FYI- Many insurance companies are waiving copayments for their clients who would like to receive online counseling at this time. Please connect with your mental health insurance provider to see if you are eligible.
Have you ever spoken to a friend on FaceTime? Participated in a Zoom meeting for work? Chances are you have virtually connected with someone via video at some point. The world is becoming more virtual as technology improves and many have smartphones that allow you to reach out to someone quite easily.
Now that much of the nation is practicing social distancing or are in places that many non-essential services are shut down due to COVID-19, we are staying home to flatten the curve and protect those who are more vulnerable to the virus. In the past, this could mean weeks of skipped therapy or inability to access help when we all need it the most. Online therapy can provide treatment while also addressing the anxieties, stressors, and fears this pandemic has caused.
Recent research reflects that online therapy can be just as effective and sometimes, more convenient in our busy lives. Also, virtual therapy can feel more comfortable for some as it is conducted while you are in your own environment. As with traditional therapy, you receive the same treatment and can discuss what you need to with your therapist as if you were face to face.
Let’s talk about the benefits of online therapy
1 It doesn’t just have to be on video
If you aren’t comfortable with video, online therapy offers other methods. Some therapists offer text-based therapy and allow you to contact them throughout the week. This can be especially useful for those with social anxiety, panic and agoraphobia. Second, there is audio therapy – in this method, you and your therapist will meet on Zoom or the telephone.
2 No commute
Commuting for therapy appointments can be cumbersome. Add the costs associated (transportation, parking, childcare and missing work for appointments) it can become a financial and scheduling burden. Many people don’t begin therapy or stop going because of the difficulties in traveling to their therapist. Online therapy removes these hindrances and makes it easier to find a time that is convenient for yourself and your therapist.
3 Great if you are uniquely abled
If you have accessibility issues or physical limitations including being housebound, online therapy is an excellent choice for you.
4 Still covered by insurance
Many insurances cover online therapy sessions, however, it always good to contact your healthcare insurance to see if they are covered under your policy.
5 As always, it is confidential
As with your visits to your therapist are private and confidential, so are your online visits! Online therapy is completely confidential and the same rules that apply offline are still applied online. The therapy itself can sometimes cause stigma around mental health; online therapy reduces this. That way you are more comfortable with the sessions and your communication during them.
Also, communication online is encrypted through an HIPAA compliant platform called VSee. VSee is free for the you and can be downloaded onto your phone or computer.
6 Your therapist must be licensed in the state you live in
Some may be licensed in more than one state. So, you know you are getting quality healthcare by a reputable and credited provider to meet your mental health needs. This also means they are aware and comply with all Health Insurance Portability and Accountability Act (HIPAA), ethic and legal practices.
7 You can have access to a specialist that you cannot find locally
You may want a certain type of therapy such as cognitive-behavioral therapy (CBT), dialectical behavioral therapy or other evidence-based treatment. Oftentimes, therapists formally trained and specialized in these modalities for panic, anxiety, and other diagnoses are much easier accessed virtually. You may more likely to find a suitable and qualified therapist if you go beyond the location you would stay in to visit a therapist in an office.
Online therapy isn’t the best choice for everyone, and some mental health disorders may be better treated in person. Clients who are actively at risk of harm to self or others are not suitable for teletherapy services. If you are feeling suicidal, it is better to be seen in person. That said, during the quarantine many therapists are allowing for online sessions regardless.
Many of my clients are finding that treatment for their anxiety and worry during this time of uncertainty has been surprisingly easy, and it is a great way for your counselor to see where you live, meet your pets and maybe even family members. If you’re interested in learning more- please don’t hesitate to reach out!
Here’s to all of us taking great care of ourselves, and making it through to the other side stronger and thriving!
Ambiguity, a sense of uncertainty about what’s going on or what might happen, is part of life. This blog post explores dealing with the unknowns in life and how to handle them.
