1) higher confidentiality standards (no insurance accepted)
2) Email support between sessions
3) Coordinate care with your medical provider, if you wish
4) Quality Assessments done periodically
5) Progress updates every 6th session
6) Handouts to reinforce what you’ve learned
8) Testing for depression and anxiety, with actual test numbers reported
9) Reduced fee/sliding scale counseling available with Intern Therapists
10) You will leave the first session with a “Prescription” of immediate, practical suggestions
|Don’t miss these tips on taking an active role in counseling|
|If you’re struggling or stuck, counseling may be a good way to get a new perspective, move forward positively and protect your well-being. And if you’re living with a mental health condition, seeing a therapist may be a key part of your treatment plan.Are you in talk therapy or considering it? These tips can help you make the most of it:1. Set goals Be sure your therapist knows what you hope to achieve. For example, perhaps you want to:
2. Discuss a timeline It will depend on your needs and goals. Ask your therapist how you’ll work together on your goals and how long you might need counseling services. Some issues are chronic or take longer than others to work through. But in other cases, people might feel that they’re making progress after just a few sessions.
3. Be honest Sometimes, talking about personal problems can be uncomfortable. But the more open you are about your true feelings and experiences, the more your counselor can help.
4. Take notes during each session Reading them over can remind you of what you discussed, including what action steps you should try.
5. Do your homework For example, your counselor might suggest you write in a journal or change your behavior in a certain way. If you don’t get specific tips, ask what you can do outside of therapy to move toward your goals.
6. Welcome new ways Often, therapy means exploring approaches that feel outside your comfort zone. But trying new strategies for managing or responding to situations is the only way to see if they work. If you give up too quickly, you might miss out on something that really helps.
7. Speak up Your counselor wants your therapy to succeed — and collaboration is a key to that. So don’t hesitate to say if you:
When you’re frank, it gives your counselor a chance to think about the best ways to help you.
It’s also vital that you develop trust and a good connection with your therapist. So if you don’t feel comfortable or you don’t feel like you’re being heard, it may not be a good fit — and you may benefit from making a change.
Savannah Ellis, MPsych
Each day, our partners make many attempts to connect with us, both verbal and nonverbal. World renowned couples research, Dr. John Gottman calls these attempts “bids” for emotional connection. A bid can be a question, a look, an affectionate touch or anything else that opens the door to connection. In his research, Gottman reports that a happy couple can make as many as 100 bids over the course of a meal! How we respond to our partner’s bids is a huge key to a successful relationship. Gottman’s research indicates that husbands who eventually were divorced, ignored the bids from their wives 82 percent of the time compared to 19 percent for men in stable marriages. Women who later divorced ignored their husband’s bids 50 percent of the time while those who remained married only disregarded 14 percent of their husband’s bids. There are three responses to a bid for connection: turning toward, turning away and turning against.
- Turning toward. This means to react in a positive way to your partner’s bid for emotional connection. Research indicates that over time, these couples develop stable, long-lasting relationships. They also can access humor, affection and interest in each other during conflict. They can stay connected and not let temporary negative feelings destroy the relationship.
- Turning away. This response is essentially ignoring or avoiding the bid or acting preoccupied. A consistent turning away response leads to defensiveness and seems to result in early divorce in married couples.
- Turning against. Couples who turn against each other’s bids for connection appear more argumentative, critical and sarcastic. According to Gottman’s research, this style leads to divorce in a majority of cases, but not as quickly as couples who more habitually turn away from bids. Once a couple gets into the habit of rejecting each other’s bids for connection, they tend to give up on rebidding or resuming efforts to connect. In stable marriages, spouses rebid about 10 percent of the time and in couples heading towards divorce, there is rarely ANY rebidding. Gottman believes that a couple that practices “turning toward” behavior metaphorically “deposits” good will into the emotional (love) “bank” of the relationship. These “credits” accumulate and allow the partners to more readily connect when times become more challenging in the relationship. The bottom line is that “turning toward” your partner is a strong basis for emotional connection, as well as a powerful tool to sustain passion, romance and a healthy sex life.
By Amie Koehn, LCS
“I just don’t know if I can do it anymore,” my client said as she cried. “He just needs so much, you know? I don’t think I can do it all.”
Are you taking care of an elderly parent, spouse, sibling or an adult child? Taking care of an adult presents unique challenges. It’s hard enough providing 24 hour care for children, but what happens when the person we’re caring for is someone who has been or “should” be able to take care of themselves but now can’t?
