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Melizza Ramirez Esperanza, LCSW is a social worker in San Diego, CA specializing in psychiatry and social work. Melizza Ramirez Esperanza, LCSW is affiliated with Regents of the University of California and UC San Diego Health.
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Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy, or CBT, is a form of psychotherapy or treatment for mental illness. It comes in a variety of methods, but the basic concept behind all CBT is the same -- thoughts cause feelings, which cause actions. If someone wishes to change problematic behaviors or emotions in their lives, they need to start by changing their thoughts. CBT examines ideas and looks for patterns that may be causing harmful actions. The therapist helps patients modify those thought patterns and, in doing so, helps them feel better and cope more effectively.
CBT is one of the most widely studied forms of psychotherapy, and it has been shown to be extremely effective for a variety of mental illnesses. Some of the issues that respond well to CBT include mood disorders, personality disorders, eating disorders, substance abuse, sleep disorders, and psychotic disorders. In some cases, CBT has been shown to be as effective or even more effective than medication. One of the interesting things that the scientific study of CBT has shown is that CBT actually changes the way the brain works, physically improving its function.
CBT differs from traditional psychotherapy in a few key ways. One of the most important distinctions is the emphasis on the power and responsibility of the patient in CBT. The patient will be encouraged to be the one asking the questions in CBT therapy, and most patients are assigned homework to complete outside of therapy sessions. There is a concept in CBT that everyone has power the power to change how they feel, even if they cannot control the situation, and this can be very empowering for patients. Because of this power shift, the therapist-client relationship is not as critical to success in CBT as it is in other modes of therapy. Patients should still get along well with their therapists, but they do not need a deep, dependent emotional connection to them. Finally, because CBT often treats a specific issue or problem, it is usually shorter in duration than traditional therapy. While some therapies may continue for years, CBT lasts on average just 16 sessions.
Depression
Everyone knows what it feels like to get the blues once in a while. But depression is a serious illness that is more severe than a bad day and lasts much longer. Symptoms of depression stop a person from being able to function and enjoy daily activities for weeks or months at a time. It can happen to anyone, and it isn't something that people can control by force of will or "snap out of it."
Some common symptoms of depression include:
We don't yet know what causes depression, but it's thought that it is a combination of genetic, biological, environmental, and social influences. Because of this, the most effective treatments for depression combine medication with psychotherapy. Therapy, especially cognitive-behavioral therapy, can be extremely helpful in resolving the negative thoughts and feelings that come with depression. It gives patients new tools that they can use themselves to cope when their depression is making them feel down.
Some of the common medications used to treat depression include antidepressants such as SSRI's (Prozac, Paxil, Zoloft) or atypical antidepressants (Cymbalta, Wellbutrin). It's important to remember that these medications have different effects on everybody, and no one medication works right for everyone. Patients may have to try a couple before finding the one that works just right for them. If the first medication they try doesn't work, they should talk to their doctor about trying something else. In extreme cases where medication is not enough, electro-convulsive therapy and hospitalization may be the answer to keeping a severely depressed person safe.
Depression is a difficult illness to deal with, but it is more common than believed and there are many people who can help. With the right treatment, individuals with depression can get back to fully enjoying life again.
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) is a form of therapy that helps people recover from distress resulting from past trauma. Founded in the late 1980's, EMDR is most commonly associated with post-traumatic stress disorder (PTSD) treatment, although it may treat other mental health conditions as well, such as:
During an EMDR therapy session, patients are encouraged to access upsetting memories and to reprocess them. Reprocessing is achieved by repeated and rapid bilateral (side to side) eye movements, tapping one's chest and face, and auditory and visual stimulation. These techniques can desensitize patients to their traumatic memory. By reframing how a patient interprets a memory, EMDR is believed to weaken the fight-or-flight response and to rebalance the nervous system. For patients with PTSD, EMDR can treat recurring flashbacks and triggers by reducing the hyperarousal response and promoting emotional regulation.
EMDR patients are first asked to identify a specific memory to reprocess, called the ?target event.? Patients can discuss their feelings, sensations, and beliefs about the event, and may share a picture or use descriptive imagery. Therapists usually employ a set of measurements called the Subjective Units of Disturbance (SUD) scale to assess the patient's distress. Later on, therapists and patients may compare the patient's initial SUD score to their score following an EMDR session. Unlike other forms of therapy, EMDR patients are not prompted to analyze and reflect on details of their traumatic memory at length.
With a target event having been selected, therapists may begin the desensitization process. They instruct patients to perform eye movements, body taps, or sounds while capturing the target event in their mind. These techniques are called dual attention bilateral stimulation (BLS) and can help a patient feel calm and aware, while simultaneously invoking the brain's processing system. Patients may continue these techniques until their SUD distress level has decreased. Patients are then asked to derive a positive thought or affirmation about the target event, and to repeat or strengthen it until it feels sincere. A final ''body scan'' is where patients focus on both the target event and positive cognition to evaluate their physical response and identify any remaining distress. If the traumatic incident is not fully processed in one session, patients are asked to contain the memory and to avoid returning to it until their next EMDR session.
EMDR may greatly improve quality of life in people who suffer from latent trauma and adverse life experiences. EMDR may also be effective for those whose prior experience with talk therapy was unsuccessful.
She has a state license in California.
Licensed In: California
Melizza Ramirez Esperanza, LCSW is associated with these hospitals and organizations:
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Ms. Melizza Esperanza's areas of specialization are social work and psychiatry; she sees patients in Chula Vista, CA and San Diego, CA. Clinical interests for Ms. Esperanza include acceptance and commitment therapy, depression, and cognitive-behavioral therapy (CBT). Ms. Esperanza is professionally affiliated with UC San Diego Health and Regents of the University of California.