Equine Assisted Psychotherapy

the farm environment (fencing/structures/ shelter/other animals) serve as a somewhat projective assessment and intervention, thus limiting interference from defenses. Also, because it is outside the client’s personal experience, greater perspective on one’s life and ways to address obstacles becomes clear. As a result, EAGALA therapy also accomplishes in a shorter period what can take much longer to achieve in talk therapy.

Client Centered In therapist training programs, client centered approaches consisting of basic helping skills and more humanistic approaches are taught first. We learn early on clients are the experts on their experiences and rarely benefit from advice – which they probably already receive from friends and family. The EAGALA model highlights the importance of the foundational principle of client focused psychotherapy. Therapists focus on use of “clean language” – which is only use of the client’s words and personal experiences to facilitate understanding and change.

Mindfulness Practice Mindfulness is an approach that has gained popularity over the years. In talk therapy, I utilize Acceptance and Commitment therapy where mindfulness is the tool which allows individuals to relate to their thoughts/feelings in more effective ways. Mindfulness, however, is much more an experiential practice than a theoretical idea that can be cognitively learned. Horses’ ability to be at once fully present in their bodies, in their environment as well as in the moment, facilitates mindful meditation by giving us a perfect example to follow and to focus on.

Emotional Attunement of Horses Horses, as prey animals, have more highly attuned senses than humans. Humans may mislead other humans (even therapists) regarding their emotions and intentions, but horses are less apt to be misled. Horses are keenly aware of emotional energies and sense what we’re feeling, sometimes better than we do. Talk therapy can easily devolve into an intellectual discussion, whereas equine therapy keeps clients present in their bodies and with their feelings – which is extremely important for processing and learning to cope with difficult life experiences. “...horses are keenly aware of emotional energies...”

Dr. Amanda Howard Pileski is originally from Rabun County and recently moved back to raise her 3 children (ages 6, 3, and 2) and provide affordable psychotherapy to the underserved communities of Northeast Georgia. She received a bachelors degree from the University of Georgia in Psychology, a master’s degree in School Counseling from Georgia State University, and a doctoral degree in Counseling Psychology from the State University of New York at Buffalo. She has worked in various college counseling centers, hospitals, and in private practice. In addition to her private practice in Rabun, she also provides geriatric psychological services to several Pruitt Health locations in North Georgia. Dr. Pileski is a strong generalist, but also specializes in treating eating disorders and bariatric surgery patients. She strives to help others know the joy and empowerment of living mindfully and appreciatively with food and their bodies. For an appointment, contact Dr. Pileski @ 404-291-4018

Talking with Monique Petteys, FNP-C

Recently we sent a list of questions to Monique Petteys, FNP-C about women’s health. Monique is part of the team at The Women’s Center at Life Point Medical located at 189 Bo James Street, Suite 105 in Clayton, Georgia. Her expertise in women’s health makes her a outstanding resource for our community. We appreciate her willingness to take the time to provide such in-depth answers. We know you will find this valuable.

If you are interested in setting up an appointment with her please call 706-250-7306

Laurel: What are the elements of gynecological care and what services are offered at The Women’s Center at Life Point Medical?

Monique: Gynecological care is a branch of medicine that treats female reproductive organs and sexual health issues. This includes Pap tests, breast exams, cancer screenings, contraceptive counseling, sexually transmitted disease screenings, and vaginal infections. It also includes management and diagnosis of hormone problems, pelvic pain, menstrual problems, ovarian cysts, and other reproductive organ disorders. At The Women’s Center we provide these services and offer a holistic, whole woman approach to any women’s health concerns. We can also refer to more specialized care should it be necessary.

Laurel: At what age should a female start seeing a gynecologist?

Monique: The American College of Obstetricians and Gynecologist recommends girls start gynecological care between ages 13-15 years old, although usually a pelvic exam is not needed at that time. Current recommendations recommend pelvic exams and breast exams start at 19 and Pap smears start at age 21. A young woman’s first visit is a good time to privately discuss puberty, hygiene, mental health, contraception, sexually transmitted diseases, or any other concerns.

Laurel: Is there an age or a circumstance when an annual exam is no longer necessary?

Monique: Although routine Pap smears are no longer necessary at 65, we still recommend annual exams for all ages. At The Women’s Center we perform whole preventative annual wellness exams for women of all ages to ensure all necessary screenings and immunizations are up to date. Laurel: What new advancements have been made in birth control?

Monique: Since the induction of the Affordable Care Act, birth control has become more affordable and more easily accessed than ever before. Women of childbearing years now have more options than ever to prevent unintended pregnancy or to tailor their family planning needs, with more on the horizon. Today there are over the counter options or emergency birth control that are easily accessed without a prescription. Advancements have also brought more options than ever before in types of oral contraceptives, shots, implanted contraceptives, hormonal and non-hormonal intrauterine contraception (IUD), and also vaginal rings, jelly, and barrier devices (like male and female condoms and diaphragms). Current research is under way also investigating a new once-amonth progestin only pill that appears to be as effective as daily pills. The invention of fertility tracking phone apps has also been great for those who prefer to not to use or cannot use hormonal methods.

