Nutrition News

Attentional Bias Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction and Disordered Eating! Check out our latest video on Attentional Bias!

This video is about Attentional Bias, which is the tendency for one’s perception to be affected by their recurring thoughts at the time. In other words, one’s bias towards noticing what they are already thinking of. How does Attentional Bias related to Disordered Eating? Find out!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We send out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

Within the next year you can look forward to the following topics being covered:

Vaping (E-cig)

Bariatric Surgery

Child Nutrition

Circadian Rhythms

Men and Eating Disorders

View last month’s video on Alcoholic Liver Disease

About Nutrition in Recovery 3

 

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Journal Publication: Nutrition Services in Los Angeles Substance Use Disorder Treatment

Rapid Assessment of Nutrition Services in Los Angeles Substance Use Disorder Treatment

One of our research studies “Rapid Assessment of Nutrition Services in Los Angeles Substance Use Disorder Treatment Centers” was recently published in the Journal of Community Health.

We assessed the prevalence of nutrition services in Los Angeles treatment centers and found that is was quite low! The article offers some important ideas about the addiction crisis.

Much thanks to Maria Schellenberger and Dr. Michael Prelip for their assistance with this research.

Link to article: http://link.springer.com/article/10.1007/s10900-018-0557-2
Direct download HERE

Journal Publication: Nutrition Services in Los Angeles Substance Use Disorder Treatment

Abstract

The objective of this study was to determine the prevalence of nutrition services and utilization of registered dietitian nutritionists at substance use disorder treatment centers in Los Angeles. This cross-sectional descriptive study utilized phone interviews with facilities within a 25-mile radius of the Los Angeles metropolitan area using the Substance Abuse and Mental Health Services Administration Treatment Services Locator to identify facilities that included a listing of substance abuse as primary focus of care (n=128). Facilities were asked if they offered any kind of nutrition services, the type of services that were offered, and the credential of the professional providing the services. We compared facilities that offered a residential level of care to those offering outpatient services only. The Fisher’s exact test was used to determine statistical significance. The study showed that only 39 sites (30.5%) offered any type of nutrition services on site, and the odds of a residential level of care offering nutrition services was 2.7 times higher than outpatient only facilities (p=0.02). Of the 39 facilities offering nutrition services, only 8 (20.5%) utilized a registered dietitian nutritionist. Overall fewer than 7% of the facilities utilized the services of a dietitian. Recovery programs for substance use disorder should consider using a registered dietitian nutritionist as a member of the treatment team, which may contribute to better clinical outcomes.

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Addiction Transfer via Nutrition During Pregnancy

Addiction Transfer via Nutrition During Pregnancy 

Ever wondered about the impact of nutrition during pregnancy? This presentation reviews the evidence from animal models.

Preclinical evidence for the addiction potential of highly palatable foods: Current developments related to maternal influence

by David Wiss, Kristen Criscitelli, Mark Gold, Nicole Avena

Abstract:

It is well established that obesity has reached pandemic proportions. Over the last four decades the

prevalence of obesity and morbid obesity have risen substantially in both men and women worldwide.

Although there are many causative factors leading to excessive weight gain including genetics and

sedentary lifestyle, the transformation of the food environment has undoubtedly contributed to the

dangerously high rates of obesity. The current food landscape is inundated with food engineered to

contain artificially high levels of sugar and fat. Overconsumption of these types of food overrides the

homeostatic mechanisms, which under normal circumstances regulate appetite and body mass, leading

to hedonic eating. Evidence from the animal literature has illustrated nutrition-influenced perturbations

that occur within the mesolimbic dopamine pathway, as well as maladaptive behavioral responses that

result from chronic ingestion of highly palatable foods. These neurobehavioral adaptations are similar to

what is observed in drugs of abuse. Recent evidence also supports that maternal exposure to these foods

is capable of provoking neurobehavioral alterations in offspring. Therefore the purpose of this review is

to summarize the current developments on the addictive potential of highly palatable foods, as well as

illuminate the impact of maternal hyperphagia and obesity on the reward-related neurocircuitry and

addiction-like behaviors in the offspring.

Journal Article HERE

Recorded webinar below!

This is a mini-webinar reviewing recent evidence of the impact of highly palatable foods on the neurodevelopment of the offspring, using animal models. The video is 10:19 and is highly recommended for those interested in brain chemistry, hormones, and epigenetics. This is a sensitive topic. Feedback is always welcome!

