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Ross Rosenberg, M.Ed. LCPC CADC M.Ed, LCPC, CADC
Ross Rosenberg, M.Ed. LCPC CADC Quick Facts
Main Areas: Addictions, Sex (sexual) Addictions, Co-addictions, Codependency, ADD / ADHD (Attention Deficit Disorder), Trauma, Sexual Abuse, Abuse Recover, 12-Step workBest Sellers: Human Magnet Syndrome: Why We Love People Who Hurt US
Career Focus: Counselor, Psychotherapist, Business Owner, Speaker, Writer
Affiliation: Clinical Care Consultants, P.C. Arlington Heights / Buffalo Grove IL
Ross A. Rosenberg, M.Ed., LCPC, CADC, is an expert in the field of dysfunctional relationships, codependency and sex, love and Internet addictions, for which he provides comprehensive psychotherapy, training and consultation services. Since 1988, Ross has been a counselor / psychotherapist, counselingpractice owner, professional trainer, consultant, certified addiction specialist and author. Ross's clinical expertise spans the areas of codependency, sex love addiction and internet addictions, dysfunctional or problematic relationships, narcissism and borderline personality disorders. Ross has also specializes in hard to reach adolescents and their families. Ross owns Clinical Care Consultants, a full-service counseling agency located in the Northern Illinois - Arlington Heights and Buffalo Grove areas.
Ross's first book, "The Human Magnet Syndrome: Why We Love People Who Hurt Us." draws on his 25 years of experience in the mental health, social service and/or child welfare fields. He also is a leading nationalseminar speaker and expert psychotherapist. By the end of 2013, Ross will have presented his current seminar, "Emotional Manipulators & Codependents: Understanding the Attraction" in 27 states. Ross is currently writing his follow up book which will focus on helping codependents who are in a relationship with emotional manipulators.
Over the span of his career, Ross has counseled individuals who struggle with substance abuse, addictions, and co-addictions / codependency. His addiction work includes chemical addictions (drugs/alcohol) and process or behavior addictions (sexual, Internet, gambling, and spending). His addiction services include counseling of all types, assessments, clinical supervision / professional consultation and training. He is considered an expert in the field of sex and Internet addictions, for which he provides comprehensive counseling services, trainings, and consultation.
Ross is well known in the local community for his work with hard-to-reach and oppositional adolescents. Typical issues with his adolescent clients include Attention Deficit Hyperactive Disorder (ADD / ADHD), drugs/alcohol, school challenges, anger control, eating disorders, self-mutilation, communication problems, and family struggles. His work with teens also includes a family/parent focus, whether it is coaching, counseling / psychotherapy, or support.
Ross's work spans problem type, culture, ethnicity, gender, socio economic status, and sexual orientation. Some areas that he specializes in include Marriage/Marital Counseling, Addictions, Codependency / Co-Addictions, Depression, Anxiety, ADD (Attention Deficit Disorder), Challenging Teens, Grief and Bereavement, Trauma Survivors (PTSD), Marital and Family Conflict, and LGBTQ issues.
Ross's counseling / psychotherapy work with Codependency has enabled his clients to achieve balance, mutuality, and feelings of respect and appreciation in their lives. Balancing the care of others with the equally important ability to care for oneself is the cornerstone of codependency counseling / psychotherapy. Hiscodependency services include individual, family, couples and/or marital therapies.
Ross's work with adult survivors of trauma and abuse enables his clients to break free from lifelong self-destructive patterns. His healing approach addresses "original wounds" (trauma of the past) which, without resolution, perpetuate emotional pain, suffering, and unsatisfying and dysfunctional relationships. This type of trauma counseling / psychotherapy promotes positive / healthy relationships, a heightened sense of well-being, and feelings of safety, control and happiness.
Another service provided is counseling and coaching for clients with ADD/ADHD. Ross provides assessment, diagnostic and a full range of ADD/ADHD psychotherapeutic services. His collaboration with family members, physicians, school, and employment personnel creates a greater opportunity for success in the treatment of this disorder. Other ADD/ADHD services include coaching, which addresses the following challenges unique to this disorder: communication, organization and follow-through, relationship and family challenges, work demands, and school demands.
Grief, loss, and death and dying are difficult issues that Ross helps his clients work through. Whether it is the loss of a loved one, job, lifestyle, or one's health, vitality and even life, he guides his clients through difficult and often heart-wrenching times. Embracing diversity / cultural competence is a cornerstone of his practice.
Ross's counseling / psychotherapy services enable his clients to achieve balance, inner peace and feelings of personal efficacy. He believes that, "within a warm and respectful therapeutic relationship lies the power to overcome seemingly overwhelming obstacles."
