College: A Generation at Risk

A College diploma is a goal for millions of Americans, yet graduation rates have never been lower and those who do graduate take 6 years on average compared to the 4 years of previous generations.  Recent research has helped us understand that these dismal outcomes are not because students cannot handle the coursework, because the vast majority of students can grasp the academic content; rather mental health issues are now the prominent struggle in College.

The statistics tell a rather grim story at first glance.  A study by the APA in 2017 found

86% of students with psychological and learning challenges left school without a diploma. The CDC discovered that suicide is currently the 2nd leading cause of death among college students and this year, WHO found that 1 in 20 full-time college students have seriously considered suicide.

There is one statistic, however, that gives hope to these startling facts.  94% of high school students with emotional and learning differences receive some form of assistance. In contrast, only 17% of college students with the same challenges do so.  The remaining 74% still need assistance in navigating the new world of College life, but faced with logistical and financial constraints, Colleges will have to adapt quickly when it comes to providing services for the mental health of its students.  Currently, there is a nation-wide average of 2,500 students for every one counselor and this clearly isn’t enough.

The good news, if you or someone you know needs help while in school, there are a couple of private and non-profit companies filling the gap in the state of Utah so please reach out for hope, healing, and help.

Originally published on

Working Through Perfectionism in Eating Disorder Recovery by Jessica Gilliland, MS, LAMFT


Perfectionism is the pressure to live up to an unreasonably high or perfect standard–no mistakes allowed. For those engaged in eating disorder recovery, combating perfectionism can feel like an uphill battle. Even for individuals who are highly committed to recovering from an eating disorder, the pressure to be “perfect,” whether it comes to body appearance, weight, emotions, choices, or relationships, can be crushing at times. This pressure to be perfect is not something that only individuals in eating disorder recovery feel; almost everyone can relate to feeling the burden of perfectionism at some point in life, especially when it comes to times of life when change and growth are a focus.

Embracing Ambiguity

In working with my clients, I have noticed perfectionism begin to rear its head as recovery starts to gain positive momentum. Suddenly it seems like there is a “right” way to do recovery. The expectation of doing recovery “right” can be just as intimidating as deciding to choose recovery in the first place. Suddenly new ways to fail start popping up, and the questions of self-doubt start getting louder:

“Was I good enough at treating my body kindly, or am I still letting my eating disorder win?”

“Part of me is still afraid of letting go of my eating disorder. Does that mean I’m not really in recovery?”

“I just turned down a lunch date with a friend because I was feeling anxious. Is that a recovery ‘fail?’”

These doubts and fears are a common part of the ambiguity that can surround eating disorder recovery or any type of change or progress. Often it can feel like there is a line dividing what is “recovered” and what is not. The truth is, recovery is not as black and white as it might seem. Sometimes turning down a lunch date in favor of another form of self-care IS the recovery-friendly choice. Another day, choosing to go out to lunch despite feeling anxious might be the next step in moving recovery forward. These grey areas can seem frustrating and even frightening, especially to a person who struggles with the pressure to do things perfectly. However, learning to be flexible and to accept ambiguity and its resulting difficult emotions can be a key part of moving away from a life governed by the strict and unforgiving rules of an eating disorder, and toward a life led by deeply held values that guide a person toward what they truly want most.

Getting in Touch with What Matters Most

Even as a therapist, I am not immune to the sneaky effects of perfectionism in my own life. Recently I realized that I still have some insecurities about my body, despite having been recovered from my eating disorder for several years. Almost without my realizing it, perfectionism started to feed those insecurities until I came to what felt like a bit of a recovery identity crisis. Those questions of self-doubt started to make themselves heard. “I’ve spent years in my own recovery, and years learning about eating disorders and how to treat them, so shouldn’t I have all of this stuff figured out by now?” The pressure to be perfect at recovery started getting stronger and stronger, and my confidence in my identity as a recovered person began to take a major hit!

After a lot of self-reflection and work with my own therapist (and yes, therapists can benefit from therapy, too!), I stumbled upon a truth that I needed to find for myself. It came to my mind as a gentle question:

“What if instead of worrying about whether I’m doing my own recovery ‘right’ or not, I tried doing what feels caring and kind to myself?”

