Long before I chose counseling as my profession, I dealt with my own personal mental disorder; social anxiety. The disorder had taken over my life when I was in high school. It got so bad that I missed several days of school due to anxiety attacks; including the first day of my senior year. After many years of suffering, my mother took me to our family physician to discuss the issue. My doctor asked me a few questions about my anxious feelings and wrote me a prescription for a relatively new drug called Fluoxetine (a.k.a. Prozac). 

After a few months on the drug, I noticed that my anxious feelings had changed, but not necessarily for the better. I had lost my fear of social situations, but I had not lost the anxiety. It was almost like living two lives at once. I now enjoyed going out with friends and meeting new people, but I still had excessive sweating, heart palpitations, racing thoughts and shaky hands. The drug was masking my fear but not addressing the reasons behind my anxiety. 

When I went to college, I was told about the student clinic that offered free counseling. Over time, I had become more knowledgeable about my disorder and realized that I needed to see a therapist, so I booked and appointment. What ensued was an amazing transformation in my outlook on life. 

Seeing a therapist to supplement the medication was the best decision I could have ever made. Before, I was taking a pill every day and ignoring all the anxious thoughts that still went through my mind. For three months I went to see the school therapist once a week. We would discuss the reasoning behind my anxiety and different ways to look at things. During these sessions, I learned a great deal about myself and about other people. I learned that everyone experienced anxiety every now and then and that most people were too worried about themselves to notice me (my biggest fear was that other people were staring at me). 

Talking through and accepting these simple truths was what eventually brought me out of my fear of social situations. By the end of my college years, I add successfully weaned off the medication. It took me years, but I finally felt comfortable in my own skin. I don't think this would have been possible had I not paired medication with counseling. 

Due to my own personal experience, I firmly believe that anyone who has been prescribed an antidepressant or other mental illness medication should seek counseling from a therapist. Yes, medical doctors can diagnose patients with mental disorders and prescribe the appropriate medications, but using a medication without taking part in therapy is like trying to lose weight through diet only and no exercise; they supplement one another and increase your chances of success.

Lindsey Webster has been a rehabilitation counselor for 15 years and also owns the site Masters in Counseling. She likes to write about different topics related to counseling and careers.

Photo Credit: Steve Snodgrass Flickr

Neuropsychological evaluations are used to gain a better understanding of a range of problems that involve the brain. For instance, people who have had a head injury, a stroke, or brain tumor may be referred for a neuropsychological evaluation to assess the impact of the injury on cognition, memory, language, and motor coordination. Neuropsychological evaluations are also performed with children or adults to gain more information about problems such as learning issues, attentional problems, autism, and even emotional conditions such as anxiety or mood disorders. Referrals for neuropsychological evaluations come from primary care doctors as well as neurologists; primary care physicians; mental health providers such as psychiatrists, psychologists, and social workers; speech/language therapists; and educational tutors. 

Neuropsychologists use indirect methods to study brain functions and their relationship to behavior. The "tools" of the neuropsychological evalauation look like puzzles, drawings, language activities, checklists and computer games. However, these tasks have been carefully designed to measure some function that is important in learning and problem solving, and then administered to a large number of people. The results are transformed into standardized scores that allow for the direct comparison of people of different ages and backgrounds. Using the pattern of strengths and weaknesses revealed by these scores, the neuropsychologist can then identify problems, make recommendations for needed services and even design interventions to improve functioning in key areas of a person's life, such as school, work, and interpersonal relationships. 

A neuropsychologist is a licensed psychologist who has completed two years of additional training in the administration and interpretation of neuropsychological measures and the development of treatment regimes to address areas of concern. Neuropsychologists may work in a hospital setting as part of an interdisciplinary team of medical doctors, physical therapists, speech and language therapists and other specialists. They may also work independently in private practices. Some neuropsychologists work in research settings where they use technology such as brain imaging to learn more about brain structure and functioning. 

Neuropsychological evaluations can vary in length and complexity, depnding on the setting and the referral questions. The actual testing time can range from less than an hour in an inpatient unit for someone who has suffered a stroke, to five hours or more in an outpatient unit if the question involves learning issues. The cost of evaluation can also vary widely depending on the amount of testing, scoring, provision of feedback and extensiveness of the written report. Insurance coverage for neuropsychological evaluations varies between insurance companies and plans, and it is important to check with your company to ascertain benefits for different conditions. 

Stephanie Monaghan-Blout, Psy.D. Formerly an adolescent and family therapist, Dr. Monaghan-Blout specializes in the assessment of children and adolescents with complex learning and emotional issues. She has a particular interest in working with adoptive children and their families as well as those contending with the impact of traumatic experiences. She is a member of the Trauma and Learning Policy Initiative (TLPI) associated with the Harvard Law Project, and is working with that group on an interdisciplinary guide to trauma sensitive evaluations. 

Dr. Monaghan-Blout obtained her doctoral degree at Antioch New England Graduate School. She completed an internship in pediatric neuropsychology and child psychology at North Shore University Hospital in New York and a postdoctoral fellowship at HealthSouth/Braintree Rehabilitation Hospital. She joined Children's Evaluation Center in 2003, and NESCA at its inception in 2007. Dr. Monaghan-Blout is currently a member of the Board of Directors of the Massachusetts Neuropsychological Society. 

Dr. Monaghan-Blout is the mother and stepmother of four children, and the grandmother of four (and counting). She is also an avid ice hockey player.