Ross's counseling / psychotherapy style has been described as supportive, solution focused, analytical, and educational, while also being warm, intuitive, healing, spiritual, and compassionate. His spirituality and metaphysical understanding enables him to reach people with diverse religious and spiritual beliefs. Ross believes that "for every problem, there is a solution; and within the safety of a trusting and respectful therapeutic relationship lies the power to overcome the most seemingly overwhelming obstacles."
Seeking an oasis of freedom and hope?Ross Can Help
"If hope and happiness always seem a tomorrow away,
If too many days end in sadness and a lack of fulfillment,
If your heart and your mind speak different languages,
If love of self and others seems to be beyond your grasp,
If you live in a desert of sadness and loneliness,
but seek an oasis of freedom and hope, I can help."
-- Ross Rosenberg
See what some of Ross's clients have to say about their experiences working with him... TESTIMONIALS
Clinical Care Consultants
Counselors Who Care
3325 N Arlington Heights Rd., Ste 400 B
Arlington Heights, IL 60004
Serving Arlington Heights and Buffalo Grove
Chicago's North and Northwest Suburbs
Favorite Quotes & Thoughts from Ross Rosenberg, M.Ed. LCPC CADC
Signs of Sexual Addiction (Based upon Patrick Carnes work)
1. Loss of Control
• Out of control sexual behavior predominates
• The addict cannot control the extent, duration and regularity of his/her
sexual behavior
• Behavior excesses continue despite clear signs of danger (consequences)
-- Compulsive masturbation
-- Compulsive pornography use
-- Chronic affairs
-- Exhibitionism: intrusive "flaunting/showing"
-- Dangerous sexual practices, i.e., asphyxiation
-- Prostitution
-- Anonymous sex (at porn shops, bars, etc.)
-- Voyeurism: intrusive "watching"
2. Continuation Despite Consequences
• Social Consequences
-- Loss of marriage/primary relationship, friendships and social networks
-- Problematic relationships with spouse, family and/or significant others
• Emotional Consequences
-- Depression, anxiety, fear, etc.
-- Suicidal thoughts, plans and/or attempts (70% have thought about it)
• Physical Consequences
-- Injury due to frequency and type of behaviors
-- Sexually-transmitted diseases
-- Unwanted pregnancies or abortions
-- Sleep disturbances
• Legal Consequences
-- Arrests for sexual crimes (voyeurism, lewd conduct, etc.),
-- Loss of job, licensure, and/or professional status
-- Sexual harassment charges
-- Fines, legal fees, probation, or incarceration
-- Being on the Sexual Offender Database
• Financial Consequences
-- Costs of pornography, prostitutes, and phone sex can cause financial hardships
-- Loss of productivity, creativity and/or employment
-- Loss of career opportunities
-- Bankruptcy
3. Efforts to Stop
• Repeated specific attempts to the behavior, which fail
• Even after multiple life changing consequences, the sex addict cannot stop
-- Leads to further frustration, anger, shame and depression (fueling further
episodes of addictive behavior)
4. Loss of Time
• Significant amounts of time lost doing and/or recovering from the behavior
5. Inability to Fulfill Obligations
• The behavior interferes with work, school, family, and friends
• High-risk behavior is continued despite responsibilities and expectations
• A pattern of broken promises and failures
6. Ongoing Desire or Effort to Limit Sexual Behavior
• Repeated but futile attempts to change, limit or stop addictive behavior
• Breaking promises to change, limit or stop behavior
• Cross Addictions: substituting or transferring another addiction to help stop
or control the sexual cravings
-- Workaholism
-- Overeating
-- Alcohol abuse
-- Illegal and prescribed drug abuse
-- Compulsive gambling
-- Religious Addiction
-- Romance addiction
7. Preoccupation (Obsession about or because of behavior)
• Sexual obsession and fantasy as a primary coping strategy
• Elevated levels of arousal are used to cover up feelings
• Sex becomes a primary drug to numb, "medicate" and/or regulate emotions
• Sex is used to block out painful and unpleasant memories
• Euphoric Recall or "Sex in the head" maintains the fix whenever needed
-- Secretive mental images of past sexual acting out, which is used to sexually
act out again
-- Its like having a personal collection of pornography to be used at any time
8. Escalation
• Amounts of behavior increase because the current levels no longer satiate
cravings
-- Higher "dosages" are needed to get the same feeling/excitement.
