Friday, April 1, 2011

Clinical Supervision for MFT Interns: Criteria

Thomas Carver is a Certified Clinical Supervisor providing a private practice teaching environment for Registered Marriage and Family Therapist Inters to satisfy their licensure requirements to the Board of Behavioral Sciences (BBS) in preparation for their Board Exams.

Internship Requirements: MFTI’s in Clinical Supervision with Thomas Carver must:

•Be in their own individual therapy.
•Be a member of at least one Professional Organization such as the American Association of Marriage and Family Therapists and attend those meetings on a regular basis.
•Choose a specialty and seek advanced Continuing Education Units and/or Certification in that discipline.
•Participate in advanced Continuing Education Units and/or Certification in Marriage Therapy.
•Participate in advanced Continuing Education Units and/or Certification in Group Therapy. Develop and facilitate at least one process group at Sespe Counseling Center.
•Participate in monthly study in clinical supervision focusing on Law & Ethics.
•Agree to purchase study materials for the Board Exams and use cases as vignettes to consistently prepare for the test throughout the internship.
•Choose a Mentor(s) other than the Clinical Supervisor to develop an eclectic experience of your residency.
•Maintain files in a professional manner that is consistent with HIPPA Requirements.
•Practice psychotherapy best-practices including participating in psychiatric/medical consultation with other mental health processionals (etc.) in client’s lives.
•Learn and develop aptitude in the business of Marriage and Family Therapy including marketing, accounting, and participating with Insurance Companies, Managed Care and Employee Assistance Programs.
•Participate fully in all regulations determining the Clinical Supervisor-Intern professional relationship including attending weekly clinical supervision and maintaining required documentation for the BBS, etc.

Thomas is accepting applications for the Registered Marriage and Family Therapist Interns for Clinical Supervision. If you are interested please e-mail a cover letter and your resume to or call him at (805) 794-7800.

Melatonin and 5-HTP for Sleep Disorders


Melatonin has been called the body's own natural sleeping pill. It plays a key role in the sleep cycle by helping you fall asleep. Low melatonin levels can cause sleep-onset insomnia.

This is how our body utilize melatonin in controlling our sleep:

The body changes serotonin into melatonin.

Melatonin is stored in the pineal gland inside the brain.

The pineal gland releases melatonin only during times when the level of light is low. Practically speaking, this means that melatonin is secreted only at night, while you are asleep. In the morning, when you open your eyes, the presence of light is a sign to your brain to shut down the melatonin production.

The pineal gland is like a "third eye", a small organ hidden within the brain. Hindu philosophy refers to a "third eye" that "sees" more deeply and truly than the other two. One of the jobs of pineal gland is to respond to changes in light and dark.

The pineal gland helps govern circadian rhythms- the biological rhythms that take place over a day, such as the sleep-wake cycle. This may be one of the reasons why it feels "natural" to sleep at night. You can learn more about circadian rhythms here.

Pineal gland is believed to use melatonin as a "messenger" to "tell" other systems what to do. Several studies suggest that melatonin induces sleep without suppressing REM (dream) sleep, as sedatives and other artificial sleep aids do. Travelers have started using melatonin to "reset their clocks" after flying across one or more time zones, and some studies seem to confirm melatonin's efficacy in combating jet lag and restoring restful sleep patterns.

In several studies, supplementation with melatonin has been found helpful in inducing and maintaining sleep in both children and adults, for both people with normal sleep patterns and those suffering from insomnia. It is also useful in banishing jet lag.

However, it appears that the sleep- promoting effects of melatonin are most apparent only if a person's melatonin levels are low. In other words, taking melatonin is not like taking a sleeping pill or even 5-HTP. It will only produce a sedative effect when melatonin levels are low. Melatonin appears to be most effective in treating insomnia in the elderly, as low melatonin levels are common in this age group. (The efficiency of the melatonin system tends to decline with age.) If you have normal or high levels of melatonin, taking melatonin supplementation will not help in getting better sleep.

