Consultee Contact

Midwest Psychiatric Center, Inc. is a private psychiatric practice owned by my colleague, Dr. Rakesh Kaneria.  I provide therapy to adults and a small number of children/adolescents at this location.  We can accept most commercial insurances, as well as Caresource (of Ohio Medicaid) and Medicare.  Adult clients who work with me at MPC also have the option to see Dr. Kaneria for evaluation and medication management if desired or needed.  Child psychiatric evaluation and medication management are not available with MPC.    We are located in West Chester, OH near the UC West Chester Hospital, just off I-75, between Liberty Way. and Tylersville Rd.

Call us:

Send a message: Contact Us

“I Ask!” Sexual Assault Awareness Month 2019

2 years ago · · 0 comments

“I Ask!” Sexual Assault Awareness Month 2019

The April marks the 18th annual Sexual Assault Awareness Month (SAAM) campaign.  This year’s theme, “I Ask” builds on the idea that consent is a healthy, normal, and necessary part of everyday interactions.  “I Ask” champions the power of asking — whether it be asking to hold someone’s hand, for permission to share personal information with others, or if a partner is interested in sex.  It also highlights the importance of listening to and accepting the answer without pressuring someone to change their mind.

Working with survivors of sexual violence is a big part of my work as a Certified Trauma Practitioner, as sadly the problem is all too prevalent.  In the U.S., one in three women and one in six men experienced some form of contact sexual violence in their lifetime.  I am proud to offer EMDR Therapy as a highly effective, evidence-based form of psychotherapy that promotes healing and empowerment for survivors.  Part of the healing process can including activism and awareness building, so I encourage all my clients, but especially those who are survivors of sexual violence, to join me in spreading the word about this year’s “I Ask” SAAM campaign.

Launched in April 2001 by the National Sexual Violence Resource Center (NSVRC), Sexual Assault Awareness Month is an annual awareness and prevention campaign observed in April and is coordinated each year with assistance from anti-sexual assault organizations throughout the United States.  For more information on this year’s national campaign, visit

Consent can be confused or complicated with one partner of a relationship holds more power than the other.  It is important to be aware of how balance or imbalance of power can impact healthy intimacy in relationships.  There are ways to make sure your partner feels comfortable communicating their needs.  As a part of the “I Ask!” campaigne, here are some suggestions from NSVRC about power and consent that can be helpful in navigating relationships with love and respect.


Smith, S. G., Chen, J., Basile, K. C., Gilbert, L. K., Merrick, M. T., Patel, N., … Jain, A. (2017). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 state report. Retrieved from the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control:


National Child Abuse Prevention Month

2 years ago · · 0 comments

National Child Abuse Prevention Month

April is National Child Abuse Prevention Month. The theme this year is “Strong and Thriving Families.”  This month and throughout the year,  we have the opportunity as  individuals and organizations to play a role in making our community a better place for children and families. By ensuring that parents have the knowledge, skills, and resources they need to care for their children, we can help prevent child abuse and neglect by creating strong and thriving children, youth, and families in our communities.

Research shows that protective factors are present in healthy families. Promoting these factors is among the most effective ways to reduce the risk of child abuse and neglect. The factors are:

  • Nurturing and attachment
  • Knowledge of parenting and of child and youth development
  • Parental resilience
  • Social connections
  • Concrete supports for parents
  • Social and emotional competence of children

April is a time to celebrate the important role that communities play in protecting children and strengthening families. Everyone’s participation is critical. Focusing on ways to connect with families is the best thing our community can do to strengthen families and prevent child abuse and neglect.

In support of these efforts, the U.S. Department of Health and Human Services’ Children’s Bureau, Office on Child Abuse and Neglect, its Child Welfare Information Gateway, the FRIENDS National Center for Community-Based Child Abuse Prevention and over 30 national prevention partners have created 2019 Prevention Resource Guide: Strong and Thriving Families. The resource guide, designed for service providers who work throughout the community to support families, is available online at

Another really helpful resource offered for families to build healthy connections and enhance parent-child relationships is the National Child Abuse Prevention Activities Calendar.  It can be found in both English and Spanish at


What’s with the giraffes?

2 years ago · · 0 comments

What’s with the giraffes?

One of the first things people notice when they come in my office for the first time is the series of three paintings of giraffes on my wall.  Many have asked, “Leah, what’s with the giraffes?”  I LOVE to share the answer to that question.

There’s no doubt that giraffes are a source of inspiration for many people.  They show up in art, literature, children’s toys and books, music, and mascots.  Their graceful and majestic appearance captivates the eye and the mind, and their endearing expressions draw us in.  For many, giraffes symbolize welfare and happiness.  Often referred to as “Africa’s gentle giant”, giraffes represent cooperation, resourcefulness, intuition, and patience.  Due to their height and long, elegant necks, they are frequently used as symbols of vision, perception, and the elevated mind.

Giraffes, particularly in their various stages of development, can illustrate the stages of recovery, and that is precisely the meaning I wanted to convey when I selected this art for my office.  Each of the three giraffe paintings in my office is intended to depict a phase of healing or recovery.  For the sake of this explanation, I will discuss the paintings in the context of recovery from addiction, however the concepts certainly can translate to healing from other forms of trauma or adversity.

The first painting depicts a baby giraffe with its mother, and it represents the beginning of the recovery process.  Baby giraffes are born after 14 months gestation, and delivery typically occurs while the mother giraffe is standing. This means Baby drops about six feet, crashing down head-first into a new, scary, and dangerous world.  The fall does not hurt Baby, but forces causes him to the first deep breath of life.  Not too long after delivery, the baby giraffe begins to test out his body, walking on long, gangly legs with knobby knees and a wobbly gait.  Baby is very vulnerable at this stage.  In the wild, predators like lions, leopards, and hyenas are a threat to giraffes, especially calves that don’t yet have the strength or awareness to protect themselves.  So this means Mama Giraffe (and often times other females of the herd) look after the little ones, providing protection and guidance.

Acrylic on canvas, Amy Jacomet, 2018

To me the calf parallels the experience of individuals who are newly sober.  Even though they may believe that sobriety is good and desirable, sober living is a scary thing because it’s new or even unknown.  In the early stages of recovery, we need the support of safe and trusted people to help us, guide us, and even offer a little protection.  Supportive family members, AA sponsors, counselors, and trusted friends can offer the much needed encouragement to help us through the scary and vulnerable beginnings of recovery.  We also sometimes need a protected environment like a sober living house, treatment program, or new housing arrangements as a part of relapse prevention.  Just like the baby giraffe is not helpless (remember Baby gets up and walks very soon after delivery), in early recovery we must begin by taking action toward change.  This can look like joining a 12-step fellowship, participating in an Intensive Outpatient Program (IOP), and changing up our habits to limit our exposure to the people/places/things that can lead us to use.

The second painting in the series depicts the juvenile giraffe, or as I like to call him, Junior.   By now he has grown larger and stronger.  He moves with more confidence and can run, reach, and explore.  He has learned some things about the world around him like who is friend and who is foe, where there is safety and where there is danger.  With this growing strength and confidence comes a little curiosity and even some boldness.  Junior begins to stretch, reach, and try new things – he’s learning to “stick is neck out”, as they say.  Sometimes Junior might get a little too bold and find himself in some sticky situations that could require the help of the older, wiser, or more experienced members of the herd. (Actually, Google tells me a group of giraffes is actually called a “Tower.”  Very apropos.)

Acrylic on canvas, Amy Jacomet, 2018

To me Junior reflects a lot of the experiences that go along with middle stages of recovery.  By this point we may have a few months or even a year (plus) of sobriety behind us.  We’ve identified triggers, overcome some cravings, and begun to establish habits that support continued sobriety.  We might be more than familiar with the 12 steps and have a growing number of effective coping skills and resources to help us manage when life gives us challenges.  There is still danger at this stage though.  Sometimes, like Junior, we get a little too bold and take chances that can compromise our recovery.  It’s important to stay self-aware and have accountability to others (like an AA sponsor) to help us stay on track or get back on our feet if we slip up.

The third painting is of the fully grown, adult giraffe.  I like to call him Dude.  The mature giraffe is fully developed, strong, and aware.  He had gained a lot of experiences that inform his decisions, keep him safe, and help him thrive. Dude has strong muscles, and he moves with grace and efficiency.  He knows how to navigate his world and is able to find food and water to help keep him well.  When Dude encounters a problem, more often, than not, his instincts serve him well.  Giraffes, even fully grown, are still prey, so Dude has to remain aware and pay attention to his surroundings.  While he is self-assured and resourceful, he knows he is still vulnerable.  Hungry predators are still after him, so he can’t let himself become overly confident.

Acrylic on canvas, Amy Jacomet, 2018

The adult giraffe shares a lot of similarities with an individual who has been sober for an extended period of time.  In order to achieve years of sobriety, we have learned a lot about ourselves.  We are more self-aware and resilient than before.  Like Dude, we are skilled and equipped to handle many of the challenges that everyday life throws our way.  We have instincts, knowledge, and reliable resources.  But just like a mature giraffe, we must remain alert and aware of potential dangers.  We must be on the watch for threats to our sobriety and make daily efforts toward relapse prevention.  Too much confidence can land us in precarious situations.

Recovery from addiction is not the only way to relate to the giraffes.  Certainly we can all relate to the process of growth and healing.  The dynamics of healing from just about any adverse life experience can be reflected in this metaphor.  Getting through a painful breakup, recovering from a severe illness or injury, moving to a new school/job/town, grieving, and so many of life’s challenges  take on a similar progression.

My invitation to you is to reflect on these three paintings and their messages.  Which painting do you connect with the most at this point in your life?  How can you use that awareness to help you be health, safe, and fulfilled?

A Message from the Artist

The three giraffe paintings are the work of artist and writer Amy Jacomet from the Miami Valley.  You can find some of her commissions on display at Dayton Children’s Hospital.  A courageous woman with a strong sense of spirituality, Jacomet shares her faith through her art.  Here is a bit of her story:

Amy Jacomet, Artist and Writer.

“A type 1 diabetic at age 10, I found myself blind, with kidney failure and desperately needing an organ transplant at age 26. By 28, I received two healthy new organs and had regained some of my sight; however, I was left with the inability to see colors correctly.

I went back to my roots of art many years after that and took to painting. At that time, I wanted to find a way to glorify God through my work. He had shown me so much love through my valley and I wanted to return that love to Him.

After a quick prayer and creating my first painting, I heard Him say that He wanted His messages on the back of my work. I didn’t know what that meant until He gave me my first message and then placed it in the perfect person’s hands.

Since then, I have been creating pieces for Him to show this world His great love.

He has used my “inability” to see colors and detail to show His ability. I have felt so honored and blessed to be on this amazing journey with Him.”

Below are the messages Jacomet inscribed on the back of each of the giraffe paintings.

A journey awaits you. Do not be afraid to step into the unknown or unseen.  Instead, know that I have already gone before you, and I am patiently extending My hand to pull you up out of your debris.  The past is the past and you are no longer bound to it.  Be of good courage and take the first step.  I promise I will be by your side.  I am leading you to a land of prosperity, so take My hand, child, and allow Me to be your guide.  I know you are fearful, and I know you feel unsure.  But know that I would not call you out of your dry and desert land if I didn’t have a plan and a purpose.  You were created for great things.  Believe these things I say to you.  You haven’t yet seen your best days.  They lie ahead.  Now venture out and take this journey with Me.  I promise you will not be disappointed.  I have so much ahead of you as you draw near to Me.  Take one step at a time.  I promise you will get there.  Take that first step.  I am waiting to embrace you in My loving arms and show you the person you were created to be. Trust Me.  I have you.   

You’re experiencing so many new things and being tested in new situations and circumstances.  Keep your eyes focused on Me like never before. Allow me to lead you on the path to the mountaintop.  You’ve exited the valley and are growing by leaps and bounds, but do not forget about Me and all that I have done for you.  I am still working My will and purpose for your life, shaping you along the way.  Allow Me to mold you.  Allow Me to show you the way to your victory.  You will conquer all.  Just be patient and do not rush ahead.  There is a time and place carved out especially for you.  It has been set aside and you have been set apart.  Be patient in your process and see what I can and will do in and through you.  You will be in awe when you see My plan unveiled before your eyes.  Trust Me.

You are bold and courageous, strong and enduring.  You have shown great perseverance on your journey.  Taking on battle after battle and conquering all that has tried to rise up against you.  You have overcome and come to a place of victory.  Be very proud of what you have accomplished.  You have refused to give up and met every obstacle placed before you with great courage.  You didn’t give up when times got tough.  Even when you’ve been knocked down, you’ve gotten back up and continued on the path that has led you to success.  Congratulations.  Be very proud of who you’ve become.  Be very proud that you have withstood the test of time.  What was once a valley for you has now become a testimony.  Never forget where you came from, as it will keep you humble, but always look toward your future.  It is so bright, and you are going to embark on many amazing things and opportunities.  Always see yourself as I see you.  When you look in the mirror, be grateful for you position in life.  When I place others on your path, use your discernment and seek My face in knowing who and how to help.  I have brought you through this journey for a reason and a purpose. You have not been forgotten.  You will be honored.  Keep walking forward with your eyes on Me, and know that I hold your destiny in the palm of My hand.  I will never let you down.   


Book Review: Girl, Wash Your Face

2 years ago · · 0 comments

Book Review: Girl, Wash Your Face

I was really looking forward to reading this book, as I had heard wonderful things about Rachel Hollis.  I was introduced to Hollis’ work through a good friend who invited me to see the Hollis’ film, “Made for More.”  I had mixed reactions to the film, but I enjoyed her energy and positive attitude.  There was a lot of hype leading up to the release of this book, and I have to say, the title totally got me!  I love the message it sends about allowing yourself to feel – even if it means the “ugly cry” that makes mascara run – but then washing your face (literally or metaphorically) and taking care of your business.  It suggests a healthy balance of emotional authenticity and practical perseverance.

The book was definitely well marketed, as there was quite a buzz before the book was even released.  It was all over social media, and people were talking it up right and left!  Not surprisingly, Rachel Hollis is a blogger and knows a ton about publicizing and internet marking.  Many of my friends and clients were also anxiously anticipating the book, having heard all the excitement.  The trendy cover and catchy title definitely got a lot of attention before the book was even available.  However in general, I felt let down once I actually got my copy.

The book’s structure is pretty straightforward, and one that kept me reading.  Essentially, each chapter presents a lie Hollis’ debunks.  For example Chapter 1 is entitled “Something Else will Make me Happy.”  As a therapist, I find this reminiscent of Cognitive Behavioral Therapy in that the goal is to root out unhelpful thinking habits (cognitive distortions) that keep us unhappy and unfulfilled.  While Hollis attempts to share lessons she has learned in her thirty-some years of life experience, she never boasts to be an expert in self improvement, psychotherapist, or guru.  Personally I respond to that transparency in two ways: 1. Good for you, Rachel, for being honest and humble, and for bravely sharing your story.  2.  While personal experience can produce a wealth of wisdom, most people are more apt to rely on the work of qualified professionals and researchers.

All that being said, I really enjoyed the simple and conversational writing style.  Hollis writes with just as much energy as she speaks!  The light, “girl-talk” style made this an easy read, though there were moments in which the tone became a little preachy, though Hollis’ openly acknowledges the influence of her upbringing having a Pentecostal Preacher father.  At times witty, at times brutally honest, Hollis tackles some of life most difficult challenges in a very accessible way.

Despite her quippy style and clever sayings, I was disappointed in the book’s content.  I found the book hard to relate to.  Many of the examples Hollis shares from her personal life are just hard for me to connect with.  I personally cannot relate to dieting so I can fit into a gown to wear on the red carpet with my husband, nor does saving up for a designer handbag motivate me.  I am not a party planner for the stars, and I don’t hob nob with celebrities.  Translating some of Hollis’ examples to my lifestyle was essential for me to personally find meaning in much of this book.  Along the same lines as relatability, “Girl, Wash Your Face” seems to be geared toward a very specific audience: wealthy, heterosexual, Christian women who are wives and mothers.  If that description doesn’t fit you, there will likely be chapters or portions of this book that you struggle with.  I did.

Standing alone, each chapter has the potential to be inspiring and helpful, however the book in its entirety is contradictory at times.  For example, in chapter one, Hollis talks about the value to gratitude and finding contentment in life, not always looking to the next  goal as the source of happiness.  “When I finally achieve _______, then I’ll be happy” is no way to live life.  However, in chapter two, Hollis advocates for such a strong sense of drive and focus on a goal and not putting off working on your goal or looking to the future.  There are moments where she supports healthy self-care habits and pacing oneself, however seemingly in the next breath she endorses sacrificing healthy sleep in order to achieve.  She cautions about using alcohol as a coping strategy but then later identifies wine as a form of self-care.  Certainly any of these tidbits of advice in and of itself could be argued as helpful (e.g. someone who doesn’t struggle with alcoholism might celebrate with a glass of wine after achieving a goal, and that’s not necessarily unhealthy), but her messages overall are a little contrary and could be confusing to someone  in search of solutions.

One thing I always look for in any self-help book is how the author addresses counseling, and as much as I was disappointed in the book in general, Rachel Hollis did not let me down here!  She shares a little about her own experience with personal growth, healing, and trauma recovery.  She does not shy away from acknowledging the role mental health care has played in her story, nor does she deter her readers from seeking help.  Therapy can help with a lot of the lies she challenges in her book, and I applaud her for encouraging others to consider working on areas in which they feel stuck with a trained professional.

I give this book a C+.

This book is not without value, but it wouldn’t be my first recommendation.  Overall I found it a little superficial and contrary, though well intended.  A savvy reader with a critical mind can certainly glean some benefit from this read, but it is far from the groundbreaking book I hoped it would be.  My response?  Girl, go to therapy! 😉

Hollis, R. (2019). Girl, wash your face: Stop believing the lies about who you are so you can become who you were meant to be. Nashville, TN: Nelson Books, an imprint of Thomas Nelson.


Happy World Social Work Day!

2 years ago · · 0 comments

Happy World Social Work Day!

March 19, 2019 is World Social Work Day, a time to celebrate the achievements of social workers world wide and take a message to communities to raise awareness about the contributions of the profession as well as needs for further action.

