July Grand Rounds featuring Markie L.C. Twist, Ph.D.

Lorenz Clinic is excited to host Markie L.C. Twist, Ph.D., during July’s Grand Rounds professional development event. Dr. Markie will present on the Clinical Guidelines for LGBTQIA-Affirming Marriage & Family Therapy (MFT) that was recently published by the American Association of Marriage and Family Therapy (AAMFT, April 2022). These new guidelines outline how marriage and family therapists practice in an affirming, inclusive, ethical, and competent way with lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) people. These guidelines are timely with the advent of Pride month to encourage positive language to affirm clients’ personal identities.

Attendees will be eligible for 2 CE credits from the following boards:

  • Board of Behavioral Health and Therapy
  • Marriage and Family Therapy
  • Social Work
  • Psychology
  • Nursing

Event Details

Date: July 13, 2022
Time: 10:00am-12:00pm
Location: In-person event will take place at the Rosemount Clinic; a virtual presentation is also available

Learning Outcomes:

  • Review the American Association for Marriage and Family Therapy (AAMFT) Clinical Guidelines for LGBTQIA-Affirming Marriage & Family Therapy (MFT).
  • Discuss common presenting LGBTQIA-related concerns via a case study and discuss and apply AAMFT Clinical Guidelines for LGBTQIA-Affirming Marriage & Family MFT.
  • Analyze shared consultation cases via the AAMFT Clinical Guidelines for LGBTQIA-Affirming Marriage & Family MFT. 

To register, use the links below. Registration is required for this event. 

In-Person Attendance

Virtual Attendance

 


 

About Markie Twist, Ph.D.

Markie Louise Christianson (L. C.) Twist (she/they), Ph.D., is an award-winning sexuality educator, sexologist, relationship therapist, author, and international speaker. Dr. Twist is Teaching Faculty in the Department of Applied Psychology in the Doctoral and Master of Arts Programs in Couple and Family Therapy and Master of Arts Program in Dance/Movement Therapy at Antioch University New England. Dr. Twist is also a licensed marriage and family therapist and mental health counselor, as well as a clinical fellow and approved supervisor of the American Association for Marriage and Family Therapy, and certified sexuality educator and supervisor through the American Association for Sexuality Educators, Counselors, and Therapists. Dr. Twist is co-author of the books, The Internet Family: Technology in Couple and Family Relationships and Focused Genograms: Intergenerational Assessment of Individuals, Couples, and Families (2nd ed.). Markie also serves as the Editor-in-Chief of Sexual and Relationship Therapy: International Perspectives on Theory, Research and Practice and is co-editor of the book Eco-Informed Practice: Family Therapy in Age of Ecological Peril. In addition, Markie serves as a session instructor at the University of Guelph. To learn more about Dr. Twist visit: drmarkie.com.

PRIDE 2022 – Making Space

Written by Lorenz Clinic’s Social Equity Committee

 

Why pride? 

The term pride comes from the sentiment behind this quote, “If the poison is shame, the antidote is pride” – Unknown

Pride History

The celebration of LGBTQIA+ pride began in New York City in June 1970 as protests in the street to commemorate the Stonewall Riots on its first anniversary. For decades since, communities in the US have gathered during the last weekend of June to honor and bring light to the resistance of advocates and agitators against a system of repeated oppression, humiliation, and dehumanization of LGBTQIA+ people.

Although Stonewall is often credited with beginning the gay rights movement, in reality, the uprising was the culmination of years of LGBTQIA+ oppression and resistance led by transgender, gender-nonconforming, and civil rights activists with long histories of involvement in concurrent Black and Latino liberation movements. Activists include: Sylvia Rivera, Marsha P. Johnson, Miss Major Griffin-Gracy, and Victoria Cruz just to name a few.

Pride Today

Today, Pride Month is more than a weekend to remember those who fought for survival and freedom. It is a whole month of events, activities, and parades to celebrate dignity, equality, increased visibility, and advancements in civil rights protections. It presents an opportunity, and perhaps an obligation, to rally around those who need support and assess the work that has yet to be done. It should be noted that while June is the month when pride is formally recognized, pride does not have to be exclusive to June, as social identities should be honored and celebrated all year long.

