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  • Wednesday, October 30, 2013 6:05 AM | Admin EBCAMFT
    Happy Fall!

    We are heading into a particularly busy time for the Chapter with elections around the corner and planning for annual General Membership meeting.

    This year we will have several open positions on the Board and I welcome your interest in participating on the Board for 2014. We have Member at Large positions open as well as the Secretary position. With all that has been going on at the State level, we are in great need of passionate members to assist the Chapter in advocating for the needs of MFT's.  Please contact me for more information. Election ballots will be sent out in mid November.

    We are currently in the process of putting together the results from our recent survey about the CAMFT bylaw changes. We will share results ASAP and appreciate all those who participated.  EBCAMFT will continue to utilize surveys to gain clarification around our Chapters’ needs and ways to best serve our community.  

    As many of you already know, State CAMFT voted at their most recent Board meeting to repeal the new bylaws and reinstate the former bylaws pending a membership vote.  This action is a step in the right direction and would not have been possible without the hard work from many dedicated members who gave their time and energy to advocating to the State Board.  In an effort to show support for the cause and the efforts of those who have generously donated their time and energy, the Board of EBCAMFT recently made a donation to Laura Strom, MFT and Heather Blesssing, Intern MFT.  These two women have worked tirelessly for the cause to reinstate the old bylaws and we wanted to show our appreciation by helping to offset the costs of their work.  

    I am including a very important write up from Jason Saffer, MFT about the upcoming membership vote to repeal the new bylaws.  Please read carefully and be on the lookout for your ballots to arrive.  Feel free to contact me at any time with comments or suggestions and please consider joining us on the Board for 2014.

    Please read carefully (Thanks to Jason Saffer, MFT for allowing us to share this):


    Dear Colleagues,

    Due to the immense outcry from the CAMFT membership, the CAMFT Board has decided to repeal the 2013 Bylaws, subject to voter approval.

    Your vote is needed by Nov. 30th!

    The CAMFT Board of Directors met in Santa Barbara September 21-22, 2013 and deliberated for 12+ hours over the many communications they received with regard to the bylaws changes. In addition, fourteen CAMFT members from across the state attended the meeting and twelve gave passionate testimony about the bylaws changes that helped the Board make their decision.

    Ultimately the Board approved the following two motions:

    1. "To approve the repeal of the current bylaws approved in July 2013 and reinstate the bylaws adopted in January 2009. The Board's approval is subject to voting members' approval by ballot."

    2. "To send the vote to the membership, regarding the bylaws, per the motion approved on September 21, 2013, for a December 4, 2013 election date. December 5th and 6th to be designated ballot-counting days."

    What does this mean? CAMFT's future depends on your level of involvement! Please vote on or beforeNovember 30th, 2013 to ensure your vote arrives by the Dec. 4th deadline in the CAMFT office. Ballots will be sent out in late October or early November 2013.

    YES Vote = You agree with the CAMFT Board to repeal the recently passed July 2013 State Bylaws and revert back to the 2009 Bylaws. (CAMFT will revert to representing just MFTs and MFTIs).

    NO Vote = You do not agree with the CAMFT Board to repeal the most recent Bylaws and therefore want the 2013 Bylaws to stay in place. (CAMFT will stay on its path of opening to all other masters level and above license types including psychologists, social workers, psychiatrists, professional counselors and educational psychologists as a broad based mental health organization).

    (Per the advice of their counsel, MFT Interns will not be allowed to vote since they did not vote on the original bylaws ballot in May 2013).

    It is important to remember that "re-setting" back to the 2009 Bylaws is a first step in a longer dialogue process about the direction CAMFT members want our association to go.

                                                    - Kelly Sharp, LMFT
                                                      President, EB CAMFT
  • Tuesday, October 15, 2013 6:04 AM | Admin EBCAMFT
    Treatment of eating disorders has historically been conceived as rather monolithic or as a bit “one size fits all.”  Until recently, little attention has been paid to variables such as the age at which the illness developed or the duration of the illness.  Fortunately, clinicians are beginning to recognize the impact of these variables on the course of the disorder and on treatment.

    Briefer-term eating disorders, have been studied and written about to some degree, and a specific treatment model exists. Longer-term eating disorders need similar attention.

    Longer-term eating disorders benefit from treatment modalities tailored specifically to the complexities unique to those types of illnesses. These include a deep and wide-ranging dependence upon the symptoms/behaviors of the disorder; the sufferer’s belief that he/she “is” the illness as opposed to a person who "suffers from" the illness; an entrenched world view based on the eating disorder that leads to profound difficulty envisioning life without the disorder and an inability to believe in the possibility of surviving without the “assistance” of the illness; diminished experience in relationships other than with the illness, and the sufferer's consequent fear of incompetence in his/her ability to cultivate and maintain fulfilling connections.

    In addition to psychological issues, medical and nutritional matters need to be considered within the context of the longer-standing nature of the illness.  Serious physiological consequences can occur in any eating disorder; however longer-term eating disorders carry with them particular risks, not the least of which is higher mortality.

    Treatment for longer-term eating disorders must navigate all these complexities, balancing attempts to reduce/resolve symptoms with the reality that the sufferer is intensely attached to and dependent upon those very symptoms. 

    In keeping with this, longer-term eating disorders need and deserve their own treatment models.

    From a psychological standpoint, some approaches to treating eating disorders view the sufferer as engaged in a “war” with his or her disorder, the objective being to “win” the war by “conquering” (destroying) the disorder. Adversarial stances can provoke unintended consequences, particularly in longer-term illnesses: escalation of symptoms, intrapsychic disconnection and antipathy, antagonistic relationships between clients and clinicians.  