Laurel: Oh those hormones! How can women best keep hormones balanced and working for them, not against them?

Monique: Hormone problems can be common anytime, but especially in the extremes of our reproductive ages. Hormone imbalances can lead to mood changes, fatigue, weight gain, decreased sex drive, skin and hair changes, changes in bowel movements, urinary problems, muscle and joint pain, and sleep

changes. If any symptoms are severe, it is always best to see your healthcare provider to discuss them and rule out medical conditions that could be causing symptoms. However, there are natural ways to help keep hormones as balanced as possible. You’ve heard it over and over again, but exercise and weight control is key! Aim to get at least 30 min of exercise 5 days a week, even if it’s just a long walk. Managing stress through meditation, physical activity, yoga, massage or relaxing music is effective at lowering cortisol levels and also increases quality of life. A healthy balanced diet high in fiber, low in refined sugars/ carbs and high in protein and healthy fats also helps keep hormones in check. Consistent sleep patterns are also very important. Again, if any symptoms are very bothersome feel free to make an appointment and we can discuss how to get you feeling back to your normal self as soon as possible.

Laurel: What is the difference between synthetic hormone replacement therapy and bio-identical hormones?

Monique: Synthetic hormones (standard HRT) are produced from animal parts or urine and are deemed close enough in molecular structure to work for human hormone replacement. Bio-identical hormones (BHRT) are made from plants and they are synthesized to identically match hormones produced by our bodies.

Laurel: What are the risks vs benefits for each?

Monique: Benefits of hormone replacement include decreased symptoms of menopause and prevention of some long term degenerative diseases including some types of cancer, osteoporosis, cardiovascular disease, diabetes, and cognitive decline from dementia. It also can help preserve lean muscle mass, and vitality, and improve libido. Benefits of synthetic hormones are they are generally less expensive and are controlled by the FDA. However, HRT with oral estrogens has in studies been shown to increase risk of blood clot and stroke. BHRT has the benefit of decreasing this possible risk via different delivery methods and also it is a “more natural option”. BHRT is generally made by compounding pharmacies. Benefits and risks of both HRT and BHRT can also differ based on delivery method.. ie, oral, transdermal patches or creams, vaginal, injectable, or pellet therapy. Whether you decide to go with standard HRT or BHRT it is important to discuss options with a healthcare professional. There are benefits and risks to both and these can depend on the age when initiating therapy, prior medical history (certain cancers, fibroids, migraines, stroke, blood clots, etc), and body composition. BHRT and HRT should be tailored individually based on the patients goals, symptoms, and also risk vs. benefit.

Laurel: What role do injectables play in women’s health?

Monique: Many women come to their healthcare provider wanting to look and feel their best. Injectables like Botox and Xeomin can help these goals. I just want my patients to feel like a million buckswhen they walk out of my office. If injectables help them with this then I’m happy to use my expertise to provide that service!

Laurel: What can a woman do to protect herself from STDs and what preventive measures are available? Monique: Sexually transmitted diseases, now termed sexually transmitted infections, are very common. Most people will get one in their lifetime They can be acquired skin to skin, or via oral, vaginal and anal sex. The best prevention is abstinence but there are more practical alternatives. Women should know that there are vaccines that can prevent Hepatitis B and Human Papilloma Virus (HPV). HPV is the virus that causes cervical cancer. It is recommended that all girls receive their first vaccination between ages 11 and 13; anyone can get that vaccine that is under age 26. I have also always recommended to my family practice patients that boys get the vaccination as well. Mutual monogamy can also be preventative. Other ways to decrease risk of STI’s is to limit sex partners and use condoms correctly.

Laurel: Should all women be tested for STD’s even if they have no symptoms?

Monique: First and foremost, if you are sexually active with a new partner you should get screened for STI’s. Many are asymptomatic but can cause serious health consequences.

The CDC recommends testing all sexually active women under 25 annually for chlamydia and gonorrhea. Patients this age of both sexes carry the largest new diagnoses statistically. Also women who are sexually active over 25 with new or multiple partners should be tested annually, also all pregnant women.

HIV screening should be done at least once in women aged 13-64 and all women presenting for STI screening.

Trichomonas should be tested for in high risk areas or in women w/ multiple partners or those w/ HIV.

Cervical cancer screening (Pap smears) should be performed every 3 years in women aged 21-29 w/ cytology alone.. Women ages 3065 every 5 years with HPV testing (co-testing).

Hepatitis B screening and syphilis should be performed in all high risk women and pregnant women.

Hepatitis C screening should be performed once in all women born between 1945 and 1965.

Laurel: What do you want our readers to know about the Women’s Center at Life point Medical?

Monique: I would like our community and readers to know that our team is here for all your women’s health needs and concerns. This clinic has been a dream come true for me and I hope to keep expanding our services in the future. As a woman, I know it can be extremely anxiety-inducingto walk into a new office and discuss delicate issues such as mental, sexual, and hormonal health. My goal is for you to walk out of our door a satisfied, empowered woman confident in your own skin and choices! If I can’t help you out I will find someone who will. We look forward to serving you!