-- Can cause self injury
• Masturbation to the point of injury
• Asphyxiation
-- Increased levels create victims
9. Severe mood changes around sexual activity
• Depression, anxiety, anger, and other mood/affective states can result from
repeated failures to stop or control the addictive behavior
• 70% described chronic feelings of depression
-- Other chronic mood or affective states include:
• Anxiety
• Guilt and shame
• Anger at self and others
• Hopelessness and despair (monitor suicidal ideations)
-- Mood changes may be "medicated" (hidden) through the use of other drugs or m
medications
10. Compulsive Behavior
• Sexual behavior that you want to stop but you can't
• A pattern of out of control behavior over time
• Sex becomes the organizing principal of daily life
• Everything revolves around it
-- On sexual obsessions and fantasizing
-- On planning next event
-- On sexual acting out (some spend 8 hours a night on the internet)
-- On covering up or making up for lost time
-- Addressing consequences of sexual behavior
11. Losses
• Losing, limiting, or sacrificing valued parts of life
-- Hobbies, family relationships, and work
-- Loss of important personal, social, occupational or recreational activities
-- Loss of friends and family (loss of relationships)
-- Loss of long-term relationships
-- Loss of talents, goals, and personal and professional aspirations
12. Withdrawal
• Stopping behavior causes considerable distress, anxiety, irritability, or
physical discomfort.
• Usually lasts for about 14 days, but can be as long as 10 weeks
-- Insomnia
-- Headaches and/or body aches
-- High or low sexual arousal and/or genital sensitivity
-- Increased appetite for food
-- Chills, sweats, shakes and/or nausea
-- Rapid heartbeat and/or shortness of breath
-- Intrusive dreams
-- High level of anxiety and irritability
-- Emotional lability (roller coaster feelings)
• Some sex addicts with a chemical dependency report that withdrawals are worse
for sex addiction than for drug/alcohol addictions
THE DANCE (CODEPENDENCY)
The "dance" of codependency requires two people: the pleaser/fixer and the taker/controller. This inherently dysfunctional dance can only happen with one partner who is a codependent and another partner who is a narcissist (abuser or addict). Codependents do not know how to emotionally disconnect or avoid significant relationships with individuals who are selfish, controlling, and harmful to them. They find partners who are experienced with their dance style: a dance that begins as thrilling and exciting, but ends up rife with drama, conflict, and feelings of being trapped.
When a codependent and narcissist come together in a relationship, their "dance," unfolds flawlessly: the narcissistic partner maintains the lead and the codependent follows. Because the codependentgives up their power, the dance is perfectly coordinated: no one gets their toes stepped on.
Typically, codependents give of themselves much more than their partners give to them. As a "generous" but bitter partner, they seem to be stuck on the dance floor, always waiting for "next song," at which time their partner will finally understand their needs. The codependent confuses care-taking and sacrifice with love and responsibility. Although they are proud of their self-described strength, unselfishness, and endless compassion, they end up feeling deflated, empty, and yearning to be loved, but angry that they are not. They are essentially stuck in a pattern of giving and sacrificing, without the potential of receiving the same from their partner. When they dance, they often pretend to enjoy the dance, but usually hide their feelings of bitterness, sadness, andloneliness.
The codependent's fears and insecurities create a sense of pessimism and doubt over ever finding a healthy partner, someone who could love them for who they are versus what they can do. Naturally, the narcissist is attracted to the codependent's lack of self-worth and low self-esteem. They intuitively know that they will be able to control this person and be able to choose and control the dancing experience.
All codependents want balance in their relationships, but seem to consistently choose a partner who leads them to chaos and resentment. When given a chance to stop dancing with their narcissistic partner, or comfortably sit out the dance until someone healthy comes around, they choose to continue to dance. The codependent dares not to leave their narcissistic dance partner because their lack of self-esteem and low sense of self-worth manifests into the fear of being alone. Being alone is equivalent to feeling lonely, and loneliness is an intolerable feeling for a codependent.
Without self-esteem or feelings of personal power, the codependent does not know how to choose healthy (mutually giving) partners. Their inability to find a healthy partner is usually related to an unconscious motivation to find a person who is familiar…someone who reminds them of their powerless childhood. Many codependents come from families in which they were children of parents who were also experts at the dance. Their fear of being alone, compulsion to control and fix at any cost, and comfort in their role as the martyr who is endlessly loving, devoted, and patient, is a result of roles they observed early on in their childhood.
No matter how often the codependent tries to avoid "unhealthy" partners, they find themselves consistently on the dance floor dancing to different songs, but with the same dance partner. Through psychotherapy and, perhaps, a 12-step recovery program, the codependent begins to recognize that their dream to dance the grand dance of love, reciprocity, and mutuality, is indeed possible. Through therapy and/or change of lifestyle, they build self-esteem, personal power, and hope to finally dance with partners who are willing and capable to share the lead, communicate their movements, and pursue a shared rhythm.