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Alcoholic Liver Disease Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our latest video on Alcoholic Liver Disease!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We send out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

Within the next year you can look forward to the following topics being covered:

Attentional Bias

Vaping (E-cig)

Bariatric Surgery

Child Nutrition

Circadian Rhythms

Men and Eating Disorders

View last month’s video on Food Politics 

 

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Have thoughts about Alcoholic Liver Disease? Reach out to us, we would love to hear your thoughts!

Read more

Nutrition and Mental Health

Nutrition and Mental Health

As a nutrition and dietetics student I developed an interest in the field of behavioral health nutrition. The idea that nutritional deficiencies or a variety of medical disorders could produce symptoms that mimicked psychiatric abnormalities [1] resonated with me early in my academic exploratations. The links between nutrition and mental health appeared to be a promising new area of investigation. In the past decade, research on the gut microbiome has documented compelling evidence that the bacteria flora in our intestines have a direct link to our brain and that these pathways are bidirectional [2]. As a registered dietitian nutritionist (RDN) working with patients with co-existing mental health conditions, I have observed an association between diet and depression. Practice experience has shown that dietary improvement can reduce some depressive symptoms [3]. Given that mental illness is a major public health problem, an emerging field known as nutritional psychiatry has received increased attention [4].

There are established links between depression and chronic diseases such as obesity [5], metabolic syndrome [6], and type 2 diabetes [7]. There are also associations between depressive symptoms and inflammatory bowel disease [8], as well as disordered eating [9]. Recent evidence suggests that altering the composition of the gut microbiome can lead to depressive-like behavior in animal models [10]. Because the human microbiome is highly influenced by foods that we eat, there may be an opportunity to improve depressive-like symptoms through dietary interventions. Randomized controlled human trials have shown that nutrition interventions can provide alternative or adjunct treatment for depression in common conditions such as obesity and type 2 diabetes [11]. The most common dietary recommendation is a Mediterranean-style diet with early trials showing a reduction in depressive symptoms [12,13]. Given the likelihood that nutrition can improve some depression-related symptoms, targeted dietary interventions should be considered a public health priority.

References

  1. Pollak, J., Levy, S., and Breitholz, T., Screening for medical and neurodevelopmental disorders for the professional counselor. Journal of Counseling & Development, 1999. 77(3): p. 35-358.
  2. Evrensel, A., and Ceylan, M.E., The gut-brain axis: the missing link in depression. Clinical Psychopharmacology and Neuroscience, 2015. 13(3): p. 239-244.
  3. Li, Y., et al., Dietary patterns and depression risk: a meta-analysis. Psychiatry Research, 2017. 253: p. 373-382.
  4. Marx, W., et al., Nutritional psychiatry: the present state of the evidence. Proceedings of the Nutrition Society, 2017. doi:10.1017/S0029665117002026
  5. Garcia-Toro, M., et al., Obesity, metabolic syndrome and Mediterranean diet: impact on depression outcome. Journal of Affective Disorders, 2016. 194: p. 105-108.
  6. Ohmori, Y, et al., Associations between depression and unhealthy behaviors related to metabolic syndrome: a cross sectional study. Asia Pacific Journal of Clinical Nutrition, 2017. 26(1): p. 130-140.
  7. Dipnall, J.F., et al., The association between dietary patterns, diabetes and depression. Journal of Affective Disorders, 2015. 174: p. 215-224.
  8. Bhandari, S., et al., Association of inflammatory bowel disease (IBD) and depressive symptoms in the Unites States population and independent predictors of depressive symptoms in an IBD population: a NHANES study. Gut and Liver, 2017. https://doi.org/10.5009/gnl16347
  9. Kim, O. et al., Binge eating disorder and depressive symptoms among females of child-bearing age: the Korea Nurses Health Study. BMC Psychiatry, 2018. 18:13.
  10. Wong, M-L., et al., Inflammasome signaling affects anxiety- and depressive-like behavior and gut microbiome composition. Molecular Psychiatry, 2016. 21: p. 797-805.
  11. O’Neil, A., et al., A randomized, controlled trial of a dietary intervention for adults with major depression (the “SMILES” trial): study protocol. BMC Psychiatry, 2013. 13:114.
  12. Parletta, N., et al., A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: a randomized controlled trial (HELFIMED). Nutritional Neuroscience, 2017. doi:10.1080/1028415X.2017.1411320
  13. Sanchez-Villegas, A., et al., Mediterranean dietary pattern and depression: the PREDIMED randomized trial. BMC Medicine, 2013. 11:208

 

Nutrition and Mental Health

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From Private Practice to Public Health

David- Tell us more about your background and private practice. Tell us about your current vision, and your decision to get your doctorate.