    Specifically designed for longer-term eating disorders, The Mediation Model holds that the sufferer and his or her disorder are not enemies. The goal of treatment is not to “kill off” the eating disorder, but to understand and then resolve what have seemed inexorable “conflicts between the sufferer and the illness.” As resolution of these “conflicts” occurs, symptoms of the eating disorder diminish.

    Treatment of longer-term eating disorders brings myriad challenges. It also offers innumerable rewards for the sufferer and his or her family, and for clinicians. Treating these illnesses should be considered a specialty in its own right, with specific training for clinicians who wish to work with these types of sufferers. Longer-term eating disorders have often been considered “recalcitrant” or “treatment resistant” or “too chronic to treat,” or worse yet, “hopeless.”

    This shouldn’t and needn’t be the case if we improve and expand our understanding of this subsection of eating disorders, and if we advance our ability to address these illnesses.

    Dr. Johanna Marie McShane has been working in the field of eating disorders treatment for twenty-two years. After beginning her career as a therapist in an inpatient/residential eating disorders program, she went into private practice in 1994, working with adolescents and adults who suffer from all types of eating disorders. She has a passion for helping sufferers, their families and other loved ones understand these illnesses, as well as for guiding them through the process of recovery.

    Johanna Marie McShane, PhD, CEDS
    Licensed Psychologist,
    Certified Eating Disorder Specialist

  • Monday, October 14, 2013 6:01 AM | Admin EBCAMFT
    Every day individuals and couples seek therapy for support around relationship difficulties.  As therapists we know that frequently this work does not result in more satisfied partnerships, but instead a decision to separate and therapy then becomes a place to problem solve how to do so most effectively.

    Therapists are often asked for guidance in this area, however we might have as many questions about the divorce process as our clients do.  In attending A Kinder Divorce you will receive information about the ins and outs of the different pathways (i.e. litigation, mediation, collaborative practice, do it yourself) available to obtain a divorce or legal separation as a way to best inform and support your clients.  We will also discuss:

    -the pros and cons of the different divorce processes
    -options for making adjustments to court orders
    -community resources available to support divorcing families
    -the legal, financial & emotional issues surrounding divorce.

    Also because this particular A Kinder Divorce workshop is being geared toward therapists, rather than its usual audience (individuals who are facing divorce or separation) we will also discuss diagnostic and other therapeutic considerations to make in assessing what divorce process could perhaps be most appropriate for a particular client.  Please feel welcome to bring questions that could benefit from consultation of this type.

    Having trained initially as a child and family therapist Sara Bisikirski, LCSW has worked with clients from the ages of 4 to 80, providing individual, couples, family and group therapy.  In addition to her role as the co-founder and therapist half of the attorney-therapist mediation team of CA Family Mediation Services, most recently Sara has worked as a therapist and clinical supervisor within the Department of Psychiatry at Alameda County Medical Center and the MindTherapy Clinic of Corte Madera and San Francisco.  Licensed to practice in California since 2006, Sara received her B.A. from Oberlin College and Master of Social Work from the University of Michigan.  She was certified as a mediator through the Northern California Mediation Center.
    With a background in psychotherapy first, Sara’s career choices have been driven by a passion for trauma prevention and treatment.   In this way she views mediation as a natural progression of her clinical work: an opportunity to help families resolve divorce or other family law issues in a way that minimizes the traumatizing impacts that traditional family court battles can have.

    Sara Bisikirski, LCSW
    CA Family Mediation Services

  • Sunday, September 22, 2013 2:03 PM | Admin EBCAMFT
    Fall is upon us and the Board of EB CAMFT is preparing for a busy few months.  The next EB CAMFT Board meeting will be held on Friday, September 20th from 4-6.   Immediately following the meeting we will be hosting our Summer Social at the Epworth United Methodist Church in Berkeley.  We welcome you to attend both the meeting and the social.

    Our Mentoring Program has really taken flight and we appreciate all the participation and feedback about this budding program.  We still have a few Mentees looking for Mentors so please let us know if you are interested in participating as a Mentor.  Recently our Program Chair, Laura Friedeberg, hosted a didactic training called Finding Inner Courage, presented by Ilene Wolfe, MFT. Laura is already planning future trainings, please check the calendar of events for upcoming trainings and other Mentoring Program events.  If you are interested in learning more or participating in the program, contact Laura at

    Stay tuned for details about our upcoming General Membership meeting.  EB CAMFT is looking to host this annual meeting in October. We are firming up dates and securing our guest speaker.  With much to discuss with our members regarding the current state of CAMFT, we are hoping for a large turnout and rich discussion.

    Please pay attention to your inbox as we have sent out a Survey Monkey link asking for your participation in a quick survey about your experience and input regarding the CAMFT bylaws.  The information gathered from this survey will have great implications for how the Board of EB CAMFT moves forward in supporting our members.  The survey results will be disseminated to our members so we can all be informed where our Chapter stands on these important issues.

    Thanks again for all the support, comments and feedback during this very active time for our Chapter.  I look forward to the continued dialogue.  Please feel free to email me with further ideas and comments or to RSVP to the Summer Social.
  • Sunday, September 22, 2013 1:42 PM | Admin EBCAMFT
    Munchausen and Origins:

    Munchausen is a severe form of Factitious Disorder where the person feigns or produces symptoms of illness designed to garner sympathy and attention. (Feldman & Ford, 1995).  In Munchausen, for example, the person may travel and may endure invasive, sometimes dangerous procedures to gain attention and sympathy. The sufferers often take on other personas and invent extensive fabrications to support their claims and gain sympathy.

