What to Expect in your Initial Therapy Appointment

(Today’s blog is the final installment in a 3-Part series regarding starting therapy. Part 1 focused on questions to ask yourself or situations that might make you want to consider therapy.  Part 2 addressed ways to find a therapist to work with, and Part 3 will focus on what to expect in your initial therapy appointment. If you missed either earlier post, click here to catch up!) 

Now that you’ve decided you want to start therapy, and you have selected a therapist to work with, what comes next? 

The therapist should give you a heads up as far as what the next step is after you schedule your first appointment.  Each therapist might do things slightly differently, so don’t be afraid to ask if you are not quite sure what to expect.  Some might have you come in 30-60 minutes prior to your first appointment to fill out paperwork. Some, like our practice, use electronic health records, and would ask you for an email address to send you access to a secure client portal.  In this case, you can view and fill out the paperwork at home, and electronically sign it.  Either way you complete the paperwork, expect to read about the practice’s policies and procedures, how they handle your confidential information, consent to treatment, and fill out some background information as far was why you are looking to start therapy.  This paperwork would outline things like if the practice allows interns or non-licensed therapist, if they accept insurances or their self-pay rates, if they use encrypted email and phone systems, and what their cancellation policies are.  It might seem boring, but we would suggest reading through all of this information, since at the end of the documents, you are going to sign your understanding and agreement with it.   

Each practice might handle insurance differently too.  Some practices do not accept insurance at all, and allow you to submit your self-payment to your insurance for possible out of network reimbursement.  Some expect you to verify your coverage with your insurance provider. Others, like our practice, will ask for your insurance information and will verify your benefits prior to the initial appointment.  Either way, you can follow up with your insurance provider to clarify your coverage or talk with your therapist about what your coverage might mean.  Feel free to ask questions about your benefits, as insurance is often confusing!

The initial appointment is called an intake.  In this session, the focus will be a little more administrative than future sessions.  You will probably review the documents you signed and ask any questions about them that might have come up.  Your therapist may have you complete more specific assessments (regarding anxiety or depression symptoms, for example) to gather more information.  Then, you will probably start to talk about what is bringing you into therapy, what your goals are for your sessions, and how you will know when you’ve reached those goals.  If you are using insurance, please realize that your therapist will need to make a mental health diagnosis in order for your insurance to cover your sessions.  An example of a diagnosis is anything from ADHD to Unspecified Depressive Disorder.  The background information will give your therapist information in order to make an accurate diagnosis.  Beyond a code to bill to your insurance, the diagnosis can mean very little, so don’t get too hung up on it.  Focus on your goals for therapy and what benefit you want to see rather than what your diagnosis is.  Or, talk to your therapist if the diagnosis bothers you or you have questions about it. 

Your therapist will most likely ask you, probably very pointedly, about drug and alcohol use, as well as self-harm behaviors and suicidal thoughts.  Part of our job involves your safety, and so we need to ask about these things.  Please speak honestly, so that we have all the information possible to best help you if you are struggling in these areas. 

If you didn’t have a consult prior to a first session, see the intake as your chance to ask questions and determine if this therapist is a good fit for you.  Our hope at The Counseling Collective is that you leave an initial appointment feeling (somewhat) more hopeful.  If you feel much worse, this could be a sign that the therapist, or his/her style, is not for you.  Either way, communicate openly with your therapist what your needs and expectations are. 

Hopefully, if you go through the steps we’ve suggested in this series, you will be in therapy with someone you feel comfortable with, getting help to address your problem or concern. We’d love to hear from you if you have any feedback or questions about this series, or therapy in general.  Our hope is that by sharing these topics over the past few weeks, you have a better understanding now of the beginning of the therapeutic process.  Here’s to better mental wellness! 

How to find a Therapist to Work With (Part 2 of 3)

So now that you've decided you want to pursue therapy, how do you go about finding a therapist?  (Today’s blog is Part 2 in a 3-Part series regarding starting therapy. Part 1 focused on questions to ask yourself or situations that might make you want to consider therapy.  Part 2 will address ways to find a therapist to work with, and Part 3 will focus on what to expect in your initial therapy appointment. Click here if you missed Part 1 to read it and catch up!)

We think the therapeutic relationship between therapist and client is a very important factor in how the client progresses in therapy. If the client feels self-conscious, or as if the therapist is judgmental, he/she might not open up and share completely and honestly. We tell our clients that working with a therapist is just like any other relationship-it may take time to develop and that is completely normal. There are some people you will naturally get along better with, some that you get along better with after you know each other a little more, and some that you won’t “click” with or feel comfortable with. 

