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Dr. Philip Bransford Gnilka, LCPC, CCMHC, PhD is a counselor in San Francisco, CA specializing in counseling.
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Couples Issues
Couples' issues are problems that occur in spousal or romantic relationships. While every couple may have some disagreements, couples' issues can grow more severe when unresolved disagreements fester over time, potentially culminating in resentment and emotional distress. These issues can lead to breakups, including divorce. Fortunately, people can strengthen their relationships through communication, empathy, and compromise. Couples counseling can help people overcome relationship problems and work through conflicts in a positive setting.
Some examples of couples' issues include:
Couples counseling, also referred to as couples therapy or marital counseling, can help people assess and better understand fractures in their relationships. A couples counselor may ask partners to determine what problems they are facing. Couples counselors may instruct each partner to describe their underlying emotions, experiences, and beliefs in detail. This process may be performed with both partners in the same room or just one at a time. The goal of this exercise is for partners to gain greater understanding of each other's needs and to create solutions for these needs to be met. For example, a couple may arrive at the conclusion that one partner's work schedule leads the other to feel neglected or overwhelmed. Then, couples might implement strategies such as increased communication and partner agreements. These strategies may address previous conflicts as well as prevent new ones from occurring.
In some instances, couples counselors may recommend individual therapy for one or both partners. Individual therapy can address mental health problems that negatively impact the relationship. With continued counseling, people can restore communication and may gain greater understanding of one another's needs, enabling them to better develop solutions for these needs to be properly met.
Dialectical Behavior Therapy
Dialectical behavior therapy, or DBT, is a form of cognitive behavior therapy (CBT) that was originally developed to help the most severely mentally ill and depressed patients accept therapy. It relies on the same concept in CBT that examines the relationship between thoughts, feelings, and actions, but in DBT the emphasis is first on acceptance rather than change. There is also an emphasis on mindfulness, 'being in the moment,' and relaxation techniques such as yoga. These are combined with a great deal of validation and encouragement from the therapist.
The word 'dialectical' means acting through opposing forces, and this word refers to a few different opposing concepts in DBT:
Dialectical behavior therapy was developed when therapists attempting to use CBT techniques on the most seriously ill patients ran into a problem. When they suggested that a patient change their thoughts, these very vulnerable patients would become overwhelmed and turn aggressive or suicidal. DBT was developed to support these patients with acceptance and validation while still guiding them towards changing problematic thoughts. Although also used for suicidal and self-harming patients today, these days, DBT is mainly used to treat borderline personality disorder. It is one of the few effective interventions for this serious illness.
DBT has been shown to be very effective at reducing self-destructive behavior. It can also be used to teach new coping skills and increase a patient's self-esteem and motivation to become healthier.
Workplace Issues
Workplace issues are problems related to one's work environment and experience. These problems can create hostility and conflict between employees and their companies or coworkers. They can lead to mental health issues such as increased stress, anxiety, depression, and even trauma. Nearly everyone who works is faced with workplace issues at one point in time. Common workplace issues may include:
These problems and others can make a workplace seem toxic. For example, a worker may be propositioned with "quid pro quo" harassment, when a superior seeks sexual favors in exchange for a job benefit. Beyond being highly inappropriate, this sexual harassment can cause the targeted employee to suffer from damaged self-esteem, emotional distress, and other mental health problems. Different workplace issues, like low salary or dangerous work conditions, can threaten a worker's financial and even physical health.
One of the most common forms of workplace issues is bullying or abuse from coworkers. It can occur in a number of situations, from high performers facing threats from jealous coworkers, to a worker receiving unreasonable requests from a supervisor. Workers may be too fearful to confront work abusers and complaints to HR departments and supervisors can be unfruitful or even detrimental, leading to incidents going unreported.
Mental health therapy can mitigate the negative emotions and behaviors arising from workplace issues. Therapists may listen to people's workplace issues and provide advice for how to navigate a number of work-related problems. Online counseling can be particularly helpful in the modern workplace. Direct access to a therapist throughout the day can help alleviate recurring pressure and anxiety arising from one's job. In some cases, therapists may encourage some to seek other job prospects and opportunities.
He has a state license in Nevada.
Licensed In: Nevada
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Dr. Philip Gnilka obtained a license to practice in Virginia.