When Your Environment is Unpredictable
Wow, what a week. Coronavirus or COVID-19 is all over the news and it seems that panic has set in. It is understandable to be anxious when uncertainty is all around us. Our world has been thrown off, and a new normal is here for the near future.
Human distaste for the unknown is well-grounded in experimental psychology, and research has shown that when given the choice, most of us feel calmer knowing that something bad will happen in the near future vs. it possibly happening. This phenomenon is apparent even if it causes us intense stress. Daniel Gilbert, author of the best-selling book Stumbling on Happiness writes:
“Consider an experiment by researchers at Maastricht University in the Netherlands who gave subjects a series of 20 electric shocks. Some subjects knew they would receive an intense shock on every trial. Others knew they would receive 17 mild shocks and 3 intense shocks, but they didn’t know which of the 20 trials the intense shocks would come. The results showed that subjects who thought there was a small chance of receiving an intense shock were more afraid — they sweated more profusely, their hearts beat faster than subjects who knew for sure that they’d receive an intense shock”.
WAYS TO HANDLE ANXIETY
We can’t eliminate uncertainty in our lives, but we can manage our reactions to the unknown in healthy ways using one technique that the best cognitive behavioral therapists employ:
REST Technique or Radical Acceptance
When you become overwhelmed or feel anxious, your first instinct may be to act impulsively or panic. There is a healthier method – Take a REST.
Set an intention
Step one is to literally freeze and stop whatever you are doing. Breathe. Step away from the situation for a few seconds. Try to find a different perspective on what is happening and create a space between yourself and the impulsiveness you may feel. You can even tell yourself out loud to “Relax” or “Rest”. Slow your breathing down and calm down before you decide on another course of action.
Ask yourself what is going on – what are the facts in the situation? You don’t need to solve an ambiguous problem or discover any answers right now. You only have to evaluate what is happening to your physical, mental, and emotional self. Move on to looking at other people around you. At this point ask yourself “How do I feel?” and “Are the people around me in immediate danger?” Think right here, right now.
Set an Intention
“Step three is to set an intention to do something.” You can also treat an intention as a goal or plan. Decide what you will do, pick a distraction or self-soothing skill and ask yourself “What do I need right now?” Whatever you choose isn’t permanent, it is only for right now.
Distractors and soothers that help get you out of the uncertainty trap do not have to be expensive or time-intensive. Good examples of immediate coping skills are:
Count all the greens or blues in your vision.
Describe a wall or other item in detail.
Alphabetize movies, songs, cities, etc. in your head or on a sheet of paper.
Breathe 4 seconds in, hold for 4 seconds, and out for 6.
Pay close attention to the living things around you
Clean, fix something, do anything where you move your body for 5 minutes.
Lastly, take action. Mindfully move ahead slowly and meaningfully toward what you are doing. Slow and deliberate often helps us get what we want to be done faster than rushing through. Even if this is not the final solution to your problem, it is a healthy and effective way to thwart any impulsive behaviors or panic that may set in when uncertain.
Once you start getting used to using the REST technique, you will begin to identify when you are distress and can implement these steps in a few seconds. You will be ready to spring your new habit into motion and “REST” when you feel like you are in a similar situation again.
QUIZ: HOW WELL DO YOU MANAGE UNCERTAINTY?
Everyone has a different level of tolerance for ambiguity. Wondering how good you are at tolerating ambiguity? There is an easy way to find out. The Tolerance for Ambiguity scale will tell you. You will respond to a set of 16 statements about your attitudes and behaviors. Whether your score is particularly high, or lower than you expected, it is interesting to know where you stand. This information might also be helpful to a therapist who you consult to help you manage anxiety.
Of course, if you follow the directions given by healthcare professionals for the coronavirus, you will feel like you have some control and they are good precautionary habits to have in our current environment.
Also, make sure you stay connected with your support system via phone and video and limit your use of social media, which is less interactive and in turn, increases our anxieties.
Matthew McKay Ph.D., Jeffrey C. Wood PsyD, et al… The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, … (A New Harbinger Self-Help Workbook) New Harbinger Publications; Second Edition, Revised edition (October 1, 2019) Print.
As the world has been inundated with news of the coronavirus, I want to share this great post by fellow therapist and gifted writer, Brianne Rehac, LMHC in how we all are coping with anxiety differently. Take good care of yourself and your loved ones this weekend! Warmly- Karen
“This week, I have spoken to many people about their heightened emotions since the outbreak of coronavirus disease 2019 (COVID-19).
Everyone has a definition of what is a stressful event for them. And everyone reacts to those events differently. If you find that you have not felt impacted at all by reports of the coronavirus outbreak, that is a perfectly okay response. If you find that you have been more anxious, sad, irritable or angry lately, that is completely normal, too. Our reaction to stressful events is a product of a multitude of factors including, our proximity to the event, socioeconomic status, personal history, and personality. Some people who may respond more strongly include individuals who are managing a mental health condition (like anxiety), children, and first responders/healthcare professionals.
Sometimes responses to a stressful event don’t present as emotions. Instead, you may notice a change in sleep patterns; change in appetite; difficulty concentrating; worsening of a chronic health problem (like GERD or chronic pain); change in behavior (stocking up on essentials or changing your routine); or increased use of alcohol or other drugs.
It is really important that during stressful times, you continue to take care of your physical and mental health. That means sticking to your treatment plan, including taking medications as prescribed; attending routine appointments; adhering to any special diet you may have. It also means reaching out to your supports—family, friends, doctors, therapists, and support groups. You’re connecting to them not just for yourself, but for them, too. Let’s all check in with each other on this, okay?”
SAMHSA’s Disaster Distress Helpline
Toll-Free: 1-800-985-5990 (English and español)
SMS: Text TalkWithUs to 66746
SMS (español): “Hablanos” al 66746
National Suicide Prevention Lifeline
Nacional de Prevención del Suicidio
Options For Deaf + Hard of Hearing
Veterans Crisis Line
Your mental health is important, why mental health apps? Sometimes you cannot afford to see a therapist, do not have time to go to one, or one isn’t accessible where you live. Perhaps you aren’t ready to see one but would like to see what therapy all is about. Maybe you see a therapist, but need help to put the helpful techniques they have given you into practice. Mental health apps can be very beneficial, free, low-cost or affordably priced, and offer a way to help give you therapeutic help on the go. So which ones are best? There are so many out there!
Mental health apps that I recommend:
Headspace is an app that just about anyone can use, whether you are dealing with stress, anxiety, lack of focus, or sleeping difficulties. It teaches you to “meditate and live mindfully”. Meditation has been shown to reduce stress, lessens anxiety, support emotional health, and enhances self-awareness. This app provides small meditation modules to accommodate people’s busy schedules and “SOS exercises in case of sudden meltdowns.” You can take advantage of their free trial and if you like it, you can make the jump to a monthly subscription.
Youper is an app that is powered by AI – “your emotional health assistant”. This app allows you to have conversations, guidance through meditations that are personalized for you and trackers that help you monitor your emotional health and mood. This technology created by doctors, scientists and engineers;focuses on the science and pursuit of happiness – helping those with depression and anxiety live happier lives with treatments personalized for them. This app also works in conjunction with seeing a therapist, as you can ‘share’ your information. Many of my clients use this app as complements many of the CBT techniques we use right in session.
Youper is free to download and have some free features; more advanced features are based on a subscription plan.
This app offers meditation training as part of a “mental fitness” approach. FitMind uses traditional techniques used since ancient times with western science. Using daily challenges, along with access to meditation instructors; FitMind can help you learn to meditate in a way that works for you. Again, meditation is a useful tool for improving mental health because of all of the health benefits you get from practicing it. This app is free and offers in-app purchases.
