Lepage Associates Newsletter
Mental Health Matters
April 2009
Lepage Associates
Call: (919) 572-0000
In This Issue
An Insider's Look at Counseling
Understanding Autism
Family Therapy
Please click on each group for a flier with complete information to include description,
Cooperative Parenting Seminar
We have a free upcoming seminar available for those who are planning their wedding. 
An Insider's Look at Counseling
In recognition of National Counseling Awareness Month, here is the story of one family's view of therapy.
Our family had just moved to North Carolina and our teenage son was in crisis. We were exhausted, frustrated, and at a complete loss as to what to do about his hostility. Nothing was working.  It was tearing our family apart. After much research, many calls to professionals, and four counseling sessions with a MSW that were getting us nowhere, we found Lepage Associates.
After months of explosive, defiant behavior, our son's anger had imploded. He completely shut down, was withdrawn and hadn't spoken to us in three months! We were desperate for help but did not know who we should trust. Finally, because Dr. Lepage took time with me on the phone, patiently listening to the details of our story, while gently making recommendations and answering all of my questions, we decided to bring our son in for help. We are so glad we did!

The therapist assigned to us did a fantastic job! She managed to connect with him on the very first day, despite his resistant attitude. She was very thorough, professional, and attentive throughout the psychological testing process, taking the necessary time to get to the root of things, and to explain everything to our satisfaction. Things improved gradually each week from there as the therapist helped our son work through his issues. She taught him much needed skills to recognize, process, and solve the problems that had caused him to act out.  He was no longer trapped in his emotional prison, but learned to deal with anger on his own, and to communicate in a more constructive manner. She then helped us as parents navigate through the dynamics that we had previously misunderstood which altogether created a more healthy, happy family life, and for which we will forever be grateful.

We are offering a CLE opportunity in May on

Successful and Happy
Living for Lawyers  

We will include a guest speaker, attorney Bryan Collins, who will discuss his own struggle with depression.
May 1st from 1-2pm
Lunch is provided in the cost. 
According to a Johns Hopkins University study, lawyers suffer the highest rate of depression among workers in 104 occupations. A University of Washington study found that 19 percent of lawyers suffered depression compared to 3 percent to 9 percent in the general population. And a University of Arizona study of law students found that they suffer eight to 15 times the anxiety, hostility and depression of the general population. Sound familiar? Come learn strategies for dealing with stress, depression, and anxiety to help you in both your personal life and in your practice.
Please call our office to register or email tlepage@lepageassociates.com


April is National Counseling Awareness and
National Autism Awareness Month.
The week of May 4th is National Children's Mental Health Week. 
Learn more about these topics
in the articles presented below.
 Understanding Autism
Parents are usually the first to notice their child having difficulty and failing to meet developmental milestones. Some things parents might notice are l
ack of joyful facial expressions by six  months, difficulty engaging in give and take interactions by nine months, and delayed language development.

There are three distinctive areas of difficulty which characterize autism. Autistic children have difficulties with social interaction, problems with verbal and nonverbal communication, and repetitive behaviors or narrow, obsessive interests. These behaviors can range in impact from mild to disabling.
The hallmark feature of autism is impaired social interaction. Some children show hints of problems within the first few months of life, while others may not show deficits until they are two years old or later. Some children may develop normally until the age of two, but then they stop making gains in language and social skills or they lose skills that they had already acquired. No two children with autism are alike and presentation may vary significantly. 
Autism impacts 1 in 150 people. It occurs in all racial, ethnic, and socioeconomic groups. Autism is four times more likely to occur in boys. Autism impacts one's overall ability to communicate with and relate to others. Symptoms range from mild to severe. There are five disorders that fall under the Autism Spectrum. These include Asperger Syndrome, Rett Syndrome, Pervasive Developmental Disorder, NOS, and Childhood Disintegrative Disorder.  
As children with autism grow up, they may respond differently to their environment. Many adolescents are overwhelmed by the transition between childhood and adulthood. Parents should expect this to be true of adolescents with autism as well. While some behaviors improve during teenage years, some tend to get worse. You may notice an increase in repetitive and aggressive behaviors as the teen has difficulty managing the stress and confusion associated with adolescence. Not to mention the physical and hormonal changes!  This is also a time where the teen is at risk for developing anxiety or depression as they become increasingly aware that they are different from their peers.   
The presentation of autism and other spectrum disorders varies significantly in adults. Some are able to live independently and maintain employment while others have significant difficulty completing daily tasks.
Long before your child finishes school, parents should research available social supports to assist your child with autism in adjusting to the "adult world."
While there is no identifiable fully effective cure for autism, early intervention obtains maximum benefits for your child. Early intervention should focus on improving communication, social, and cognitive skills. 
Although there is no single treatment protocol for all children with autism, most individuals respond best to highly structured behavioral programs.
Psychosocial and behavioral interventions are key parts of comprehensive treatment programs. In addition to these interventions, therapies often include occupational therapy, sensory integration therapy, and speech therapy.

If you have concerns about your child's development, speak to your pediatrician to determine the best course of action and complete screenings with other qualified professionals, such as a psychologist.


FAMILY THERAPY is a form of psychotherapy that involves all the members of a nuclear or extended family. It may be conducted by a pair or team of therapists. Although some forms of family therapy are based on behavioral or psychodynamic principles, the most widespread form is based on family systems theory. This approach regards the family, as a whole, as the unit of treatment, and emphasizes such factors as relationships and communication patterns rather than traits or symptoms in individual members.
Family therapy tends to be short-term treatment, usually several months in length, with a focus on resolving specific problems. It is not normally used for long-term or intensive restructuring of severely dysfunctional families.

In family therapy sessions, all members of the family and the therapist are present at most sessions. The therapists seek to analyze the process of family interaction and communication as a whole; they do not take sides with specific members. They may make occasional comments or remarks intended to help family members become more conscious of patterns or structures that had been previously taken for granted. Family therapists, who work as a team, also model new behaviors for the family through their interactions with each other during sessions.

Family therapy is based on family systems theory, which understands the family to be a living organism that is more than the sum of its individual members. Family therapy uses "systems" theory to evaluate family members in terms of their position or role within the system as a whole. Problems are treated by changing the way the system works rather than trying to "fix" a specific member.
To read the full article and to read about other forms of treatment, click here.


Monthly Reader
Each month we will recommend a book that someone at our practice has found useful. This month's books are:
ACT on life not on anger
by George Eifert, Matthew McKay, and John Forsyth
Look Me in the Eye: My Life with Asperger's
by John Elder Robinson
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Links for more information on Autism: