Napping Improves Learning

Well here is an interesting research article. Taking a brief nap after learning can help consolidate learning when sound cues are introduced while sleeping. Northwestern researchers conducted a study in which subjects were shown objects on a computer screen in a specific location. Those images were associated with a sound (e.g., an image of a cat and the sound of a cat meowing). Subjects were then instructed to take a nap. While sleeping the sounds of some of those images were played. Subjects were more likely to remember the positions of images if they had heard the sound in their sleep. Additionally, the subjects reporting having not heard anything while napping.

The researchers concluded that consolidation of learning occurs during sleep and can be influenced by auditory stimulation.

Apparently the learning has to happen before the sleeping part. This is evidenced by my inability to remember anything from morning classes in high school. Then again, it could just be because that was a long time ago.

Can Counseling Change Your Brain?

I recently was tweeted about an interesting study about the effects of psychotherapy. In a study authored by Jakob Koch of Christian-Albrechts University in Kiel, Germany, it was suggested that psychotherapy with depressed patients is associated with chemical changes in the brain.

This is pretty exciting stuff. I've seen many studies that associate psychotherapy with behavior change or change in self-report of moods. I've never seen a study that has associated psychotherapy with actual biological change in brain chemistry. This study does that. The research found that psychotherapy, in-and-of-itself, was demonstrated to be associated with positive changes in brain chemistry.

Wellstone-Domenici Mental Health Parity Act

Mental Health Parity is coming to a health insurance plan near you on January 1st, 2010. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (commonly known as the Wellstone-Domenici Parity Act) was enacted into law on October 3, 2008. After a long lag time, most insurance plans are required to be in compliance with this law by the first day of the new year.

This bill is designed to end the health insurance benefit inequity between mental health/substance use disorders and medical benefits for group health plans with more than 50 employees. This means that there cannot be arbitrary limits for the coverage of biologically based conditions (e.g., 12 sessions a year for the treatment of depression if there are no similar limits for medical visits).

It is estimated that under this law, 113 million people will have the right to non-discriminatory mental health coverage.

Massachusetts has had a parity law for sometime. However, under this law individuals who are enrolled in self-funded plans (fully funded by the employer) were not covered by the parity law in the Commonwealth. This is changing on January 1st, 2010.

There are some important caveats. Mental health and addictions coverage is not mandated. No insurance plan is required to offer this type of coverage. Mental health coverage is offered at the discretion. An employer can elect to purchase a plan that offers no benefit at all. Additionally, companies with less than 50 employees are not required to provide parity. Lastly, there is a cost exemption. If, after six months of meeting the requirements of this law, a company can demonstrate and have certified by a licensed actuary that the costs of providing this coverage are excessive, their group health plan can be exempted. Excessive is defined as an increase of the actual total costs of coverage by two percent during the first year or one percent in subsequent years.

For more information:

Mental Health Parity Summary

Have a complaint about your insurance plan?

Commonwealth of Massachusetts, Division of Insurance 

National Day of Listening

This coming Friday is the National Day of Listening. The goal is to reserve one hour of the day to record a conversation with someone you find important: an older relative, friend, teacher, or someone you've noticed but have never taken the time to learn about.

Want to know more? Head to the National Day of Listening website to learn how to participate.

Twitter

It's interesting really. I consider myself a pretty tech-savvy person in my day-to-day life. I'm a fan of electronic gadgets and tend to be an early adopter of new technology.  Those of you know know me in my private practice would feel differently: according to some my little paper calendar makes me look like a dinosaur.

I'm making a slow crawl toward moving my psychotherapy practice into the 21st century. I've opened up a Twitter account. If you look to the toolbar on the right, there is a box in which you can click to follow my tweets.

For now, I'm going to use Twitter to make general annoncuments: updates to my website or blog, my vacation schedule, inclement weather or traffic calamity alerts, and notifications of being out sick. Twitter will not be my primary way of notifying current clients about changes in my schedule: I will always contact by phone and/or e-mail first. I will not utilize Twitter as a primary way to contact clients.

