WCPA Winter 2025 Newsletter

Our winter, 2025 newsletter includes articles about teen mental health, adult ADHD, AI and therapy, retirement choices, and care management services.

• Navigating Teen Mental Health Needs , by Heather Hanvy, MA, CRC, LPC
• Understanding Adult ADHD: Breaking the Myths and Finding Your Strengths, by Angela Cook, MSW, LCSW
• AI and Therapy, by Bryan Duckham, MSW, LCSW, Ph.D.
• Retirement: What Do I Do Now?, By Julia Covilli, MSW, LCSW 
• Difficult Care Choices: Care Management Helps Families Navigate, by Maria Miskovic, MSW, LCSW

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Navigating Teen Mental Health Needs

Heather Hanvy, MA, CRC, LPC

Recently in the U.S., about 20% of youth (ages 12-17) reported suffering from at least one major depressive episode in the past year, with about 13% of youth reporting that they experienced serious thoughts of suicide (“Youth Ranking 2024”, n.d.). These statistics can be very scary to think about, no matter our life situation. They can be downright terrifying when we suddenly find that it is our own teen who is showing signs of depression or hopelessness. Based on these statistics, many of us will find ourselves thrust into seeking mental health treatment and/or crisis intervention services for our adolescents at some point. This can often happen without much outside support, and while navigating our own fears and sadness about learning that our teen is struggling in this way. 

It is crucial for us to take our teens’ mental health seriously, especially if we know that they are experiencing feelings of sadness or depression, or having any thoughts of suicide. It is also important for us, if possible, to remember that there is hope and that seeking mental health services for our teen can help them navigate through this difficult time. Two-thirds of youth with depression who received mental health treatment or counseling reported that it helped them at least ‘some.’ A little over a third (36%) even reported that it helped them ‘a lot’ or ‘extremely’ (“Youth Ranking 2024”, n.d.). 

So, where do we start if we are worried about our own teen? If we are comfortable, we can first start by talking to our teen about their feelings and the things going on in their life regularly, to keep that line of communication open. This is especially important if we have started to notice any changes in behavior, such as no longer engaging in activities that used to bring them joy, withdrawing from friends, changes in eating, and/or sleeping too little or too much. Changes in likes/dislikes, friend groups, and even mood and behavior can be a normal part of adolescence, but it can also be a signal to us that we need to pay closer attention and maybe even do some investigating. 

If we are noticing changes in our teen and are unsure of the significance of what we are observing, we can consider speaking to our child’s school counselor or social worker to gain insight into functioning at school. School counselors and social workers can give us valuable insight into their peer interactions and overall mood and behaviors at school. School mental health professionals can also be a wonderful resource and can help us navigate some of the initial conversations with our teen, if we are feeling unsure of how to start them on our own. 

If we discover that our child is experiencing any feelings of sadness or depression, then we may want to consider seeking out a therapist. Therapy is a great place for adolescents to have the space to explore all of the stressors they are experiencing and to learn important life skills. Therapy can help teach adolescents how to use a variety of coping skills to manage difficult emotions, how to engage in healthy conflict resolution, how to view situations from different perspectives, how to become aware of his/her own role in situations, how to better appreciate personal strengths, and how to recognize unhealthy thinking patterns that may be increasing their distress.

If we find out that our teen is having a mental health crisis, such as thoughts of suicide, then it is very helpful if we have knowledge of local crisis resources. Knowing what is available in a time of crisis can at least give us a little bit of calm in a moment that can be potentially terrifying to us as a parent. Here are some ways that we can get emergency help for a mental health crisis with our child:  

1. Calling 911 If our child or adolescent is experiencing a medical or safety emergency, we should call 9-1-1. When we call, we can let the operator know that it is a mental health emergency and they can utilize mental health trained first responders, if they are available in our area. 

2. Emergency Room We can take our child to any emergency room ourselves, if it feels safe to do so. Several area hospitals have inpatient behavioral health units for children and adolescents. Be prepared that wait times in emergency rooms can be excessive – if possible, go prepared with phone chargers, some snacks or activities, and your own medications that you may need to take. 

3. Urgent Care We can take our teen to a behavioral health urgent care facility. Urgent care facilities that focus on mental health care are expanding in our area, and can offer a way to access physicians and mental health professionals during a crisis without the longer wait times of emergency rooms. 