Five years ago, after completion of my master’s degree in Family and Consumer Sciences and becoming a Registered Dietitian Nutritionist (RDN) I founded a company called Nutrition in Recovery which specializes in treating patients with challenging eating and substance use disorders (SUDs). The group now comprises six RDNs who supervise educational groups at SUD treatment centers throughout Los Angeles. My continuing interest in this patient population led me to develop specialized dietary and educational curriculum for people in early recovery. When possible, I have used evidence-based principles to better manage patients with nutrition-related abnormalities. This has led to three journal publications, two book chapters, two poster exhibits, seven webinars, and over 20 podium presentations. I have also written six articles for the Behavioral Health Nutrition Dietetic Practice Group who recognized my work with the “Excellence in Practice” award presented at the national Food and Nutrition Conference and Expo (FNCE) in October 2017. I have also been a master’s thesis committee member for students enrolled at California State University, Long Beach. What I am particularly proud of is my commitment to research and academics from my private practice setting.

I am finishing my first year as a Ph.D. student in Community Health Sciences at UCLA, hoping to improve the role of nutrition interventions in patients with various SUDs. My overall goal is to reduce the incidence of disordered eating in early recovery and to improve the quality of life for patients with disabling addictive disorders.  SUDs are associated with malnutrition, preference for nutrient-poor food, compromised gastrointestinal health, and disordered eating. Given the current addiction epidemic, consideration should be given to prioritizing efforts to improve eating habits and overall health in recovery programs. Nutrition interventions during recovery may promote abstinence and prevent or minimize the onset of chronic illness including eating disorders (EDs). Currently there is an urgent need for improved treatment modalities for SUDs to prevent overdose and death, reduce healthcare burden, and to improve quality of life. Nutrition protocols in SUD treatment are not widely utilized. My goal is to develop evidence-based guidelines for nutrition interventions for various addictive disorders, which will hopefully lead to better policies and procedures.

Introducing the concept of food and nutrition into an SUD treatment program faces many obstacles. Many patients in early recovery are not ready for multiple health behavior changes, since most are simply trying to get past the immediate crisis of addiction and the associated life adjustments of abstinence. In several of the treatment centers where I work, patients are surprised when they discover that making small nutritional changes (such as drinking water or eating breakfast) can impact energy levels, overall sense of wellness, and optimism about being sober. There are numerous questions that relate to food, SUDs, disordered eating, and recovery that remain unanswered. Can nutrition be used to improve SUD outcomes? What is the best practice for treating co-occurring eating and substance use disorders? How can RDNs help with recovery from mental health disorders? What policy implications can address food addiction on a societal level? What new programs can be developed for underserved populations that struggle with SUD and nutrition-related challenges?

My goal in pursuing a doctorate in public health is to produce data that guides treatment. I am confident that my work in this area will create better evidence to improve funding for nutrition services, creating opportunities for dietitians to work in publicly-funded as well as underserved SUD treatment centers. RDNs desperately need more evidence of effectiveness in order to advance our profession. With new information, it may be possible to change the way we approach SUD treatment, but more importantly to improve the recovery process amidst the current opioid crisis.

About Nutrition in Recovery

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Food Politics Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our latest video on Food Politics!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We send out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

Within the next year you can look forward to the following topics being covered:

Alcoholic Liver Disease

Attentional Bias

Vaping (E-cig)

Bariatric Surgery

Child Nutrition

Circadian Rhythms

Men and Eating Disorders

View last month’s video on Night Eating Syndrome

Nutrition in Recovery

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Have thoughts about Food Politics? Reach out to us, we would love to hear your thoughts!

 

Read more

David Wiss Speaking Schedule 2018

Mr. David Wiss has a passion for speaking at the podium. He is not afraid of large crowds. He loves to create PowerPoint presentations summarizing the latest research related to nutrition and substance use disorder, as well as other topics such as eating disorders, microbiome, food politics, and public health. Here you will find the David Wiss speaking schedule for 2018.

Speaking Schedule 2018 

Tuesday March 6, 2018 12:00pm – 2:30pm

Sober College: 6022 Variel Avenue, Los Angeles, CA 91367

DESCRIPTION

Nutrition and Fitness in Recovery
CAMFT#140434

David Wiss, MS, RDN & Ken Niemann, MA, DC

About the Course:
We all know how important it is to pay attention to nutrition and fitness. Maintaining Body/Mind balance is especially important for those in recovery. Join the amazing David Wiss, founder of Nutrition in Recovery, and the ever-energized Ken Niemann, Fitness Director for Sober College, as they discuss the different elements of nutrition and fitness that help with neurochemical balance and optimized physical well-being.

