Author Archives: Phil Boissiere

ADD, ADHD, or AD/HD, Which is it and Why So Many Names?

Posted on by Phil Boissiere
27 Apr

When looking for information related to Adult ADHD, one will quickly find considerable information using terms such as ADD, ADHD, or even AD/HD. This creates a lot of confusion about the correct terminology and name of the disorder. The correct name is Attention Deficit Hyperactivity Disorder (ADHD). There are three subtypes of ADHD, primarily inattentive type, primarily hyperactive type, or combined type. Even using the term “Adult ADHD” is a bit misleading as it is not an actual disorder name, but more of a casual classification to highlight adults with the disorder.

One reason that there is so much use of incorrect terms like “ADD” by prominent people, is that the disorder is actually poorly named to begin with. Anyone dealing with ADHD as an adult or a child will tell you that it is much more than having trouble focusing. The core neurological issue behind ADHD is an under functioning of the Prefrontal Cortex, mainly an underproduction of the neurotransmitter Dopamine. This leads to trouble with stimulus selection (i.e. focusing one’s attention) and/or trouble selecting responses to stimuli (i.e. behaviors). When someone’s Prefrontal Cortex is functioning properly they are able to create a very important “pause” that allows them to have a choice in what to focus on and how to respond. Further compounding these issues are the social and psychological stressors that accompany repeated failures to perform. These stressors (i.e. problems with friends/family, occupational struggles, etc.) lead to engrained emotional responses and thought patterns that foster shame, guilt, and lack of confidence. When anyone (with ADHD or not) is feeling shameful and lacking self confidence, they are less apt to perform well in social and occupational settings.

If we are going to move the field of treating adults with ADHD forward, we may want to think about broadening the scope of the name of the disorder. Something that incorporates terms like executive functioning, stimulus selection, motivation, or performance, may help. However, we are very far away from the DSM team coming up with a fresh new name for this disorder. Until then, we must expect/demand that leaders in the field use the correct terminology. For example, Daniel Amen’s new product is called Healing ADD at Home in 30 Days. There are a multitude of problems with this title, from the fact that he uses the term ADD to making a claim that it can be “healed” in 30 days. ADHD is life long disorder that when treated appropriately can be managed tremendously well. However, saying things like “healed” can create false expectations that ultimately lead to unattainable goals.

There are no examples of someone telling a diabetic that they have a “sugar problem” and that they can “get over it” in a few weeks. Adults and children with ADHD deserve the same level of respect when talking about their disorder.

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Phil Boissiere, MFT specializes in the treatment of ADHD in adults and couples in San Francisco, Menlo Park, and the Silicon Valley. He is available for interviews and article contributions on the topics of Cognitive Behavioral Therapy, Adult ADHD, Group Psychotherapy, or Teen Drug Prevention.

Overview of CBT for Adult ADHD

Posted on by Phil Boissiere
15 Apr

Cognitive Behavioral Therapy approaches for the treatment of Adult ADHD are designed to help people overcome deficits in executive functioning. Executive functions are critical for effective time management, organization, and planning. CBT also improves stress management, emotional regulation, and impulse control.

CBT has been established as an effective treatment for adults with ADHD who suffer from co-existing anxiety and depressive disorders. A major national study showed that 51% of adults with ADHD suffer from anxiety and 32% suffer from depression. This means treatments that incorporate CBT for anxiety and depression may be helpful to many adults with ADHD, even though they are not designed specifically to address the symptoms and impairment associated with ADHD. However, the skills training associated with specific CBT programs for ADHD adults, tend to show the greatest results.

Treatments that address executive dysfunctions aid adults in developing more adaptive thought patterns about how to go about planning, organizing, and gain more effective skills. For example an adaptive technique that utilizes CBT is to break down long or unpleasant tasks into manageable parts, while utilizing positive visualization. Positive cognitions(thoughts) and positive behaviors tend to reinforce one another. In other words, as a person becomes better at managing time, they also come to have more positive beliefs and thoughts about themselves. This pattern acts like a generator of positive/adaptive thinking and effective skill development.