4. Calling 988 If it is not a medical or safety emergency, we can call the Suicide and Crisis Lifeline at 9-8-8, which will route us to a local behavioral health hotline. The Lifeline allows callers to speak immediately with a mental health professional who is highly trained in crisis intervention, 24 hours a day. If you are uncertain which choice you should make in a behavioral health crisis, accessing the crisis professionals through 9-8-8 is a good first step to get advice and guidance. 

Finally, as parents, it’s critical that we also consider our own self-care. We so often focus all of our energy into caring for our children and pay little attention to taking care of ourselves. It is so important when we are walking through something stressful with our teen, though, that we make taking care of ourselves a priority, too. We may be called upon to be calm while also potentially navigating some very scary and stressful situations as we get mental health treatment started for our teen. This requires us to have our own safe places to talk through our fears, stresses, and frustrations. 

We can always utilize our current support systems, such as friends, family, and faith communities. We may want to consider that our family and friends may also have their own fears and opinions surrounding our teen’s mental health journey and sometimes that might cause us additional stress or leave us not feeling like we can fully open up about our own feelings. It might be helpful in these situations to consider getting therapy for ourselves so that we have a safe space to process our emotions and learn some parenting strategies to utilize with our adolescent in this difficult time. There are also parent support groups that we might find helpful. Support groups allow us to talk through how we are feeling with other parents who are navigating similar situations. 

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Understanding Adult ADHD: Breaking the Myths and Finding Your Strengths

Angela Cook, MSW, LCSW

For many adults, ADHD symptoms look very different compared to how they manifest in children. This often leads to misunderstandings and misdiagnoses, with some people going through life being told over and over that they are lazy, not smart enough, or just need to “try harder.” This message can be deeply internalized, leaving these adults unaware that their brain simply works differently. With the right tools and support, these individuals can thrive and unlock their full potential. 

How ADHD Symptoms Differ in Adults The common symptoms of ADHD in adults often go unnoticed, because they don’t always resemble the hyperactivity typically associated with children. 

In adults, ADHD may look like: 

• Frequently losing or misplacing items (phone, wallet, keys) 
• Chronic procrastination, especially with tasks that feel overwhelming or difficult 
• Challenges in conversation, such as interrupting others and saying inappropriate things (“foot in mouth moments”) 
• Making hasty, impulsive decisions 
• Struggling to prioritize tasks and figure out what comes first 
• Time blindness, which often shows up as frequent tardiness or difficulty estimating how long tasks will take 

At this point, many people—especially busy moms or professionals—might be thinking, “That sounds like me!” However, ADHD isn’t just occasional forgetfulness or disorganization. For a diagnosis, symptoms must have started in childhood, continue into adulthood, and significantly impair functioning in at least two areas of life, such as work, school, self-care, social relationships, or household management. 

The Struggles of Undiagnosed ADHD Many adults with undiagnosed ADHD fly under the radar. Over time, they may develop both functional and dysfunctional coping mechanisms to mask their struggles. Some examples include job-hopping, turning to drugs or alcohol, or avoiding situations that highlight their challenges. Others try endlessly to adopt organizational systems or self-help strategies that never seem to “stick.” 

This cycle of frustration often leads to self-blame. These adults may think, “If I could just try harder to remember things, everything would be okay.” But the truth is, ADHD is not about a lack of willpower or effort. Without the “secret code” to unlock how their brain works, even the best systems can fall apart. Over time, the shame of repeated failures creates a bubble that prevents many people from seeking help. 

Breaking the Myths and Seeking Help A common misconception is, “I’m too old to change,” or, “I don’t want to take medication.” However, treatment options for ADHD have come a long way. While medication is one effective approach, there are also many non-medication helpful options, such as therapy, coaching, mindfulness practices, and lifestyle changes. These treatments can provide the tools to manage symptoms and transform your life. 

It’s never too late to seek help. A diagnosis can provide clarity, validation, and a personalized blueprint for addressing the problematic behaviors and issues that have been holding you back. With the right support, you can embrace the superpowers of ADHD—passion, creativity, empathy, and exceptional problem-solving skills. 

Moving Forward If this resonates with you, know that help is available. Acknowledging the possibility of ADHD is the first step to creating the life you want. Reach out for an evaluation, connect with professionals who understand adult ADHD, and don’t be afraid to advocate for yourself. 

You aren’t lazy, unmotivated, or broken. You’re just wired differently—and that difference can be your greatest strength once you have the tools to harness it. 

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AI and Therapy

Bryan Duckham, MSW, LCSW, Ph.D.

