you would like to learn more about our staff at the Inner Door Center, please visit our website at www.innerdoorcenter.com. For more information on Inner Door Center and our treatment programs, please contact us at 248-336-2868.

Yoga and Binge Eating Disorder

Binge Eating Disorder (BED) is characterized by symptoms such as eating large quantities of food in a short period of time; feelings of lack of control; eating rapidly; and eating until uncomfortably full.  BED is associated with low self-esteem, poor self-acceptance and increased stress levels.   BED is a relatively new disorder, appearing as a separate disorder for the first time in the Diagnostic and Statistical Manual-V (2015), however it is not a new phenomenon.  It is suggested that 20-30% of individuals seeking treatment for obesity may have moderate to severe symptoms of BED.  Individuals with BED use binge eating as a way to avoid negative affect, including depression and anxiety.  This leads to a lack of awareness of the internal processes, sensations and experiences, disconnecting the individual’s internal state and bodily experience.  This disconnect is then generalizes to the way one experiences, perceives and reacts to others and the world around them.

viewTreatment for BED has typically centered on cognitive behavioral therapies, weight loss therapies and interpersonal therapies. Many of these therapies have shown some success their effects are often short term.  Mindfulness based treatment approaches are quickly gaining recognition as providing value in treating dysregulatory disorders.   Mindfulness based approaches have shown success in improving awareness of the internal experience, interrupting maladaptive patterns, decreasing stress related reactions, and increasing a sense of control and self-acceptance.  Such processes are congruent with the struggles of individuals with BED.

Yoga has been shown to be an effective mindfulness based experience.  Yoga is a beneficial treatment modality for individuals with BED for several reasons.  Yoga focuses on mindfulness, increasing one’s awareness of their internal experience while reconnecting one with their body.  Yoga has been beneficial in shifting from feeling distracted and physically disconnected to focused and physically present.  Several research studies have found a reduction in disordered eating patterns and food consumption, as well as increases in body awareness, satisfaction with physical appearance and an overall improvement in connectedness to physical well-being.

Mindfulness-based yoga therapy is an effective treatment for Binge Eating Disorder.  While individuals with BED may initially be uncomfortable with yoga, due to a disconnect with the body, multiple studies have shown significant improvement in BED symptoms through yoga.  Yoga allows the opportunity for individuals with BED to reconnect with their unfamiliar bodily and emotional experiences, thus reducing negative BED symptoms and improving awareness, satisfaction and overall quality of life.

Valerie Luxon, Psy.D.Fully-Licensed Clinical Psychologist and  Director of Clinical Training and Program Development at Inner Door Center.

Do you struggle with?

Regularly eating far more food in a limited time period?
Feeling that your eating is out of control?
Eating extremely fast?
Eating beyond feeling full?
Eating large amounts of food when not hungry?
Feeling terrible and disgusted with yourself after a binge?
If you experience three or more of the above on a weekly basis for three months, you may be struggling with Binge Eating Disorder (BED)

http://innerdoorcenter.com/index.php/eating-disorder-treatment-center

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Staff Feature: Marina Belfiore

Inner Door Center® is headed for a busy summer in Metro Detroit with clients, events, presentations and outreach work. What a perfect time to bring on an intern to help support us through our eventful summer!

Marina Belfiore is a student at West Virginia University studying Public Relations and Business Administration. She is highly involved on campus being on the board of WVU’s Public Relations Student Society of America (PRSSA) and being a member of Chi Omega.10568910_10203512982958145_4458189973615865053_n

She chose to major in Public Relations because she likes that it can be fast paced and it’s not just sitting at a desk every day. There’s a variety of work to be done in Public Relations. It’s also something every company uses so there’s a wide variety of options as to what someone can do. When it comes to the future, Marina would love to work in the health industry and work in crisis communications.

When she came across our internship posting, it immediately struck interest.

“I have had a lot of friends go through eating disorders, I was there to help them through it, so I’m very passionate about it. And I’m very passionate about PR and Marketing so it seemed like a good fit.”

This isn’t Marina’s first time working in a health setting. She has worked with the Boys & Girls Club, World Medical Relief, NFL Day-Of-Play and Make A Wish planning events and fundraisers for these non-profits.

We are very excited for Marina to join the Inner Door® Center team for the summer. With her past experience in event planning, fundraising and PR, we know she’ll add tremendous value to our marketing efforts!

Treatment Graduation Ceremonies, good or bad?

