Trauma Informed Information

March 9, 2018

SMART Recovery Meetings

October 4, 2017

LaCrosse SMART Recovery Meeting Schedule

We have grown!

SMART Recovery is an abstinence based program

SMART = Self Management And Recovery Training

We offer Tools, Strategies and Exercises to help you in recovery

SMART is based on science and 4 principles:

1-  Building and maintaining motivation

2- Coping with urges

3- Managing Thoughts, Feelings and Behaviors

4- Living a Balanced Life

Mondays 5:30 – 7 pm       401 West Avenue

Unitarian Universalist Fellowship Building

Wednesdays 5:30-7 pm   921 West Avenue

Coulee Council on Addictions

Fridays 5:30-7 pm            921 West Avenue

Coulee Council on Addiction

Women’s SMART meeting

Saturdays 1:00-2:00 pm

Coulee Council on Addiction

Handling Conflict

June 14, 2017

Handling Conflict in Your Life


Let’s face it.  Conflict is going to happen in your life – possibly even daily.  It will occur at work, home, and in the community.  How you handle it will have a large impact on the quality of your life.

Some people thrive on conflict.  If it doesn’t exist, they will create it simply for the thrill of the drama.  They tend to be very loud and use explosive, if not obscene, language to draw attention to themselves.  They believe that the loudest person will win the argument.  And, as we become embarrassed by their display, they ramp up the volume.

Others find conflict so distasteful that they give in automatically to the person they are having a disagreement with.  They are even willing to give up their rights if they can avoid those ugly scenes.

An effective way to respond to conflict is to manage it. Here are a few steps to take to handle conflict without losing your cool or your rights:

  1. The first step is to speak with the person(s) you have a conflict with and state the truth:  “We don’t agree on this.”  Simply make clear what the issue is without assigning any blame.
  2. Make a statement about what you hope a conversation would lead to:  “I would like to talk about this with you and see if we can come up with a solution.  We work together every day and it would be nice if we could get along.”
  3. Now, the most difficult step.  Be quiet.  Listen without interrupting them.  And listen in order to get a complete understanding of where they are coming from.  Allow yourself to be influenced by what they say.  Do not listen just to debate.
  4. Next, prove to them that you listened with the honest intention of understanding.  Summarize what they have said back to them.  “So, you feel that I was putting you down when I said that.”  Or,  “You don’t like it when I do that because then you have to pick up the slack.”
  5. Now that you have invested the energy to understand their viewpoint, agree with whatever you can.  “Oh, I didn’t realize that you had to be the one who finished that up.  Now I see why you are frustrated with me.”
  6. And, now, the most important step.  Let what they said sit with you for a bit.  Does what you now understand change your opinion in anyway?   Those who take the time to give serious consideration to what the other person said are those most likely to come up with a solution or compromise.
  7. It is now your time to respond with your feelings and opinions.  Don’t use this time to jab back at some of the comments they may have made that you found offensive. Stick with the issue – even if they haven’t.   Talk about the problem – not them.
  8. Keep calm.  If they are fired up and you add fuel to that fire with your anger, it will only make things worse.  Nothing will get resolved.
  9. Regardless of the outcome, I suggest you end by shaking hands or at least making a statement of appreciation for their willingness to have an honest discussion with you.
  10. And, again, regardless of the outcome, do not ignore this person later or talk about them behind their back.  Treat them with the respect and courtesy you would like to receive from them.

Fix the problem, not the blame.

Karen Wrolson, MS, MEd

Stein Counseling and Consulting Services, Ltd.

Winter Blues or Depression?

February 24, 2017

Winter Blues or Depression?


Wisconsin is not the easiest place to live – especially in the winter.  Often stuck inside, people are missing the sunlight and fresh air they benefit from in other seasons.  Many socialize less, avoid outside activity, and may even put on a few extra pounds from those “comfort foods”.  Sleep can also be affected from these unhealthy habits.  All of this can lead to what is known as the “winter blues”.