This year’s theme is “Promoting the Importance of Human Relationships” emphasizing a particular core value of the profession that is of great importance. There are seven core values of the social work profession:

• Service
• Social Justice
• Dignity and Worth of the Individual
• Importance of Human Relationships
• Integrity
• Competence

These values guide our efforts as social workers and must be central to all that we do.

As I reflect on this year’s theme for World Social Work Day, I find it particularly relevant at a time when fear and division dominate our communities. Relationships are essential to what makes us human beings. Relationships create opportunities for growth, support, discovery, and healing. They also can lead to hurt, hate, division, and oppression. Particularly here in the United States, many relationships are becoming strained and even severed, families are being divided over disagreement and polarization. Politics, religion, and race have become hotter topics than they’ve been in years, and as a society we seem to be losing the ability to build healthy and fruitful relationships if there is any disagreement whatsoever.

It’s time we extend the value of the importance of human relationships beyond the social work profession and related professions. Let’s work toward respectful connection and partnership, even when we don’t see eye-to-eye. It is in relationship that we grow and flourish as people.

One of my favorite authors, Brené Brown offers some very useful suggestions on navigating relationships, forging connections, and finding true belonging in her book “Braving the Wilderness.” She tells us, “People are hard to hate close up. Move in.” If we take the chance to get closer to those with whom we have differences, it is easier to find mutual respect. You can read my review of the book HERE. I highly recommend it for those looking to more deeply connect despite today’s challenges.

So much of what we do in our lives cannot exist without relationship. Business, art, sports, therapy, family…virtually every human activity involves some type of relationship. We are at our best when our relationships are healthy and strong. So today I am especially grateful for the healthy relationships in my life:

• I am grateful for the relationship I have with our Creator, who sustains me every day.
• I am grateful for my spouse who fills my life with love, laughter, and adventure.
• I am grateful for my family who encourage and teach me, each in a unique and special way.
• I am grateful for my colleagues and coworkers who help me hone and practice my craft.
• I am grateful for my client’s who honor me with the chance to witness to their amazing journeys of healing and resilience.
• I am grateful for my friends and neighbors who make me smile and bring joy to everyday life.

What relationships enrich your life? I invite you to join me and the rest of the social work profession in celebrating human relationships, enhancing positive relationships, and improving those that are strained.

Book Review: The 36 Hour Day

2 years ago · · 0 comments

Book Review: The 36 Hour Day

You know how they say children don’t come with an instruction manual?  The same this is true for diagnosis of Alzheimers or Dementia.  However, this book comes pretty close!

With the Baby Boomer generation officially entering the Senior Citizen category, many in younger generations are finding themselves navigating the murky waters of caregiving.  Understanding a diagnosis and disease progress is the first step, but the very nature of Alzheimer’s and Dementia is progressive, meaning caregivers are constantly in a state of monitoring and adjusting as changes occur.  “The 36 Hour Day” has been called by many “The Caregiver’s Bible” as it goes beyond understanding the disease and its progression and treatment.  It explores the impact the disease has on the family unit, strategies for caregiver respite and support, making difficult decisions (e.g. when Mom or Dad should no longer be driving), treatment options, and caregiver self-care

While  this book is fairly comprehensive and widely recognized a go-to resource for caregivers, I do not recommend reading this book cover-to-cover.  Especially for those who are new to caregiving, the multitude of topics and problems addressed in the book can be overwhelming or even a little scary.  I advise using this book more as a reference, using the sections that apply to you, your loved one, and your family at the time, to avoid catastrophizing or excessive worry.  Don’t get ahead of yourself!

This is an older copy. I highly recommend the more recent 6th edition.

There are many additions to this book since it’s original publication in 1981.  The book has grown and evolved over the years, as our knowledge of Alzheimer’s and Dementia has also grown and evolved.  I recommend the more recent editions for the most up-to-date information and resources.  The 6th Edition was published in 2017.  Below you can hear one of the authors, Dr. Peter Rabins talk about the latest edition.

I give this book an A.

It’s comprehensive, honest, and compassionate.  Be prepared that reading it may stir up some strong emotions, however you will come away from reading informed, equipped, and self-aware.

Mace, N. L., & Rabins, P. V. (2011). The 36-hour day: A family guide to caring for persons with alzheimer disease, related dementing illnesses, and memory loss in later life. Baltimore: Johns Hopkins University Press.


AA 101

2 years ago · · 0 comments

AA 101

Alcoholics Anonymous or “AA” is a common part of addiction recovery for many individuals who have struggled with Substance Use Disorders.  It is “an international fellowship of women and men who have a drinking problem.”  It was founded in 1935 by Bill Wilson and Bob Smith in Akron, Ohio and has spread globally since.  AA maintains a group identity that is “nonprofessional, self-supporting, multiracial, [and] apolitical”, and the only requirement for membership is a desire to stop drinking.