    The word Munchausen comes from Baron Karl Friederich Heironymous Freiherr von Munchausen (1720-1797), a German nobleman and cavalryman, who is said to have regaled his friends and associates with fantastic and often outlandish stories of his exploits.

    In 1953, Richard Asher, reported on people feigning illness and  named this disorder after Baron Munchausen. Dr. Asher was a British endocrinologist and haematologist. He worked in the mental observation ward at the Central Middlesex Hospital and described Munchausen Syndrome in an article in 1951 (The Lancet, 1951).
    Munchausen differing from other disorders:

    In her profiling journey, Pat Brown, talks of volunteering in hospitals to learn and observe people’s behaviors and often seeing how some willingly create and act out symptoms to get attention and sympathy and to control others around them, often unaware and uncaring of the toll it takes on others.(Pat Brown, The Profiler: My Life Hunting Serial Killers and Psychopaths, 2010).

    Munchausen is also commonly recognized as Munchausen by Proxy, where a primary caregiver fakes or exaggerates illnesses or symptoms in a dependent, usually a child. This illness is extremely difficult to diagnose since the caregiver is often very attentive and caring and puts on a good show. The caregiver is often familiar with the medical illnesses and carefully plans the exaggeration of symptoms, at times, putting the child at grave risk.

    Munchausen differs from Malingering which has external incentives, while attention and emotional gains are the driving motives for Munchausen. Malingering is the purposeful production of falsely or grossly exaggerated complaints with the goal of receiving a benefit or reward, such as money, insurance settlement, drugs, avoidance of work or military duty or some other kind of responsibility (Psychology Today, 2010)  

    In Somatoform disorders, the symptoms are not voluntarily produced.  The somatoform disorders are a group of psychiatric disorders in which patients present with a myriad of clinically significant but unexplained physical symptoms. They include somatization disorder, undifferentiated somatoform disorder, hypochondriasis, conversion disorder, pain disorder, body dysmorphic disorder, and somatoform disorder not otherwise specified.1 These disorders often cause significant emotional distress for patients and are a challenge to family physicians. (American Family Physician, 2007)

    Conversion disorder, also known as Hysterical Neurosis, is a mental health condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation. Sufferers are not making up the symptoms and usually are afflicted because of an underlying emotional or psychological conflict/stress or trauma (A.D.A.M. Medical Encyclopedia., Nov 17, 2012)

    Munchausen by Internet:

    With the advent of the internet and the resources it offers, Munchausen has developed in a new way. As we all know and utilize, and often direct clients to, there is an abundance of online support groups, chat rooms, newsgroups, social media, etc. Often, the ones using these groups, see them as an invaluable resource where they receive and offer support to others like them, sharing their hopes, fears and information. However, at times, some of the members are not there because they too have suffered as the because of an underlying emotional or psychological conflict/stress or trauma (A.D.A.M. Medical Encyclopedia., Nov 17, 2012)

    Recent Events:

    There have been several recent events reported in the news media about people claiming to be someone they are not, while inserting themselves in people’s lives to gain sympathy and emotional support, like Mandy Wilson and Manti Te’o. The behaviors demonstrated by the Mandy Wilson and T’eo’s relative are surprisingly similar along with the motive of gaining love and sympathy.

    Mandy Wilson from Australia, posted her plight to an online support group attended by people from around the world, about her struggle with cancer as a single mother. Her Facebook page showed postings from her friends regarding her condition, which all turned out to be falsely created to get the emotional support and sympathy of the support group members. It all came to light when a 42 year old Canadian, Dawn Mitchell, who was closely involved with Mandy Wilson, grew suspicious after seeing pictures of Mandy after chemotherapy. Mandy had hair growing out quickly, something that doesn’t happen after hair loss due to chemotherapy. Dawn searched for obituaries of Mandy’s friends who had supposedly died and was unable to find any news on their deaths. Dawn was instrumental in exposing Mandy to the other group members. Mandy Wilson disappeared and has probably joined other online support groups under a different persona with a new set of online community supporters She left behind many who were disillusioned and jaded with the online group and hurt at the time and emotional investment they had put forth.

    Manti T’eo, a Notre Dame football player, got involved with a woman online in 2011. He never met her in person, but carried on a 2 year online relationship. He went on to dedicate a game to his girlfriend, who he believed to have died because of cancer. When people questioned T’eo about meeting this girl, he claimed to have met her because he did not want to be ridiculed for having a purely online relationship and not questioning the identity of that person. It was eventually revealed that the online persona was created by a family friend who was in love with Te’o. To save face, T’eo frequently changed his story, at one point claiming he had met the woman in person. Te’o, like numerous others, was embarrassed for his gullibility in falling for this deceit.

    Unfortunately, as news  stories reveal, Te’o was not initially believed and many a sports writers had a field day making fun of him. The person who defrauded Te’o came up with an elaborate explanation for his actions. He calls himself confused and in recovery from homosexuality.

    In the following case, the progression of events are very apparent with how the stage was set, how convincing the story was, how it evolved to fit the needs of the person, and how it hooked those close to her to fill her deep need for attention.

    Setting The Stage: Paints a pitiful picture
    In the beginning of 2007 after a painful breakup, Liz reconnected with her first cousin, Karen who lived in Toronto. Karen was 14 years younger, told Liz of a difficult childhood, including sexual abuse by a babysitter’s husband and physical abuse by her parents. Karen quickly inserted herself into Liz’s  life, often calling and texting her, telling her about her (Karen’s) medical problems and unsupportive family. Karen told Liz about a horrible gang rape in high school and her first boyfriend dying tragically a few years previous. Karen’s current boyfriend contacted Liz about Karen’s health, showing great concern. Shortly thereafter, Karen accused her boyfriend of raping her and cut off contact with him. Her counselor, in Toronto also contacted Liz, via email and text about Karen’s  depression. When Liz  expressed concern about Karen’s health, Karen’s cardiologist contacted Liz about Karen’s heart problems. From 2007 onwards Karen began visiting Liz  regularly: Karen often  insisted on being introduced as Liz’s oldest daughter.