The clinical name for the “winter blues” is Seasonal Affective Disorder, or SAD.  The most significant characteristic of SAD is that it is cyclical.  Most in this northern area begin to feel SAD in the fall, find that it worsens in the winter, and that it begins to recede in the spring.  There are many simple ways to work through SAD.  Get as much sunlight as you can, exercise every day, and keep yourself on a regular sleep schedule despite your desire to sleep more.  Another option is to purchase brighter light bulbs to simulate sunshine.


Why is it important to figure out if you have depression?  Simply put, it is to improve your quality of life.  If you are depressed, you are feeling weighed down and will continue to be sad until that depression is gone.  Spring and/or more light will not lift your depression.  And remember, depression doesn’t only affect you.  It impacts those you love, work, and socialize with.  Also important to know is that depressed people sometimes don’t think clearly and may make permanent decisions to try to escape the sadness: divorce, quitting their job, moving, etc.  Unfortunately, none of those major changes will take away the depression.

There are two main categories of depression: situational and clinical.  When something tragic happens, like the death of a loved one or receiving a diagnosis of a disease, we can develop situational depression.  This type of sadness will gradually diminish when we become adjusted to the new reality.  Clinical depression, however, is a more persistent feeling of sadness which can lead to physical and behavioral problems that last for years such as those as listed below:


  • Difficulty in making decisions
  • Hard to concentrate
  • Avoiding things that used to give you pleasure (including sex)
  • Spending less time with friends and family
  • Significant weight loss or gain
  • Changes in sleep pattern
  • Frequently feeling sad or irritable
  • Having pessimistic or hopeless thoughts
  • Suffering from aches and pains that won’t go away
  • Wondering if others would be better off without you – considering suicide


Should you seek help for your depression?  Yes, if it is negatively affecting your life.  Otherwise your depression can deepen and go on for years.  It could even become a threat to your life as one in 10 people with depression commit suicide.


Check with your doctor first to find out if what you are feeling is related to a medical condition.  If it is not, seek out a mental health professional.  You may find that counseling will make a great improvement in your life and the lives of those you love.  In addition, develop habits that will improve your mental outlook: physical activity, healthy eating, adequate sleep, socializing, and eliminating those things that cause you unnecessary stress.


Take care of yourself.  You are worth it.

Karen Wrolson MS, MEd

Choosing the Right Therapist

October 21, 2013

By Jerry Nelson October 20. 2013

What is Psychological Health?

I have spent the last seven years working with our military Service Members and their families as they contended with the cycle of being deployed, coming back and being deployed again. As you can imagine, their service to our country impacted every area of their life. This was especially difficult for our National Guard and Army Reservists who came back home to their community without the same resources available to active duty personnel.  Working closely with these individuals, reinforced for me that our daily life consists of four main areas, as illustrated below, and that there is a lot of overlap. Psychological health takes a holistic approach to wellness – recognizing we are an integration of mind, body, and spirit. Difficulties in any one or more of these areas can have a major impact on other areas. Psychological health is achieved with balance in these four areas.

4 spheres


When Should a Person Seek Assistance?

I also used to work as a surgical nurse and often assisted with cancer surgery.  Most cancers start as a small group of cells that can grow to produce a noticeable lump.  If caught early enough, the cancer can be stopped in its tracks. In our daily life we can have early warning signs, lumps if you will, starting in any of the four areas illustrated above. These can spread into other areas and infect how you view yourself and/or others. For instance, there may be a situation in the social aspect of your life where a relationship has gone bad, such a divorce, unforgiveness, hurt by a friend, etc. Soon you notice you don’t want to associate with others, your appetite has gone away, sleep is impossible, you’re grumpy and irritable and it seems life is spiraling downward. It doesn’t take long for all four areas of your daily life to be affected.  It may be time to do something about these signs and look for a change.

Need a Change?