Sanvello is an app designed for stress, anxiety, and depression using strategies and resources that can help you with the symptoms and situations you are dealing with at the moment. You can customize goals; like mindfulness, building confidence and thinking positively. Based on clinically proven techniques, this app offers tracking for mood and sleep, tools for relaxation and meditation and you can connect to a group of your peers for further support. Free to sign up and install.
This mental health app uses four tools that are designed to enhance your mood, identify and change unhealthy thinking, track mood, and create journal entries. Managing negative feelings thoughts by identifying situations that cause stress, changing how you think, monitoring your mood through tracking, and developing self-awareness through writing is all of the ways MoodKit is designed to help you improve your mood and mental health. This app is only available on the iPhone and iPad, but is just $4.99.
Mental health treatment is no longer limited to the office and self-help books. Whether you are on the road, want quick help, or establish a daily cognitive behaviorally based self-care routine, there has never been so many options on how to start. It’s good for you, and most apps have a free trial! Jump in and let us know how it goes.
We want change to happen quickly. However, it takes time to accomplish our New Year’s goals. The following are 7 tips to help you stick with your resolutions and succeed!
Tip #1: Stick to One Goal
When deciding on a New Years’ resolution, stick to the one thing.
Do not overwhelm yourself.
When you feel overwhelmed, you get discouraged.
When you get discouraged, you are more likely to quit at the first sign of difficulty.
Try to relax, and stay away from any change that may be unrealistic.
Tip #2: Keep it Measurable
The best way to keep your resolution measurable is to start small. Begin by taking baby steps once a day. If your resolution is to hydrate, drink one more glass of water a day. If you want to stop drinking soda, start by drinking one less a day. Over time, these little changes add up to help you reach your goal. In addition, try to be mindful of your goal throughout the day. When you remember, take a micro-step toward achievement.
That means drinking an extra glass of water when it crosses your mind!
Tip #3: Anticipate Barriers
Before you even try to enact your resolution, make a list of the barriers you anticipate in the process. Ask yourself what self-defeating roadblocks you have encountered in past efforts. Then, ask yourself what you see as impeding your future efforts.
These could sound like thoughts such as, “I don’t feel like it” or “I don’t have time”.
You may also notice yourself engaging in sabotaging self-talk such as, “I deserve a break” or “I’m not motivated”.
Now, write down your personal barriers.
Afterward, record what you are going to do the next time this barrier rears its ugly head. In your quest for a change, you are bound to hit upon the barrier of resistance. At its root, resistance is a reaction founded in fear. If you are afraid of change, you are essentially afraid of reality, because change is the essence of reality. So, why are you afraid of change?
Here are some ways to cope with the fear of change
Replace negative self-talk with positive self-talk
Research makes fear disappear because research gives you control
Practice makes perfect, so practice until you are less afraid
Nip fear of failure in the bud by becoming okay with any possible criticisms or embarrassment. Consistent failure is what leads to success.
Tip #4: Make an Advantages Card
Why do you want this? What is the benefit? There are going to be some hard times throughout your journey of change, times when you need to remind yourself of the why. Therefore, an important step in keeping your New Years’ resolution is making an advantages card.
An advantages card can be made of anything you want. Some people like to use a notecard, while others write on mirrors or dry erase boards. The content is simple. Just make a list of all the reasons why you want to accomplish your goal. Maybe you want to lose weight to become healthier, or maybe you have a specific clothing size you want to hit.
Read your list twice a day, really reflecting on why you want to accomplish your goals. In times of extremely self-defeating thoughts, it is recommended by cognitive behavioral therapists that you read your advantages card as needed.