    The Plot Thicken; Hooking The Prey:
    In 2007, when Liz  signed on to, Karen’s counselor in Toronto introduced Liz to her close friend, Tony. This online relationship developed quickly. However, they never talked on the phone and he was reluctant to visit. Karen quickly put any doubts on Liz’s part, to rest, telling Liz  she was friends with Tony’s now deceased daughter, confirming he suffered from PTSD so could not talk on the phone. Karen often assured Liz that Tony would someday visit Liz in the Bay Area.

    More Drama
    In 2009, Karen told Liz that she had begun a new relationship with her best friend’s ex-boyfriend. She asked for Liz’s help and support as she was afraid of being ostracized by her best friend. Karen’s health problems had escalated and she had now been diagnosed with Lupus. Tragically, Karen’s new boyfriend died suddenly of massive heart failure at the age of 30 in London, England. Tony was instrumental in helping Liz connect with Karen’s new boyfriend during his hospitalization, through some of his good friends who were physicians in England. Along with these physicians there were several minor players introduced, too many to mention here.

    The Unraveling
    Liz became increasingly exasperated with Tony and his reluctance to meet her. Her relationship with Karen also began faltering in 2012.  Liz cut off contact with Tony, and lost touch with some of the people in Karen’s life, her counselor and cardiologist, who had been regularly contacting her until that time. . Karen’s counselor had sent some bizarre accusatory messages to Liz  regarding Karen’s care, so Liz cut off contact with the counselor.  Liz finally broke off with Karen herself when Karen became increasingly needy and self- centered, all her conversations focusing on herself, her needs and her successes.

    The Truth
    In the early part of 2013, at the urgings of a friend, Liz began to search for Tony, Karen’s therapist and Karen’s cardiologist. She called other family members to confirm Karen’s illnesses and the people involved in her life. She discovered that none of them existed. In all, Liz found that Karen had created over 12 online personas who had contacted Liz at various points in the past 5 years, to create a concerned and supportive network for Karen. All them were email entities only, all the emails originating from proxy servers and from one single server based in the Bay Area. Some were modeled after real people in Karen’s friend’s lives, but no one in the whole story except Karen was real.

    Symptoms or Ways to Recognize Munchausen by Internet: So what do you do when you suspect someone you know online is not being honest? It is important to note, these people are very intelligent and should really be script writers in Hollywood instead of creating elaborate schemes to hook their supporters. Some of the red flags are:

    Working knowledge of symptoms of diseases and illnesses, some descriptions match posts and explanations on websites.
    Symptoms escalate if doubts are brought up or focus shifts to others.
    Miraculous recovery or dissipation of symptoms.
    Contradictory statements with no relevant explanations.
    Online postings, emails, phone calls,(?) texts etc. by people around the person such as friends, family, etc. who support the individual, often similar wording and patterns. These people never appear in the flesh.
    Elaborate stories and events, one more fantastic then the other like dying or moving away, etc.

    Some technical ways to verify people and emails: You can find anyone, anywhere, if you know how. I learned a lot and I can find anyone, as long as they exist. Once someone sends an email, they have created an un-erasable path or signature.

    Questioning and verifying addresses, if possible, to verify authencity of the user.
    Similar methods of communication: same messenger, like Yahoo, or Gmail, which send texts directly to phone numbers.
    Find people online using people search engines like People Search, Zaba Search, White Pages.
    Use reverse email look up to see originating point of emails. Usually there may be a common originating IP address and/or Proxy servers. Looking for people through home ownership records and other services which are public.

    Treatment for the Victims and those diagnosed with Factitious disorder
    The victims of people with Factitious Disorder or Munchausen By Internet, often need extensive help and support through their recovery. Their faith and trust in people and the group process is usually shattered. They are deeply ashamed and embarrassed at falling for lies. They need a safe, non-judgmental place to regain that faith and trust again, through individual and ironically, through group therapy. Dr. Feldman recommends an online group therapy to rebuild the broken trust and faith in the power and healing of the group process.

    Treatment for those diagnosed with Factitious Disorder, can include several modalities though primarily depends on the
    individual’s commitment to change their behaviors. There are no known statistics on successful treatment for Munchausen by Internet.

    Some treatment options include but are not limited to:
    Traditional talk psychotherapy for the people who commit these frauds is recommended. Treatment includes transparency in their relationships, working in individual and family therapy, on issues of ownership and responsibility. Family therapy increases the chances of recovery, and/or some suppression of some behaviors, like tall tales.

    Friends and families can help confront the person and keep them on track. As a word of caution, those involved should be prepared for histrionics and further manipulation. Treating any co-occurring or underlying issues of depression, anxiety or OCD behaviors. Evaluation and treatment for addictions and other maladaptive behaviors.

    Those diagnosed with Factitious Disorder, do not take responsibility quickly and easily. They lack empathy for the people hurt by their lies and actions, and often show no remorse for others. Most of the persons who commit such acts usually disappear when confronted. They often manipulate others to generate sympathy for themselves and not their victims.