ATTENTION DEFICIT DISORDER (ADD), AN OVERVIEW ADD (Attention Deficit Disorder) is neither a “new” mental health problem nor is it a disorder created for the purpose of personal gain or financial profit by pharmaceutical companies, the mental health field, or by the media. It is a very real behavioral and medical disorder that affects millions of people nationwide. According to the National Institute of Mental Health (NIMH), ADD is one of the most common mental disorders in children and adolescents. According to research sponsored by NIMH, estimated the number of children with ADD to be between 3% - 5% of the population. NIMH also estimates that 4.1 percent of adults have ADD.
Although it has taken quite some time for our society to accept ADD as a bonafide mental health and/or medical disorder, in actuality it is a problem that has been noted in modern literature for at least 200 years. As early as 1798, ADD was first described in the medical literature by Dr. Alexander Crichton, who referred to it as “Mental Restlessness.” A fairy tale of an apparent ADD youth, “The Story of Fidgety Philip," was written in 1845 by Dr. Heinrich Hoffman. In 1922, ADD was recognized as Post Encephalitic Behavior Disorder. In 1937 it was discovered that stimulants helped control hyperactivity in children. In 1957 methylphenidate (Ritalin), became commercially available to treat hyperactive children.
The formal and accepted mental health/behavioral diagnosis of ADD is relatively recent. In the early 1960s, ADD was referred to as “Minimal Brain Dysfunction.” In 1968, the disorder became known as “Hyperkinetic Reaction of Childhood.” At this point, emphasis was placed more on the hyperactivity than inattention symptoms. In 1980, the diagnosis was changed to “ADD--Attention Deficit Disorder, with or without Hyperactivity,” which placed equal emphasis on hyperactivity and inattention. By 1987, the disorder was renamed Attention Deficit Hyperactivity Disorder (ADD) and was subdivided into four categories (see below). Since then, ADD has been considered a medical disorder that results in behavioral problems.
Currently, ADD is defined by the DSM IV-TR (the accepted diagnostic manual) as one disorder which is subdivided into four categories:
1. Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type--previously known as ADD--is marked by impaired attention and concentration.
2. Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive, Impulsive Type--formerly known as ADD--is marked by hyperactivity without inattentiveness.
3. Attention-Deficit/Hyperactivity Disorder, Combined Type--the most common type--involves all the symptoms: inattention, hyperactivity, and impulsivity.
4. Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified. This category is for the ADD disorders that include prominent symptoms of inattention or hyperactivity-impulsivity, but do not meet the DSM IV-TR criteria for a
diagnosis.
To further understand ADD and its four subcategories, it may be helpful to illustrate hyperactivity, impulsivity, and/or inattention through examples.
Typical hyperactive symptoms in youth include:
• Often "on the go" or acting as if "driven by a motor"
• Feeling restless
• Moving hands and feet nervously or squirming
• Getting up frequently to walk or run around
• Running or climbing excessively when it's inappropriate
• Having difficulty playing quietly or engaging in quiet leisure activities
• Talking excessively or too fast
• Often leaving seat when staying seated is expected
• Often can't be involved in social activities quietly
Typical symptoms of impulsivity in youth include:
• Acting rashly or suddenly without thinking first
• Blurting out answers before questions are fully asked
• Having a difficult time awaiting a turn
• Often interrupting others' conversations or activities
• Poor judgment or decisions in social situations, which result in the child not being accepted by his/her own peer group.
Typical symptoms of inattention in youth include:
• Not paying attention to details or makes careless mistakes
• Having trouble staying focused and being easily distracted
• Appearing not to listen when spoken to
• Often forgetful in daily activities
• Having trouble staying organized, planning ahead, and finishing projects
• Losing or misplacing homework, books, toys, or other items
• Not seeming to listen when directly spoken to
• Not following instructions and failing to finish activities, schoolwork,
chores or duties in the workplace
• Avoiding or disliking tasks that require ongoing mental effort or
concentration
Of the four ADD subcategories, Hyperactive-Impulsive Type is the most distinguishable, recognizable, and the easiest to diagnose. The hyperactive and impulsive symptoms are behaviorally manifested in the various environments in which a child interacts: i.e., at home, with friends, at school, and/or during extracurricular or athletic activities. Because of the hyperactive and impulsive traits of this subcategory, these children naturally arouse the attention (often negative) of those around them. Compared to children without ADD, they are more difficult to instruct, teach, coach, and with whom to communicate. Additionally, they are prone to be disruptive, seemingly oppositional, reckless, accident prone, and are socially underdeveloped.
