Doctor Update: Rick Dawson retires from our practice next month!

Thank you Dr. Dawson for all of your hard work with IHC Associates!

This change will become effective November 2018.

What is Dialectical Behavioral Therapy?

Dialectical Behavioral Therapy, or DBT, is an off-shoot of Cognitive Behavioral Therapy (CBT), with some additional assumptions and techniques to complement cognitive-behavioral interventions. The first difference, obvious from the name of the treatment, is that DBT is based on a dialectic, which means that it attempts to integrate two opposing tensions. In this case, those opposites are the need to accept oneself despite one’s faults and the effort to change oneself and one’s faults.

DBT was first developed by Marsha M. Linehan in the late 1970s when working with patients with Borderline Personality Disorder, but it has since been shown to be effective for many other conditions and complaints, including substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.

The technique consists of four particular aspects: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. Mindfulness means learning to be aware of oneself and one’s feelings in the present; distress tolerance is learning to tolerate distressing or uncomfortable emotions and situations; interpersonal effectiveness is learning to behave in and experience relationships in a productive and affirming way; and emotional regulation means learning to regulate one’s emotions to avoid the extremes of negative emotional experiences.

Through building each of these skills, the therapist helps the client to accept and validate him or herself while at the same time setting goals for behavioral and emotional change.

For more information on DBT, see the Linehan Institute.

Is mindfulness just a fad, or can it help you live a fuller life?

Mindfulness has become a trendy word recently. It seems like everyone, from business executives to exercise gurus, is using mindfulness as a way to improve performance and reduce stress. But what does it really mean to practice mindfulness, and can it really do what everyone says it can?


It may be trendy now, but mindfulness has a very long history. Mindfulness has its roots in ancient Buddhist practices of meditation, used for millennia to cultivate spiritual awareness. It wasn’t until the 1970s that Western thinkers, such as Jon Kabat-Zinn and Marsha Linehan, started realizing the psychological benefits of such practices and bringing them into Western psychology.

Today, mindfulness is an important aspect of several different therapeutic modalities, including Dialectical Behavioral Therapy, Acceptance and Commitment Therapy, and Mindfulness-based Cognitive Therapy. However, many therapists use it on its own as a general practice designed to reduce stress and bring the client into greater self-awareness and present-focus.

What is Mindfulness?

Strictly speaking, mindfulness simply entails taking the time to focus on the present moment. This can be done through meditation practices, but it does not have to include meditation. Many therapists use mindfulness to help clients focus on the feelings, thoughts, and behaviors that they normally don’t recognize, but that have a negative impact on them anyway. Slowing down and paying close attention to one’s actions and reactions is one way of preventing people from getting caught in the same old habits and patterns that unthinkingly keep them from living a successful or fulfilling life.

One of the most important components of mindfulness is non-judgment. A therapist can help a client to learn to observe her emotions without immediately judging herself in a negative way because of them. Learning to find this emotional distance from one’s own habitual self-punishment can be an important way to intervene when a client is spiralling out of control emotionally, experiencing depression or anxiety, or contemplating self-harm.

More generally, learning to be in the present, instead of worrying about the future or ruminating about past mistakes, can help people to appreciate the positive aspects of their lives and move past places where they have become stuck. Such present-focus can be helpful for managing chronic pain, depression, anxiety, addictions, and many other conditions that rely on habitual patterns or seemingly-intolerable sensations.

Do I have to Meditate?

As noted before, meditation is only one of the ways that a person can cultivate mindfulness. Other techniques might include focusing on physical sensations, breathing exercises, or guided imagery. All of these techniques help the client to learn to turn his attention away from the noisy thoughts that often crowd our minds, observing but not getting caught up in the many negative reactions that can increase stress and impede happiness or relaxation.

The Strengths-based Approach to Counseling

A strengths-based approach to counseling has become a common therapeutic tool over the past decade. The model is just what it sounds like: a way to focus on a person’s strengths, rather than on his or her weaknesses, to help facilitate healing. Instead of looking at a client through the eyes of an expert diagnosing a disease, the therapist considers herself a partner in helping the client draw on his or her own resources of character and support to improve his or her situation.