Safety: Studies of melatonin's safety are limited, with isolated reports of exacerbation of depression, fatigue and restriction of coronary arteries.

Do not take melatonin supplement if:

You are pregnant or breast-feeding
You are under the age of 35
You are suffering from cancer of the blood or immune system
You have kidney disease

Melatonin supplementation can disrupt the normal circadian rhythm. In one study, a daily dosage of 8 mg a day for only four days resulted in significant alterations in hormone secretions.

Synthetic melatonin may be safer than melatonin from animal sources.

Dosage: Start with 1.5 mg daily, taken 2 hours or less before bedtime. If this is not effective, gradually increase the dosage until an effective level is reached (up to 5 mg daily).



5-HTP (5-hydroxytryptophan) is a compound produced by the body from tryptophan. It is naturally found in many foods and most commonly extracted from the seeds of the Griffonia plant.

In Europe, 5-HTP has been used for decades as an approved treatment for depression, sleep problems, weight loss, and other medical complaints. It is now starting to be used in the USA.

Clinical trials show that 5-HTP is a safe, natural way to boost the brain serotonin levels. Use of 5-HTP has been shown to produce results equal to or better than those of standard synthetic drugs used in the problems arising from serotonin deficiency syndrome.

5- HTP provides the quickest, most effective, and most consistent overall results in treating insomnia. It is an effective alternative for dealing with sleep problems in a safe and natural way compared to sleep medicines. 5-HTP improves the quality of sleep. More importantly, clinical studies show that 5- HTP is also useful in the treatment of sleep disorders other than insomnia.

5-HTP increases REM sleep significantly (typically by about 25 percent) while simultaneously increasing deep sleep stages 3 and 4 without increasing total sleep time. 5- HTP accomplishes this by shortening the amount of time you spend in sleep stages 1 and 2, which in certain ways are the least important stages of the cycle. The higher the dose, the more time spent in REM.

By shifting the balance of the sleep cycle, 5-HTP makes sleep more restful and rejuvenating. Instead of waking feeling tired, worn out, and "hungover," people taking 5- HTP feel vibrant, well rested, and ready to take on the challenges of the day. When we sleep more deeply and dream more efficiently, we wake in the morning with our physical and psychological batteries fully charged.

The impact of 5-HTP on sleep stages is dose-related; taking higher doses produces a somewhat greater impact. In most cases, the lower dosage is adequate. Higher doses may lead to a greater number of disturbing dreams and nightmares due to abnormally prolonged REM sleep. It can also lead to mild nausea.

Melatonin vs. 5-HTP

5-HTP bypasses the brain's light-regulation system that controls the secretion of melatonin. 5-HTP results in the increased the production of neurotransmitters such as serotonin and norepinephrine that stimulate the noradrenergic receptors in the brain. This stimulation directly triggers the production and release of melatonin.
Thus, when you take 5-HTP, it causes the release of melatonin irrespective of how much light is present. The higher levels of melatonin in circulation, helps you to fall asleep and stay asleep better.

People with low melatonin who take 5-HTP at nighttime can enjoy the same sleep enhancing benefits as they will from taking melatonin alone, but they will also be getting the broader spectrum of benefits that comes from increased serotonin levels. (If you take melatonin alone it does not enhance the functions of the serotonin system.)

The effects of 5-HTP on melatonin depend on:

How much 5-HTP you take and
Time of the day 5-HTP is taken.

People who use melatonin as a sleep sedative may find that switching from melatonin to 5-HTP will make it easier to fall asleep and to stay asleep. They will also enjoy healthy and memorable dream periods, and wake up without the morning grogginess that some of them experience with melatonin.

Recommended Dosage for 5-HTP: Take 100 to 300 mg, thirty to forty-five minutes before retiring. Start with the lower dose for at least three days, then consider increasing the dose if results are not what you expected.