Parents of ADD youth often report frustration, anger, and emotional depletion because of their child’s inattention, impulsivity, and hyperactivity. By the time they receive professional services many parents of ADD children describe complex feelings of anger, fear, desperation, and guilt. Their multiple “failures” at trying to get their children to focus, pay attention, and to follow through with directions, responsibilities, and assignments have resulted in feelings of hopelessness and desperation. These parents often report feeling guilty over their resentment, loss of patience, and reactive discipline style. Both psychotherapists and psychiatrists have worked with parents of ADD youth who "joke" by saying "if someone doesn't help my child, give me some medication!"
The following statistics (Dr. Russel Barkley and Dr. Tim Willens) illustrate the far reaching implications of ADD in youth.
• ADD has a childhood rate of occurrence of 6-8%, with the illness continuing
into adolescence for 75% of the patients, and with 50% of cases persisting into
adulthood.
• Boys are diagnosed with ADD 3 times more often than girls.
• Emotional development in children with ADD is 30% slower than in their non-ADHD peers.
• 65% of children with ADD exhibit problems in defiance or problems with authority figures. This can include verbal hostility and temper tantrums.
• Teenagers with ADD have almost four times as many traffic citations as non ADD/ADD drivers. They have four times as many car accidents and are seven times more likely to have a second accident.
• 21% of teens with ADD skip school on a regular basis, and 35% drop out of school before finishing high school.
• 45% of children with ADD have been suspended from school at least once.
• 30% of children with ADD have repeated a year of school.
• Youth treated with medication have a six fold less chance of developing a substance abuse disorder through adolescence.
• The juvenile justice system is composed of 75% of kids with undiagnosed learning disabilities, including ADD.
ADD is a genetically transmitted disorder. Research funded by the National Institute of Medical Health (NIMH) and the U.S. Public Health Service (PHS) have shown clear evidence that ADD runs in families. According to recent research, over 25% of first-degree relatives of the families of ADD children also have ADD. Other research indicates that 80% of adults with ADD have at least one child with ADD and 52% have two or more children with ADHD. The hereditary link of ADD has important treatment implications because other children in a family may also have ADD. Moreover, there is a distinct possibility that the parents also may have ADD. Of course, matters get complicated when parents with undiagnosed ADD have problems with their ADD child. Therefore, it is crucial to evaluate a family occurrence of ADD, when assessing an ADD in youth.
Diagnosing Attention Deficit Disorder Inattentive Type in youth is no easy task. More harm than good is done when a person is incorrectly diagnosed. A wrong diagnosis may lead to unnecessary treatment, i.e., a prescription for ADD medication and/or unnecessary psychological, behavioral and/or educational services. Unnecessary treatment like ADD medication may be emotionally and physically harmful. Conversely, when an individual is correctly diagnosed and subsequently treated for ADD, the potential for dramatic life changes are limitless.
Psychologists, Clinical Social Workers, Licensed Clinical Professional Counselors, Neurologists, Psychiatrists, and Pediatricians/Family Physicians can diagnose ADD. Only physicians (M.D. or D.O.), nurse practitioners, and physician assistants (P.A.) under the supervision of a physician can prescribe medication. However, psychiatrists, because of their training and expertise in mental health disorders, are the best qualified to prescribe ADD medication.
While the ADD Hyperactive Type youth are easily noticed, those with ADD Inattentive Type are prone to be misdiagnosed or, worse, do not even get noticed. Moreover, ADD Inattentive Type youth are often mislabeled, misunderstood, and even blamed for a disorder over which they have no control. Because ADD Inattentive Type manifests more internally and less behaviorally, these youth are not as frequently flagged by potential treatment providers. Therefore, these youth often do not receive potentially life-enhancing treatment, i.e., psychotherapy, school counseling/coaching, educational services, and/or medical/psychiatric services. Unfortunately, many “fall between the cracks” of the social service, mental health, juvenile justice, and educational systems.
Youth with unrecognized and untreated ADD may develop into adults with poor self concepts low self esteem, associated emotional, educational, and employment problems. According to reliable statistics, adults with unrecognized and/or untreated ADD are more prone to develop alcohol and drug problems. It is common for adolescents and adults with ADHD to attempt to soothe or “self medicate” themselves by using addictive substances such as alcohol, marijuana, narcotics, tranquilizers, nicotine, cocaine and illegally prescribed or street amphetamines (stimulants).
There is no "cure" for ADD. Children with the disorder seldom outgrow it.