Mental Health Statistics for the LGBTQIA+ Community

Members of the LGBTQIA+ community experience higher rates of instances of mental illness.

The National Alliance of Mental Illness (NAMI, www.nami.org) highlights some staggering statistics:

  • 86% of teenage youth who identify as LGBTQIA+ have been harassed or assaulted in their schools
  • LGB people are 2x as likely to suffer from substance abuse; transgender people are 4x as likely when comparing to a heterosexual adult
  • LGB high school-aged students are 4x as likely to attempt suicide compared to their heterosexual peers
  • 40% of transgender adults have attempted suicide compared to 5% of the rest of the population

How Can Lorenz Clinic Help?

Lorenz Clinic is committed to providing an equitable and accessible space for all people from all walks of life. People do not need to struggle with a mental health crisis on their own, and Lorenz Clinic aims to be a source of support that people can trust. Further, Lorenz Clinic approaches patient care through systemic and relational lenses; thus, it is important to consider ways in which clients’ families and the larger systems in which they live impact their perceptions of support and access to mental health care.

The need for access to mental health resources has always been high for the LGBTQIA+ community. As has been noted throughout the coronavirus pandemic, mental health issues and saturation of the mental healthcare system have become significant concerns. Lorenz Clinic is here to make space and provide care to members of the communities which each clinic serves.

Making Space 

  1. Recognize your responsibility to actively ensure that your space is accepting and affirming both as an organization and an individual provider. This includes reviewing your practices, policies, and paperwork for bias, ensuring all staff are trained and being proactive and consistent when communicating with youth and families about trust, confidentiality, and clients’ rights.
  2. Be mindful that clients are aware of the national conversations about access to care and the rights of LGBTQIA+ people, and acknowledge that any feelings or fears that arise from witnessing prejudice towards LGBTQIA+ people are valid. Be prepared to offer a space for them to process, ask questions, and plan for their safety.
  3. Create space for clients to explore the fullness of their gender and other cultural identities without fear of judgment or harm. Recognize how intersecting marginalized identities—including race, ethnicity, religion, ability, socioeconomic status, and mental health status—can reduce access and amplify the impact of rejection and fear of consequences for accessing gender-affirming care.
  4. Consider interventions that work. A practical intervention to help families presenting to Lorenz Clinic with a gender-expansive youth is to model and promote the use of the youth’s chosen name and/or pronouns. In a 2018 study, Russell and colleagues found that an increase by one context (e.g., home, school, friends, work) in which a gender-expansive youth’s chosen name could be used predicted a significant decrease in depressive symptoms (a 29% decrease in suicidal ideation and a 56% decrease in suicidal behavior).

 

Citations

Clarke, M., Farnan, A., Barba, A., Giovanni, K., Brymer, M. & Julian, J., (2022). Gender-affirming care is trauma-informed care. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.

Russell, T., Pollitt, A., Li, G., Grossman, A. (2018). Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. Journal of Adolescent Health, 63(4). https://doi.org/10.1016/j.jadohealt

 

About the Social Equity Committee

Founded in the summer of 2020, the mission of the Social Equity Committee is to identify systemic oppression that may be present within  the mental health profession and to dismantle any oppression within the Clinic. The committee is comprised of Dr. Morgan Bobo,  Outpatient Psychotherapy (Chair), Emily Ertel, Human Resources, Travis Grundy, Business Operations, Danielle Kuka, Outpatient Psychotherapy, BJ Suarez, Training, and Ashley Utz, Outpatient Psychotherapy.

 

May Grand Rounds with Bill Doherty, Ph.D.

Lorenz Clinic is excited to host Bill Doherty, PhD., and his presentation Therapy in a Polarized Political Environment, for our May Grand Rounds continuing education event. This event will be presented from 10 am-12 pm on Wednesday, May 11, both virtually and in person at our Rosemount Clinic. In support of Mental Health Awareness month, and after a great turnout for our April Grand Rounds, we are excited to offer this event to clinicians in and around the Twin Cities area.