The key to a strengths-based model is in seeking out the strengths one possesses to cope with life problems. No matter how difficult the challenges, each person has character traits, life goals, deep knowledge, and social support networks that he or she can draw on to feel empowered to work through the difficulties that life presents. Therapists will generally begin a strengths-based session by focusing more on what a client wants to achieve in his or her life than on what is going wrong. This shift in perspective allows the therapist to assist the client in seeing him or herself as a capable and valuable person who has much to offer.

In addition, a therapist using a strengths-based approach will consider him or herself a collaborator with the client, working together to find solutions, rather than telling the client how it is. The client uses the therapist as a strong and conscientious support for the client’s own self-improvement. It requires that both therapist and client be active collaborators, working together toward the client’s goal.

Empirical research has begun to show that a positive attitude will result in a healthier outcome. After all, if you believe that your situation is hopeless and that you are broken, you are unlikely to be able to improve your sense of well-being. A therapist using a strengths-based approach will help you to discover what strengths you possess and how to use them to find a sense of hope and optimism in your struggle to live a full life.

IHC Adds New Clinicians

IHC Associates would like to welcome many new clinicians to our practice! Britania Latronica, Ph.D will be joining us at the Parkrose Clinic.

Dr. Melisa Finch, Ph.D Offers Sleep Class

IHC Associates and Dr. Melisa Finch are offering a new class:

Promoting Good Sleep: Applying the Science of Sleep

IHC provider Melisa Finch, PhD, will teach this ongoing three-session class, using the science of sleep to help participants cope with insomnia and other sleep problems.

Each session of this class includes:

  • A relaxation/imagery experience
  • Education on one or more of the factors influencing sleep
  • Self-assessment and monitoring of progress
  • Setting and review of individualized goals related to healthy sleep practices

This class meets every other week and new members can begin at any session and then continue through the remaining sessions. The classes are billed to the patient’s insurance: there may be a copayment for each session, and a sliding scale fee is also available.

To join this class, call IHC Associates at 503-740-1971 and ask for an initial assessment for the science of sleep class with Dr. Finch.

March is Social Work Month

You may have wondered why many of our providers have “LCSW” at the end of their names. This is because they are licensed clinical social workers and have a Masters in Social Work (MSW) from an accredited institution.

Providers choose many paths to become therapists, but clinical social work is a very common one. Providers who choose the LCSW path are often drawn to social work in addition to behavioral health therapy, because of the major impacts social work has had on our society in the last half century.

The National Association of Social Workers, which celebrates its 60th anniversary this year, writes that “Social work paves the way for change,” highlighting the efforts of social workers in many of the seminal struggles of the 20th century, including promoting equal rights for disenfranchised populations, strengthening the social safety net for our nation’s most vulnerable people, and advocating for social justice initiatives.

Every day, social workers tackle persistent social problems, helping students, patients, children, the elderly, and many others to build and maintain strong families and communities. Those who practice mental health therapy as their path to social support choose to help individuals, couples and families to learn the skills and mindset to stay healthy and happy.

Thank you to all our providers, LCSW as well as others, for being a part of the solution! For more information on social work and Social Work Month, visit the National Association of Social Workers.

Adventist Wellness Center Lecture Series on Insomnia

Are you having difficulty getting to sleep, sustaining sleep, awakening early, or having non-restorative sleep?

Vanessa Peterson, MD and IHC’s Rocky Garrison, Ph.D. present three lectures to help you develop healthy sleep habits.

2015 dates for this lecture are:

  • May 14
  • August 5
  • November 11
  • Patients are encouraged to call 503.256.4000 to RSVP for this FREE event.

    Welcome Joan Pugh!


    IHC has a new provider! We are excited to welcome Dr. Joan Pugh as a clinician at IHC Associates. Joan is a Licensed Clinical Psychologist with a Psy.D from the University of La Verne.

    As a specialist in geriatrics, Joan works with clients and their families to understand and manage dementia, but she also has extensive experience with depression, anxiety, and PTSD, as well as transitional issues such as grief, identity, and divorce.

    Joan strongly believes that therapy is beneficial and effective. She works from multiple perspectives, including person-centered, strengths-based, cognitive behavioral and relational. She believes that we can all be our best selves if we identify negative patterns and strive for healthier habits.

    If you’d like to set up an appointment with Joan or one of our other highly-qualified providers, give us a call today at 503-740-1971.