As with anything else, word of mouth referrals are always a good way to find out about local therapists.  If you know someone who has been in therapy, ask them what they liked or didn't like about their therapist, or their experience in therapy.  Ask if they'd go back to that therapist, and if not, why.  You ask your friends for a recommendation for a roofer, dentist, or pediatrician, so why not for a therapist too?

Another great place to find a good therapist is to ask your primary care doctor for a referral.  Many doctors know therapists in the area, and are happy to provide contact information for local therapists.  Your primary care doctor can also give you assessments to determine your level of anxiety or depression (for example), and can make referrals based on how you answer these questionnaires.

You can also call your insurance provider and ask for a list of therapists in your area.  This way you know for sure that the therapist you contact works with your insurance, if you are planning to use it.  Just realize that working through insurances dictates some elements of treatment, such as session length or frequency.  Some insurances can filter down therapists in your area based on availability or treatment concerns to a few that most closely match what you are looking for.  From this list, you can either google them to look around their website for more information, or call the therapists directly.

After you find a therapist to contact, feel free to ask for a free consult, whether in person or on the phone.  (Not all therapist offer free consults, and how they do them will differ slightly.)  A consultation offers the chance for both the therapist and potential client to determine if them working together would be a good fit. Regardless of if you are able to do a consult or not, if you can, speak with the therapist on the phone, just to ask any general questions you may have.  By having a phone conversation, you will be able to pick up on their tone of voice, inflections, and displays of empathy. Ask yourself if your first impression is that the therapist is likable and someone you think you could grow to trust.  If so, give it a try!

When you are on the phone with the potential therapist, here are some ideas of some questions to ask:

"How often do you meet with new clients?"

"Can you accommodate my scheduling needs?"

"Do you work with my insurance?"

"How have you worked with others with “X” issue before?"

Be honest with what it is you are struggling with or are looking for help to address, so you can best assess if this therapist is a good fit for you.

Another idea is to commit to 4-6 sessions before deciding if you think the therapeutic relationship will work for you. Typically in the first 1-3 sessions, you will be going over administrative things, and getting to know each other and your history, so give yourself a few sessions beyond that before evaluating if you want to proceed further.

Be sure to check back in 2 weeks for our final installment "What to expect in your initial appointment" in this 3-part series.  Let us know if this post was helpful, or if you have other thoughts or questions!

Guidance to know the answer to "When should I consider therapy"?

Today’s blog is Part 1 in a 3-Part series regarding starting therapy. Part 1 focuses on questions to ask yourself or situations that might make you want to consider therapy.  Part 2 will address ways to find a therapist to work with, and Part 3 will focus on what to expect in your initial therapy appointment.  

We find that many people have misconceptions about therapy, and I am hoping this 3-Part series will help answer some of those questions, and address some inaccuracies about therapy. 

How do I know when I should consider therapy?

Great question, and of course my first answer would be anytime!  The reason I say that is because therapy can be a time for self-reflection, a pause in your busy life to prioritize what you are doing and why.  Just like scheduling a massage, going for a run, or getting a mani/pedi allows you time to focus on YOU, therapy can offer the same benefit. A gym membership can lead to good physical health while therapy can lead to good mental health.  Maintaining good mental health is always a good idea, and therapy can help with that.

Therapy is also appropriate when you might be looking for unbiased,professional help. Therapy can be considered if you are feeling stressed and overwhelmed, or are dissatisfied with your job, but can also be helpful if you don’t want to leave your house due to sadness or worry. The spectrum of people who can benefit from therapy is quite wide! As long as you are willing to open up to a therapist and are interested in having guidance to address some of your concerns or help get you back on track, then therapy is appropriate. 

A good rule of thumb is if you are consistently feeling: 

Unfulfilled

Stressed

Unhappy

Worried 

Sad

Drained

Questioning yourself or what you're doing, then therapy might be something to consider. 

Oftentimes, we feel dissatisfied, and don’t know why. You might say “I’m doing everything I can and I’m still not happy.”  This might lead to just trying harder, and doing more, which ends up leaving you even more drained.  This is when having a professional with an outside perspective assisting you could be beneficial.