Below is an excerpt from David Mee-Lee’s Tips and Topics newsletter from November 2014 (Volume 12, No. 8). 

The emails and verbal appreciations are gratifying.  This month however, one reader, Izaak Williams, went much further than simply read and digest a previous edition. In the March 2011 edition, I wrote in SKILLS about the sometimes negative, unintended consequences of “graduation” ceremonies in residential treatment.

http://www.tipsntopics.com/2011/03/march-2011-tips-topics/#more-1625 

 

Izaak researched the topic and wrote his version in a peer reviewed paper entitled “Drug Treatment Graduation Ceremonies: It’s Time to Put This Long-Cherished Tradition to Rest” He even received permission to allow you free access to the whole paper at this link:

http://www.tandfonline.com/doi/full/10.1080/07347324.2014.952995 

 

So I asked Izaak Williams to summarize his paper for the November edition. Here is how he did that (with some minor edits from me.)

 

TIP 1

Are Graduation Ceremonies a Therapeutic Celebration or Hollowed Concept? You Be the Judge

  1. Where did substance use treatment graduation ceremonies originate?

The history of this tradition finds its roots in “early 19th century treatment institutions. It was the practice in the Keeley Leagues (KL) – (for example, the patient-led recovery mutual aid fellowship within the Keeley Institutes) for the person leaving treatment to recount their experience, receive the best wishes and guidance of other KL patients before KL members walked the departing patient to the train station in Dwight, Illinois. The function of this ritual was to reaffirm commitment to sobriety, cement the bonds of fellowship, and form a bridge between the institutional group and the Keeley League meetings in one’s own home” (Personal Correspondence, W. White, November 6, 2014).

  1. What’s wrong with using the term graduation or commencement?

Just about any dictionary definition of “graduation” or “commencement” spells out the notion of “wholeness” that refers to completion of everything needed or required. When we talk about graduation in the education system the discussion shifts to prerequisites and credits towards a degree program—requirements that are clearly articulated.

For example, asking a high school or college student if he or she will graduate would invite the student to talk about how many credits they’ve completed or what classes they plan to take in the near future in order to graduate or commence. Moreover, while the meaning of commencement in the dictionary may refer to “a beginning”, this very same definition is often qualified with cross-reference to graduation. In other words, to start anew or “begin” one must first completely finish (high school or college degree program).

With this in mind, how does one commence or graduate from a substance use disorder?

Why might it not be such a Good Idea to Graduate Treatment Participants?

Here are Izaak’s thoughts on how graduations appear to affect participants:

  • There can be an overblown sense of confidence about their prospects of not returning to use. This reinforces a willpower stance toward addiction. It seems to foster a particular relationship with their drug of necessity which directly contributes to continued drug use or relapse.
  • For some clients who tend to reward or celebrate with drug use, a festive celebration with entertainment value may trigger a drug craving in order to enhance the fun.
  • It may foster the false belief that “cure” has occurred and that treatment support or ongoing mutual aid is no longer needed or will ever be required.
  • Treatment participants may be working on repairs or making amends while relationally cutoff from loved ones. If loved ones are not invited or refuse to participate in graduation, this can provoke client distress, anxiety, and other not-so-good feelings and negative emotions.
  • Returning to treatment after graduating would seem to provoke a sense of stigma in light of embarrassment and disappointment of having to face treatment staff and possibly other peer clients who celebrated with them.
  1. What is the future for graduation ceremonies?

There are many ongoing changes in drug treatment industry standards in light of the Affordable Care Act (ACA) and Mental Health Parity and Addictions Equity Act (MHPAEA)(2008).  In the future, the existence of graduation ceremonies will hinge on the availability of empirical evidence to support it as a therapeutic practice.  This is because traditional stand-alone addiction treatment programs which perpetuate this tradition mostly aim at targeting drug use on the basis of stabilization. This is an acute care model; it’s not sophisticated enough to be effective for chronic disease management.  One emerging model of care is the patient-centered “medical home” or “Patient-Centered Primary Care Home Program” (PCPCHP) (see: http://www.oregon.gov/oha/pcpch/Pages/index.aspx for patient-centered primary care programs). In short order, here are but a few of the key standout words characterizing this model: comprehensive, integrated, coordinated, continuous, patient and family centered, collaboration.

As treatment industry standards encourage collaborative plans of intervention that are holistic and promote wellness, the future of both acute care model and graduation ceremony is bleak. This is because both appear antithetical to the new standards of care conforming to the medical model of drug addiction promoted by ACA and MHPAEA.