Group Therapy for Adult ADHD

Posted on by Phil Boissiere
23 Jan

Group Therapy for Adult ADHD has been shown to be very effective. It is fairly easy to find a support group for Adult ADHD in San Francisco, Menlo Park, and the Silicon Valley at large. However, it is nearly impossible to find goal oriented Cognitive Behavioral Therapy and Skills Training groups for Adult ADHD.  Due to the demand and level of efficacy associated with CBT group therapy for Adult ADHD, I have decided to launch a new group.

Mary V. Solanto of Mount Sinai is a well know expert in the field of ADHD who has conducted research on the results associated with CBT and Skills Training groups for Adult ADHD. Her work yielded very promising results. She found that when people come regularly and put adequate effort into their group therapy, they can obtain improvement that is far superior to standard support groups (Reference: Solanto et al. American Journal of Psychiatry., 167 (2010) 958-968.).

The support of peers and the accountability of meeting weekly can really jump start someone’s treatment for Adult ADHD. I hope my new group that follows Mary V. Solanto’s work and treatment recommendations from experts such as Ned Hallowell, MD of Harvard Medical School and Russell Barkley, PhD. of CHADD, will provide adults in San Francisco, Menlo Park and the surrounding areas with positive results.

For more information, please visit the dedicated page for the group here.

Please use the form below to receive more information or explore signing up.

[contact-form-7 id=”3925″ title=”Contact form 1″]

 

Adult ADHD Relationships

Posted on by Phil Boissiere
03 Dec

There is considerable information out there about adult ADHD relationships. Unfortunately, the bulk of this information focuses on the negative effects adult ADHD has on relationships. I think it is of equal importance to give some attention to how adult ADHD can actually prevent the person with ADHD from being empowered in their relationship. This lack of empowerment can limit one’s ability to change or even get out of a bad relationship.

I see this often with clients who “come out of the ADHD fog” as I have named it. When adults are too distracted, forgetful, or struggling to maintain work or school performance, they often don’t have the psychological resources to address their romantic relationships. Something that also makes this problem worse, is that most adults with ADHD have considerable shame and self-doubt, which leads them to believe that any relationship struggles they face, are their own fault. It is true that adult ADHD can wreak havoc on relationships. However, this does not give clemency to the non-ADHD partner, nor does it mean that issues unrelated to adult ADHD also plague some relationships.

It is an honor to accompany my clients on their journey towards change. We all deserve healthy, symbiotic, and supportive relationships. Those people challenged by adult ADHD need to know and believe that also, so they may advocate for themselves and shape their lives in a positive way. There are many people walking around San Francisco that I have worked with around adult ADHD relationships through Cognitive Behavioral Therapy (CBT), skills training, and relationship work. To know that there are people who are out of the fog and living life to it’s fullest, and know that I touched their lives, gives me a great big smile inside.

Couples Counseling San Francisco

Posted on by Phil Boissiere
20 Nov

San Francisco and the surrounding areas (Silicon Valley, Berkeley, Menlo Park, Palo Alto etc.) are full of psychotherapists providing couples counseling. Unfortunately, there seems to be a large amount of therapists treating couples without adequate direction and focus on goals. It is very common for a couple to come to me with the same complaints about previous therapy. Often the husband or boyfriend feels “ganged up on” or the couple feels that they paid weekly to fight in-front of someone and were sent home without anything to try or practice.

I work diligently with couples of all combinations to quickly identify the reasons that have brought them to my office, their individual goals, and their shared goals. I believe it is paramount to have clear goals in couples therapy in order for it to be effective. Couples in San Francisco and the Silicon Valley are often pressed for time and want to feel that they are being provided with tools and skills to improve their relationship on a weekly basis. My entire practice, whether working with individuals or couples in therapy is focused on using research based and targeted treatments, such as Cognitive Behavioral Therapy (CBT).

In my work with couples in counseling, I bring in elements of the Gottman Method, Relational Life Therapy, and Emotionally Focused Therapy (EFT) in a way that is specific to the couple. No two couples are the same and every couple deserves individualized treatment.

If my approach sounds like a good fit you and your partner, give me a call so we can explore working together.

Contact Phil here.

CBT and Adult ADHD

Posted on by Phil Boissiere
18 Nov

There are a multitude of treatment approaches for adult ADHD. However, research has shown that a combination of Cognitive Behavioral Therapy (CBT) and Skills Training is most effective in the treatment of adult ADHD. It is important to note that ADHD is caused by an under stimulated portion of the brain, that in-turn leads to an underproduction of Dopamine. In order to adequately address this under stimulation, most adults with ADHD will need to explore medication with a trained psychiatrist.