Or, sometimes your friend, boss, or your spouse might suggest you talk to someone.  If someone close to you suggests this, please take a pause to consider. Might they see something that you don't ? Maybe they see you drinking too much to calm down every night, or maybe they see you pulling away from friendships due to anxiety.  As long as these are trusted people in your life, this might be another indicator that seeing a therapist would be a good idea.

“I don’t need therapy.  My doctor gave me medicine for my sadness/anxiety” – My reply to this would be that you should still consider therapy.  Medication can be helpful, but it might not target some of the underlying reasons you are feeling sad or worried.  Research studies have repeatedly shown that clients receive the most benefit when medication is combined with therapy, rather than just medication alone.

In the end, therapy can help you maintain good mental wellbeing, and adjust what you are doing so you are happier, more fulfilled, or less anxious.  And, who doesn’t want that?!

Feel free to reach out to our office if you aren’t sure if therapy could benefit you.  And, stay tuned to our next blog – Part 2 in this series on how to find a therapist!

Lessons Learned After One Year in Private Practice

It just so happens that today my biweekly Tuesday blog post falls on the exact date that I opened the doors of my private practice! July 17, 2017 was the first day I saw clients in my own business.  So happy one year anniversary to us! 

In the past year, I have formed a business and expanded into a group practice.  I went from being a solo clinician going out on my own to hiring another therapist to be able to better serve the referrals I am receiving.  Through it all, I have appreciated your support.  The kind words, the encouragement, the “shares” and “likes”.  I hope that you are receiving helpful information from the business, and that you are more aware of how to strive for and preserve overall mental wellness.   

In reflection, here are some life lessons I’ve learned over the past year in private practice.  I hope that they can be valuable tips to you too! 

Be Willing To Grow And Ask For Help. I fully admit I don’t know everything. A year ago, I had no idea what was required to work with insurance companies as a private mental health practice.  I just knew others who had done it and figured I would be able to figure it out too!  Throughout this process, which was more than a year in the making, I have consulted with other private practitioners and other entrepreneurs. I regularly meet with others to “pick their brain” and get a sense of how they think, procedures they have in place, what’s working and what’s not, etc.  I would recommend that you consider surrounding yourself with people from which you can learn.  Always be looking for ways to learn and grow in your abilities.  You won’t be disappointed. 

Embrace Change.  Changes can be scary. Don’t we all like knowing what to expect?! Life is so much easier when our day to day is the same.  But, that can become immensely boring!  I would challenge you to work at not letting that fear of change stop you from doing the things that will help you pursue your dreams.  If you can learn to act despite fear, you might accomplish great things! 

The Next Important Thing. Starting a business is overwhelming.  Really stressful, with multiple moving parts to focus on and try to control.  I had to form an LLC, decide where to host my website, build my website, set up encrypted emails, contract with insurance companies, set up a bank account, go through the design process for a logo, finalize practice policies, write practice documents, decide on an electronic health record, find a way to send/receive faxes, decide on a phone system.  And, that’s just the short list!  Some of these tasks were of course exciting and fun, but when you have a huge list, it can be daunting!  And, yes, there were times I worked all day seeing clients, and then worked until midnight on this list, and never felt like I could get it all done.  The way that I stayed (mostly) relaxed through all that was focusing on the next important thing. By breaking down the tasks into more manageable steps, I was able to avoid being overwhelmed. Ask yourself, “what needs done next?” or “what is the most important thing to do next?” and then focus on that.  Sometimes all you have to do is focus on what needs done next. And then the next thing. And not get overwhelmed by the enormity of it all, by instead focusing on small steps. You can accomplish a lot by just focusing on the next important thing, and one small accomplishment at a time, you can get to where you want to be. 

Again, a sincere thank you for your support and encouragement as I formed the business, started writing this blog, and expanded into a group practice.  I’m working to live my dream, and I hope to help inspire you to do the same! 

3 Quick Ways to Connect with your Teenager

Since we work with teens, we often see distance and miscommunication between parents and their teenagers.  Teens say that their parents don’t get them, or maybe don’t care, and they think they don’t have much in common.  Parents say they don't know how to reach their teen.  Both sides seem to have a desire to strengthen their bond, but don't know how.  With that in mind, here are a few quick ways to connect with your teenager: 

1 - Conversations are a good place to start.  But, don’t just ask, “How was your day?” or "How are you?" Instead, ask some of these questions: 

“What was the best part of your day?” 

“What are you looking forward to this week/month/school year?” 

“What are you most dreading or most nervous about?” 

