Family | Marriage Expert
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Family | Marriage Expert – Tiffany N. Smith, LMFT, LPC, NCC,
Tiffany Smith Counseling, LLC Tiffany N. Smith, MS, is a Licensed Marriage and Family Therapist, Licensed Professional Counselor, and National Certified Counselor. Prior to opening her private practice in Flower Mound, Tiffany co-authored “Strategic Family Therapy” and “Multiculturalism in Family Therapy” in the textbook A Practical Approach to Teaching Family Therapy (Springer Publishing, 2010). She served as a workshop presenter at the Texas Association of Marriage and Family Therapy Conference in 2006 and has offered various seminars and workshops throughout the Metroplex on topics such as: Aging, Mental illness, Parenting, Marriage Enrichment, Sexuality, Grief & Loss, Co-Parenting, Motherhood, and Stress Management.
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| Disclaimer: No other individual or organization mentioned here is in any way responsible for, nor do they necessarily endorse, any content on this portion of Ask The Expert on FlowerMoundFamily.com. Any opinions are those of Tiffany Smith, and any errors, omissions, or misrepresentations are Ms. Smith’s responsibility alone. Tiffany Smith does not offer online counseling services and any opinions submitted here are not to be considered psychotherapy treatment. The information provided is for instructional or educational purposes only. Please consult your own physician, mental health provider, or other appropriate health care provider, about the applicability of any information provided with respect to your own symptoms, or medical or psychiatric conditions. Copyright Tiffany Smith Counseling, Inc. 2010. All rights reserved. |
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What’s Your Family, Child Behavioral or Marriage Related Question? (click here to ask)* |
| Questions submitted by other readers (click on question to go directly to answer): | ||
| Q. Our daughter just turned 6 years old and is still wearing a pull-up to bed at night, which is wet every morning when she wakes up. She has been in panties and dry during the day since she was 3 1/2. Is there a secret to nighttime potty training? Could this be an emotional issue? Should we be worried? | ||
| Q. I am having baby #2 next month and I want to be better emotionally prepared. I got the baby blues pretty bad (though not as far as depression) for about 6 weeks or so. It didn’t start right away, but a couple weeks after birth. I want to keep sanity in our house my myself (the mom of a 2-year old and new baby) and for my husband. Let me know what I can do to prepare. | ||
| Q. I know I need help, but I don’t think I can afford therapy. What can I do? | ||
| Q. There are so many counselors to choose from. How can I be sure to choose the one that is right for me? | ||
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| Answers submitted by “The Expert”: | ||
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Q. Our daughter just turned 6 years old and is still wearing a pull-up to bed at night, which is wet every morning when she wakes up. She has been in panties and dry during the day since she was 3 1/2. Is there a secret to nighttime potty training? Could this be an emotional issue? Should we be worried? A. The cause for concern would be that if your child had been going for months or years without a nighttime accident and then suddenly began having nighttime accidents. Or if she began urinating right in front of you on the floor or inappropriate places during the day. That would indicate that she would need to see her Pediatrician immediately for further evaluation. However, if she is only struggling with nighttime bed-wetting and has no other behavioral or physical symptoms it sounds like she could have primary nocturnal enuresis. According to Dr. Alan Greene, “Children who can control their bladders during the day, but who have never been dry at night for at least a six month period, have what is known medically as primary nocturnal enuresis (PNE), the most common form of bed-wetting. Over five million school-age children in the US alone have PNE.” The only way to be sure is to have her seen by her Pediatrician. There are many factors that can contribute to nighttime bed-wetting. First, it can also be genetic. In other words if someone in your immediate family had a history of nighttime bed-wetting, than your children might also be affected. If your child is a deep sleeper and has a small bladder, or her body makes more urine than her bladder can hold in a night, the combination of the two create a child that is likely to have difficulty waking when needing to urinate during the night. This is where as a parent, you have to step in and assist. Elimate drinking any liquids after dinner. Encourage your child to empty her bladder completely right before bedtime. Before you go to bed, wake your child and carry her to the bathroom to urinate. If she is not wearing pull-ups, find out the pattern to her night time urination. What time of night does it usually occur? Then set an alarm for 30 minutes before that time to wake yourself and then wake her to urinate. There are also some websites available that sell bed pads with alarms that will sound when liquid hits them and are supposed to wake children to inform them they need to go to the bathroom. Eliminate caffeine from your child’s diet (sodas, tea, and chocolate) as they can exacerbate the problem as well. Lastly, you can always ask your Pediatrican for a referral to a physician who specializes in bed-wetting for additional tips and assistance. Although, night time bed-wetting can cause great frustration in the house, it is important to not shame your daughter when it occurs. Night time bed-wetting can be especially embarrassing for children. Ask her to assist you with clean-up but also talk with her about how you understand she did not urinate in bed on purpose. Valdiate any feelings she may have. Talk with her in the morning and during the next day about the reasons you want to enforce diet and liquid restrictions to help her avoid having nighttime accidents. |
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Q. I am having baby #2 next month and I want to be better emotionally prepared. I got the baby blues pretty bad (though not as far as depression) for about 6 weeks or so. It didn’t start right away, but a couple weeks after birth. I want to keep sanity in our house my myself (the mom of a 2-year old and new baby) and for my husband. Let me know what I can do to prepare. A. Right after delivery, hormone levels in a woman rapidly drop. This often results in what is called, ”Baby Blues” which usually does not last more than 10 days. However, some women experience symptoms much longer for 3-6 months after delivery which is known as Post-Partum Depression. Post-Partum Depression symptoms can range from mild to severe (including psychosis). Women who have severe symptoms including thoughts of harming themselves or their child(ren) need to seek help immediately.