  1. Is there another way of thinking about Graduation Ceremonies?
  • One suggestion is that the word “graduation” and its substitute or euphemism-“commencement”— be avoided in program speak. This would then permit the notion of continuum of care transition to creep into thought rather than

“end of treatment”, “completion”, or “graduation.”

  • Perhaps the proverbial graduation ceremony performed in a grand ballroom could be scaled down to a more individualized patient-centered setting-an intimate meeting-  between the treatment team, client, family members, sponsor, and friends willing to offer ongoing support.  This forum would provide a structured opportunity to talk safely and formulate support roles.  Add to this: the possibility of clarifying misconceptions about addiction dynamics and facilitating ongoing treatment recovery processes.
  • As David Mee-Lee suggests, this could be called the Reflection, Celebration, and Anticipation (RCA) (see http://www.tipsntopics.com/2011/03/march-2011-tips-topics) stage.  At its very essence, what this entails is establishing a road map to help patients and his/her support system see where they are now and where they are headed in treatment recovery.  This might be called a ”life in recovery transition day” centered on the sharing of a solid, longitudinal, community-based Continuing Care Recovery Plan (CCRP) in supporting further stages of recovery.

In closing, Izaak indicated that Thomas McGovern, editor of the Journal of Alcoholism Treatment Quarterly invites comments in response to the article entitled “Drug Treatment Graduation Ceremonies: It’s Time to Put This Long-Cherished Tradition to Rest” (Vol. 32 issue 4). “We welcome critique and criticism to stimulate further dialogue, compel critical thinking, and encourage empirical scrutiny of substance use disorder treatment graduation ceremonies.”

Izaak L. Williams, Hawaii State Certified Substance Abuse Counselor (CSAC), was selected in the 2014 cohort of emerging leaders by the Center for Substance Abuse Treatment’s (CSAT’s) Behavioral Health Leadership Development Program. He can be reached at: izaakw@hawaii.edu

Reference:

Williams, Isaak L (2014): “Drug Treatment Graduation Ceremonies: It’s Time to Put This Long-Cherished Tradition to Rest” Alcoholism Treatment Quarterly Volume 32, Issue 4, pages 445-457

Published online: 06 Oct 2014 http://www.tandfonline.com/doi/full/10.1080/07347324.2014.952995

Something New

My name is Sydney. I just started as a intern at Inner Door Center from Cranbrook Upper School. As someone who has had friends that have struggled with eating disorders in the past, I thought I knew everything there isIMG_0004_2 to know about eating disorders. I could not have been more wrong. I thought that eating disorders stemmed from nothing more than the desire to be thin or as society deems “perfect”. Eating disorders are serious physical, mental and emotional problems that can have life threatening consequences. Eating disorders affect eleven million males and females in the United States alone.

On my first day working at Inner Door, I participated in the Partial Hospitalization Eating Disorder Program. The first thing I did was yoga with all the patients in the program. As someone who has never really enjoyed yoga, I was skeptical as to whether or not I would like it, but to my surprise, I really enjoyed myself and felt more at peace than I ever have before. If I had to choose one thing that made me feel the most at peace during the entire experience, I would say that it was the focus on breathing and how it clears your mind of anything stressful and makes you focus on yourself and why you’re here.

The rest of the day began with a snack and was followed by a variety of group therapy sessions and meals/snacks. During the group therapy sessions, I not only learned a lot about eating disorders and the individuals in treatment here, but I also learned a lot about myself as well. I felt very comfortable in a room full of people I did not know because of the type of environment the therapists provided. Everyone was so incredibly supportive and accepting of each other, which is something you do not see every day.

Inner Door Center is such a good place to come for recovery. There is zero judgement of anyone and the therapists truly care about the clients. I also saw that the clients support each other, which was really nice. They use each of their individual experiences to help and support each other.

Spending the day in this program made me think about what it means to be a woman in society and how ridiculously high the standards set for women, especially young women. After leaving the program that day, I realized that loving yourself and being at peace with who you are is more important than anything you can get from society.

Mental Health Equality & Obamacare

We recently received an email from The Law Firm of Kanter & Kanter with a legal news update about Mental Health and Obamacare. We wanted to share with you what they found! Below is the update on Mental Health Equality and if it’s working under Obamacare.