These questions are open ended, meaning your teen can’t just answer with a “good/bad”, or “yes/no”.  These questions are thoughtful, show that you want to try to better understand them, and can help to start more meaningful conversations.  Take the opportunity of driving in the car to chat, or when you are working on making dinner together.  It's usually easier (and more natural) to talk in situations like these where you are physically doing something.

2 - Listen to music together.  Recent research shows that listening to music together can be a great way to connect with your teen.  Have them play some of their favorite songs for you.  Then, ask what they like about the song or artist, what the song means to them, or what feelings that song brings up.  A rule here: No judgment of songs, or negative comments about the music they are sharing. Be appreciative that they are sharing their favorite music with you.  Sharing a musical experience, whether driving to soccer practice in the car together singing out loud, or at a concert, can help the two of you to bond.  And, while you’re at it, share some of your favorite songs with your teen too! 

3 - Ask them to show you how to play their favorite video game.  As long as the two of you can have patience with each other, this is a fun way to switch roles and have your teen be the expert!  Have them teach you the trick of their favorite game, and play together! 

The common thread with these ideas is spending more time together.  Developmentally, teens often want to spend more time with their peers.  But rather than just being with their friends, or alone in their rooms, these are some ideas that can bring you together.  Shared experiences, and even just more time together, can help you connect. 

6 Simple Tips to Reduce Your Anxiety so You Feel More Relaxed

I thought I'd put together a brief list of simple ideas to help you feel more relaxed, especially if you are feeling worried or anxious.  You certainly don't need to do all of these, but if you're feeling run down, try figuring out how to add one or two of these practices into your day.  It just might help you feel better!

1- Develop a list of coping skills (things that help you to feel better when you are feeling nervous or anxious). Add things you have seen others do, or you have done in the past and helped you to feel better. Some ideas include: listening to music, getting some fresh air, and practicing deep breathing. Also, identify things you are doing when you feel anxious that DO NOT help you feel better, and stop doing them!  

2 - Build a positive support system of friends and/or family that you can talk to when you are feeling anxious (or down), when you need a reality check, or need to help remembering your coping skills.  Or, if you need a little more help than friends and family can provide, consider therapy.

3-Get moving! Exercise has numerous benefits, including helping to lift your mood. Exercise serves as an excellent outlet, and a great way to channel your “nervous” energies (if you are feeling a tendency to fidget) into something productive.    Even just taking a short walk at lunchtime can benefit your mental clarity.

4-Journaling offers a chance to do some reflective writing on your triggers to your anxiety and what coping skills are working for you. Journal nightly as a way to process your day, to find anxiety triggers and patterns in your behaviors.  You can add in gratitude journaling as well to help you focus on the positives. 

5-Practice Mindfulness. Anxiety is typically future oriented, and fear based. Practice mindfulness techniques (such as grounding) to train your mind to focus on the here and now rather than your anxiety about the future.   

6-Deep breathing. This is a quick and easy skill you can do anywhere, that requires no equipment or preparation. Take a slow deep breath in (to the count of 5), then hold it for a count of 5, then slowly exhale to the count of 5. Do this 5 times. This breathing can be combined with closing your eyes, focusing on your chest rising and falling, or picturing a place that makes you feel calm and happy. 

If you want to read more about simple techniques to help you feel less anxious, check out this article that elaborates on the above ideas.  What else would you add that helps you relax?

Updates on the Exciting Changes at our Office

Let me explain why my blog has taken a hiatus, and why I promise it will be back on the regular schedule!  

As you might have read two weeks ago on our Facebook page, I’m delighted to announce some exciting changes with my practice. A little backstory....I opened my private practice in July 2017 and by November I was turning people away because I was full.  All through the winter, I wasn’t accepting new clients, and then I realized that I could help all of these people who I was turning away if I had other therapists who could see them! So it was earlier this year that I decided to pursue the idea of expanding my private practice to be able to better serve my clients and the referrals I was receiving.

Over the past few months, there have been a lot of changes made: I created an LLC, changed the business name, I hired my first therapist and a virtual assistant, and I've been working to train them both. I've been updating my credentialing with all the insurances I work with, and switched over both my email and phone systems.  Our Facebook page has been updated, and we launched a new website.  (My previous blog posts have been reposted at this new website in case you are looking for them.)  The Counseling Collective is also now on Instagram!  Follow us @TheCounselingCollective, or leave a message below with your handle so we can follow you!  I was looking to expand to another office eventually and space opened up in my building, and so I decided to jump on it! As of mid-June, The Counseling Collective will have two offices to see our clients in the East Petersburg location. I teamed up with my sister-in-law (my interior designer!) to outfit the new office so it feels just as homey and comfy as the first office.