When stimulant medication, CBT, and Skills Training are combined to address adult Attention Deficit Hyperactivity Disorder, people tend to have the best results. San Francisco and the Silicon Valley at large (Menlo Park, Palo Alto, Cupertino, Sunnyvale etc.) are full of people trying to reach optimal productivity and success. Unfortunately, the majority of psychologists, psychotherapists, and even medical doctors do not have this same dedication to productivity and results. In fact most do not adhere to effective treatments, backed by research when treating ADHD in adults. This can lead to tremendous frustration as life seems to continue to pass people by while in treatment.

I partner with only a handful of psychiatrists who have the knowledge, experience, and careful approach needed to work with ADHD. When a psychotherapist partners closely with a patients doctor, the results tend to be achieved more quickly and tend to last.

I welcome your questions and about adult ADHD and if I cannot meet with you due to scheduling etc., I will work to help you find an ADHD specialist in the San Francisco Bay Area to meet your needs.

Psychotherapy, Coaching, and the Silicon Valley

Posted on by Phil Boissiere
26 Aug

The second tech boom is in full swing in the Silicon Valley. The seeming limitless opportunity for professionals and executives in the Bay Area is leading people to explore all options available to increase their performance and personal growth. Many people turn to coaching, business coaching, or executive coaching with positive results. Unfortunately, many people are missing the tremendous importance of addressing the cognitive factors (thoughts) that can be best addressed with a psychotherapist or psychologist. I’m not saying that all mental health professionals are equipped to work with professional and career issues. What I am saying is that it can be done and I have had great success working with professionals.

Quite often people from executives to support staff find themselves feeling miserable about their work environment or the career choices they have made. The majority of times these feelings can be greatly shifted via Cognitive Behavioral Therapy and therapeutic coaching.

For example, many people find themselves stuck in a position they are not happy with and cannot muster the strength to find a new job due to negative thoughts, “No one will hire me.” or “There are no good jobs out there.” Additionally, many will be in a working environment that they dread, because of a co-worker or boss.

The effect that both of these situations has is poor career advancement and lack of personal growth. Now, we can’t change the angry boss or bizarre co-worker, but we can change the way these people affect our thoughts, feelings and behaviors. Also, thoughts and feelings can be the very factors keeping someone stuck in a job they hate.

I am a business professional and accomplished psychotherapist who specializes in working with business professionals and executives in the Silicon Valley in a very matter of fact and goal oriented way. I believe therapy can and should be an empowering process that moves people forward to reach their full potential.

 

Chicago Presentations June 2013

Posted on by Phil Boissiere
14 May

I will be doing two presentations this June in Chicago, please see the information below. Hope to see you there!

Phil Boissiere, MFT will be presenting at both The Family Institute at Northwestern University and the American Family Therapy Academy-Annual Conference on June 7th in downtown Chicago.

The Family Insitute at Northwestern University June 7th at 4pm:

Group therapy is one of the most valuable and effective treatment modalities for youth. Often agencies and programs will utilize either mental health graduate trainees or registered interns to provide these groups. The upside to this practice is cost savings for the agency and the benefit of collecting hours and gaining experience for the clinician. Unfortunately, most new clinicians and students have had little or no training in working with youth populations in a group setting. Further compounding this issue is that fact that groups are often comprised of youth with behavioral issues or other difficult psychopathology, which can make management of the group very intimidating and difficult. 

In this training Phil Boissiere, MFT uses his experience running groups with youth to teach new clinicians how to operate successful groups and build the needed confidence to be a successful group facilitator. Come ready to gain skills, ask questions, and participate in experiential learning.

Attendees of this training you will learn why it is important to do group therapy with youth, understand how to manage your own expectations around groups, capitalize on your strengths, and hold the frame of the group.  In the training we will also discuss who should be in the group, what type of group to have, what activities to have during the group, a basic structure, how to manage behavior in the group, and how to address barriers of working with difficult youth in groups.