2 Free CEUs for Addiction & Mental Health Professionals*

Open to all who register here. Free. Lunch provided.

Schedule:
12:00pm – 12:30pm – Check-in & Lunch (Not included in CE Hours)
12:30pm – 2:30pm – “Nutrition and Fitness in Recovery” (CE Course)

Friday March 16, 2018 1:15pm – 2:15pm

Alabama Dietetic Association Annual Meeting

Birmingham Jefferson Civic Center (East Hall), Birmingham, Alabama

TITLE: Nutrition for Substance Use Disorder Recovery: Gut-Brain

David Wiss MS RDN 

Lecture Objectives:

  1. Discuss the impact of addictive substances on nutritional status and gastrointestinal health
  2. Explore disordered and dysfunctional eating patterns in addicted populations
  3. Propose nutrition therapy guidelines for specific substances and for poly-substance abuse

 

More information and registration here

Saturday April 14, 2018 One Day Conference 9:00am – 3:45pm

Los Angeles District of the California Academy of Nutrition and Dietetics Annual Conference:

“One Size Does Not Fit All: Promoting Diverse Perspectives in Dietetics”

TITLE: Shortcomings of the Evidence Base in Dietetics 10:50am – 11:20am

David Wiss MS RDN 

Learning Objectives:

  1. Describe the challenges with conducting nutrition-related research
  2. Identify limitations, sources of bias, and other conflict in the current evidence base
  3. Suggest practice strategies when evidence is limited

 

More information and registration here

Saturday June 2, 2018 2:00pm – 3:30pm

West Coast Symposium on Addictive Disorders (WCSAD)

La Quinta, CA. May 31 – June 3, 2018

TITLE: Nutrition for Substance Use Disorder Recovery: Gut-Brain

David Wiss MS RDN 

DESCRIPTION

The prevalence of substance use disorders continues to rise with a significant impact on families, communities, and the healthcare system. The current opioid crisis suggests a need to re-assess entrenched treatment protocols for addictive disorders. Classically, treatment includes mental health services such as psychopharmacology and individual and group therapy sessions. There is little data about the role of physiological recovery particularly nutrition during early recovery. It is well known that substance use disorders are associated with neglected health including nutritional deficiencies. There is recent evidence linking the gut and brain, suggesting that proper dietary intake is critical for mental health. Substance use disorder treatment protocols may benefit from including nutrition services as a treatment modality.

Learning Objectives:

  1. Discuss the impact of addictive substances on nutritional status and gastrointestinal health
  2. Explore disordered and dysfunctional eating patterns in addicted populations
  3. Propose nutrition therapy guidelines for specific substances and for poly-substance abuse

 

More information here (registration opens in March)

Thursday July 12, 2018 1:15pm-2:15pm

9th Annual National Collegiate Recovery Conference – Associate of Recovery in Higher Education

Houston, TX. July 9- July 12, 2018.

TITLE: Nutrition for Substance Use Disorder Recovery: Gut-Brain

David Wiss MS RDN 

DESCRIPTION

The prevalence of substance use disorders continues to rise with a significant impact on families, communities, and the healthcare system. The current opioid crisis suggests a need to re-assess entrenched treatment protocols for addictive disorders. Classically, treatment includes mental health services such as psychopharmacology and individual and group therapy sessions. There is little data about the role of physiological recovery particularly nutrition during early recovery. It is well known that substance use disorders are associated with neglected health including nutritional deficiencies. There is recent evidence linking the gut and brain, suggesting that proper dietary intake is critical for mental health. Substance use disorder treatment protocols may benefit from including nutrition services as a treatment modality.

Learning Objectives:

  1. Describe the connection between gastrointestinal health and mental health, particularly as it related to alcoholand opiates.
  2. Explain the rationale behind offering nutrition services in addiction treatment settings
  3. Apply  knowledge learned about the importance of nutrition for addiction recovery at theirworkplace or treatment center.

