Chronic Disease Management & Health
For centuries, we have known about the intricate linkages between body and mind. For those dealing with health issues, ability to cope, adapt and heal often hinge on our physical and mental health.
At Endeavor Psychology, we leverage tools from the disciplines of health psychology and behavioral medicine to help clients prevent, manage and treat a variety of chronic conditions – from heart disease, diabetes and hypertension to cancer and chronic pain. Our approach builds on a comprehensive understanding of individuals – and the way that their biology, life experiences, family history, social networks, and communities impact their psychological and physical health.
We work with clients who are dealing with their own health challenges as well as clients who are impacted by the health concerns of a partner, parent, child or other loved one. Within our practice, we use a number of research supported techniques to help our clients:
Make healthy lifestyle changes (changes to diet, exercise, stress management) and pursue health goals (weight loss, stress management, smoking cessation)
Deal with a new or chronic health problem
Adjust to a medical diagnosis, treatment or prognosis
Navigate pre- and post-surgical adjustment, including bariatric surgery assessment
Manage health conditions (diabetes, cardiovascular disease) that require lifestyle and/or behavior changes
Diabetes Management
Managing diabetes can be challenging – not only physically, but also psychologically. In order to effectively manage blood glucose levels it is important to understand the many factors that make blood glucose levels rise and fall – including lifestyle (diet and exercise), mental health (stress), and treatment (medication) factors.
At Endeavor Psychology, we help clients develop strategies to understand and manage the many aspects of their lives, habits and behaviors that impact diabetes. We recognize the intricate interrelationships between the client’s physical and mental health. Our approach focuses on enhancing clients’ self-awareness, self-efficacy, and self-care.
We work intensively with clients to implement lifestyle changes and behavioral strategies to improve their physical health and help clients manage the emotional demands of diabetes – treating anxiety, depression, mood disorders and stress – all of which can have an impact on an individual’s ability to effectively cope with and successfully manage diabetes.
Stress Management
We all experience stress — in response to our environment (school, work, home), our relationships, the events happening in our lives, and our thoughts and worries about life’s demands. Stress is a normal human reaction to changes that require us to adjust or respond. When we feel stress, our bodies react through physical, cognitive, and emotional responses.
At Endeavor Psychology, we use a variety of proven therapeutic approaches to help clients reduce and manage stress. Because stress can cause or contribute to so many physical and mental health conditions, our focus in on helping clients learn tools that they can use to identify and combat stress triggers throughout their lives.
Heart Disease
“Heart disease” and “cardiovascular disease” are broad terms used to describe a number of conditions affecting the heart and cardiovascular system, including: diseases of the blood vessels (coronary artery disease); problems affecting heart rhythm (arrhythmias); heart infections; birth defects affecting the heart (congenital heart defects); and atherosclerosis, a buildup of fatty plaques in your arteries that can cause heart attack, chest pain (angina) or stroke. While a variety of risk factors can contribute to heart and cardiovascular diseases, many conditions can be prevented or treated by implementing healthy lifestyle changes.
At Endeavor Psychology, we have extensive experience working with clients facing heart and cardiovascular conditions — in inpatient hospitals, outpatient cardiac rehabilitation programs, and through group therapy and individual counseling. We draw on proven therapeutic techniques, including Cognitive Behavioral Therapy, Interpersonal Therapies, mindfulness strategies, lifestyle modification and stress reduction strategies to help clients reduce their risk of cardiovascular problems, improve quality of life and advance their health goals.
Heart Disease
“Heart disease” and “cardiovascular disease” are broad terms used to describe a number of conditions affecting the heart and cardiovascular system, including: diseases of the blood vessels (coronary artery disease); problems affecting heart rhythm (arrhythmias); heart infections; birth defects affecting the heart (congenital heart defects); and atherosclerosis, a buildup of fatty plaques in your arteries that can cause heart attack, chest pain (angina) or stroke. While a variety of risk factors can contribute to heart and cardiovascular diseases, many conditions can be prevented or treated by implementing healthy lifestyle changes.