Need a change

Often the longer we wait to do something about the warning signs, the more entrenched the problem becomes in all aspects of life. Perhaps there is a lot of uncertainty in your life and you feel like you’re in a giant maze.  My experience with military Service Members and their families, as well as private practice, revealed that often changing one area of life, (such as emotions, behaviors, relationships, or even a direction in life) can help bring back the psychological health that was once enjoyed.


How CAN a Counselor Help?

Counselor Help 1 Counselor Help 2

You can think of a counselor as someone who comes along side of you and helps you sort out the changes you want to make. Often this involves giving you a new perspective on an issue, or developing new skills to approach old problems in a new way. Maybe you need someone to be more directive and point out things you just can’t see. In the illustration above, can you see the young woman/saxophonist, or the young woman/old woman? Some people can see the images right away, but others need more direction to make the distinction.

Wrong Results?


I often hear “I tried counseling and it just didn’t work,” especially from men.  Perhaps the problem was you weren’t getting the results you were looking for after just one session. No matter who the counselor is, try to give it at least 2 to 3 sessions before you leave counseling with that individual. However, research shows that the best predictor of a positive outcome is being connected to your counselor. One way to avoid future conflicts is to interview several counselors before starting counseling sessions. I recommend you briefly describe your problem and ask the counselor how much experience they have with that problem. Ask them what their approach to your problem would be. Also ask them how they know when someone is done with counseling. You are listening for two things: the first is the actual answers the counselor gives you; and the second is how they answer you. Do you like what you hear and do you think you can connect with the therapist? You have a right to be proactive in your counseling.

The Bottom Line!

 Bottom Line Military

The military has a credo of leaving no one behind. Finding the right counselor to come alongside you as you work through some things in your life goes a long way toward having, and maintaining, psychological health.

Contact Jerry right now at 608-785-7000 x221 to schedule an appointment or click here to make an appointment request. 

Unleash the Power of the Positive in You….

April 25, 2013

The power of the positive…….by Diane Walker

What really happens to us when we get “stuck in the negative”; what does our body experience as a result? Conversely, how does our body react when we have a more optimistic outlook, believe in the good?

Research shows that men in unhappy marriages/relationships have a shorter lifespan of 10-15 years compared to those in happy marriages. For the purposes of this writing, we’ll define a happy marriage as one in which both partners exist on equal footing, emotional safety is present for both partners, and the ability to be completely ourselves is constantly present.

Negative thought patterns can lead to depressive symptoms, lack of energy, physical illness, unsatisfactory relationships, anxiety, anger, and that feeling of “just wanting to stay in bed all day.” It is often very difficult to maintain positive relationships when we don’t trust or believe in the goodness of others. Negative thought patterns can be instilled when we’re kids, by parents, school experiences, “life” in general. Most of us have some type of trauma in our childhoods, experiences and perspectives are individual and varied. We view our pasts through our own rose colored glasses, our own perspective, which has to be as important as anyones.

Let’s look at recent events in this country such as the Boston bombing a few weeks ago. We think about the victims with sadness, horror, and anger. We ask “why does this have to happen”; we want answers and feel like someone has to pay. Sometimes, we may get stuck in thinking we can’t explore the “unsafe” world, we don’t want to leave our houses. We may start or continue viewing other’s intentions as negative, wanting something from us, “why would you want to spend time with me”. We may look at the incredibly terrifying experience as a whole, not the incredibly compassionate events that take place within the tragedy.

What happens when we see the positive in this world; we acknowledge the negatives and violence, but do not let them define our own life’s parameters. Positive thinkers live longer, are healthier, are quick to smile, see the best in others, are motivated and believe in the power of change, and have deeper and more satisfying relationships.
The research surrounding positive thinking is prevalent and everywhere. Some people are born with natural optimism, others learn the secret of positiveness as they age. This is a skill that can be learned, that can transform your life. What about the people who help the victims of the bombing, the vast numbers of people who send cards, donate prosthetics, time, money, and smiles. How do some people get to forgiveness and begin the process of moving on with their lives?