American Family Therapy Academy-Annual Conference June 7th at 12:15pm:

Phil Boissiere, MFT will discuss what family therapists need to know in order to work with families during the elementary school years to aid in the prevention of drug and alcohol abuse during adolescence. His early intervention approach will help clinicians understand why the lure of drugs are so strong, how to understand the risk factors of children and families in their practice, and gain a reality based proactive model of prevention. He will also be discussing how cultural factors and social inequities increase the risk in many populations. His model of prevention has gained international attention and has been well received by many audiences.

For more information on either of these presentations, please contact Phil Boissiere, MFT directly here.

Tips for Achieving Your New Year’s Resolutions

Posted on by Phil Boissiere
03 Jan

New Year’s resolutions are often made with the best intentions, but with little to no attention to the factors that will lead to the greatest success (i.e. change a behavior, start going to therapy, be more healthy, etc.). In fact, the statistics about people actually keeping their resolutions are not very good. However, there is hope! By following a few techniques you can greatly increase the success of your New Year’s resolutions.

Be Realistic: Setting a goal that is too massive will surely fail. For example, many people set New Year’s resolutions that they are going to change their career, or “become healthy”, or stop fighting with their partner for family. The problem with creating resolutions in this way is that they can feel overwhelming. What does it mean to “become healthy”? A full over haul of your lifestyle is tough. Start with something more manageable, “I am going to walk more, make more of an effort to stay connected with people I care about, and explore finding a healthy outlet for stress.”

Set Objectives: Be very clear about how you will measure your progress, while allowing for some wiggle room. Remember, you are a human, not a robot. Decide what a reasonable amount of success towards your New Year’s resolution is. Then write down the steps you need to take to achieve your goal. An important rule of thumb: if you break down a project or resolution into steps and still have trouble getting started, then the first step is still too big.

Use Positive Visualization: People often tend to think of the dread of starting a project or goal, “I hate the gym.” or “I’ll never be more organized, my place is a mess!” Instead of being confronted with these negative thoughts, think about the how you will feel and how your life will be different if you meet your goal, “If I make it to the gym today I will sleep better, feel better, and get out of the house.”

Don’t Let Setbacks Stop You: There are always going to be hiccups and hassles that can impede your progress from day to day. It is totally normal for this to happen. However, when it does, get out a piece of paper and write down one small thing you can do to get started again working towards your New Year’s Resolution. The old adage of “The hardest part is getting started.” can be very true. Get started and don’t give up when you miss a step towards your goal.

I often get many calls from people this time of year wanting to start therapy or find ways to be more successful in their career or personal life.  I work with all of my client’s to identify manageable goals, capitalize on their strengths and make the most of their life and relationships, through the use of Cognitive Behavioral Therapy, Positive Psychology, and other goal oriented techniques.

I welcome your calls and emails and hope to help you reach your full potential in 2013.

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Phil Boissiere, MFT provides goal oriented Cognitive Behavioral Therapy in San Francisco and Menlo Park.

Positive Psychology for Success

Posted on by Phil Boissiere
13 Dec

All to often people shy away from seeking therapy due to misconceptions about what therapy is. This is in large part due to psychodynamic (Freudian etc.) approaches that do a fair amount of “digging” around in peoples childhood experiences. Unfortunately, this leads to people not receiving the support they need, which in turn increases or leads to dysfunction and dissatisfaction with life. Fortunately, modern approaches to psychotherapy and counseling, such as Cognitive Behavioral Therapy, focus on helping people reach their goals and capitalize on their strengths.

In recent years the field of Positive Psychology has come to fruition and has been shown to have a profound effect on furthering an individuals occupational, social, academic, creative, and intellectual goals. Positive psychology is a rich empirical basis for health, work, quality of life, and leadership coaching. 

So, what is Positive Psychology exactly? Very simply put, it is the exploration of processes and circumstances that lead to optimal performance, life satisfaction, and health.

Unlike psychological theories from the past, which tend to focus on “what is wrong”, Positive Psychology focuses on human strengths and healthy positive experiences to improve the lives of people.

I utilize the principals and applications of Positive Psychology to help business professionals, artists, authors, and tech leaders advance their careers, personal growth, and success. I have had great success combining Cognitive Behavioral Therapy and Positive Psychology with coaching in San Francisco, Palo Alto, Menlo Park, and the greater Silicon Valley. A common statement from my clients is “I didn’t know therapy could be this way!” or “This is so empowering.”