While my day-to-day life looks very different now than it did when I was in the throes of my eating disorder, I have recognized that being intentional about treating myself with kindness is still an essential part of staying committed to recovery. Kindness and compassion are some of my core values, or principles that I want to rely on in guiding my life. Perfectionism started to get in between my values and my thoughts and attitude toward my body. As I have gone through the process of facing my insecurities and getting back in touch with my values, the draw toward perfectionism has seemed less urgent and less appealing. While it has not been easy to accept that I still do have some body image woes, giving myself permission to struggle with them has opened the opportunity for me to grow and gain insight as I have reconnected with what is most important to me.

For me, recovery does not mean suddenly arriving at a place where I always make the “right” choice about food, exercise, my body, or anything else. In most cases, it actually means taking away the pressure of the labels “right” and “wrong,” and instead responding to my physical and emotional needs. It doesn’t mean that I never experience negative feelings about the way my body looks. It does mean that I give myself permission to make loving choices for myself and for my body, despite negative feelings that may come up at times. I can maintain my commitment to recovery even when I feel shaken up by difficult emotions, as long as I can keep my core values in sight.

Breaking Free

While perfectionism can develop a tight grip on us as we try to change and progress, there is hope for breaking free. When we give ourselves permission to struggle and stumble on the journey of change, we open the door for peaceful self-acceptance, wherever we may be on that journey. As we allow ourselves to be guided by what matters most deep down, rather than by the harsh and inflexible rules of perfectionism, we find satisfaction and meaning in our experiences. Letting go of the “right” way to do recovery, or any type of change, can be like taking a breath of fresh air.

Medication Management and Mental Health

In my career in healthcare, I have seen far too many patients who have been prescribed medication and continue to take that medication faithfully; Yet after a time, they are not really sure why they are taking that specific medication or if it is even helping with the diagnosed issue.  

 What is missing for these patients? Medication management 

Medication management is the process of following up with the healthcare provider on a regular basis to assess the effectiveness of the prescribed medication therapy, discuss any side effects that may go along with the medication, and make adjustments in order to achieve proper dosing. In some cases, the follow-up may be to change the prescribed medication therapy, if it is not providing the desired outcomes. Medication management should be an ongoing process. It should include open dialogue between the patient and provider about the effects of the medication combined with any other therapies or treatments that may be in place. This is to ensure useful data is being collected, so decisions can be made based on the whole picture; not just the medication piece. 

When it comes to psychiatric and mental health services, the importance of quality medication management cannot be overemphasized. Not all people who seek psychiatric help will require medication. In some cases, amino acid therapy may be appropriate or continued therapy and counseling with regular psychiatric follow-up is warranted. If medication is prescribed, the patient should plan to see the psychiatric provider within 2 weeks (in most cases) for the first medication management visit.  Continued follow-up visits should be scheduled monthly, or as needed depending on the individual case. 

During these visits, the patient should plan on communicating openly with the psychiatric provider about their use of the medication, any side effects that they may be noticing, and any changes they are feeling in relation to their mental health diagnosis. At times, genetic testing can be used to pinpoint what medications are more likely to work for each individual patient. This testing can be used not only for patients who are just beginning psychiatric treatment but also for patients who have been prescribed medication therapies that aren’t working. The patient should also plan to consult with the psychiatric provider before taking any other medications. They should inform the provider of other mental health therapies being used or medical complications that may arise during treatment. The patient should expect the provider to ask questions that will direct and lead the conversation, so time is well spent and modifications can be made with confidence. 

Ultimately, the key to effective psychiatric medication management is open and continual communication between the patient and provider. At the Center for Couples and Families, our psychiatric providers strive to provide thorough psychiatric assessment, follow-up, and medication management. 

Originally published on



Maintaining A Relationship That Is Juicy, Fun, Passionate and Loving by Dr. Matt Eschler, Ph.D

I am pretty certain that we all hope for a juicy, fun, passionate, loving relationship with our lovers! The relationships that maintains a spark over decades of being together are built carefully they most definitely are NOT accidents! You don’t connect with a “soul mate” and settle into mandatory bliss. If you are hoping, longing, reaching for a juicy fun passionate relationship then you will want to read the rest if this article!