*This legal news update belongs to The Law Firm of Kanter & Kanter distributed in their newsletter. To sign up for their newsletter here. All rights and credibility belong to The Law Firm of Kanter & Kanter. Inner Door Center did not contribute to this update.

Mental Health Equality Under Obamacare: Is it Working?

According to a new survey conducted by the National Alliance on Mental Illness (NAMI), many insurance companies are failing to provide adequate mental health coverage under Obamacare. Although President Obama’s health care law has helped an estimated 62 million people access health care, policies still have a long way to go before making a significant difference in the lives of those with mental illness.

What do we need?

What we need and deserve is the opportunity to access the right treatment, at the right time, in the right setting. Unfortunately, insurance companies continue to fall short in meeting these basic needs while consistently finding ways to evade mental health parity laws. Barriers are set into place immediately for those seeking insurance coverage for mental health care. Many people experience delays and difficulties when seeking treatment, limitations in types of treatment, limitations in geographic location of treatment, or outright insurance denials. For some, these obstacles become too overwhelming to manage. Any of these barriers can be a reason to say, “Never mind, I give up. This is too hard.”

What are the issues?

The Mental Health Parity Act (MHPAEA), enacted in 2008, requires that mental health benefits be provided on the same terms as medical/surgical care. This ground-breaking law applies to employer-sponsored health plans with more than 50 employees, including self-insured and fully insured plans. The Patient Protection and Affordable Care Act of 2010 (ACA) strengthened parity requirements by extending federal parity requirements to individual and small group plans. Additionally, mental health and substance use disorder services were mandated as one of ten categories of “Essential Health Benefits” required for all plans sold though the federal health insurance marketplace, or state exchanges (NAMI). These laws indicate a huge step forward in the fight for mental health parity and mental health inclusion in insurance policies. However, the definition of parity remains elusive, allowing insurance companies to craft their own interpretations and definitions for coverage. In their survey, NAMI evaluated the experiences of those living with mental illness (and their families) with private health insurance. The following issues were reported:

▪ Serious problems in finding mental health providers in health insurance plan networks;

▪ High rates of denials of authorization for mental health and substance use care by insurers;

▪ Barriers to accessing psychiatric medications in health plans;

▪ High out of pocket costs for prescription drugs that appear to deter participation in both mental health and medical treatment;

▪ High co-pays, deductibles and co-insurance rates that impose barriers to mental health treatment;

▪ Serious deficiencies in access to information necessary to enable consumers to make informed decisions about the health plans that are best for them in ACA networks.

What can we do?

Enforcement: Achieving true parity in accessing mental health care places a great deal of responsibility on us as a community (healthcare providers, advocates, patients, lawmakers etc.). It means staying vigilant and holding insurance companies accountable for their actions. Achieving true parity means continuing to challenge unfair mental health insurance denials and continuing to fight for equal access to mental health care.

Transparency: Insurers should be required to publish the clinical criteria they use to approve or deny care. In our office, we see countless insurance denials for eating disorder treatment. Insurers often use ambiguous language when referring to internal guidelines for coverage. For example, we often see insurers deny coverage claiming that a patient isn’t making enough progress, so they must step down to a lower level of care. In reality, according to American Psychological Association guidelines, when a patient isn’t making enough progress, they may need to step up to a higher level of care. We see things like, “your eating disorder is not medically necessary,” “your eating disorder is chronic and therefore cannot be treated,” or weight based denials such as “your weight is now stable and you do not need residential treatment.” These seemingly nonsensical decisions are made by insurers every single day, hindering access to life-saving mental health treatment. We need greater transparency from insurers on how these decisions are being made.

Furthermore, health plans should be required to publish accurate lists of providers, including mental health providers, participating in plan networks and to update those lists regularly. This information should be easily accessible to everyone.

Although both MHPAEA and ACA have paved the path to parity and equal access to mental health care, the road ahead remains long and complicated. Much work remains before we all understand parity in the same way, before access to mental health care is smooth and seamless, before discrimination and stigma in mental health care is eliminated.

At Kantor & Kantor, we continue to fight unfair insurance denials and challenge parity violations so that our clients can have access to the life-saving treatment that to which they are entitled.

If you have experienced a mental health related insurance denial, or have been denied coverage for the treatment of an eating disorder, please do not hesitate to contact our office for a no-cost consultation.

We understand, and we can help.
www.kantorlaw.net (800)446-7529

For more information on the NAMI survey, click here and here