How do some people learn the power of hope, despite everything they have been through in their lives. One Sunday, there was a story about a guy who never learned to read. He is a World War II veteran who survived the landing at Normandy. He worked as a civilian after the war until retirement age. His wife and co-workers covered for him so no one ever knew he couldn’t read. His lifetime dream was to read a book before he died. He is now 90 and has finally read several books; he tries to explain his intense feelings related to accomplishing his goal. He said, “Get in there and learn, you ain’t going to learn in that pine box”. How simple would it have been for him to just forget about this and live his life the way he always had. Change is possible at any age, in any environment, in any circumstance if we want it badly enough.

We can all learn the power of positive thinking and embracing positive change. Counseling can help with your outlook.

To schedule an appointment with Diane, click here now or  call 608-785-7000 x221!


Here is a great video on Mental Health Wellness vs Mental Illness…


Online and Telephone Help Now Available

April 10, 2013

Click the link below to get help fast! Get scheduled with a provider today!

Online or Telephone Help!!


January 5, 2012

Where Do I Start?

(from American Foundation for Suicide Prevention www.afsp.org)

Know that you are not alone.

If you have lost someone to suicide, the first thing you should know is that you are not alone. Each year over 33,000 people in the United States die
by suicide — the devastated family and friends they leave behind are known as “survivors.” In fact, research shows that during the course of our lifetime
85% of us will lose someone we care about to suicide. That means that  there are millions of survivors who, like you, are trying to cope with this
heartbreaking loss.Survivors often experience a wide range of grief reactions, including some or all of the following:

  • Shock is a common immediate reaction. You may feel numb or  disoriented, and may have trouble concentrating.
  • Symptoms of depression, including disturbed sleep, loss of appetite, intense sadness, and lack of energy.
  • Anger towards the deceased, another family member, a therapist, or  yourself.
  • Relief, particularly if the suicide followed a long and difficult mental illness.
  • Guilt, including thinking, “If only I had.…”

These feelings usually diminish over time, as you develop your ability to cope and begin to heal. We care and want to help.

Professional, compassionate help is available. Call us at 608-785-7000 or click here for an appointment request. 

National Violent Death Reporting System findings with respect to suicide in 2008:

 For 2008, a total of 15,755 fatal incidents involving 16,138 deaths were captured by NVDRS in the 16 states included in this report. The majority (58.7%) of deaths were suicides, followed by homicides and deaths involving legal intervention (i.e. deaths caused by police and other persons with legal authority to use deadly force, excluding legal executions) (26.4%), deaths of undetermined intent (14.5%), and unintentional firearm deaths (0.4%). Suicides occurred at higher rates among males, American Indians/Alaska Natives (AI/ANs), non-Hispanic whites, and persons aged 45–54 years. Suicides occurred most often in a house or apartment (70.6%) and involved the use of firearms (51.5%). Suicides were precipitated primarily by mental health (45.4%), intimate partner (30.9%), or physical health problems (22.6%), or by a crisis during the preceding 2 weeks (27.9%).

 Suicide Patterns

Similar to the 2005–2007 NVDRS data years, the suicide rate for the 2008 data year was highest among males and American Indian/Alaskan Natives, although at least 85% of the suicide victims each year were of white non-Hispanic race/ethnicity. Also, the 2008 suicide rate was highest among those of aged 45–54 years, in general, but the highest rate remained among males of aged ?85 years. These findings have also been documented in other reports (10,11 ).

In 2008, mental health issues (i.e., having a current depressed mood and/or a current mental health condition) remained the most common health characteristic among decedents, which was also reported in previous years (79). Intimate partner and relationship problems, alcohol/substance abuse problems, serious physical health problems and crises immediately prior to death also remained common characteristics or circumstances among decedents (7,8,12–16). This report also showed that intimate partner problems were more common among male decedents and diagnosed mental health conditions were more common among female decedents. However, both male and female decedents were almost equally as likely to be noted as having a current depressed mood prior to death. This finding supports previous research that showed females are more likely than males to seek mental health care and receive a diagnosis for their mental distress (17,18). Among those who received a diagnosis, the majority of both male and female decedents were diagnosed with depression. However, this report revealed some differences in diagnoses by sex; attention deficit disorder was more commonly found among male suicide decedents and bipolar disorder and anxiety disorder were more commonly found among female decedents.