Approximately 60% of people who had ADD symptoms as a child continue to have symptoms as adults. And only 1 in 4 of adults with ADD was diagnosed in childhood—and even fewer are treated. Thanks to increased public awareness and the pharmaceutical corporations’ marketing of their medications, more adults are now seeking help for ADHD. However, many of these adults who were not treated as children, carry emotional, educational, personal, and occupational “scars.” As children, these individuals, did not feel “as smart, successful and/or likable” as their non ADD counterparts. With no one to explain why they struggled at home, with friends, and in school, they naturally turned inward to explain their deficiencies. Eventually they internalize the negative messages about themselves, thereby creating fewer opportunities for success as adults.
Similarly to youths, adults with ADD have serious problems with concentration or paying attention, or are overactive (hyperactive) in one or more areas of living. Some of the most common problems include:
• Problems with jobs or careers; losing or quitting jobs frequently
• Problems doing as well as you should at work or in school
• Problems with day-to-day tasks such as doing household chores, paying bills, and organizing things
• Problems with relationships because you forget important things, can't finish tasks, or get upset over little things
• Ongoing stress and worry because you don't meet goals and responsibilities
• Ongoing, strong feelings of frustration, guilt, or blame
According to Adult ADD research:
• ADD may affect 30% of people who had ADD in childhood.
• ADD does not develop in adulthood. Only those who have had the disorder since early childhood really suffer from ADD.
• A key criterion of ADD in adults is "disinhibition"--the inability to stop acting on impulse. Hyperactivity is much less likely to be a symptom of the disorder in adulthood.
• Adults with ADD tend to forget appointments and are frequently socially
inappropriate--making rude or insulting remarks--and are disorganized.
• They find prioritizing difficult.
• Adults with ADD find it difficult to form lasting relationships.
• Adults with ADD have problems with short-term memory.
• Almost all people with ADD suffer other psychological problems-particularly depression and substance abuse.
While there is not a consensus as to the cause of ADD, there is a general agreement within the medical and mental health communities that it is biological in nature. Some common explanations for ADD include: chemical imbalance in the brain, nutritional deficiencies, early head trauma/brain injury, or impediments to normal brain development (i.e. the use of cigarettes and alcohol during pregnancy). ADD may also be caused by brain dysfunction or neurological impairment. Dysfunction in the areas in the frontal lobes, basal ganglia, and cerebellum may negatively impact regulation of behavior, inhibition, short-term memory, planning, self-monitoring, verbal regulation, motor control, and emotional regulation.
Because successful treatment of this disorder can have profound positive emotional, social, and family outcomes, an accurate diagnosis is tremendously important. Requirements to diagnose ADD include: professional education (graduate and post graduate), ongoing training, supervision, experience, and licensure. Even with the essential professional qualifications, collaboration and input from current or former psychotherapists, parents, teachers, school staff, medical practitioners and/or psychiatrists creates more reliable and accurate diagnoses. The value of collaboration cannot be understated.
Sound ethical practice compels clinicians to provide the least restrictive and least risky form of therapy/treatment to youth with ADD. Medication or intensive psycho-therapeutic services should only be provided when the client would not favorably respond to less invasive treatment approaches. Therefore, it is crucial to determine whether “functional impairment” is or is not present. Clients who are functionally impaired will fail to be successful in their environment without specialized assistance, services, and/or psycho-therapeutic or medical treatment. Once functional impairment is established, then it is the job of the treatment team to collaborate on the most effective method of treatment.
All too often, a person is mistakenly diagnosed with ADD, not due to attention deficit issues, but rather because of their unique personality, learning style, emotional make-up, energy and activity levels, and other psycho-social factors that better explain their problematic behaviors. A misdiagnosis could also be related to other mental or emotional conditions (discussed next), a life circumstance including a parent’s unemployment, divorce, family dysfunction, or medical conditions. In a small but significant number of cases, this diagnosis of ADD better represents an adult’s need to manage a challenging, willful and oppositional child, who even with these problems may not have ADD.
It is critical that before an ADD diagnosis is reached (especially before medication is prescribed), that a clinician consider if other coexisting mental or medical disorders may be responsible for the hyperactive, impulsive, and/or inattentive symptoms. Because other disorders share similar symptoms with ADD, it is necessary to consider the probability of one mental/psychological disorder over that of another that could possibly account for a client’s symptoms. For example, Generalized Anxiety Disorder and Major Depression share the symptoms of disorganization, lack of concentration, and work completion issues. A trained and qualified ADD specialist will consider differential diagnoses in order to arrive at the most logical and clinically sound diagnosis. Typical disorders to be ruled out include: Generalized Anxiety, Major Depression, Post Traumatic Stress Disorder, and Substance Abuse Disorders. Additionally, medical explanations should be similarly sought: sleep disorders, nutritional deficiencies, hearing impairment, and others.