Dr. Doherty’s workshop will be both clinical and practical, offering breakout opportunities, plenty of time for Q&A, and also video demonstrations.

This workshop style event will cover the following learning objectives:

  1. Identify the scope and sources of today’s high levels of political polarization
  2. Discuss how political stress can affect clients in their relationships.
  3. Describe tools for helping clients cope with political differences in ways that buffer their relationships and potentially improve them.

Clinicians who participate will be eligible for 2 Continuing Education Hours that have been approved by the following Minnesota Boards of Licensure:

  • Psychology
  • Social Work
  • Marriage and Family Therapy
  • Behavioral Health and Therapy

Registration for the event is free and is required for all attendees.

Register to attend in-person, here.

Register to attend virtually, here.

About Dr. Doherty

Bill Doherty is a family therapist and professor in the Department of Family Social Science at the University of Minnesota where he directs The Citizen Professional Center. Following the 2016 U.S. Presidential election, he co-founded Braver Angels, a citizen initiative bringing conservatives and liberals together to counteract political polarization and restore the fraying social fabric in American society.  Braver Angels now has volunteers working in all 50 states. At the same time, he co-created the Police and Black Men Project, for which he facilitates an ongoing group of police officer and community members who have forged relationships of trust with the goal of safe communities for all.  He has a strong interest in social change based on assets rather than deficits for everyone involved.  Among his awards is the Lifetime Achievement Award from the American Family Therapy Academy.

De-Masking Our Kids and Managing Their Anxiety

“You may take your mask off if you’d like.” 

This is a statement that I’ve been told several times over the past few weeks. It’s my ‘go to’ line while walking a client back to a therapy session in my office. Wow, what a strange feeling. It’s been two years of living with this “temporary normal”.

Is it really safe to take the mask off now? Will we have to put the mask back on again? What if I have food in my teeth? What if someone perceives me differently without my mask? All of those thoughts whirl through my mind as I enter the grocery store, walk my daughter into school, or sit with a client in a therapy session, with nothing covering the bottom half of my face. If I have those worries and fears as an adult, imagine what children and teens must be thinking and feeling.

Is your child struggling to take their mask off? Do they fight you to go to school or insist on keeping their mask close by, just in case? Maybe your child becomes more withdrawn when they eventually take their mask off. Do you notice they aren’t as social or their behavior changes  when asked to go mask-free in public? Maybe their grades have changed or they seem nervous about their surroundings.

These are all possible signs of anxiety and are likely due to underlying uncertainty about the change. The mask has become more than just a barrier for germs. For many kids, the mask functions as a security blanket of sorts.

If your child is struggling with anxiety about going mask free, here are a few things you can do to help them:

  1. Remember, just like when we transitioned towards masking, it will take time to adjust to the change. Try giving your child time and space to explore the change without excessive pressure.
  2. Meet them where they’re at. Seek to understand their fears by asking questions and try to avoid judgmental or dismissive language. The fear or worry may seem small or silly to you, but it is very real for your child.
  3. Make a plan with your child, to separate from the mask slowly. Could they wear the mask for part of the day? You could challenge them to go as long as they can without the mask with permission to put it back on if the anxiety becomes overwhelming. Maybe they leave the mask in their pocket, then in their locker, the car, and eventually it stays at home.
  4. Ask your child questions about what it feels like to take the mask off. What was their experience and did they notice anything that surprised them?
  5. Reduce avoidance of your own. Do not change plans or avoid situations that will raise the mask issue. Avoidance will perpetuate anxiety for both you and your child.
  6. If your child is severely anxious or experiencing panic, the sympathetic nervous system is likely activated (think fight flight or freeze response). At this time, reasoning and logical problem solving probably won’t serve you or your child very well. Instead, try using mindfulness techniques with your child, to engage all 5 senses in a soothing way.
    1. Comfort with touch, a hug, or a gentle back rub (with permission from your child)
    2. Visualize a safe space such as their bedroom or their favorite place
    3. Speak slower and more quietly or move to a less overwhelming spot
    4. Pace breathing; 4 seconds in, 7 seconds hold, 8 seconds out
    5. A cold ice pack or water on the back of their neck or wrists
    6. Suck on a sour candy or chew a piece of minty gum
  7. Lastly, If your child is struggling to function e.g., missing school, struggling with sleep, changes in appetite, severe anxiety, or panic on a weekly basis, it is time to reach out to a professional for support. Psychotherapy can be immensely helpful for both children and adults who are struggling with anxiety.