The book “Alcoholics Anonymous” (commonly referred to as the “Big Book”) was published in 1939, and the original text has been preserved in subsequent editions.   It outlines 12 steps for achieving and maintaining sobriety.  The 12 steps are

  1. We admitted we were powerless over alcohol – that our lives had become unmanageable.
  2. Came to believe that a Power created than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

In meetings, participants study the Big Book and the 12 Steps, share their stories (often called “giving a lead”), offer support and encouragement to one another, and build a community of individuals committed to sobriety.  Most active participants work with a sponsor to serves as a point person when support is needed, as well as a mentor in the recovery process.

There are many similar programs modeled after AA including Al-Anon (for family members of alcoholics), Overeaters Anonymous, Debtors Anonymous, Narcotics Anonymous, and others.  Additionally, there are other 12-step fellowships that are partially modeled off of AA including Celebrate Recovery.

Due to emphasis on confidentiality and anonymity as well as inaccurate depictions of 12-step groups in film and television, there are many misconceptions about AA.  At best these misconceptions simply misrepresent the fellowship.  At worst, they hinder those in recovery from accessing potentially beneficial support and healing.

Myth #1: I can’t go to AA because I don’t go to church.

Many people in recovery believe AA is not for them because they do not participate in organized religion, have left or been separated from their faith community, or feel uncomfortable in church.  The reality is that ANYONE who is interested in recovering from a substance use disorder can participate in AA, regardless of their spirituality.  It is actually Step 2 which emphasizes the belief in a Higher Power and Step 3 which encourages surrender to it.  While the Big Book uses the word “God”, this is not necessarily restricted to the Judeo-Christian God.  The text actually emphasizes the ides of God “as we understood Him”, which allows room for an individual and evolving relationship with a Higher Power.  Many AA meetings take place in church buildings, but membership to a particular religion is not required.

Myth #2: After I complete the 12 Steps, I’m done.

An expression commonly used by AA participants is, “I’m working the steps.”  Most people work on the 12 Steps with the help of a sponsor.  A common misconception is that once a person gets to Step 12, they graduate or finish AA.  In reality AA is intended to be an ongoing process.  Steps 10, 11, and 12 are actually more like maintenance steps.  Step 10 is intended as a method of ongoing self-checking, emphasizing self-accountablity and honesty.  Step 11 is the practice of continued seeking, growth, and relationship with the Higher Power.  Step 12 calls for service, sharing, and ongoing sober living.  Much like a car requires routine maintenance and care, a person in recovery (and I would argue, everyone) needs habits that encourage healthy self-awareness, an ongoing journey or personal growth, and a commitment to relationships and community.

Myth #3: All AA meetings are the same.

There are a variety of types of meetings, each with a different goal, feel, and dynamic.  Closed Meetings generally consist of a specific and limited group of people.  Open Meetings are just that – they are open for anyone to participate, including observers who are no struggling with a substance use disorder.  Speaker Meetings (sometimes called Gratitude Meetings) tend to feature a visiting member who shares the story of their experience with addiction and recovery.  Big Book Meetings center around a certain section of passage of the Big Book and group discussion.  12-Step Meetings typically focus on a specific step, and in larger meetings participants may even divide into smaller groups based on the specific step they are working.   There are even online meetings.  While AA meetings are generally inclusive, there are some meetings aimed at a certain demographic or population (gender, sexual orientation, profession, language).

As with any community of human beings, there is variance in dynamics and group culture among AA meetings.  Sometimes it takes a few tries before an individual finds a meeting where they feel “at home.”  Unfortunately, not all AA meetings are created equal.  There are some that remain very faithful to the original intents of the AA founders and others that stray from the tenants of the model.  Similarly, some groups naturally foster an atmosphere of mutual support, respect, and healing, while others can become distorted by unhealthy interpersonal dynamics or even toxically distorted interpretation of AA tenants.

Myth #4: AA is only for alcoholics.

Again AA is generally very inclusive.  Many indivuals in recovery have struggled with multiple substance, no just alcohol.  It is not uncommon for a participant in a meeting to identify as “an alcoholic and an addict.”  AA and its related groups can be very helpful to individuals who struggle with a variety of addictive behaviors (e.g. overeating, gambling, sex, illicit drugs).  Open meetings, again, welcome nonalcoholic observers, and meetings like Al Anon, Alateen, and Adult Children of Alcoholics cater to friends and family members of people with substance use disorders.

Myth #5:  AA is treatment.