At Endeavor Psychology, we have extensive experience working with clients facing heart and cardiovascular conditions — in inpatient hospitals, outpatient cardiac rehabilitation programs, and through group therapy and individual counseling. We draw on proven therapeutic techniques, including Cognitive Behavioral Therapy, Interpersonal Therapies, mindfulness strategies, lifestyle modification and stress reduction strategies to help clients reduce their risk of cardiovascular problems, improve quality of life and advance their health goals.
Weight Management
Maintaining a healthy weight and implementing good eating habits are two central steps in improving physical health and quality of life. Yet more than a third of adults in the US struggle with obesity. “Overweight” and “obesity” are both labels used to describe ranges of weight that are greater than what is generally considered healthy for a given height; these ranges of weight have been shown to increase the risk of certain diseases and health conditions.
Combatting obesity and achieving an ideal weight can be challenging. That is because food and our eating habits are fundamentally connected to so many aspects of our history, our lives and our sense of self. For many of us, our identities, emotions, families, culture, and coping mechanisms are tied to our food choices and eating behaviors. While there can be biological contributors to obesity and being overweight, the good news is that for many people effective weight loss and weight management strategies rely almost entirely on modifying behaviors that are within your control to change.
At Endeavor Psychology, we understand the challenges of weight loss and weight management. We use psychoeducation and a number of therapeutic techniques (Cognitive Behavioral Therapy, behavior modification) to help clients understand the mechanics of weight loss and explore their thoughts, beliefs and feelings about food, weight and health. We work with clients to set achievable goals, implement lifestyle changes, and build support networks to maintain long-term health strategies.
Chronic Disease Management & Health
At Endeavor Psychology, we leverage our extensive training in health psychology and behavioral medicine and a depth of experiences helping clients deal with and manage chronic health problems, including:
Diabetes
Heart disease and cardiovascular disease
Connective tissue disorders
Cancer diagnoses
Chronic Pain
Headaches
Insomnia
Cognitive decline
Additionally, we work extensively with clients on implementing healthy behaviors that can prevent chronic health issues and improve general health outcomes and quality of life. We help clients implement sustainable strategies to:
Lose weight and maintain weight loss
Increase physical activity
Improve nutrition
Reduce and manage stress
Stop smoking
The Endeavor Psychology practice was founded by a clinical health psychologist – as such, we have a fundamental focus on helping people identify and address health goals and challenges. At Endeavor Psychology, we are trained to help clients address challenges related to improving health, coping with disease and improving treatment outcomes. We also address the way that clients’ mental and emotional health impacts and is impacted by health transitions. Our approach to therapy is empirically based (research-based), but tailored to our clients’ specific needs and the health challenges they are facing.
We use a number of therapy approaches, including Cognitive Behavioral Therapy, Behavioral Medicine Interventions, and Interpersonal Therapy, to help clients, their partners and families:
- Understand the psychological, behavioral, interpersonal and environmental factors that may impact their ability to cope with and adapt to health challenges;
- Deal with the emotional weight of health transitions – which may include feelings of confusion, shock, worry and despair
- Set goals and identify strategies to help clients enhance physical, emotional and mental wellbeing
- Disempower negative or disorganized thoughts that may cause feelings of helplessness and potentially negatively impact health outcomes
Develop strategies to manage and cope with transitions related to health issues, including the impacts that health transitions can have on relationships - Understand and resolve mental health issues (e.g., depression, anxiety, mood disorders) that may precede, amplify or be triggered by health challenges
- Develop and leverage internal strengths and external support networks to build resiliency and cope with health concerns
Work with medical providers to consult on psychotropic medication management and further assess issues, such as cognitive decline
Diabetes Management
The term “diabetes” refers to a group of diseases that affect how your body uses blood sugar, or glucose. Glucose is a critical source of energy for the cells that make up your muscles and tissues and is the brain’s chief source of fuel. If you have diabetes, you have too much glucose in your blood. The causes of this glucose imbalance differ across three main types of diabetes:
- Type 1 Diabetes: Your body does not make insulin, a hormone that is needed to take the sugar (glucose) from the foods you eat and convert it into energy for your body. People with Type 1 Diabetes can live long, high-quality, healthy lives with the help of regular insulin therapy, exercise, and a diet designed specifically for people with diabetes.