Lorenz Clinic offers a variety of services such as outpatient psychotherapy, psychiatric medication management, day treatment programs, and home-based family therapy services.

(952) 443-4600

 

About the Author:
Emily Groteboer-Distad, MS, LPCC, NCC, is a mental health professional, based out of our Rosemount Clinic. She joined Lorenz Clinic in 2021 and has been in the mental health field for 10 years, serving as a practicing clinician for 5 of those years. Emily, her husband, and her daughter call Minnesota home after living in various places while her husband served in the USAF.

Annual Conference Features Expert in Couples

Lorenz Clinic announces its Fifth Annual Invited Practitioner Conference. This year’s conference will be held Friday, November 5, 2021 and will feature Dr. Anthony Chambers, a leader within the Couples and Family Psychology specialty, and expert on therapy with multiracial couples and systems-oriented therapy. Dr. Chambers will present his APA-published work on assessing couples distress in systemic context. The presentation will have important implications for all clinicians working with special populations and providing justice-focused care, not just those seeing couples.

Lorenz hosts an Annual Invited Practitioner series, an annual conference that invites internationally recognized scientist-practitioners to help bring science to practice on Main Street. Along with bi-weekly consultation and over 100 in-house continuing education hours each year, this conference is open to the regional provider community and contributes to a rich professional ecology for staff and trainees alike and enlivens work at all levels of the organization.  To register for this event, visit the event page here.

Conference Summary:

The current trend in professional psychology education calls for trainees to be evaluated on the basis of core functional and foundational competencies (Fouad et al., 2009). Despite calls for competency-based training in couple and family psychology (CFP; e.g., Kaslow, Celano & Stanton, 2009) and couple and family therapy (Celano, Smith & Kaslow, 2010), only recently has there been attention to the knowledge-, skill-, and attitude-base that a psychologist must possess in order to achieve specialty status as a CFP (Stanton & Welsh, 2011). As the field of CFP matures and more Psychologists move towards specialization in professional psychology, training models are needed that can facilitate competencies at the specialty level.

Towards that end, one of the most challenging skills for any couple therapist is being able to move from an individual to a systemic case conceptualization. Consistent with Stanton & Welsch’s (2011) couple and family psychology competencies, a thorough case conceptualization involves problem formulation, case formulation, and treatment formulation. However, this can be overwhelming for many trainees and established therapists conducting couple therapy. Thus, this presentation will present a systematic and systemic model that actualizes the case conceptualization competency.

The framework presented is a four-session evaluation that includes an initial conjoint session in order to understand the couple’s relationship problems followed by separate sessions in order to understand each person’s individual and family of origin histories (Chambers, 2012; 2018). The evaluation concludes with the therapist providing feedback to the couple that is used to establish a working alliance. Although the notion of routinely meeting with each member of the couple separately as part of an evaluation is not new (Karpel, 1994), the purpose of this presentation is to describe this procedure in enough detail that audience members will be able to teach this model to their trainees and/or be able to replicate this model for use in their own practice with couples.

Specifically, the presentation will describe the rationale and goals for the model, the tasks and pertinent issues to assess in each session, as well as how to present the model to couples during the initial phone call and initial visit. Finally, the presentation will discuss how to provide a dyadic/systemic conceptualization of their relationship problems, and how to make appropriate recommendations for treatment. Ethical and complicated issues such as confidentiality, how to handle secrets, and how to know when couple therapy is contraindicated will also be presented.