Caregivers are uniquely prone to depression and anxiety. Most often women, caregivers devote their physical energy- meal preparation, being present with the person, perhaps helping that someone walk or feed or even bathe and toilet themselves. They expend mental energy- arranging appointments, arranging services, keeping track of medication, and even providing stimulation and direction when needed, and emotional energy- feelings of sadness, grief, frustration, futility, anger, resentment and guilt are common in caregivers.
The devotion of all this energy often results in depression and anxiety, with the effects of caregiving lasting well beyond their loved one’s death or placement of their loved one in a more structured environment. Virtually all of the caregivers I’ve worked with over the last fourteen years felt guilt. A LOT of it. Guilt about not providing enough care or the right kind of care, guilt about feeling angry or resentful toward their loved one at times, even guilt about wishing sometimes that their loved one’s life would end so that they could both be better off. Caregivers often believe they could have/should have done something more or different to help their loved one- even though they logically can’t put their finger on what that something is.
Caregivers often take increasingly less time for themselves, usually out of concern that something bad will happen to their loved one if/when they leave them to run errands or just get away for a couple of hours; or they feel awkward asking someone else to help. They stop spending time with friends or doing hobbies or fun activities because taking care of their loved one seems to take all of their time. For this reason, many develop tunnel vision about themselves and what needs to be done, and feel isolated. With all of this going on, is it any wonder that caregivers are more prone to depression and anxiety?
There are ways to make caregiving less stressful:
- Ask for help. Adult siblings, friends, neighbors you trust can help with everything from chores and cooking to sitting with your loved one so that you can get a break. Professional respite care is also available.
- Accept help. When someone offers to help, accept it! If they offer to help, but don’t know how to help, be prepared to name a few things that you could use help with- respite care, meal prep, errand running, etc. It doesn’t have to be a major task; even getting help with the little tasks can make life easier for you.
- Stay in touch with community. To the extent possible it is vitally important to keep up your social activities- spending time with friends, faith practices and clubs are examples. These activities “re-charge your batteries” and help you keep perspective on life. Support groups are also quite helpful.
- Know your limits. You are human. Humans are not built for staying up all hours of the night without a break to take care of someone, or physically managing someone who weighs as much or more than we do, or to devote all physical, mental and emotional energy toward another human being on an ongoing basis. We simply are not designed for it. With some disease processes, such as dementia, there comes a time when one person cannot do it all. It’s okay to recruit professional help or consider placement in a structured environment where they can get the 24 hour structure and care they need by a team of people who are specifically trained to deal with your loved one’s condition.
- Keep in mind your feelings are valid. It’s normal and okay to feel angry, frustrated, or resentful at times. These are just feelings and we have them for a reason. Taking care of someone else is very hard work; and it would be surprising if you didn’t feel this way at times. If you’re experiencing these feelings more often than not, it’s long past time to get some help.
How to know when you need professional help:
- Feeling down, depressed, sad or hopeless more often than not
- Loss of interest in fun activities
- Unable to “turn off your mind”- constantly worrying about what needs to be done or what you’ve already done; intrusive random thoughts
- Feeling resentful, angry, frustrated more often than not
- Increased tearfulness
- Increased feelings of guilt or thoughts that you’ve let your family or others down
If you’re having trouble dealing with the aftermath of caring for someone you love, call me! With my solution-focused approach, you can learn tools that will aid in caring both for your loved one AND YOU.
Alcohol Use—or Overuse? Screening Questions to Consider
Have you ever wondered if, or been told that, you drink too much? Contrary to popular opinion, there are standards by which professional therapists measure and diagnose whether or not your use falls into troublesome levels. These standards are based on research produced by the National Institute on Alcohol Abuse and Alcoholism.
It’s not just drinking daily– if it’s no more than 1 daily drink a week for a woman and two for a man, it’s generally not considered problematic—but also HOW MUCH at one time. So, even if you only drink once a month, IF you drink in excess of more than 4 drinks for a man or 3 for a woman in one day, you can be considered alcohol-dependent, have alcohol related problems, or be at risk. Medical, behavioral, and family history will all be taken into consideration. Further testing, such as the SASSI (Substance Abuse Subtle Screening Inventory) may be done by your therapist.
Fill out this form below and submit to your therapist for further evaluation. Take that first step toward your best YOU!
On average, how many days a week do you drink alcohol? ____________
On a typical day when you drink, how many do you have? ____________
On any given day, what is the maximum number of drinks you had in the past month? _________
Have you ever felt you should CUT DOWN on your drinking? Yes No ____
Have people ANNOYED you by criticizing your drinking? Yes No _______
Have you ever felt bad or GUIILTY about your drinking? Yes No _______
Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?
Yes No _______
If YES to any of these: has this occurred in the past YEAR? Yes No ______