Dr. Anthony Fiore, PhD, Psychologist

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.

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.

Each family member can be affected by an issue in an individual and unique way, typically depending on age, maturity, and involvement. This means that family issues are often inequitable, with one or more family members bearing a disproportionate weight of the problem. A frequent example is parental divorce. While both parents may appreciate the immediate relief, divorce can rapidly threaten a developing child's sense of stability and self-confidence. Similarly, a mother who is subject to domestic abuse may conceal the issue in order to shield her children from her distress. In some cases, family issues are generational; a father may cause residual guilt or disagreements from his childhood to carry forward to his own son. While each family's experience is unique, common family issues can include:

• Financial disputes
• Divorce and separation
• Abuse and violence
• Narcissistic caretaker(s)
• Death
• Infidelity and relationship issues
• Sibling rivalry
• Religious and cultural conflicts
• Lifestyle disagreements
• Severe physical illness
• Mental health issues
• Neglect
• Retirement and older adulthood
• Unsafe or unstable household environment

Some family issues are inevitable – such as retirement and minor lifestyle disagreements – while others can be unexpected and dramatic. Unsafe household environments, abuse, and neglect can lead to severe trauma and intervention by social services or law enforcement.

Most common family issues can be addressed through therapy with one or more family members. Family therapy involves sessions led by a licensed mental health therapist. These sessions often include family discussion, resolution strategies, and other activities to promote family harmony. Another form of treatment for family issues is couples counseling, in which a couples counselor can help spouses communicate and employ problem-solving techniques to improve the strength of their relationship. For children, specialized child therapy can help children and adolescents manage and overcome family issues with age-appropriate methods.

Some people find individual therapy or counseling beneficial in resolving family issues, especially for those who are unable to attend family therapy with other family members. Therapists may encourage the creation of family boundaries. At an extreme, therapy may cause an adult to come to the conclusion that communication with a narcissistic parent must stop in order to preserve mental health and wellbeing.