All of these updates and changes have been made in order to expand, so please join me in welcoming Stacy Martinez LCSW to the practice!  She and I were previous coworkers, and I know what kind of training and work ethic she has first-hand!  Stacy is an LCSW (refer to this post about what these letters mean), and also a certified health coach, trainer, and coach.  She has been helping clients for over 6 years by focusing on their strengths with a total body wellness perspective.  She enjoys working with ages 10 through adulthood, and also enjoys working with couples.  

I’m really excited for these changes, to be better able to serve more clients, and to have Stacy join the practice.  Thank you for your support and encouragement over the past year!

Join Me On A Video Tour Of My Awesome Office

How to Stop Rumination on Negative Thoughts

I recently attended a multiple day symposium in  DC on psychotherapy, and one of the trainings I attended was on disrupting rumination.  Some excellent ideas were presented there, and I wanted to share some of those ideas and my own thoughts with you. 

Let's first begin my clarifying what we're talking about.  Rumination is a repetitive focus on the negative.  (I’ve previously written about shifting your brain to focus on more positive things).  Rumination goes beyond what you tend to pay attention to or notice.  It’s a thought cycle you can’t seem to stop, thinking again and again about the same things.  It's being "stuck" on a thought.  Anxiety rumination focuses on “why” or “what if….”, while depression rumination tends to focus on feeling hopeless, helpless, inadequate or worthless.   

I was surprised to learn that one of the easiest techniques for disrupting rumination is singing.  Singing takes the focus away from rumination to a more pleasant and productive thought.  You have to pay attention to the notes, the tone and pitch, and the words, in order to sing.  Even if you are not a talented singer, singing is an excellent replacement activity to stop your rumination.  You can’t have two thoughts occupy the same space in your brain, and by shifting your focus to be the song you are singing, you naturally disrupt your ruminative thoughts.   

Tip to Try #1: If you want to try this out, I’d suggest that you start by picking a few of your favorite songs.  Chose 2 or 3 songs that you are quite familiar with, to have as you “go to” songs.  Maybe a hymn if you are a person of faith, or a song with lyrics that calm you down and resonate with you.  Decide ahead of time what your song(s) will be, so in the moment, you only have to (1) recognize that you are stuck in a negative thought cycle, and (2) remember your pre-selected song to sing.  This takes the guess work out of it! 

Another noteworthy discussion point from this training is that of the role of imagination and repetition.  Let’s say you repeatedly think about how horribly your next presentation at work will go.  You think about it in the shower in the morning, as you are getting dressed for work, as you are commuting, and while in your office preparing.  You anticipate misspeaking or forgetting an important piece of information.  Repetition strengthens your brain activity, bringing more blood (and an increase in glial cell activity) to that section of your brain.  As these pathways become strengthened, your worry pathway changes into a superhighway of worry.  And, your brain doesn’t know the difference between real and imagined.  So, those thoughts you were having of forgetting a part of your presentation your brain interprets as if it really happened.  By ruminating on a horrific or embarrassing event that you fear may happen, your brain responds as if it actually did!

Tip to Try #2: If your brain can't tell the difference between real and imagined, why cause yourself to suffer thinking about made up things?  Instead, try to imagine the life you want, and the accomplishments you would like to reach.  Try to picture yourself acing that presentation at work. 

My hope by sharing this is that the more you understand how your brain works, you can use it more to your benefit!  So, if you are going to ruminate, think repetitively of positive things.  If you are going to imagine, imagine uplifting and inspiring things happening to you.   

P.S. Breaking a repetitive negative focus is also something that you can seek professional help with, especially if it is pervasive, impairing, or significantly upsetting to you. 

How to Deal with Difficult Family Members

It's time for a quick pep talk! 

You are in charge of who you let into your life.  Just because someone is a blood relative does not give them the right to be in your life.  They must EARN the right to be in your life, to have access to you.  Do they inspire, support, encourage, and uplift you?  Or, do they just make you feel badly about yourself, physically hurt you, put you down, or yell at you often?  Are they harsh, judgmental, and critical? 