    The Internet can give us a thousand identities and the power to change them as needed. In the end, it is our responsibility to be vigilant of our online communications and interactions, to follow our gut instinct, check and recheck when possible. Remember, if someone feels too good to be true, and you have never seen them, they probably are just that, Too Good To Be True.
    I am in full time private practice in Fremont, for the past 7 years. Prior to that, my background includes working for the City of Fremont Youth & Family Services, the Fremont Police Department, Shelter for Violent Environment, the New Haven Unified School District and the Alameda County Sheriff's Office. During the course of the past few years, I have worked with kids, teens, families, individuals and families on a variety of topics. I have dealt with Domestic Violence, Child and Adolescent behavior issues, depression, ADD & ADHD. I work extensively with children, adolescents, individuals, couples and families with emphasis on cross cultural and gender issues, sexuality, assimilation, expectations and communication, using non-verbal methods like play and art therapy with young kids. I am also trained and certified in EMDR.   

  • Sunday, September 22, 2013 1:35 PM | Admin EBCAMFT
    Editor: A few weeks ago I received an email from a colleague containing a link for a petition related to the amount of time it took for the BBS to review interns' hours, allowing them to take the licensing exams. I contacted the petition's author, Jenny Kepler for information on her motivation and hope behind the petition. Here's her response:

    Jenny Kepler: I want to convey how unfair it is that after the years of school, training and interning we do (the 3000 usually takes 3 years to attain), the BBS makes us wait at times up to 8 months to approve us to sit for the exam.  We put in so much time and energy, working for nothing or very low wages (I have 2 kids, I could never support them on intern wages on my own) despite our professional level of education.  During the time it takes the BBS to approve our hours, we continue to work for free or low wages, pay for supervision and be denied access to the professional status we have earned - even though we have completed our training.  We work in agencies, seeing really hard clients.  We do the jobs that people further along in their professional paths often opt out of.  We do this because we are passionate about our work and its value to society.  We deserve to be valued for our commitment, not punished.  We deserve a license as soon as possible.
    The application itself says that approval should take 4-6 weeks.  While the hours approval is very important, there are many ways that the BBS could streamline it for us.  Since I started this petition I have heard so many horror stories about people who've waited all this time just to be told they are missing a signature or a class.  They could have taken care of those issues while they waited for their hours to be approved.  Now how much longer must these folks wait?  Surely, the State of California has the technology and the funds to make this process more efficient.
    I hear that many interns drop off the licensing track since they can't afford to work for such low pay without family support, independent wealth or a second  or third job for so long. I wonder how this impacts the socio-economic range of diversity of the licensed population.
    It's not just interns that suffer because of this archaic system.  Clients suffer too, as agencies often can't  hire therapists without licenses, clients must wait in line.  As ObamaCare rolls out and more people will be able to access mental health services I imagine this will only get worse.  Unless the BBS makes a change.

    I received my bachelor's degree in modern literature from UCSC in 1995 and master's degree from CIIS in 2011.  I have worked in the food, wine and travel industries, and more recently have been a doula and a therapist.  I have been with Through the Looking Glass in Berkeley providing parent/infant therapy with their Early Head Start program since 2012.  


    To access and sign the petition, please visit:

    The full text of the petition:

    Petition Statement

    We are dedicated and have worked hard to prepare ourselves to serve California’s growing mental health needs. MFT interns should be able to take the licensing exam within a reasonable amount of time so we can get to work providing these much needed services.

    Petition Background

    It takes Marriage and Family Therapist interns like me years to complete our licensing requirements, including our 3000 supervised clinical hours. After we’ve met these requirements, the Board of Behavioral Sciences currently takes 7+ months to verify our hours, simply because they are understaffed. Hiring just one more employee at the BBS would make an enormous difference in the lives of interns who are forced to wait almost a whole year despite being basically license-ready.

    To check on important updates from the BBS, please check their site regularly: It appears that they are in the process of switching to online license and renewal applications, however it isn't clear whether they are including the hours verification process in this new system. You can read more about BreEZe here:

    Please complete your applications prior to September 15, 2013 in order to avoid delays.

    The Department of Consumer Affairs will be transitioning to the new BreEZe online licensing and enforcement system in early October. During this transition, there will be temporary disruptions in cashiering and other services.

    If your license renewal date is anytime in September or October, these disruptions could affect you.

    Please renew your license early! Do not wait and risk a late renewal!

    Examination candidates whose test eligibility expires late September and early October may also be affected.  Please submit your application prior to September 10, 2013 to avoid delays.
  • Monday, September 02, 2013 1:29 PM | Admin EBCAMFT
    Hope everyone is enjoying this beautiful summer.   A lot has happened over the past month and EB CAMFT has busily been trying to keep up and remain active with the recent State CAMFT Bylaw changes.  We have heard from several Chapter members who have emailed, attended Board meetings and/or  made personal calls informing us of their concerns and questions regarding the bylaws.  We appreciate your voice and continue to solicit your input so that we can serve you best and stay informed about the needs of our Chapter.  Most recently the Board sent a letter to Jill Epstein and the State Board reinstating our position about nullifying the recent vote and beginning the process over to include more dialogue and input from members.  On July 27th there was a great turnout in Marin for the meeting with Jill and 2 other State Board members.  If you were unable to attend the meeting, you are able to watch a video of the meeting on YouTube.

    Fall is around the corner and the Board has begun conversations about upcoming elections.  Now is a great time to consider ways you can become more active in EB CAMFT and participate in creating changes that are in line with our members’ needs.  We will have several positions open and welcome your application to serve as a Board member.  Feel free to email me at if you are interested or have questions about the details.