Juicy fun passionate relationships are created. If you keep a few rules you can be certain your marriage is all you ever fantasized about! Keep these three incredibly simple rules of engagement and juicy, fun, passion will be yours!

Get to know each other every day.

By constantly developing connection and strengthening your relationship bond you breath new life into your marriage every chance you get. Sometimes you will be giving rescue breathes during crisis and struggle while other times you are giving extra oxygen creating a sense of peace and relaxation. Know your lovers top five or six needs to be happy. Many couples think they know each other and know what drives happiness only to find they have lost touch with change, growth, and each other. To keep on the razor edge front line of juicy passionate fun you have to meet together and talk. I suggest three meeting a week is the minimum. These three meetings each come with there distinct purpose. First have a date night. This is where couples flirt, tease, kiss, and talk about hopes and dreams with each other. Second meeting is couples council. In this meeting you discover the struggles you each face. You empathize with each other, grow through strife and strain while talking about hard topics trusting you will stand by each other for better or worse. Third meeting is family night. This is a time to organize your family share family activities, dreams, and structure the household as a unified front. All three of these meetings are really mandatory and refreshing if you engage weekly on purpose.


Second of the three “must” for juicy fun passionate relationships is all about transparency. Share your whole self holding nothing back. If you only share what your lover approves of your holding them hostage. Allow your lover to see all of you and realize your love for each other grows with knowledge of what makes us tic. Sharing a deep sense of fondness and adorationfor each other! (Number one cause of divorce is contempt) is a major part of the intimacy you will Experience. Have you ever caught yourself thinking fond thoughts about your lover and not expressing these thoughts out loud because it feels way vulnerable? My challenge to you is be vulnerable every day! Dare to share all your fondness and admiration out loud and often! Pray with each other express gratitude to the God of your understanding for each other. Imagine the power you will have as Couple joining in prayer to begin each day unified! Celebrate victories, Support each other’s interests, and helping achieve each other’s dreams are all ways of generating juicy fun passionate marriages. I think you get the idea.

Positive Sentiment Override (Gottman Term)

Finally the third principle followed by juicy, passionate, fun couples is a constant positive sentiment override. You always have two choices in how you SEE your lover. You can think negative or you can see the good. You can interpret what is said through a filter of offense. Seeking to be offended will generally lead to you finding a way to actually be offended. The thousands of interactions will be filled with minor slights and errors that can be exploited and used to feel sad, hurt and bugged a each other. On the other hand you have every right to filter all those same interactions through a sieve that separates out all the warm juicy passionate sentiments and feel love and joy. It’s really fun p to you! No, your not burying your head in the sand your simply seeking the good gifts offered.

Think about all of this and have an incredible juicy fun valentines month in February.

About the Author:  Dr. Matt Eschler lives in St. George, Utah where he and his wife Chris are enjoying their life with each other. Since their kids have grown and moved out perusing their dreams Matt and Chris travel the world. They want to visit 200 countries before the are done. Matt and Chris are active in their community and enjoy working out, training for marathons, and spending time participating in numerous activities with their adult children.  Matt has received his PhD in Psychology. He is focused on the arena of resolving personal conflicts and improving interpersonal relationships. In addition to his Doctorate Degree Matt has earned a Masters in Marriage and Family Therapy, studied Criminal Justice and received a category I licensure with Peace Officer Standard of Training along with a degree in the Arts of Business Management. Matt is a professor at Dixie State University and hopes to be part of the positive growth of Southern Utah.

Tips for Stopping Binge Eating in its Tracks, by Jessica Gilliland, MS, LAMFT

At one point or another, all of us have turned to food to deal with uncomfortable emotions. Some of these instances are minor, like grabbing a bag of chips to munch away the stress of a difficult work day, or downing a milkshake to feel better after an upsetting event. Chocolate chips are my traditional pick-me-up treat. It makes sense that we often turn to food for comfort, or to numb emotions. Eating can feel good, and it is meant to be a pleasurable experience. However, when turning to food becomes a compulsive, habitual means of coping, and when emotional eating (eating to deal with feelings rather than to satisfy physical hunger) starts to become uncontrollable, the consequences can be physically and emotionally distressing. If you have ever found yourself swept up in an eating binge without knowing how to stop yourself, here are a few tips that may be useful for interrupting a negative interaction with food.