- Type 2 Diabetes: Your body does not use insulin properly, a condition called “insulin resistance.” While your body initially makes extra insulin to compensate, over time your pancreas can’t produce enough insulin to maintain normal levels of blood sugar (glucose). Type 2 diabetes is typically treated first with weight reduction, diet, and exercise. If blood sugar levels can’t be managed effectively with these measures, oral medications and in some cases insulin treatment may be used.
- Gestational Diabetes: Some women develop gestational diabetes late in pregnancy. While this condition causes a pregnant woman’s pancreas to work harder to produce insulin, the insulin does not effectively lower blood glucose levels. As a result, the extra blood glucose passes through the placenta, raising blood sugar levels in the baby and causing the baby’s pancreas to produce extra insulin.
While women often “recover” from gestational diabetes after the baby is born, effective diabetes management during pregnancy is critical, both for the health of the mother and baby. Treatment for gestational diabetes aims to control blood glucose levels through diet, exercise, and sometimes blood glucose testing and insulin therapy.
Regardless of the type of diabetes you have, there are several important measures that you can institute to effectively manage your diabetes. At Endeavor Psychology, we work with clients to understand the psychological, behavioral, interpersonal and environmental factors that may impact their ability to cope with and manage diabetes. We help clients leverage their internal motivations and strengths as well as external supports to implement sustainable strategies for diabetes management.
Our approach focuses on targeting several health behaviors and lifestyle changes, including:
- Instituting healthy eating habits: People with diabetes need to understand how to implement and maintain a diet specifically tailored to their needs. It is important not only to know how specific foods affect blood sugar levels, but also how portion sizes and combinations of food types affect glucose levels. Specific nutritional requirements are usually addressed through a nutritionist and/or diabetes specialist. At Endeavor Psychology, we can help you develop strategies to implement dietary changes and stick to a dietary plan to help you manage your diabetes.
- Physical Activity: Physical activity is another critical component of diabetes management. When you exercise, your muscles use blood glucose for energy. Regular exercise helps your body use insulin more efficiently and helps lower your blood sugar level. A diabetes specialist can prescribe an exercise plan designed to include a balance of aerobic and muscle-strengthening exercise that is right for you. At Endeavor Psychology, we can help you set attainable goals and implement strategies to adhere to your exercise plan.
- Medication Adherence: For some people, diabetes management may include insulin therapy or other diabetes medications designed to lower blood sugar levels. Because the effectiveness of these medications depends on timing and dosage, adhering to medication can be tricky. At Endeavor Psychology, we work with clients to implement behavioral strategies to incorporate medicinal therapies into their lives and adhere to the medication plans prescribed by their physicians.
- Stress Reduction and Management: When you are stressed, your body produces hormones that may cause a rise in your blood sugar level. Stress, anxiety and life pressures may also make it difficult to follow your diabetes management routine. At Endeavor Psychology, we work with clients to identify stressors and understand how stress affects blood glucose levels. We help clients learn and utilize techniques to cope with and manage stress and address psychological issues that may be negatively impacting physical health and mental wellbeing.
- Other lifestyle/behavioral changes: For everyone, healthy behaviors are critical to physical health. For people with diabetes, unhealthy behaviors such as smoking, unhealthy eating habits, or being overweight can be particularly critical as they can exacerbate already increased risk of heart attack, stroke or other diabetes-related health problems. At Endeavor Psychology, we use a number of therapeutic approaches including Cognitive Behavioral Therapy to help clients implement healthy lifestyle changes.
It is normal for anyone facing a health challenge to experience feelings of sadness, helplessness or anger. For people with diabetes, it is important to deal with these feelings – as well as more serious mood disorders, including depression and anxiety – as they can undermine an individual’s ability to cope with and effectively manage diabetes. Mental health issues can have serious physical impacts (biological, hormonal) and behavioral impacts (ability to adhere to diet, exercise, medical treatments) for people dealing with diabetes.