Evaluating if someone is an asset to your life, or a detriment, is hard to do.  There are specific behaviors that are easier to identify as toxic, such as physical or verbal abuse.  Insidious behaviors like always trying to one-up you, put you down, or calling you names can be just as harmful if you hear these messages long enough.  I encourage you to ask yourself if you feel better or worse after spending time with someone.  If you find you feel worse on a consistent basis, I would suggest setting limits with those difficult family members.  Limit your time with them or limit their access to you as a way to begin to stand up for yourself.  Limits could be anything from:  

-not talking on the phone for more than 10 minutes at a time, or only in person with a trusted friend present 

-designating certain topics (such as your partner, education, or job) as off limits for discussions 

-only seeing them in public.   

Let your family member know that these are your limits and if they don't respect them, that you will not continue to have contact with them.  For example, if you've decided your job is an off-limits topic for your aunt to talk to you about, then when she begins to lecture you about it, perhaps you get up and leave the room.  WARNING: Setting limits with anyone will take consistent effort to enforce.  Those close to you who are used to saying whatever hurtful or harmful thing they want will be confused by your new limits.  They will think you are joking or won't really follow through.  They will test you to see if you are serious.  So, just setting limits is not the solution.  You MUST FOLLOW THROUGH WITH WHATEVER YOU DECIDE!  Make sure you can follow through and do what you say if you are going to set limits.  Perhaps start small, with things you know you can be successful. 

It is your responsibility to look out for and advocate for yourself, because, as an adult, no one else will do that for you. Ask yourself: “Has this person earned the right to be in my life?" 

The positive side of this is that you can create a "family" of loving people surrounding you, regardless of if they are biologically related to you or not.  Surround yourself with those who you trust, who care for you, and who want the best for you.  Having cheerleaders around you can be inspiring and encouraging, especially when setting and enforcing limits with difficult people.  

If you feel comfortable sharing, I'd love to hear if you have successfully set boundaries with difficult family members. 

Let's Talk Letters: A Quick Guide To The Letters After Our Names

I realize in the counseling field there are a lot of acronyms, and I thought it might be helpful to write about what all those letters mean.  Although it’s shorthand everyone in this field uses, I think we just assume others understand it too.  The world of therapy can seem so cryptic, because it’s hard to know what goes on in a therapy office unless you’ve actually been there.  I want to try to help explain things in this field, and part of that is educating others about things as simple as the letters after our names.  The credentials become more and more specific as you have more training.  Think about it like a path, and with each turn you are getting to a more specific location.

Let’s talk letters!

General Counseling Field:

In general, therapists diagnose and treat mental disorders, and address problem behaviors. 

MS, MA: Master’s degree in either science (MS) or arts (MA) -  Someone in the counseling field may have either of these designations, depending upon how their school classified their program.  This means that the person completed 4 years of their Bachelor’s degree, and then did another 2-3 years in a Master’s program.  This helps narrow their focus and deepen their training on a specific topic, so they are then a “Master” at that topic.

LPC:  Licensed Professional Counselor – This is the highest level of training someone with a MS or MA can receive after completing a certain amount of hours of supervised work and passing a clinical exam.

Social Work:

In general, social workers focus on helping people cope with their everyday lives.  This includes connecting them to resources, advocacy, and treating and diagnosing mental disorders.

MSW: Master’s degree in social work -  Someone would receive their Bachelor’s in social work, then get their MSW.

LSW: Licensed social worker – After receiving a MSW, someone would pass an exam to achieve this designation.

LCSW: Licensed Clinical Social Worker -  For a Social Worker, this the highest level of training they can achieve after completing a certain amount of hours of supervised work and passing a clinical exam.

Other categories:

MFT: Master’s degree in marriage and family therapy – Someone who has extensive training in family dynamics and relationships.

LMFT: Licensed marriage and family therapist – Received supervision beyond their Master’s degree.

CADC: Certification as a Drug and Alcohol Counselor – This person has been trained regarding drug and alcohol use.  This is not a Master’s degree, but this person has a Bachelor’s degree and then received further training.

RPT: Registered Play Therapist – This person received additional training beyond a Master’s degree to use play therapy with young children as a way to express themselves.

A few other things to note:

Some insurance companies will allow any Master’s level clinician to offer therapy.  Some require a license beyond the Master’s degree.  This is why you have to verify with your insurance to make sure who you are seeing or want to see has the appropriate credentials that your insurance will cover.

This is just a basic introduction on the acronyms within the counseling field, and there are a few other less common acronyms I didn’t cover (especially for children in play therapy and BHRS).  And, there might be some exceptions to what I’ve shared.