When a non-medical practitioner formally diagnoses a client with ADD, i.e. a licensed psychotherapist, it is recommended that a second opinion (or confirmation of the diagnosis) be sought from a psychiatrist. Psychiatrists are medical practitioners who specialize in the medical side of mental disorders. Psychiatrists are able to prescribe medicine that may be necessary to treat ADD. In collaboration, the parents, school personnel, the referring psychotherapist, and the psychiatrist, will monitor the effectiveness of the medical component of the ADD treatment.
In summary, ADD is a mental health and medical disorder that has become increasingly more accepted and consequently treated more effectively. To achieve high professional assessment, diagnostic, educational, and treatment standards, it is important that trained and qualified practitioners understands the multidimensional aspects of ADD: history, diagnosis, statistics, etiology, and treatment. Training, experience, a keen interest for details, a solid foundation of information, and a system of collaboration creates the potential for positive outcomes in the treatment of ADD.
References
1. Genetic factors, not necessarily sex of child, influence ADHD by Jim Dryden
http://record.wustl.edu/archive/1999/04-15-99/articles/ADHD.html
2. What are the risk factors and causes of Attention Deficit Hyperactivity
Disorder
http://www.adhdissues.com/ms/guides/adhd_risk_factors/main.html
3. What Causes ADHD?
http://add.about.com/od/adhdthebasics/a/causes.htm
4. History of ADHD by Keith Londrie
http://EzineArticles.com/?expert=Keith_Londrie
5. Taking Charge of ADHD, Dr. Russell Barkley
http://www.healthcentral.com/adhd/c/1443/13716/addadhd-statistics/
6. ADHD Facts by Dr. B, Murray, Ph.D.
http://www.upliftprogram.com/bob_murray.html
7. Cause ADHD
http://www.myadhd.com/causesofadhd.html
8. ADHD.org.nz (New Zealand ADHD Support GroupP
http://www.adhd.org.nz/cause1.html
9. Understanding the Causes of ADHD Keath Low, About.com
http://add.about.com/od/adhdthebasics/a/causes.htm
10. Interventions for ADHD: Treatment in Developmental Context By Phyllis Anne Teeter 1988
11. Diagnosis of AD/HD in Adults
National Resource Center on AD/HD Children and Adults with Attention-Deficit/Hyperactivity Disorder
http://www.help4adhd.org/en/treatment/guides/WWK9S
12. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.
13. The Numbers Count: Mental Disorders in America
The National Institute of Mental Health Website
http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-dis...
14. Historical Development of ADHD Margaret Austin, Ph.D., Natalie Staats Reiss, Ph.D., and Laura Burgdorf, Ph.D.
http://resources.atcmhmr.com/poc/view_doc.php?type=doc&id=13848
15. ADHD, Alcoholism and Other Addictions by Wendy Richardson, M.A., LMFCC
Soquel, CA—1998
http://www.addresources.org/article_adhd_addictions_richardson.php
16. National Institutes of Neurological Disorders and Stroke
NINDS Attention Deficit-Hyperactivity Disorder Information Page
http://www.ninds.nih.gov/disorders/adhd/adhd.htm IS SEXUAL ADDICTION REAL? Unlike for alcohol or drug addiction, there is no formal diagnosis for Sex Addiction in the American Psychiatric Association’s Diagnostic Statistic Manual (DSM IV). According to Chester Schmidt, chair of the DSM-IV Sexual Disorder Work Group, there is “no scientific data to support a concept of sexual behavior that can be considered addictive. (1)” Schmidt believed that what is called sex addiction is more likely a symptom of other psychological problems like depression, obsessive-compulsive disorder, or bipolar disorder. According to Benoit Denizet-Lewis (2), "Believers in a sex-addiction diagnosis point out that for many years, doctors and psychiatrists similarly dismissed alcoholism, refusing to accept that it was a serious problem in itself, not merely a symptom of something else." Many of practitioners in the sexual addiction field are hopeful that the DSM V, which is due out in 2012, will include expanded diagnostic choices for process addictions, including sex, gambling, spending, eating, and/or religion addictions. According to Elizabeth Hartney, "a working group of professionals has recently suggested diagnostic criteria which may be considered for the next edition of the manual, due to be published in 2012."
According to John M. Grohol, Psy.D. (3) "What is both amazing and a little disturbing, however, is to see entire professional societies, such as the Society for the Advancement of Sexual Health, spring up around a disorder that isn’t even officially recognized as such. And despite no clinical agreed-upon criteria for sex addiction, the Society estimates that 3 to 5% of Americans have it." According to the Mayo clinic, sex addiction is estimated to affect 3 to 6 percent of adults in the United States.