AA and treatment are two different things.  AA is more accurately understood as a “spiritual program of action.”  It is the adoption of and practice of keep beliefs, behaviors, values, and traditions in the context of a community.  AA is peer-led and self-supporting.  Treatment on the other hand is facilitated by trained professionals in clinical settings with a prescribed set of interventions (e.g. medical detoxification, partial hospitalization and intensive outpatient programs, and psychotherapy).  Treatment can be finite, whereas AA in its truest form is an ongoing process.  AA and formal treatment can work beautifully together, along with other community and interpersonal supports, to help a personal on the path of healthy and whole hearted living.

If you’re interested in learning more about AA, consider starting with the main website at  There you can locate meetings near you, access the Big Book and other AA related literature, read daily reflections, make contributions, find other ways to get involved.

Alcoholics Anonymous: The story of how more than one hundred men have recovered from alcoholism (4th ed.). (2001). New York City, NY: Alcoholics Anonymous World Services.

Marich, J. (2012). Trauma and the twelve steps: A complete guide to enhancing recovery. Warren, OH: Cornersburg Media.


Narcan Basics

2 years ago · · 0 comments

Narcan Basics

Substance Use Disorders and overdose deaths have reached frighteningly high rates in recent years and are sky rocketing in the Dayton and Cincinnati regions.  Opioids are one of the more frequently used and abused drugs in the country, to such a degree that in October 2017 the President declared the opioid overdose problem a Public Health Emergency.

What is an opioid?

There are three types of opioids: natural opioids (also called opiates), semi-synthetic opioids, and synthetic opioids.  Natural opioids are derived from the opium poppy plant and are commonly prescribed by physicians for pain relief.  These include medications like morphine and codeine. Semi-synthetic opioids are natural opioids that have chemically been altered or modified, and they are sometimes combined with other medications.  For example, the pain killer Percocet is a combination of the semi-synthetic opioid Oxycodone combined with Acetaminophen (the same thing as Tylenol).  Other examples of semi-synthetic opioids include Roxicet, hydrocodone, oxycodone, and hydromorphone.  Heroin is also a semi-synthetic opioid.  Synthetic opioids are known to have opiate-like effects (meaning they mimic the effects of drugs like morphine or codeine).  They provide pain relief and sedation but with significant risks as they are more potent.  Examples of synthetic opioids include fentanyl, carfentanil, and acetyl-fentanyl.

As all types of opioids can be abused, but the drug traffickers are increasingly cutting heroin with cheaper and stronger synthetics like fentanyl – a highly dangerous combination contributing to recent spikes in overdoses.

An important thing to consider: Not all overdoses result from intentional drug abuse.  Many people are prescribed pain killers after an injury or surgery, and many work with a physician who specializes in management of chronic pain.  It is not impossible for an individual to accidentally overdose by confusing when or which medications they have or have not taken.  This risk is especially a concern for older adults who tend to take more medications.  Monitor your loved ones closely, especially those who can sometimes struggle with confusion or forgetfulness.  The danger is present, regardless of the reason the individual ingested the drug.

What is Narcan?

Narcan is a brand name for the drug naloxone hydrochloride.  Another common brand of the same medication is Evizio.  This drug is used to temporarily the dangerous effects of overdose.  It helps the individual begin breathing again and restore consciousness.  Many refer to Narcan as “the antidote for overdose.”

Narcan is typically administered by injection or by nasal spray.

The side effects of Narcan are very rare, and the potential benefit of the drug typically trumps the risk of side effects, as individuals who have overdosed on opioids typically die without intervention.  Some of the potential (though again rare) side effects include unconsciousness and withdrawal symptoms (e.g. body aches, irritability, diarrhea/vomiting).  Life with a small likelihood of temporary discomfort far outweighs a high likelihood of death.

Obtaining Narcan

Narcan can be purchased in most pharmacies, and in most states you can purchase Narcan without a prescription.  A 2015 Ohio law allows pharmacies to fill Narcan on a standing order from a physician, allowing the individuals to obtain it without a written prescription from their doctor.

Many non-profit and public agencies also make Narcan readily available.  For example, I obtained a Narcan kit for free from the Hamilton Co. Board of Health.  It is common for people to prefer the nasal pray delivery to the injected form of naloxone, as the nasal spray is easy to administer and doesn’t pose the challenge of working with a syringe.

Most trainings recommend having at least two doses available, as some individuals require more than one dose to halt deadly overdose reactions.  Generally speaking, Narcan can be stored at room temperature, however following the manufacturer’s instructions on your specific kit is advised.  Narcan does expire, in that it loses its potency, so keep track of the expiration date and replace as needed.

If administering Narcan, always always ALWAYS call 911 first!