 

More information here

Friday July 27, 2018 10:15am – 11:45am

The Adolescent and Young Adult Collective

Los Angeles, CA July 26- July 27, 2018

TITLE: Nutrition for Mental Health: Understanding the Gut-Brain Axis

David Wiss MS RDN 

DESCRIPTION

With a changing food environment and an evolving human brain, adolescents and young adults are facing new challenges in developing a meaningful relationship to food. Most recently, we have discovered that the microorganisms inhabiting our gastrointestinal tract (the “second brain”) impact mental well-being. Do we need educational protocols for the second brain? This presentation will discuss the implications of gut health and the importance of nutrition in recovery from substance use disorders, eating disorders, depression, and anxiety.

More information here

Sunday October 21, 2018 1:30pm-3:00pm

The Food and Nutrition Conference and Expo (FNCE)

Washington, D.C. October 20-23, 2018

TITLE: Nutrition Interventions Amidst an Opioid Epidemic: The Emerging Role of the RDN

David Wiss MS RDN 

DESCRIPTION

The evolving opioid crisis continues to create a devastating impact on individuals, families, communities, and the healthcare system. Emerging evidence supports the positive impact of nutrition interventions during recovery from alcohol and drug abuse. This presentation will outline the various roles of the RDN as a member of the treatment team.

More information here

Tuesday November 13, 2018 1:00pm-2:30pm

American Public Health Association (APHA) Annual Meeting

San Diego Convention Center, November 10-14, 2018

TITLE: Nutrition Interventions for Substance Use Disorder Recovery

David Wiss MS RDN 

DESCRIPTION

With substance use disorder rates rising, there is an urgent need for new and effective treatment modalities. The utilization of nutrition services in addiction treatment has not been standardized, but there is a growing trend towards incorporating registered dietitian nutritionists into the treatment team. Nutrition therapy should address the most serious medical and nutritional conditions first and then target the psychological and behavioral aspects of eating. This comprehensive overview explores the impact of alcohol, cocaine, methamphetamine, and opioids on nutritional status. This presentation places particular emphasis on gut health, microbiome, and associated neural interactions. Homeostatic and hedonic mechanisms of eating behavior are discussed in the context of eating disorders and food addiction. In summarizing the available published evidence on human subjects, a case is made for both individual nutrition counseling and group education, as well as the implementation of food service guidelines in treatment settings. Given the current crisis of addictive disorders, consideration should be given to prioritizing efforts to improve eating habits and overall health in recovery programs. By promoting positive recovery outcomes, nutrition may reduce costs and improve resource allocation. Public health measures promoting nutrition standards in treatment settings should be implemented. Guidelines for nutrition interventions will be proposed, and a summary of where more information is needed will point towards future directions.

More information here

More events to be posted soon!

We hope to see you at one of these conferences!

 

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Night Eating Syndrome Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our latest video Night Eating Syndrome!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We will be sending out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

Within the next year you can look forward to the following topics being covered:

Food Politics

Alcoholic Liver Disease

Attentional Bias

Vaping (E-cig)

Bariatric Surgery

Child Nutrition

Circadian Rhythms

Men and Eating Disorders

View last month’s video on Impulsivity

Nutrition in Recovery

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Have thoughts about Night Eating Syndrome? Reach out to us, we would love to hear your thoughts!

Read more

Impulsivity Video

Nutrition in Recovery is thrilled to announce our new monthly newsletter! Get the latest information on Nutrition for Addiction! Check out our seventh of many videos! This video is on impulsivity!

Nutrition in Recovery is a group practice of Registered Dietitian Nutritionists and other health professionals who specialize in the treatment of addictions, eating disorders, body image, mental health, as well as general wellness.

We will be sending out a monthly Newsletter summarizing the latest research linking nutrition and mental health. Each newsletter will include a short video with some helpful hints and actions you can implement to improve mental, spiritual, and physical wellbeing for yourself and for your clients. You will be among the first to hear the findings and insights from cutting-edge data, and we are providing references so you can do your own research if interested.

Within the next year you can look forward to the following topics being covered:

Night Eating Syndrome

Food Politics

Alcoholic Liver Disease

Attentional Bias

Vaping (E-cig)

Bariatric Surgery

Child Nutrition

Circadian Rhythms

Men and Eating Disorders

View last month’s video on Trauma & Disordered Eating

Nutrition in Recovery

Please SIGN UP HERE so you will not miss out on this revolutionary information!

Do you know someone who might be interested in the link between nutrition and mental health or any of the topics mentioned above? Please forward this to them so they can join us and don’t keep us a secret!

Thank you for all your support as we embark on the journey of improving the health and wellbeing of our clients and their loved ones.

Have thoughts about impulsivity? Reach out to us, we would love to hear your thoughts!

Read more
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