A few years ago, I remember hearing a researcher say that we were still far away from developing reflective and highly responsive Artificial Intelligence. Yet ChatGPT arrived on the scene with lightning speed; along with it have come AI programs that offer counseling. Recently, a “60 Minutes” episode featured the developer of one of these programs. She discussed the successes and the challenges in creating an AI counseling application that is reliably empathic. On the plus side, research psychologist and entrepreneur Alison Darcy rightly pointed out that, “The majority of people who need care are not getting it,” and AI can get it to them sooner. Still, counselors and those seeking counseling need to be asking, “What might we gain and what might we lose by using AI counseling?” 

Most technological advances provide some benefit. AI counseling may reach people who have difficulty accessing or affording traditional treatment. AI treatment that is low-cost or free and available digitally may be the only way one can get help. Often, people who are in a mental health crisis need immediate help. Having a program ready-at-hand could stave off a more serious crisis. Finally, a well-attuned AI program might even, occasionally, be more effectively empathic than an egregiously fallible human being. 

What, then, is there to be concerned about? My lifelong education and experience have taught me to understand that meaningful growth stems from complex interactions between two or more human beings. A brief description of two of these categories of interaction and human need can help us better understand the unique value of a human therapist: 

First, everyone needs a caregiver to idealize, whether that is a parent or a mentor. No perfect one exists. However, an idealized caregiver must be attuned enough to help the child accept the frustration that goes with not always getting the care or things they want. This dynamic of idealization and comforted disappointment contributes to a solid sense of self and to security, to pursue ambitions and goals. It also provides a solid base from which the adult can continue to process the idealizing of others while handling disappointments. This core interactional process is a foundation of productive therapy. 

Secondly, humans need to find people with whom they identify, and from whom they can discover inspirational goals. Caregivers uniquely provide this modeling and reflection. As children grow into adulthood, they must find mentors, teachers, or others to assist them in the process of becoming a unique self. As in the case of the first dynamic, this interactional process is activated and imitated successfully in the therapeutic relationship. 

It is hard for me to imagine that a computer program could fully, successfully provide these two critical, developmental, and healing interactions. An overreliance on AI counseling will likely lead to deficits in these two areas. The process of idealization invariably includes unique human non-verbals – voice, tone, facial and bodily expressions. Having humans to look up to, while also acknowledging and experiencing their imperfections, is essential for humans. They allow us to accept ourselves and others as imperfect while maintaining healthy relationships. They also allow us to risk failure and imperfection as we take risks in order to become who we are meant to become. 

AI programs today cannot mirror the panoply of human characteristics and possibilities for one’s life. I remember my own experience with my mentor. His interest in philosophy, psychology, and theology reflected a nascent interest of mine and allowed me to develop in these areas. Looking up to him enhanced this process. How can a computer program construct an algorithm that includes all aspects of humankind if we are unique and ever-evolving? 

Even if these programs could be made to provide optimal empathic responses (and we are far off from that), by failing to serve in these two critical developmental tasks, AI runs the risk of leading to an undesirable conformity. Without supporting uniqueness in development, we could be pushing humankind toward an unhealthy, and severely limited, vision of the world. 

Some say these artificially intelligent therapists are coming whether we want them to or not. The philosopher Yuval Harari in his book “Sapiens” even entertains the notion that we may evolve into some sort of hybrid human-computer. I hope not. My hope is that we always aim to use technology to enhance what is best about being human. Perhaps AI counseling programs will do just that. How can I know? After all, I’m just an evolving human. 

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Retirement: What Do I Do Now?

Julia Covilli, MSW, LCSW

According to the United States Census Bureau in their article, “America is Getting Older” (2023), in 2022, roughly 17% of the national population was 65 years old or older, meaning now, all of those people are eligible for full social security benefits (as 67 years old is considered “full retirement age”) and are considering or already have retired. This is a significant proportion of our population transitioning into a new phase of their life, with many questioning, “What will I do now?” 

As with any life transition, some people move through it with grace and determination while others struggle to accept the new direction in which they are heading. It can be intimidating for those individuals to decide what they should do with their time and how they are “supposed” to be living their life at this stage. Much of this mentality and resulting anxiety can be traced back to childhood and the generational expectations placed on these individuals. 

According to Natasha Rezende of the Only Child World blog, “The parenting style of the Greatest Generation was characterized by strict discipline and a focus on conformity. Children were expected to obey their parents and conform to societal norms.” A substantial proportion of the baby boomer generation was raised in households in which emotions were not allowed, one did not discuss personal problems with anyone, and mental illness was perceived as weakness. With parents who put a heavy focus on conformity, children had less freedom to express themselves and discover their passions. 