Related Resources

  • The CDC offers a plethora of helpful resources and information of the addiction crisis in America.  They have an especially good fact sheet available on prevention of death by overdose.
  • The Ohio Department of Health has a wonderful program called Project DAWN (Deaths Avoided With Naloxone), which is a community-based effort focusing on overdose education, distribution of and training on naloxone.
  • Here is a helpful training video that gives a brief overview on administering the Narcan nasal spray:



Book Review: Braving the Wilderness

2 years ago · · 0 comments

Book Review: Braving the Wilderness

Clients frequently ask me for recommendations of books they can read to supplement or augment the work they are doing in therapy.  This is a book that I have recommended NUMEROUS times.  It’s one that has been especially helpful to me as a therapist, as a woman, as a Christian, and as an American.

Through this bold and poignant exploration of human connection in the context of contemporary society, New York Times best selling author, Brené Brown shows us methods to live our lives courageously and foster healthy connections.  

Brown asserts that society is currently facing a crisis of disconnection, and she presents specific strategies or “practices” (four to be precise) that challenge the status quo of disconnection and inauthenticity.  She defines true belonging not as fitting in but as “the spiritual practice of believing in and belonging to yourself so deeply that you can share your most authentic self with the world and find sacredness alone in the wilderness.  True belonging doesn’t require you to change who you are; it requires you to be who you are.”  This means sometimes going on your own, even in the face of criticism or rejection.  It means sometimes we must stand firm in our values, beliefs, principles, and choices even if it means solitude and vulnerability.  Through research and stories, Brown, illustrates concepts in ways that challenge but do so with humor, honesty, and even some irreverence.

I personally found this book helpful in light of the present social climate in the United States,  beset by tensions created by so many racial, religious, and political divisions.  Brown writes, “…in a culture that’s rife with perfectionism and pleasing, and with the erosion of civility, it’s easy to stay quiet, hide in our ideological bunkers, or fit in rather than show up as our true selves and brave the wilderness of uncertainty and criticism. But true belonging is not something we negotiate or accomplish with others; it’s a daily practice that demands integrity and authenticity. It’s a personal commitment that we carry in our hearts.”  She challenges us to resist the tendency to “sort” one another (and ourselves) into groups, which can lead to silencing, extremism, and confirmation bias.  In other words, it’s unfair and unhelpful to pigeon hole others and ourselves with limiting labels.  Sorting stops us from being true to ourselves and it fosters loneliness.

Through courage, vulnerability, honesty, civility, connection, and compassion we can live out the paradoxical way to freedom so wisely stated by Dr. Maya Angelou, and quoted by Brown:

“You are only free when you realize you belong no place – you belong every place – no place at all.  The price is high.  The reward is great.”  

I give this book an A.

The main reason I didn’t give this book an A+ is that there is some repetition of concepts from some of her previous books – which I loved, by the way! – I just wish there had been a little more “new material.”  There are however many shining moments of truth in this book that had me exclaiming out loud in my car (as I listened to the audiobook), “Right on, Brené!”

Brown, B. (2017). Braving the Wilderness: The Quest for True Belonging and the Courage to Stand Alone. New York, NY: Random House.

Happy Social Work Month!

2 years ago · · Comments Off on Happy Social Work Month!

Happy Social Work Month!

Social Work Month is in March and this year’s theme is ELEVATE SOCIAL WORK. Each day, nearly 700,000 social workers nationwide work to elevate and empower others, giving them the ability to solve life’s problems, cope with personal roadblocks, and get the services they need.

For generations, social workers have worked tirelessly to improve our wider society and make our nation a better place to live.  These social workers include Labor Secretary Frances Perkins, who pushed for a minimum wage and Social Security; Nobel Peace Prize winner Jane Addams, who is considered the mother of social work; Civil Rights leaders Dorothy Height and Whitney Young Jr.; and Ambassador Wendy Sherman, who helped broker the Iran Nuclear Agreement.

You may not realize it, but social workers are everywhere. For example, they work in hospitals and mental health facilities and clinics, helping place people on the path to recovery from sickness and mental illness. They support our brave military personnel, veterans, and their families. They are in schools, helping students overcome issues that prevent them from getting a good education, and they protect children who have been abused or neglected. They also help children find new families through adoption.

According to the Bureau of Labor Statistics, social work is one of the fastest-growing professions in the United States, with 100,000 more social workers expected to enter the profession in just seven years.  Still, this year’s theme – Elevate Social Workers – is not just about discussing the success of the social work profession. Despite the life-affirming, invaluable work that social workers perform, their salaries tend to lag behind that of other helping professions such as nurses, teachers, and policeman.

Social workers are needed now more than ever as the nation grapples with serious issues such as preventing violence and abuse, preventing suicide, ensuring access to good health care, as well as addressing the growing opioid addiction crisis now gripping the nation.

During Social Work Month, I urge you to learn more about the social work profession and how you can help members of this great vocation continue to make this nation better and get the compensation they need to do the amazing work they do.  You can learn more about the profession from the National Association of Social Workers.