Many women experience Post-Partum Depression. Although each pregnancy and Post-Partum period is different, women who have struggled with this with their first pregnancy are likely to struggle with it again. It is important to be pro-active in taking control of your depressive symptoms should they develop again. Find time to do things everyday that help keep your spirits up such as taking a shower, putting on make-up, taking a walk, listening to music, or journal writing. This is accomplished by finding someone to watch the children for 20 minutes so you can have time to focus on yourself. If there is no help around, let that load of laundry sit unfolded while the baby sleeps so you can watch a funny movie. Find time to be silly each day. Make funny faces with your 2-year-old. Giggle, laugh, and dance in the living room. Rest at night between feedings and try to get a nap in during the day (maybe two). Try to get some exercise each day to help alleviate anxiety. This can be done by simply pushing the stroller around the neighborhood. Eat a balanced diet with a lot of protein, vegetables, and fruits. Be sure to add in your extra 1,000 calories each day if you are breastfeeding. The most important thing to help you prepare is for you to not be afraid to ask for help. In fact, welcome it. Its like that old saying, “It takes a village to raise a child.” It is important during this time to have a strong support system in place. Many friends, family, and neighbors may want to come visit and ask what they can do to help you. Make a list of things that you could use help with that way when you are feeling overwhelmed you can designate things out for others to help you with such as laundry, meals, rocking the baby while you take a shower or nap, or taking your 2-year-old to the park or to a friend’s house. Find a support group of mother’s who have struggled with Post-Partum Depression and talk with them about your feelings. Visit with a counselor who can assist you with processing your overwhelming feelings and help you find balance. Lastly, be sure to communicate about your feelings openly and honestly with your doctor. Talk with your doctor about your previous experience with Post-Partum Depression so you can come up with a plan of action should you develop symptoms again. After your delivery, if you at any point develop any symptoms of Post-Partum Depression, please let your doctor know immediately so that he/she can get you the help you need.
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Q. I know I need help, but I don’t think I can afford therapy. What can I do? A. Not all psychotherapy has to be long term and last for years and years. There are many therapists who now offer brief psychotherapy which is intended to last only a few months for minor issues. It is also important to look at the big picture. If you are looking for marital therapy, isn’t the cost of that cheaper than a divorce? Or if you are looking for therapy for your children, how can a price possibly be put on that? But the truth of the matter is there is a financial cost involved with psychotherapy and although it may be necessary, sometimes it just is not in the budget for your family. If that is the case, the first thing you can do is check your health insurance benefits to see what providers are covered under your plan. There are obstacles when going through your health insurance company and sometimes they may not cover the type of therapy you need. So it is important to discuss the limitations of your plan with your insurance provider when verifying your benefits. If you do not have health insurance or counseling is not covered under your benefits, you can contact some local non-profit agencies in the area that offer sliding fee scale such as Youth and Family Counseling in Flower Mound. Additionally, Texas Woman’s University and the University of North Texas have community clinics where graduate students receive training in psychotherapy by their professors and therefore the fees for services are extremely low. It is important to remember when using a non-profit agency or University clinics that some of the providers are under a limited time contract and it is important to ask when their contract will expire when beginning treatment. Whatever you decide, it is important to find someone that is right for you and your pocket book because the overall knowledge, experience, and growth you receive from therapy is priceless. |
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Q. There are so many counselors to choose from. How can I be sure to choose the one that is right for me? A. The most important thing you can do as a consumer is to research your therapist and feel free to ask questions about their experience and clinical training. Be sure to choose some one who is Licensed by the State of Texas. Counselors and Psychotherapists must pass Licensing exams and board requirements before being awarded a license. Additionally, they must continue to acquire continuing education and follow the ethical guidelines and rules outlined by their boards. You can easily do this by visiting their counseling website and reading his or her bio. Next, look at the counselor’s specialization or focus of practice to determine if he or she is the best person to help you with your specific problem. Many counselors also offer a phone consultation prior to your first appointment. This is where you get to get a feel for his or her personality and approach to treatment. This is a time where you can decide if you think the two of you would work well together. The next step after this is scheduling an initial appointment. After meeting with your counselor for your first appointment, you will have a good idea if you think this person will be the right counselor for you. |
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Are You Ready to Make a Positive Change Call Tiffany Smith Counseling Today! 2901 Corporate Circle, suite H 214.405.4030 |
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All questions submitted to FlowerMoundFamily.com’s Ask-the-Expert Feature will be anonymously submitted to the appropriate Expert. Once we receive your answer we will email you and post the question and answer anonymously on the appropriate FlowerMoundFamily.com Expert webpage. All answers are generated by the above listed expert and are solely intended for informational and/or entertainment purposes only and do not necessarily reflect the beliefs and/or opinions of FlowerMoundFamily.com and its staff. |