Please let me know if you have specific questions and I’d be happy to address that.

Practicing Gratitude

“Be thankful for what you have; you’ll end up having more. If you concentrate on what you don’t have, you will never, ever have enough.” —Oprah Winfrey

“Gratitude is the healthiest of all human emotions. The more you express gratitude for what you have, the more likely you will have even more to express gratitude for.” —Zig Ziglar

Gratitude is often a word we hear thrown around near Thanksgiving time, but I think it is something we should talk about more often. Gratitude is more than just something related to turkey dinners.  Gratitude is being thankful and grateful for what is present in your life, rather than focused on what is missing.  Practicing gratitude can help change your perspective.  In one of my favorite books, “Man’s Search for Meaning”, Viktor Frankl writes,

“A human being is not one thing among others; things determine each other, but man is ultimately self-determining. What he becomes - within the limits of endowment and environment- he has made out of himself. In the concentration camps, for example, in this living laboratory and on this testing ground, we watched and witnessed some of our comrades behave like swine while others behaved like saints. Man has both potentialities within himself; which one is actualized depends on decisions but not on conditions.”

Frankl is saying is our decisions, how we behave and what we focus on, then determines who we become.  Wouldn’t you rather become someone who sees possibilities, who believes in and looks for the good in the world, who can uplift another with a smile?  I know I would like to be this kind of person.

To practice gratitude on a more regular basis, why not start to keep a daily gratitude journal?  You can write 3-5 the things you are grateful for that day, or something that you are proud of yourself for accomplishing.  This can help shift your thinking from negative to positive, and help you to notice the good things in your life.  Try to think of things unique to the day, rather than repeating the same basic things like food or shelter.

I’m grateful I was able to have coffee with my friend today.

I’m grateful the kids slept all night in their beds last night.

I’m grateful that my spouse folded and put away the towels yesterday.

I’m grateful I have a job.

I’m proud of myself that I called and made a doctor appointment (even though I hate talking on the phone).

I’m grateful to have one kind neighbor who said good morning to me today.

It might initially be hard to come up with 3-5 things that are positive every day.  So, aim for one or two.  After that becomes easier, than increase to 3-5 things for every day.  To go a step farther, you can elaborate on these daily gratitudes by journaling more about your day, and how you feel.  Especially on days that are harder, journaling more might be a good idea to help you process your day.

For those of you who want more physiological details about how gratitude can shift our perspective, google and read about the Reticular Formation and Reticular Activating System (RAS). Basically, focusing on the positives rather than the negatives tells this part of your brain, responsible for conscious awareness and attention, that positive things are important to notice.

This increased attention applies to anything though, not just positive things.  For example, a few years back I was looking to getting a new car.  I was set on getting a Nissan Maxima, and because I told my RAS that these were important cars, I began to notice them everywhere I went!  It's not that all of a sudden there were more Nissans on the road.  They were always there.  Previously, my brain had just decided they weren't important to notice.  But, once I started researching them, my brain picked up on the fact that they WERE important to me, and I started to see them everywhere! Ah, the power of our brains!  (The neuroscience nerd in me loves this brain stuff!)

How can you express more gratitude in your daily life?  I'd love to hear your thoughts on this.

More Tips on Sleeping Well, part 2

As a follow up to last week's blog post on tips for sleeping well, I wanted to share a recent article on the same topic.  This article discusses 12 ways to improve your "sleep hygiene" (which is just a fancy way of saying anything that helps your sleep).  I'm excited that some of the tips I've shared with you last week are included in this article! I will offer a quick snapshot of the ways to improve your sleep, but also suggest you read the full article for more detail.

Tip #1 to improve your sleep hygiene: Go to sleep at the same time every day

Ideally, your sleep/wake time shouldn't vary by more than one hour.  Yes, I know that you look forward to sleeping til noon on a Saturday, but in the big picture of "sleep", this can do more harm than good.  Try to wake up and go to sleep at about the same time every day.

Tip #2: Reserve your bed for sleep (and sex)

Don't watch tv in bed, or do work in bed, because then your brain will associate your bed with more stimulating things than sleep.

Tip #3: Unplug

This is one of my biggest suggestions (see my #5 tip)!  Turn off electronics to allow your body the opportunity to naturally produce melatonin, which will cause you to feel sleepy.

Tip #4: Be active during the day

Living an active lifestyle, or exercising can help you to sleep better.