Another similarity with previous data years was that nearly 30% of suicide decedents in 2008 disclosed their intent to commit suicide to others and approximately 20% had made previous suicide attempts (79). This finding indicates that there still remains the need for proper follow-up treatment and monitoring for those who attempt suicide as well as the need for public education on how to respond and seek help when faced with someone disclosing suicidal intentions (79,19).

In contrast to previous NVDRS data years, slightly greater proportions of suicidedecedents in 2008 were identified as having job problems and having financial problems prior to death. In 2008, both proportions were estimated to be 13.4% whereas, in previous data years, the proportion of suicide decedents identified as having job problems ranged from 11.1%–11.5%, and the proportion identified as having financial problems ranged from 11.0%–11.7%. Financial hardship was not found among decedents of undetermined deaths, which further indicated this circumstance was more associated with suicide. Financial and job problems were more common among male decedents and decedents aged >50 years. Job loss can trigger a cascade of negative events, such as more financial problems and relationship problems (20), which can increase risk for suicide. These findings suggest that strategies that incorporate financial planning and social support are warranted for those who might be at risk for losing employment, particularly during difficult economic times.

 Description of System: NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS data collection began in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two in 2010 (Ohio and Michigan) for a total of 19 states. This report includes data from 16 states that collected statewide data in 2008; data from California are not included in this report because NVDRS was implemented only in a limited number of California cities and counties rather than statewide. Ohio and Michigan are excluded because they did not begin data collection until 2010.

To view the entire report, visit:  http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6010a1.htm?s_cid=ss6010a1_e&source=govdelivery

‘How to react to OPC (other people’s children) when they throw public tantrums’

March 27, 2009

I was contacted by an old friend following my blog regarding managing children’s behavior in public. He asked me about how others should react to others peoples children when they are throwing a tantrum. Admittedly, I laughed at first but that was rather intrigued. I decided that this would be a good topic for a brief blog addressing this very issue.  At first, I thought how would I address this issue. I know I am guilty even as the parent of looking at other parents and thinking “wow! They’re having a very difficult time with the child.” I’ve even thought about stepping in and offering help, however; I do not think the help would  be well received. After careful consideration and consulting with my colleagues. We did some research and found the best solution to offer parents of tantruming children is to suggest the following:


Depression – Are medications for me?

March 2, 2009


The lifetime prevalence of depression is estimated to be 16.2% in the general population, indicating that more than 30 million adults (about 1 in 6) in the United States will experience an episode of depression.(1)   Many individuals with depression contemplate medication for treatment. Best results for treatment are medication combined with therapy and a regular exercise program.  Here is some information the consumer needs to be aware of regarding depression and anti-depressants. There are a large number of safe and effective antidepressants that are generally well-tolerated with minimal, time limited (2 to 4 weeks) side-effects.

The goal of the treatment of depression is remission, meaning the complete or near-complete resolution of all symptoms.(2) Current guidelines suggest the acute phase of treatment—when medication is started—generally lasts for up to 12 weeks. In the acute phase, the treatment goal is to get the depression into remission, the point at which symptoms are completely, or nearly completely, gone. Once the depression is  in remission, consumers enter the maintenance phase of treatment, which should last for an additional four to nine months.(3) The main problem is that many consumers do not remain on medication long enough to reach remission, let alone stay on medication for the additional recommended months. Up to 33% of patients stop medication within the first month, and up to 44% discontinue medication within three months of initiating therapy.(4-6) This often progresses to a more intensive re-occurrence of the depression – and consumers state “I feel like myself again” meaning the depression has returned.  Many times, the consumer is the last person to recognize depression has taken hold – spouses, parents, peers, and colleagues are often the first line of defense.