Because sex is a part of normal human functioning, it is difficult and at times a scientific challenge to compare sexual addictions to chemical addictions. Both "normal" or pathological (addictive) sexual patters are open to diverse and often controversial definitions. Clearly, factors such as personality, psychopathology, gender differences, sexual preferences, cultural differences, socio-economic status, and other "filters" have made a clear consensus for a definition of sexual addiction that much more challenging. Making matters even more complicated is the fact that topic of sexual deviance and/or sexual pathology remains as one of the most taboo topic in our society. Individuals with a sexual addiction are often the subject of ridicule and harsh judgment, whereas others suffering from drug/alcohol or other more accepted process addictions, ie gambling, spending, elicit more social acceptance.
Another ironic twist is that the co-founder Alcoholics Anonymous, Bill Wilson, was considered a sex addict. According to biographers and Alcohol Anonymous historians, Bill Wilson not only was an alcoholic, but was also a sex addict. Wilson was flirtatious, had multiple affairs, and according to biographer, Susan Cheever (4), "had an inability to regulate his behavior with women” and was “often accused of groping and unwelcome fondling,” However, he was married to the same woman for 53 years.
Until sex addiction is formally included in the DSM V, we currently derive a "diagnosis" through assessments protocols specifically designed for this addiction. Such protocols are provided by specially trained qualified mental health practitioners. Clinicians, such as myself, utilize uniquely designed instruments that are designed to collect relevant information necessary for a diagnostic conclusion. Information collected during the assessment includes: sexual history, drug/alcohol history, psychosocial assessment, mental health history, and other relevant information. Additionally, an assessment involves interviews with the client, affected partners, i.e. spouse or partner, and if possible, mental health providers who have or who are providing services to person being evaluated.
According to data collected by Patrick Carnes, many sex addicts also have other addictions. For example, in Carnes' research, of the individuals who were diagnosed with a sex addiction, 42% were chemically dependent, 38% had an eating disorder, 28% were compulsive workers (workaholics), 26% were compulsive spenders, and 5% were compulsive gamblers. Ruling out cross addictions is an important component of the assessment. Because of the high prevalence of cross addictions, the sex addiction evaluator must have a background in the general field of addictions.
When a cross addiction is present, it is important to identify which addiction requires attention first. This is crucial when it is determined that the sex addict is also addicted to a drug/alcohol. In these cases, detoxification (detoxing) of the drug may require medical services in order to ensure that the client physical health is not compromised. The experience of physical withdrawals can potentially create medical risks.
As many practitioners and sex addicts know, that despite a formal recognition of this disorder, it is indeed very real. Lets the intellectuals battle out what is and what is not a diagnosis. In the meantime, lets provide the much needed services to those who are suffering from this disorder.
(1) (http://psychcentral.com/blog/archives/2008/09/30/is-sexual-addiction-real/)
(2) www.americaanonymous.com
(3) psychcentral.com/blog/archives/2008/09/30/is-sexual-addiction-real
(4) http://nymag.com/nymetro/arts/books/reviews/n_9880/
(5) http://edition.cnn.com/2008/HEALTH/09/05/sex.addiction/index.html
(6) http://addictions.about.com/od/sexaddiction/a/sexaddiction.htm Author's Bio
Contacting Ross Rosenberg, M.Ed. LCPC CADC
My contact info:
Ross Rosenberg, M.Ed., LCPC, CADC
Clinical Care Consultants, P.C.
Buffalo Grove and Arlington Heights, IL
(847) 749-0514 ext 12
http://clinicalcareconsultants.com/
Providing counseling / psychotherapy / marital therapy / couples therapy to communities including: Northern Illinois (IL), Cook County, Lake Country, Northern and Northwest Suburbs Including: Antioch, Arlington Heights, Banockburn, Barrington, Barrington Hills, Buffalo Grove, Crystal Lake, Deerfield, Deerpark, Des Plaines, Elk Grove, Evanston, Fox Lake, Fox River Grove, Glencoe, Glenview, Grays Lake, Gurnee, Hawthorn Woods, Highland Park, Hiighwood, Hoffman Estates, Inverness, Island Lake, Itasca, Kenilworth, Kildeer, Lake Bluff, Lake Forrest, Lake Villa, Lake Villa, Lake Zurich, Lakemoor, Libertyville, Lincolnshire, Lindenhurst, Long Grove, McHenry, Morton Grove, Mount Prospect, Mundelein, Niles, North Barrington, Northbrook, Northfield, Palatine, Park Ridge, Rolling Meadows, Round Lake, Round Lake Beach, Schaumburg, Skokie, South Barrington, Streamwood, Vernon Hills, Volo, Wadsworth, Wauconda, Waukegan, Wheeling, Wilmette, Winnetka, Zion