It is through feeling and expressing our emotions and dreams that we discover what we like about the world and ourselves. If someone spent most of their childhood being told their enthusiasm was too much and exhausting; or their disappointment and frustration was too dramatic; or if they cried, their parents would ‘give them something to cry about,’ then they were less likely to discover their dreams and passions. This experience, for many, resulted in either failing to realize their passions and potentials or being too anxious about disapproval to pursue or explore those avenues. 

If we stop earning money or stop putting the needs of others before our own, what are we producing? Where does our value go, when we start living for ourself? 

Caregiving expectations have also defined this generation. Of women born in 1960, 33% had their first child between the ages of 20-24, and 24% had their first child between the ages of 25-29. Only 16% did not have children. Most baby boomers moved in with their spouse after marriage, from their family home, and had children soon after – leaving them little to no time to live on their own and explore their preferences as an individual. They went from balancing the demands of their parents, to the demands of their marriage, and soon after the demands of their children. 

When do individuals who grew up with these expectations – to caregive for everyone but themselves – find the time or confidence to consider what they love and how they want to spend their time? Many individuals in today’s retirement generation have spent much of their lives in a state of people-pleasing and putting the needs of others before their own. This is particularly true for women, who are socialized to caregive and prioritize others. The retirement generation helped care for their siblings as children and have cared for their spouses and their own children as adults. They are now being expected to care for their aging parents, maintaining the status quo that the needs of others supersede their own and it is not only inconsiderate but also irresponsible to prioritize themselves. 

When your family of origin emphasizes conformity and people pleasing, it tends to lead to a mentality that humans are to gain and maintain their value based on how much they produce, whether that be through earning money and producing financial security or producing happiness for those around us. If we stop earning money or stop putting the needs of others before our own, what are we producing? Where does our value go, when we start living for ourself? Is following our passions or trying something new “productive”? Can we value our own strengths and abilities without frequent validation from others? 

As the life stage of retirement begins, how can individuals start prioritizing their own needs to live the life they want to live? Some of those ways may include: 

• Setting boundaries – according to Ayushi Mathur from Health Shots (2023), “By setting boundaries, you’re showing yourself that you value and respect your own needs. Setting boundaries also helps prevent burnout and emotional exhaustion. It helps you avoid taking on too much, or things that don’t align with your values or priorities.”

  Setting boundaries involves identifying your personal values and aligning with them. If this feels arduous, reflect on times in which you have felt exhausted or resentful towards someone after interacting with them. A common boundary violation consists of others having unrealistic expectations around time management and caregiving. If you feel someone does not respect your time by anticipating you will accommodate their every whim, setting boundaries can help maintain a healthy relationship and your own mental health.

  The act of saying “no” to unreasonable demands without self-imposed guilt can be incredibly empowering. Expressing to another person how their behaviors affect you and explaining how you would prefer they act towards you can help give that person a guide to treating you more appropriately. Expect to have to assert your boundaries more than once, because habits are hard to break and people do not always agree with others’ boundaries. This can feel daunting, but the more we assert our boundaries, the more confident we become to hold firmly to them.

• Practicing self-compassion – Dr. Kristen Neff writes, “Self-compassion is simply the process of turning compassion inward… Research indicates that self-compassion is one of the most powerful sources of coping and resilience we have available, radically improving our mental and physical wellbeing. It motivates us to make changes and reach our goals not because we’re inadequate, but because we care and want to be happy.”

  Can you recall having someone in your life who seemed to always see the worst in you and consistently debased your efforts? Consider for a moment how they made you feel. Now let’s compare that to times in which you have received constructive criticism (or feedback that highlights mistakes in a way that gives us hope that we can improve). How did that constructive criticism affect your attitude toward yourself and that person? When we see ourselves as ever growing, learning, and changing individuals, we feel more confident to try again or try new ways of doing things rather than wanting to give up or give-in to self-criticism. Self-compassion involves unlearning our self-critical ways and practicing new, compassionate ways of treating ourselves to enhance our self-confidence and self-perception.

• Practicing self-care – Many people believe that self-care consists of bubble baths and massages, but it is so much more than that! Self-care is the act of doing things to improve our overall health and well-being. According to Dr. Matt Glowiak in his article, What is Self-Care and Why is it Important For You? “Engaging in a self-care routine has been clinically proven to reduce or eliminate anxiety and depression, reduce stress, improve concentration, minimize frustration and anger, increase happiness, improve energy, and more. From a physical health perspective, it has also been clinically proven to reduce heart disease, stroke, and cancer. Spiritually, it may help keep us in tune with our higher power as well as realize our meaning in life.”