About the Presenter

Anthony Chambers, PhD, ABPP, is the Chief Academic Officer and a Licensed Clinical Psychologist on staff at The Family Institute at Northwestern University. Dr. Chambers is also the Director of Northwestern University’s Center for Applied Psychological and Family Studies and is a Clinical Professor in the Department of Psychology. He is also the former Director of the Couple Therapy program at The Family Institute. Dr. Chambers is one of the few Psychologists in the United States Board Certified in treating couples (ABPP). Dr. Chambers is also a former President of the American Psychological Association’s Society for Couple and Family Psychology. He currently serves as President for the American Academy of Couple and Family Psychology and serves on the Board of Directors for the American Board of Couple and Family Psychology, which are the two organizations responsible in board certification for Psychologists in Couple and Family Psychology. Dr. Chambers’ professional accomplishments have resulted in becoming a Fellow of the American Psychological Association and several other organizations. He also serves on the editorial board for the journal Family Process and is the past Associate Editor for the flagship journal Couple and Family Psychology: Research and Practice. Finally, Dr. Chambers was recently elected to the Board of Directors for the American Psychological Association.

Dr. Chambers completed his internship and post-doctoral clinical residency at Harvard Medical School & Massachusetts General Hospital (HMS/MGH), specializing in the treatment of couples. He currently maintains a thriving clinical practice comprised of 90% couples. Dr. Chambers also engages in scholarly writing, teaching and public speaking aimed at disseminating the latest knowledge about how to have a healthy relationship.

Lorenz Announces Wayzata Clinic

We are delighted to announce our new Wayzata clinic, which will open in 2022!

The clinician experience played heavily into our location selection process.  Wayzata is an eminently walkable community and a great place to work and play, essential aspects of clinician experience and wellbeing.  Most importantly, Wayzata is a gateway community for all points west, which fits with our mission of expanding access to quality mental healthcare on Main Street in vibrant downtowns and serving outlying areas.

The new location will house outpatient psychiatry, psychology, and various intensives in addition to serving as a hub for home-based clinicians who will serve Hennepin, Wright, and Carver Counties.

We have already begun staffing the new clinic, as the lead time lends itself to clinicians hoping to practice remotely or in a hybrid model over the near term. Contact for more

Policy-Makers Cut Ribbon in Rosemount

A ribbon cutting ceremony was held for the new Lorenz Clinic in Rosemount April 7, 2021.  The event was hosted by the Rosemount Port Authority, City Council, and Chamber of Commerce and featured remarks by local policy leaders committed to mental healthcare.

Rosemount Mayor Bill Droste welcomed the new clinic to the community. “I can’t say how proud we are to have you move your office here,” said Droste as he stressed the importance of clinical services that support families, children, couples, and adults.

Congresswoman Angie Craig

Founder of Lorenz Clinic, Dr. Chad Lorenz had the honor of cutting the ribbon to welcome the community to the new clinic. “I grew up in a town like Rosemount—a vibrant, healthy downtown, a walkable community—and one of the things that I noticed in my hometown that was really lacking was access to mental health professionals.” He continued, “We are going to celebrate access embedded in the community.”

Congresswoman Angie Craig thanked those in attendance and all clinicians, “Mental health care is health care. I thank every single one of you for the work that you do to treat mental illness as the disease it is.”

Minnesota Representative John Huot thanked Lorenz for investing in the community and tasked its clinicians with aiding the effort to treat issues exacerbated by the pandemic. “I’m going to charge you with a very important task. Minnesota is going to have to heal….I lay it on your shoulders and I know you’re capable.” He also announced that the Health and Human Services Committee, where Huot serves as Vice Chair, was approving telemedicine to continue as a reimbursable service.

MN Rep. Huot

Expanding on one of the clinic’s core values, Dr. Lorenz emphasized the need for equal access. “Folks think there’s equal access to services like this within our communities, but there isn’t. It’s really important for places like this exist that take all the payers, that see everybody regardless of their ability to pay.”

The new clinic will host a variety of integrated levels of mental health services under one roof.  These include psychological testing, psychiatric medication management, outpatient psychotherapy, and intensive, trauma-focused day-treatment for very young children.  KSTP was in attendance; their coverage of the event can be found here.