    The next EB CAMFT Board meeting is Friday, August 16th from 4-6pm.  We will continue discussions of the bylaw changes, revisit hosting another social and begin strategizing for building a strong Chapter Board in the next year.  We welcome your input and attendance.

                             Kelly M. Sharp, LMFT
                             President, EB CAMFT

  • Monday, September 02, 2013 12:44 PM | Admin EBCAMFT

    The food you eat can be the most powerful form of medicine, or the slowest form of poison.      ~ Ann Wigmore

    The CDC reports that 11% of all Americans over 12 years old are currently prescribed antidepressants. This is a staggering 400% increase since 1988. Among women aged 40 to 59, one in four women are on these medications.

    At the same time, concerns about the efficacy and safety of psychotropic drugs are the on the rise.  Clinical trials show mixed benefit, with a study famously showing superior results from placebo. Because of this, more patients and providers are looking to natural medicine for solutions.

    Supporting patients with mood disorders using diet usually involves one or more of the following strategies:
                          1.Blood Sugar Regulation
                          2.Providing Nutritional Building Blocks and Precursors
                          3.Modulating Inflammation
                          4.Healing the Gut

    Blood Sugar and Mood
    For the majority of people suffering from anxiety and fatigue, skipping meals is an aggravating factor.
    To assess whether blood sugar is an issue, I ask my patient if she feels lightheaded or jittery between meals, tired after meals, or feels much better after a meal. I also ask if she craves sweets. Her answers let me know if I need to work on stabilizing her energy input via food, or whether I need to investigate insulin resistance.
    Insulin resistance can also show up as difficulty losing weight, a belly that is wider than the hips, or a tendency to gain weight under stress.

    Why is insulin resistance, or pre-diabetes, important in mood issues?
    Glucose is the primary fuel source of the brain. Without a steady supply of fuel, synapses don’t work efficiently, neurons
    degenerate, and this manifests in suboptimal mood and thought coherence. Insulin resistance is a phenomenon that develops over time, due to a combination of genetics and constant, excessive influx of sugar from the diet.

    The natural function of insulin is to trigger glucose absorption into cells. The more glucose is in the bloodstream, the more
    insulin is pumped out by the pancreas. Over time, insulin receptors on cells become resistant to the insulin signal. It’s a little bit like starting to tune someone out, if all they do is yell at you all day. Cells naturally become less sensitive to insulin (e.g insulin resistant) when they get too much, too often.

    Unfortunately, insulin resistance takes place in the brain as well. Which means brain cells resist the signal from insulin, and don’t absorb their vital fuel, glucose. It’s no wonder that people with diabetes are more likely to suffer from depression – their brains are starving for glucose! But the solution is not to give them more sugar – that’s what got them in trouble in the first place. The solution is to re-set their insulin receptors so that they start to respond to insulin again.

    Reversing Insulin Resistance
    Have you ever heard the term “so quiet, you could hear a pin drop”? When there is no sound, our ears seem to be extra sensitive even to small noises. It’s the same for receptors. If you lower the volume of insulin, over time, the receptors start to pay attention and follow the signals to absorb glucose again. Note – this only applies to people who are not insulin-dependent!

    How do you lower the volume of insulin? By lowering the volume of glucose in the blood. This is done via  low-glycemic diet – low sugar, low refined carbohydrates, mostly whole foods.  When done right, a low glycemic diet also provides all the nutrients needed for healthy mood and brain function.

    Delivering the Raw Ingredients
    The physiology of mood is dependent on several players – neurotransmitters, hormones and enzyme co-factors, to name a few. When treating mood disorders with diet, I need to ensure that patients are getting all the raw materials they need. Most neurotransmitters are made up of amino acids. The body gets about 70% of amino acid needs met through the food we eat – specifically, from protein.

    The first order of business is usually to eat a palm-size worth of protein three times a day – especially breakfast. Most people skip this meal or power up with coffee and a pastry, setting off a mood and energy rollercoaster. Protein in the morning stabilizes blood sugar, and usually reduces cravings.

    It is also important to ensure that they are getting enough fat. Every cell in the body is wrapped in fat, and many vitamins need fat for absorption. Good fats like olive oil, avocados, nuts seeds and fatty fish provide satiety, reduce overeating and provide for proper cell signaling and hormone production.

    The fish-sourced EPA and DHA are crucial for mood. DHA in particular makes up a significant portion of the fat in the brain. It is EPA, however, that appears to be more important in treating depression. This may have a lot to do with the fact the EPA is a potent anti-inflammatory.

    What is the relationship of inflammation and mood?
    Inflammation is a major focus of almost every field of medicine. It a process that appears to underlie all of chronic disease – heart disease, cancer, autoimmunity to name a few.  Inflammation is closely related to oxidative free-radical damage, a process implicated in degenerative diseases.

    The central nervous system is in constant communication with the periphery –inflammation on one side of the blood-brain-barrier will affect the other. Depressed people are more likely to have inflammatory markers evident in blood tests, compared to non-depressed cohorts. EPA and DHA, powerful anti-inflammatory fats, have been shown to help in the treatment of depression.

    The Power of Plants
    Plant foods, particularly vegetables and fruit, are undisputed nutritional powerhouses. They are high in anti-inflammatory and anti-oxidant compounds. They contain the vitamin and mineral co-factors needed for the conversion of neurotransmitters. A British study showed that eating seven servings of fruit and vegetables was associated with greater mental well-being.

    In addition to their incredible nutrient content, whole plant foods are high in soluble and insoluble fiber, making them essential for gut health. Which, you guessed it, plays a major role in the regulation of mood.