Two of the many reasons consumers discontinue antidepressant medication are intolerance to the medication (adverse events) and lack of response (either partial or complete). When a consumer is having intolerable side effects, or when a patient is not responding to an antidepressant, consumers are recommended to  consult with their MD or therapist about treatment options which may include  choose to switching from one antidepressant to another.


Side effects from antidepressant medication include those that occur during the acute phase of treatment, as well as those that become problematic during long-term treatment, such as weight gain and sexual dysfunction. Common adverse effects of antidepressants may result in the need to switch medication.

Adverse side effects are consumer specific – meaning it is difficult to get a true picture of the adverse effects a consumer can expect from any single antidepressant until the consumer begins the treatment. Many beliefs about the side-effect profiles of antidepressants are based on the marketing data of pharmaceutical companies and treatment providers experiences with small numbers of patients. However, we do know of the common side-effects produced by specific anti-depressants. Some include headaches, metallic taste in mouth diarrhea, mild nausea, and others (these are often temporary lasting 1 to 3 weeks).

Up to 60% of consumers taking an anti-depressant will experience some degree of sexual dysfunction such as delayed orgasm, inability to have an orgasm, and/or decreased libido.(7)  While each medication may claim different rates of sexual dysfunction,  this adverse effect appears to be apply to almost all SSRI’s (anti-depressants).   There are medicinal strategies to manage this side effect and a consumer should consult with his or her treatment provider. (8) Weight gain is also a common late side effect of antidepressants. Nutritional counseling and exercise are usually the only measures necessary to deal with this problem.


In most cases, many consumers placed on a reasonable dose of an antidepressant begin to experience relief within 2 to 9 days with more pronounced relief of symptoms after 4 weeks.

It is estimated that 12% to 15% of consumers will partially respond and 19% to 34% will not respond at all to a given antidepressant medication. (9)

Options available to consumers who do not achieve remission on a single antidepressant include increase dosage, additional treatment with a second drug, and/or switching to a new medication.

Consumers with depression should have at least 3 follow-up visits during the first 12 weeks of treatment.(10)

The longer consumers stay on medication, the more likely they are to get to remission and enjoy life!


  1. Kessler RC, et al. JAMA. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication 2003;289:3095-3105.
  2. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder [revision]. Am J Psychiatry. 2000; 157(4 suppl):1-45.
  3. Depression Guideline Panel. Depression in Primary Care, Vol. 2: Treatment of Major Depression. Rockville, Md: US Dept of Health and Human Services, Public Health Service, and Agency for Health Care Policy and Research; 1993. Clinical Practice Guideline No. 5.
  4. Simon GE, VonKorff M, Wagner EH, et al. Patterns of antidepressant use in community practice. Gen Hosp Psychiatry. 1993;15:399-408.
  5. Venturini F, Sung J, Nichol M, et al. Utilization patterns of antidepressant medications in a patient population served by a primary care medical group. J Manag Care Pharm. 1999;5:243-249.
  6. Lin EH, VonKorff M, Lin E, et al. The role of the primary care physician in patient’s adherence to antidepressant therapy. Med Care. 1995;33:67-74.
  7. Masand PS, Gupta S. Selective serotonin-reuptake inhibitors: an update. Harv Rev Psychiatry. 1999;7:69-84.
  8. Keltner NL, McAfee KM, Taylor CL. Mechanisms and treatments of SSRI-induced sexual dysfunction. Perspectives in Psychiatr Care. 2002;38: 111-116.
  9. Fava M, Davidson KG. Definition and epidemiology of treatment-resistant depression. Psychiatr Clin North Am. 1996;19:179-200.
  10. National Committee for Quality Assurance. HEDIS 2000: Technical Specifications. Vol 2. Washington, DC: National Committee for Quality Assurance; 1999:105-110.

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