 

Lorenz Opens New Rosemount Clinic

Over this past winter, Lorenz Clinic opened a new, 12,000 square foot facility in Rosemount.  Lorenz has been a fixture in the Rosemount community since 2013 but saw the need for new, more dedicated space.

The new clinic will host multiple mental health service lines including psychiatry, psychological testing, and intensive early childhood day-treatment in addition to the weekly psychotherapy the clinic has hosted for years.  The clinic will also serve as a hub for home-based mental health clinicians.

The new facility features space dedicated to training psychologists and other mental health professionals.

A slideshow of the space can be found here.

Lorenz Announces Early Childhood Day Treatment

Lorenz Clinic has initiated a significant expansion plan at its Chaska location, where the clinic has been actively pursuing the development of added service lines including early childhood day-treatment and family-focused home-based services in addition to its existing outpatient psychotherapy and medication management offerings.  Overall, the initiative will provide notably expanded access to early childhood mental health services in Carver County and outlying areas where such services for very young children have been conspicuously lacking.  The program will open 3/1/20.

The new Day Treatment and its companion Home-Based program will feature high treatment fidelity and demonstrable clinical outcomes.  Young children often require access to various levels of care, and these changes will offer families a more seamless experience of what for many has become an inaccessible and
all-too-fragmented system.

The expanded clinic will features four service lines:

  • Outpatient Psychotherapy for all ages
  • Early Childhood Day-Treatment
  • Family-Focused Home-Based Services
  • Medication Management

In order to add day-treatment and home-based services, the clinic has been preparing for Children’s Therapeutic Support Services (CTSS) certification with the State of Minnesota.  The addition of CTSS certification will allow providers to serve families outside the four corners of the clinic and will enable them to provide a higher level of care that includes more than the typical one hour per week of therapy commonly found in outpatient settings.

About Day Treatment 

The day treatment program will be based on the treatment practice of Developmental Repair, an intensive treatment model that was developed by Dr. Anne Gearity to treat children who have experienced early complex trauma and are displaying aggressive and disruptive behaviors (Gearity, 2009).  The treatment model will be used to treat children ages 3-7 in a day treatment program, three hours a day, five days a week.  Through Developmental Repair, day treatment will target 4 main areas of functioning: relating, feeling, thinking, and acting.  With a combination of group therapy and group skills training, children will move through a daily routine that includes art projects, snack, large motor play, structured learning activities (books, puzzles, and games), and school work.  Each child will have individual goals created through collaboration among mental health professionals, clinical trainees, and/or mental health practitioners, and caregivers.

Each day treatment room will be comprised of up to 6 children and 2-3 trained staff.  The day treatment team will have day treatment specific consultation at least one time per week for 1.5 hours. Consultation will be provided by a mental health professional trained in Developmental Repair. 

Children participating in day treatment will attend either the morning session (9am-12pm) or the afternoon session (1pm-4pm).  A premier goal of Developmental Repair is to support continued inclusion in the community and prevent social isolation due to challenging behaviors (Gearity, 2009). Collaboration between day treatment staff, caregivers, and educators will work to support attendance in both preschool and day treatment for the younger children, and day treatment and kindergarten for the older children.  Ongoing collaboration between day treatment staff and educators will also support use of common language and goals.

Mental Health Professionals and Practitioners working in day treatment will work to build a partnership with families of clients in day treatment.  Clinicians will encourage weekly family therapy that will include sessions with caregiver and child, and/or caregiver without child.  Family therapy will happen in-center or in-home based on medical necessity.   The Developmental Repair model will be utilized in family therapy and work to partner with caregivers to improve the child’s functioning in the community. 

For More Information

For more information about the program, interested parties should contact Anne Fleming, the Assistant Clinical Director in charge of the program’s implementation and overall direction, at (952) 443-4600.

References

Gearity, A.G. (2009). Retrieved from http://www.washburn.org/pdf/WCCDevRepairGrayscale-singlepages-smallerfile.pdf, on 11/14/19.

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