Twitter raises some privacy concerns that I'm working on sorting out. I believe that anyone can see who follows me on Twitter. If you choose to follow me on Twitter, you will need to agree that it is okay that other people know you are doing so. In that Twitter is not confidential and thus I cannot protect the privacy of such communications, I will not be using Twitter for any direct contact with individual clients.

Hang in there with me as I develop this tool. I also am working on the development of a revision of my privacy policy that will include Twitter, this blog, and communications in the electronic realm in general. When it is finalized, that privacy policy will be posted on this blog, on www.drjasonmihalko.com, and discussed in my office.

Animal Assisted Therapy

Since I've started bringing Maggie into the office on a regular basis I've been fielding a lot of questions about the benefits of animal assisted therapy. Here are a few interesting research articles. I found them to be interested and thought I'd share a few abstracts. I am particularly struck that even the presence of an aquarium in an ward of patients who have Alzheimer's has been shown to have a significant positive effect.

Barak, Y., Savorai, O., Mavashev, S., & Beni, A. (2001). Animal-Assisted Therapy for Elderly Schizophrenic Patients: A One-Year Control Trial. American Journal of Geriatric Psychiatry, 4, 439-442.

In a blind, controlled study, the effects of animal-assisted therapy were studied with elderly patients diagnosed with schizophrenia. The study indicated that there was a significant increase in mobility, interpersonal contact, communication, personal hygiene and self-care through the use of cats and dogs as modeling companions.

Barker, S. B., Pandurangi, A. K., & Best, A. M. (2003). Effects of Animal-Assisted Therapy onPatients' Anxiety, Fear, and Depression before ECT. The Journal of ECT, 19, 38-44.

This study was done to determine whether animal assisted therapy is associated with reductions in fear, anxiety, and depression in psychiatric patients before electroconvulsive therapy (ECT). The effect of AAT on fear was significant in the study and the conclusion was drawn that animal assisted therapy may have a useful role in psychiatric and medical therapies in which the procedure is inherently fear-inducing or has a negative societal perception.

Edwards, N. E. & Beck, A. M., (2002). Animal-Assisted Therapy and Nutrition in Alzheimer'sDisease. Western Journal of Nursing Research, 24, 697-712.

This study was really interesting to me. It examined the influence of animal-assisted therapy--this time fish aquariums--on the nutritional intake for individuals with Alzheimer's disease. The researcher's collected baseline nutritional date for two weeks before the study began and then every two weeks after the aquariums were introduced. Nutritional intake increased significantly when the fish were introduced and continued to do so over a 16-week period. They study also found that the participants required less nutritional supplementation (they were eating better) and thus had a net savings effect on their health care costs!

Filan, S. L., & Llewellyn-Jones, R. H., (2006). Animal-Assisted Therapy for Dementia: A Review of the Literature. International Psychogeriatrics, 18, 597-611.

This article reviewed several small studies that suggest the presence of a dog reduces aggression, agitation, and promotes social behavior in people with dementia.

Martin, F., (2002). Animal-Assisted Therapy for Children with Pervasive Developmental Disorders. Western Journal of Nursing Research, 24, 657-670.

This study evaluated the effects of interaction with dogs on children with pervasive developmental disorders. These disorders are characterized by a lack of social communications and abilities. While interacting with a therapist, children who were also exposed to a therapy dog exhibited a more playful mood, were more focused, and were more aware of their social environments.

Folse, E. B., Minder, C. C., Aycock, M. J., & Santana, R. T., (1994). Animal-Assisted Therapy and Depression in Adult College Students. Anthrozoos: A multidisciplinary Journal of the Interactions of People and Animals, 7, 188-194).

This study investigated the effects of animal assisted therapy on self-reported depression in college students. Students were randomly assigned to one of three groups: animal assisted therapy in conjunction with psychotherapy (directed group), animal assisted therapy only (non-directive), and a control group. They study demonstrated a significant difference between the control group and both the directive and non-directive group, suggesting that that just the presence of a therapy dog can have a positive effect on depressive symptoms.