  For some, self-care looks like exercise, being outdoors, taking a much-needed nap, or talking to a close friend or therapist. An introverted person may gain back their energy reserves by taking some time alone to do a hobby or meet with just one or two close friends or family members, while an extroverted individual may feel restored by participating in a social event like joining a local club, intramural sports team, or religious organization. Engaging in activities that improve our mental, spiritual, and physical health sets us up for success in all other areas of our lives, including being able to be there for our loved ones.

• Avoiding comparing ourself with others – This is a daunting task for most, since societally we are conditioned to prove our worth by being the best and competing with others. However, just as self-criticism depletes our self-esteem, comparing ourselves to others debases our real accomplishments and reduces our confidence. To avoid comparisons, it is helpful when we engage in these key skills: identify strengths and lean into them by setting personal and attainable goals, practice gratitude, challenge negative thoughts and reframe thoughts more accurately and honestly, and manage social media through following people who inspire and unfollowing those who trigger comparisons. Comparing ourselves to others takes place in real world experiences and on social media, so taking social media breaks can be just as critical in improving our self-esteem and confidence as any other choice to reduce social comparison.

There is no right or wrong way to be retired. For those in the midst of this life transition, try to remain intentional in giving yourself grace. People spend their entire lives building up who they think they are and want to be. Retirement dramatically changes that. It challenges individuals to reconsider much of their identity and purpose in this world, which can be intimidating, but if people take these in stride and allow themselves to explore all that they can become, retirement can be just as invigorating of a transition as any other experience one has in their lifetime. 

Julia Covilli, MSW, LCSW enjoys providing therapy to adolescents, adults, and seniors with a wide variety of mental health and relationship concerns. 

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Difficult Care Choices: Care Management Helps Families Navigate

Maria Miskovic, MSW, LCSW

During the summer of 2024, West County Psychological Associates experienced a transition in leadership. After almost four decades under the ownership and direction of Dr. Mary Fitzgibbons, the new ownership team (myself, my husband Steve Miskovic, and co-owner Matt Skaggs) have been busy learning about the company, getting to know its therapists and staff, and building relationships with WCPA’s many connections in the community. 

Before acquiring WCPA, Steve and I have had backgrounds in care management services, specializing in serving people with disabilities and geriatric needs for the last 30+ years. For over a decade, we have primarily provided that care through our company, Care Choice Care Management. 

What is Care Management? Professional care management is a holistic, client-centered approach to caring for older adults, disabled, or mentally ill persons. The goal is to improve the client’s quality of life and reduce family stress through assessment and monitoring, education and advocacy, planning and problem-solving, and family caregiver coaching. 

Care Managers are professionals in social work, nursing, gerontology, & similar fields, who assist in a variety of areas, such as: 

• Housing – helping families evaluate and select appropriate level of housing or residential options 
• Home care services – determining types of services that are right for a client and assisting the family to engage and monitor those services 
• Medical management – attending doctor appointments, facilitating communication between doctor, client, and family, and if appropriate, monitoring client’s adherence to medical orders and instructions 
• Communication – keeping family members and professionals informed as to the well-being and changing needs of the 
• client 
• Social activities – providing opportunity for the client to engage in social, recreational, or cultural activities that enrich the quality of life 
• Legal – referring to or consulting with elder law or disability attorneys, providing expert opinion for courts in determining level of care 
• Financial – may include reviewing bill paying or consulting with the accountant or client’s Power of Attorney 
• Entitlements – providing information on federal and state entitlements; connecting families to local programs 
• Community Connection – identifying appropriate community programs and services that might enhance one’s quality of life and afford additional benefits that were otherwise unknown to family or the client 
• Safety and security – monitoring client at home; recommending technologies to add to security or safety; observing changes and potential risks of exploitation or abuse 

If you or someone you know are choosing care options for a loved one, you know how bewildering and time-consuming these decisions can be. Care Choice is one of the leading practices of its kind in the Midwest. Our wide network of specialists in aging, special needs, and health care help coordinate the best care for individuals and loved ones. Clients’ plans are modified as circumstances and needs change, to continue to meet the goals of the individual and family. 

If you have questions about care management services, feel free to call our office at 636-288-1764 ext. 1. Let us help you or a loved one navigate the healthcare system. 

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