At Endeavor Psychology, we realize that you are the most important member of your health care team; you are the one who manages your diabetes on a daily basis. The more you know about psychological factors that affect your blood sugar level, the better equipped you will be to anticipate blood glucose changes and utilize your diabetes management plan to target those factors. We focus on helping you be self-aware, empowered and practice self-care to achieve your health goals and maintain a high quality of life.
Stress Management
In some ways, stress can be protective – it helps us stay “on guard” and react in the face of danger or difficulty. But persistent stress – stress experienced over a long period of time without relief — can become counterproductive. Repeated acute stress and chronic stress can both negatively impact our physical and emotional wellbeing. When stress becomes ‘distress’ – a negative stress response – it can trigger or exacerbate physical problems including headaches, upset stomach, elevated blood pressure, tightness or pain in the chest, fatigue and sleeping difficulties.
Chronic (persistent) stress can also lead to more serious health problems if not addressed. These include:
- Depression
- Anxiety
- High blood pressure
- Abnormal heartbeat (arrhythmia)
- Hardening of the arteries (atherosclerosis)
- Heart disease
- Heart attack
- Heartburn, ulcers, irritable bowel syndrome
- Gastrointestinal problems — cramps, constipation, and diarrhea
- Weight gain or loss
- Changes in sex drive
- Fertility problems
- Asthma or arthritis flare-ups
- Skin problems such as acne, eczema, and psoriasis
Chronic stress triggers health problems by causing physiological responses in a number of body systems including:
- Musculoskeletal System – the muscular responses to stress can lead to headaches, migraines, and chronic pain.
- Respiratory System – stress can intensify breathing difficulties, particularly among people with asthma, lung disease, emphysema or other respiratory conditions; it can also cause hyperventilation, and sometimes trigger panic attacks.
- Cardiovascular System – chronic (long-term) stress, can cause exaggerated variations in heart rate for a prolonged period of time, and elevate stress hormones and blood pressure, which can lead to long-term problems for heart and blood vessels including hypertension, heart attack and stroke.
- Endocrine System – “stress hormones” released in response to stressors may contribute to liver dysfunction and diabetes.
- Gastrointestinal System – stress can increase the severity of heartburn and acid reflux, stomach pain, and can cause diarrhea, constipation or even vomiting.
- Nervous System – stress sends the nervous system into a “fight or flight” response – shifting all of its resources to fend the body from a perceived “threat” or stressor. When in this state, the nervous system triggers the body to release stress hormones that result in rapid heart beat and breathing, blood vessel dilation, changes in digestive processes and blood sugar levels. Over time, stress – and the responses triggered by the nervous system — can strain the body in many ways.
- Male Reproductive System – stress causes the body to release excessive amounts of a hormone called cortisol, which can affect normal functioning of the male reproductive system. Over time, chronic stress can impact testosterone and sperm production and cause erectile dysfunction and even impotence.
- Female Reproductive System – among women, stress can affect menstruation, worsen the symptoms associated with premenstrual syndrome and menopause, and negatively impact sexual desire and drive.
At Endeavor Psychology, we understand that multitude of triggers can cause stress, which can take a toll on your mental and physical health, relationships, studies, work and overall wellbeing. Our practice draws heavily on Cognitive Behavioral Therapy to develop stress management plans that are tailored to our clients’ stress triggers, experiences, thoughts and beliefs and designed to help clients effectively manage stress and achieve their psychological and physical health goals.
Heart Disease
There are a number of factors that can increase your risk of heart disease, including age, gender, and family history of heart problems. The good news is that many other risk factors are “behavioral” and can be addressed by making healthy lifestyle adjustments. These include:
Smoking: Heart attacks are more common in smokers than in nonsmokers. That’s because smoking constricts and damages the lining of blood vessels, making them vulnerable to atherosclerosis (build-up of fatty plaques in the arteries) that can lead to heart attack and stroke.