Tip #5: Watch what you eat (and drink) at night

5 Tips on Sleeping Well

Do you have trouble falling asleep?  Does your mind seem to race even after you climb into bed?  Do you have worries on your mind that prevent you from easily falling asleep?  Do you toss and turn, finding you can't shut your mind off?  Or, do you sleep ok, but wake up and find you are still tired?

You are not alone!  Trouble sleeping (difficulty falling asleep and/or sustaining sleep) is something that I've noticed many people struggle with.  Or, maybe you are able to fall asleep easily now, but you've had times in the recent past when you couldn't fall asleep no matter how tired you were.  The Sleep Foundation (https://sleepfoundation.org/media-center/press-release/lack-sleep-affecting-americans-finds-the-national-sleep-foundation) reports that 45% of Americans said they had difficulty sleeping in the past week, with women struggling with insomnia more than men.  Good quality restorative sleep is so important for us to function at our best!  It is necessary for memory consolidation, helps reduce our risk of certain diseases like heart attacks and diabetes, and improves our decision making.

'Sleep hygiene' is the fancy term for any practice that helps you to sleep well consistently.  I suggest the following tips, which can be especially helpful for the ones who suffer with anxiety and racing thoughts at bedtime:

1-Use a sound machine.  Any sound, whether it’s white noise or rain softly falling, can help block out other extraneous sounds.  The soothing, repetitive nature of any sound machine track can help you relax.  There are even apps (Relax Melodies, or Sound Machine) available that have tracks of the rain forest, a babbling brook, or birds chirping that you can use for free.

2-Keep your bedroom cool and dark.  Use blackout curtains if you need it.  Conversely, when it is morning time, open up the curtains immediately, as the sunlight can help jumpstart your day and give you energy.

3-Limit naps to 15-30 minutes at most.  Skip naps if at all possible, because you most likely won't be ready for bed at your typical bed time. 

4-Have a consistent sleep/wake time.  Even if it’s the weekend, or your day off, it’s best to wake up within 1 hour of your normal wake time to not throw off your bed time that night.  And, go to bed at approximately the same time every night.

5-(THIS ONE IS THE MOST IMPORTANT!) Create a relaxing bedtime routine that includes no electronics.  Just as children crave routine, especially at bedtime, we do too!  A routine (like bath, pjs, read a book, and bedtime for kids) helps our brains to understand what is coming next.  Your brain will learn to expect that soon you'll want to fall asleep.  So, starting at least one hour prior to bedtime, turn off all electronics (yes, this includes your iPad, computer, tv and cell phone).  Some of these electronics have a “nighttime” lighting setting, but any light that they emit can prohibit your brain from naturally producing the melatonin that signals your body that you are tired.  Take a warm bath or shower.  As your body temperate decreases from the bath or shower, you will naturally become drowsy.  Take some time to journal your thoughts, or work on a crossword puzzle.  Read.  Crochet.  Do Sudoku.  If you turn off your phone, you’ll find you have time to do some of the things you previously did in the non-digital age, while promoting good sleep habits.

Give some of these a try and let me know what works for you!

Let's Start This Journey Together!

I decided I wanted to start to blog, as a way to offer some insights, thoughts, tips to more than just my clients.  I often see patterns in my sessions, certain topics that come up from multiple clients, and thought it might be helpful to share with you!  I also want to provide information on improving your mental health or maintaining good mental health, addressing topics that maybe are not completely understood or talked about often.  I want to help fight the secrecy and shame that is often portrayed in seeking therapy services.  Unless you have been in therapy, you might not know what really happens behind closed doors.  And, I’ve found, we tend to be scared of what we don’t know!  

Additionally, I challenge my clients to grow and change in areas in which they desire, and writing this blog is my challenge for myself!  I figured it wasn’t fair to talk about growth, and doing things you are afraid of, if I didn’t take my own advice!  My writing style is very formal, due to years of schooling and graduate training.  I was trained to write scientific research papers, and never really developed a conversational style of writing.  My area of growth is to be more relatable (and, less stuffy) with my writing.  I am going to use this blog to grow!  I ask for your grace and understanding as I go along, and as I learn.

I also ask for feedback from you.  What do you want to read or learn about?  In what ways could I make things easier for you to understand?  So, please, make comments, ask questions....I want to help make mental health easier to talk about.

I look forward to learning with you!  Stay tuned....my next few blog posts will be covering good sleep habits, dealing with difficult family members, and anxiety.