Tip 1: Check in with your gut

Sometimes a quick check-in with your body when you feel the urge to binge can be very effective. Pay attention to how you feel, and try to notice if the signs of physical hunger are present in your body. Do you feel hunger pangs, emptiness, or growling in your stomach? Are you feeling lightheaded or irritable? If you are physically hungry, then by all means, eat! Responding to physical hunger cues before you feel ravenous can actually help you regulate your eating. If you are not physically hungry, give yourself a chance to reconsider your choice to put food into your body when you might not need it, then think about why you might be reaching for food. Could it be boredom, habit, emotional distress, loneliness, or some other reason? These are often starting points for a binge. For more helpful strategies for recognizing hunger and fullness cues, see the Appetite Awareness Workbook.

Tip 2: Name your feelings

Perhaps you know very well that you are not physically hungry, but are instead trying to avoid or numb an uncomfortable emotion. Before stuffing your emotions down with food, try to take a moment to name the emotion you are experiencing. Perhaps “disappointment,” “helplessness,” “loneliness,” or “shame” is driving your craving for comfort. Identifying the discomfort you feel can give you a chance to take care of what hurts, rather than going for the “quick fix” binge that will likely leave you feeling worse off than you started. For more tips on coping with emotions without turning to food, I highly recommend the book Intuitive Eating by Evelyn Tribole and Elyse Resch.

Tip 3: Seek connection

At times, what you may be seeking through binge eating is comfort and connection. When connection seems out of reach, food can become an easily accessible caretaker. Eating while alone can also make it easy for compulsion to take over. When you feel the momentum of a binge beginning to sweep you away, reach out to find connection somewhere. That may mean going into a room where other people are, calling someone, making a spiritual connection through prayer or meditation, connecting to nature by walking or looking outside, or even connecting with your own body by noticing your breathing or the temperature of the air on your skin. As you begin to consciously choose to connect, you may notice yourself feeling more grounded, calm, content, and no longer in need of the numbing effects of a binge.


These are just a few tools that may be helpful in managing the urge to binge eat. Frequent compulsive or emotional eating can feel like an impossible obstacle to overcome, but it is possible to heal your relationship with food and eating.

Simple Ways to Improve Mood by Alberto Souza, MSN, APRN, FNP-C

We all have those days when it feels like we woke up on the wrong side of the bed. For whatever reason we are just in a bad mood. Often times these bad mood feelings are associated with difficult or stressful events in our lives such as trouble at work, financial problems or disappointment. Sometimes these bad mood feelings last for only a few hours, but sometimes they might linger for days at a time. There are many simple strategies to improve one’s mood in spite of what it is that might be bringing us down.

Be With People

Often times when we are feeling low just being with a trusted friend or family member and talking about our feelings can make all the difference. Having a sympathetic listener or someone that can get us laughing or looking at the bright side of things can make all the difference. We shouldn’t be embarrassed to talk about our mood or admit that we need help. In fact, many times isolating ourselves can be one of the biggest culprits in a lingering bad mood.

Get Out

Whether its a brisk walk through the neighborhood or a trip to the grocery store, getting out of the house can do wonders for improving our mood. Sometimes we just need a little sunshine or to breathe in some fresh air. The sights and sounds of everyday life can get our mind off of things and be a beautiful distraction.

Enjoy Yourself

When a bad mood strikes we might find ourselves not even wanting to do the things we normally enjoy, but doing them anyways can take our minds off of negative thoughts and often times will help us feel better overall. Think of simple pleasures like reading, exercising, cooking or baking, shopping or just watching a funny movie or show.

Talk to a Professional

Feeling sad or moody are normal human emotions that we all experience from time to time.  Depression is different from these emotions primarily because depression is a pervasive feeling of sadness that impacts our entire life and doesn’t just go away even when things in our lives are good. We should not hesitate to reach out to a professional to help us understand our feelings and deal with them appropriately.

Source: Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.