    The Gut-Brain Connection
    The gastrointestinal tract is also known as the “second brain”; it contains more neurons than the spinal cord or the peripheral nervous system. It contains 95% of our serotonin, as well as a large part of our immune system. The immune system, in turn, regulates inflammation.

    The gut has the complicated task of absorbing nutrients, while keeping out microbes and other undesirable elements. This crucial process is disrupted in the medical phenomenon known as “leaky gut” – nutrients are poorly absorbed, and inflammatory particles enter the blood stream, causing immune reactions that can affect the brain. Leaky gut has been associated with depression and alcohol addiction.

    Dietary fiber from plant foods helps correct leaky gut by nourishing GI cells with short-chain fatty acids. This is done with the help of beneficial bacteria, also known as probiotics. Research into the relationship between gut microflora and neurological issues is growing, as are findings that link the status of the “microbiome” with inflammation.

    For the patient with a combination of mood problems as well as digestive problems, normalizing the GI is  essential in the
    restoration of balance and can have profound benefits. By stabilizing blood sugar, supplying the raw materials for
    neurotransmission, controlling inflammation and healing the gut, it is possible for many individuals to avoid or minimize their need for medication.

    The process does require education, commitment and patience. It also has the potential not just to treat mood disorders, but also prevent other disease, making it an incredibly efficient use of time and effort on the part of the clinician and the patient.

    Dr. Teray Garchitorena has been practicing naturopathic medicine in Berkeley for five years, and is co-founder of the Berkeley Naturopathic Medical Group. Her programs provide integrative solutions for depression, anxiety, autoimmunity and fatigue.

    2615 Ashby Avenue, Berkeley CA

  • Monday, September 02, 2013 11:58 AM | Admin EBCAMFT
    They come from all walks of life: doctors and hairdressers, personal trainers and stay-at-home moms, law-breakers and law enforcement. They are upper class, working class, adult children of alcoholics, daughters of porn addicts, clergy, or both.   Many of them have concurrent eating disorders and/or alcohol or drug problems.  They span all ages, and while a number fit the cultural stereotype for “attractive,” many others can and do go unnoticed in a crowd.

    I have been working with women who are sexually and romantically compulsive/impulsive for five years now in my role as Director of Women’s Programs at Impulse Treatment Center (ITC). ITC currently runs 11 groups a week for male Sex Addicts and four groups per week for Partners. However, having even one women’s group for Sex and Love Addicts has been difficult to establish on an ongoing basis.

    A major reason that Sex Addiction was not added to the recent DSM-5 was the lack of women in treatment for Sex Addiction.   Sex Addiction in women may be relatively rare while Love and/or Relationship Addiction appears to be more common.  As noted in the proposed DSM-5 criteria, no single sexual or romantic behavior gives rise to a diagnosis of Sex and Love Addiction. To be termed “Sex and Love Addiction,” a clear destructive sexual/romantic pattern must be evidenced that disturbs relationships, careers, physical and/or emotional health.

    In Ready to Heal, author and therapist Kelly McDaniel delineates the four cultural beliefs that underlie the development of Sex and Love Addiction (as known as Sex/Love/Relationship Addiction or SLRA) in women:
        I must be “good” in order to be worthy of love
        If I am sexual, I am “bad”
        I am not really a women unless someone desires me sexually and/or romantically
        I must be sexual to be loveable

    The obvious impossibility of navigating these diametrically opposed beliefs is hard to miss. Throw in some childhood trauma, attachment issues, lack of boundaries or lack of modeling of healthy intimacy, and it is remarkable that more women aren’t struggling with SLRA. Or perhaps they are.

    After several years of running groups for Partners of Sex Addicts I began to notice a curious phenomenon.  While most Partners evidenced the classic signs of codependence – focusing on others rather than focusing on self – many others were clearly focused on their own needs to the exclusion of all else. They felt entitled to an available partner, insisting on their fantasy version of the addict as sexual/romantic object of choice despite all evidence to the contrary.  It was the insistence on the fantasy that got me curious.  Was it possible that a number of women  in my Partners of Sex Addicts groups were also Sex/Love/Relationship addicted themselves?

    I’ve never been big on labels and use the various terms primarily as a guide to treatment, so my first thought was to deal with the women together on a continuum, treating the lack of worthiness that both the Partners and the Addicts bring to their self-in-relation.  This lack of worthiness comes from many different sources; for some Partners it may result from living in too close proximity to addiction for too many years, while in other Partners or the Addicts it may go back a lot farther, all the way to childhood. And there can be distinctly different ways of acting out these issues (which gave pause to my idea of treating them together in a group).

    Both nature, nurture, and the current sexualized cultural climate contribute to women’s addiction and codependency patterns. Neither role ultimately satisfies the need for self-esteem and empowerment which accounts for the cyclical shift from addiction back to codependency back to addiction. (Kasl, 1989).
    According to the Society for Advancement of Sexual Health (SASH), sexually addictive behavior patterns in women may include: Prostitution, excessive flirting, dancing, or personal grooming to be seductive; wearing provocative clothing whenever possible; changing one’s appearance via excessive dieting, excessive exercise, and/or reconstructive surgery to be seductive; exposing oneself in a window or car; making sexual advances to younger siblings, clients, or others in subordinate power positions; seeking sexual partners in high-risk locations; multiple extramarital affairs; disregard of appropriate sexual boundaries, e.g. considering a married person, one’s boss, or one’s personal physician as appropriate objects of romantic involvement; trading sex for drugs, help, affection, money, social access, or power; having sex with someone they just met at a party, bar or on the internet (forms of anonymous sex); compulsive masturbation; and exchanging sex for pain or pain for sex.