Poor diet: Diets high in fat, sodium, and cholesterol can contribute to the development of heart disease.
High blood pressure: Without proper management, high blood pressure can lead to hardening and thickening of your arteries, narrowing the vessels and limiting blood flow to your heart.
High cholesterol: High levels of low-density lipoproteins or “bad” cholesterol in your blood can increase the risk of atherosclerosis (build-up of plaque in the arteries). Plaques can form as the result of having high levels of “bad” cholesterol, or low levels of “good” cholesterol.
Diabetes: Diabetes and many of the health factors that can contribute to diabetes (obesity, hypertension, high cholesterol, lack of physical activity, poor diet and poor control of blood sugar) can also increase heart disease risk.
Obesity: Excess weight often exacerbates other risk factors for cardiovascular disease.
Physical inactivity: Lack of exercise and sedentary lifestyle is associated with many forms of heart disease and worsens other risk factors.
High stress: Chronic (persistent) stress may also damage arteries and increase other risk factors for heart disease.
Poor hygiene: Viral or bacterial infections can also increase risk of heart infections, particularly if you already have a heart condition. Good hygiene, such as washing your hands and implementing good dental health may also protect against heart disease.
The Endeavor Psychology practice was founded by a clinical health psychologist – as such, we have a fundamental focus on helping people identify and address health goals and challenges. At Endeavor Psychology, we help clients prevent, manage and cope with cardiovascular diseases. We use proven therapeutic techniques, including Cognitive Behavioral Therapy, stress reduction and relaxation techniques, and behavioral strategies to help clients implement and sustain healthy lifestyle changes, including:
- Quitting smoking
- Implementing healthy diet
- Reducing stress
- Keeping diabetes under control
- Increasing physical activity
- Maintaining a healthy weight
- Adhering to medication and exercise regimes prescribed by medical specialists
- Preparing for and adjusting to life after surgical procedures
- Maintaining motivation and addressing barriers in order to adhere to cardiac rehabilitation.
Weight Management
Obesity is a complicated health issue – that’s because so many factors contribute to weight, including genes, metabolism, behavior, environment, culture, and socioeconomic status. When broken down into the most fundamental mechanics, being overweight or obese results from an imbalance in energy – too many calories consumed and too few calories expended.
Because behavior and environment play a significant role in contributing to weight management and obesity, these are the areas that are the primary targets for prevention and treatment.
Research has found that as weight increases to reach the levels referred to as “overweight” and “obese,” risks increase for the following conditions:
- Coronary heart disease
- Type 2 diabetes
- Cancers (endometrial, breast, and colon)
- High blood pressure (Hypertension)
- High total cholesterol or high levels of triglycerides (Dyslipidemia)
- Stroke
- Liver and Gallbladder disease
- Sleep apnea and respiratory problems
- Degeneration of cartilage and its underlying bone within a joint (Osteoarthritis)
- Gynecological problems (abnormal menstruation, infertility)
For more information about health problems associated with being overweight or obese, visit the National Heart, Lung and Blood Institute’s Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
At Endeavor Psychology, we use psychoeducation, psychotherapy and psychological assessment to support clients with weight loss and weight management. Specifically, we help clients:
- Set weight loss goals
- Understand the mechanics of weight loss
- Identify positive factors that can be motivational in maintaining weight loss as well as “negative” triggers and barriers that can undermine weight management goals
- Implement healthy weight loss and weight management strategies (healthy diet, exercise)
- Institute strategies to counteract unhealthy triggers and address barriers to weight loss, including Cognitive Behavioral Therapy strategies addressing maladaptive thoughts, beliefs, and behaviors, stress reduction and management strategies, environmental control, strategies addressing unhelpful relationships that may sabotage weight loss goals
- For clients considering surgical intervention (bariatric surgery) we can help assess psychological readiness for surgery and provide pre- and post-surgical counseling
- Cope with and manage other physical health conditions (diabetes, cardiovascular disease, other health conditions)
- Treat other psychological needs that may be contribute to weight loss/weight management success (depression, anxiety, other mood disorders)