    Again, it is important to note that no one sexual/romantic behavior qualifies for a diagnosis of Sex Addiction;  diagnosis is not about judging anyone's sexual expression or behavior, but rather an evaluation of an overall pattern and history of behavior that results in legal, financial, medical, emotional and/or relational consequences.

    Women who seek treatment for Sex and Love Addiction (including sexual anorexia, the other end of the acting-out continuum) usually do so because of some crisis; either confrontation or fear of confrontation by family or friends, or the legal, financial, medical, emotional and/or relational  consequences themselves.  The ageing process itself can also present a window for change.

    There are a lot of challenges to working with women who have both an overwhelming longing for and fear of connection.  Early research (and the approximately 40 women we have seen at ITC to date) shows that women SLRAs have more trauma then male sex addicts.  Many women SLRAs have difficulty trusting other women; a women’s group is overwhelming just by definition.  Attachment issues in general make it difficult for women to form a safe connection with a therapist or group members.  

    Initial contact by phone is extremely important.  A number of women call to talk, but can’t actually come in for treatment
    because, unlike the male sex addicts, they often do not have their own money or transportation or both.  At Impulse Treatment Center, a large portion of the men we work with are still in relationship with wives/partners who are willing to support their treatment process.  Women SLRAs do not generally find the same willingness on behalf of their partners; dependency, both financial and otherwise, is a key barrier to seeking treatment.

    Despite these barriers, as anyone who works with addicts of any description knows, recovery is possible. Until my work in
    establishing a solid group for women SLRAs is achieved, I rely on 12-Step programs, including Sex and Love Addicts Anonymous ( and Sex Addicts Anonymous ( to provide the ongoing community so necessary to support the Addict’s vulnerable self that emerges in early sobriety. And in the meantime, I look forward to the day that a female celebrity, a la Tiger Woods, will come out of hiding and open the door to a greater cultural understanding of the truth behind Sex and Love Addiction as it impacts women.
    Charlotte Kasl, Ph.D., Women Sex and Addiction (New York: Harper and Row, 1989) 46.
    Kelly McDaniel, Ready to Heal: Women Facing Love, Sex and Relationship Addiction (Gentle Path Press, 2008) 35. Society for the Advancement of Sexual Health (SASH)
    Joan Gold is a licensed Marriage & Family Therapist and the Director of Women’s Programs at Impulse Treatment Center in Walnut Creek, the oldest and largest comprehensive Sex Addiction Treatment Program in Northern California (  

    She also has a private practice focusing on general addiction and codependency treatment as well as issues of ageing and creativity in Berkeley, CA ( Joan can be reached directly at 510.418.2387
  • Monday, September 02, 2013 11:55 AM | Admin EBCAMFT
    My son died almost 30 years ago.  It brought me face-to-face with this “crazy” thing called “grief”.  “What was this powerful thing that can knock you down, take your identity away and explode your life as you know it?”  How do you maneuver through the maze of intense feelings of despair, anger, longing, fear and the biggest ones of Guilt and Powerlessness without getting stuck?  

    Grief is two things: Feelings and Changes. Getting though it requires movement and connection.
    Everyone grieves differently, but when we know what tasks we need to accomplish to be able to move through it, and when we know the warning signs and guide posts so we don’t get stuck or lost, we can heal.  We can even grow and transform on the journey though healthy grief.

    Grief walks into our offices in a huge variety of ways, some of which are: death in the family, divorce, life-threatening or life-limiting illness, the end of a meaningful relationship, change in career direction, fertility issues, empty nest, or a major move. Profound Grief is a multi-layered, complex process that can impact every corner of our and our client’s lives.  Unprocessed, it can get stuck and become chronic depression, anxiety, anger, substance abuse, family dysfunction, or it can be projected onto future generations.

    For the past 25 years I have been exploring Grief, learning from clients, students and my own experience.  I built my work on the foundation of a Master’s degree with a Clinical Specialization in Grief Therapy.  I have added my own experience and insights gained from working with thousands of children and adults while running a Children’s and Family Grief Program at a local hospice for 8 years, teaching classes on Grief at JFKU, and doing more than a hundred presentations on Grief for Conferences, interns, doctors, churches, health care providers and schools, as well as working with clients in my own private practice.

    Over the years many therapists have expressed to me how valuable my concept of “The Grief Closet” has been to them.  Grief doesn’t go anywhere unless we have a chance to process it.  It just gets stuffed into our “grief closet”.  Then, when we have new losses, the “grief closet” door swings open and all the old grief tumbles down on top of us and we feel overwhelmed.  Entering a new developmental stage also opens the closet door.  Children’s Grief and “National Grief” (Sandy Hook trauma, etc.) can also trigger our old grief that we haven’t had an opportunity to process.

    The “stickiest” feeling in Grief is Guilt.  Clients can go through layers of guilt throughout the grieving process, often ending with feeling guilty about finishing their acute grief.  We most commonly know about survivors guilt,  and the “woulda, shoulda, coulda” built on hind-sight. Children find amazing, creative ways to feel guilty.  Why?  It took me many years of asking myself this question to realize that it was because of “powerlessness”.   At least if we’re guilty it means we were powerful enough to cause the death (or other grief), if it’s my fault, then I’m not powerless.  But we are powerless over some things, and in death it’s an existential crisis since we weren’t given total control over life and death.  The Serenity Prayer is our way out of this dilemma: to figure out what we can and what we can’t do, and the wisdom to know the difference.  Then we can take our power and not get trapped (or like one kid said “I beat my head against the wall”) in those places where we don’t have power.

    Copyright 6/30/2013
    “Grief Closet” copyright 1998
    Ninette Larson MFT / /

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