Tip #5: Accept You Will Have Bumps
It is important not only to realize but also to accept you will slip up along the way. There are instances when you will be barraged with berating thoughts and crumble under the pressure. However, do not use a mess up to engage in all or nothing thinking! When you encounter a bump in the road, do not give up! For example: when you smoke that cigarette you know you shouldn’t have, do not throw in the towel and buy a whole pack. Remember, in order to make a habit your new behaviors take a minimum of 3 weeks. Be patient and practice self-compassion, especially when you inevitably mess up!
Tip #6: Ask Someone to Hold You Accountable
This tip sounds as though it would be easy. However, it can be the most difficult, especially if you are allergic to criticism. That is why it is important to find someone you trust and respect to hold you accountable. Although you may want to fight them, you will be more likely to listen when you know they are giving advice with good intentions. A good CBT therapist holds their clients accountable by assigning homework and expecting follow-through, so don’t be afraid to seek out professional guidance if you are having difficulty finding external support.
Tip #7: Make a Plan
When you make your plan, focus on the small steps and not the goal. Instead of writing down “I will lose 20 lbs this year”, break that larger goal down into more manageable steps. This could look like, “I will drink more water” and “walk around the block each day”. After you accomplish small successes, find a way to celebrate! Don’t skip this step, because it is extremely important. When you reward yourself, your brain will remember the dopamine rush and be more willing to do your bidding.
Check out this blog from TED to give you some motivation!
Other articles in this series: A Cognitive-Behavioral Approach to Holiday Success’
According to a recent Wall Street Journal article by Elizabeth Bernstein, around 40 percent of people in the US say they are lonely. Thirty years ago that number was halved, around 20%. However, feeling lonesome is not just an unpleasant emotion you need to learn to live with. In fact, loneliness actually re-arranges your genes and changes you from the inside out. Unsurprisingly, recent studies have shown this emotion is linked to anxiety and depression.
Feeling isolated from time to time is natural, but it is important to understand why and nip it in the bud before it becomes something deeper. This article will give you the rundown of why you feel lonely, how you feel lonely, and what to do if you feel lonely.
Holy Moly! So Many Ways to Be Lonely
In order to keep away the lonesome blues during the holiday season, it is important to understand why you are feeling this way. According to Psychology Today, there are 7 distinct types of loneliness. Here is a run-down.
#1. A New Situation – You are a new person in a new place. If you just switched jobs, moved to the city, or are the new person at school what you are feeling is new-situation loneliness.
#2.I am Different – If you feel as though you are different from the people around you, you may be experiencing this type of loneliness. Maybe everyone around you grew up together except you. It could be you feel deeply passionate about a social issue that no one else around you cares about.
#3. No Romantic Partner – Sometimes, simply not having a partner during the holidays can drag you down.
#4. No Animal– Maybe you deeply want a cat, but right now is just not the right time. Maybe seeing pictures of cats dressed up like Santa depresses you. This is no-animal loneliness in action.
#5 No Available Friends – This tends to happen when your friends and family make life changes. No one has time for you, and you feel lonely.
#6 Bad Friends – If you do not trust your friends, you may feel lonely. You can have a lot of fun with a lot of bad friends over the years. However, at the end of the day, you ultimately felt unfulfilled.
#7. No Warm Body – Maybe you are completely satisfied with your social life and your work-life balance. However, you miss the feeling of another person sharing your home. Living alone can be difficult sometimes, especially around the holidays.
We Were Born this Way
Well, about half of our loneliness can be attributed to our genetics. We know this due to studies on Dutch twin separated at birth. Unfortunately, this emotion is generational as well as heritable, especially for those less privileged.
As a result of Romania’s communist dictatorship’s ban on birth control, the 1980’s saw tons of children abandoned in orphanages. In these poorly run institutions, there were around 20 children per 1 nurse. When brain studies were given to the unloved and attention-deprived orphans, scientists discovered the children failed to develop a normal amount of grey matter. This means the children’s neural connections between the amygdala and prefrontal cortex were not strong. What is the result? According to New Republic, these people can be “moody, self-doubting, angry, pessimistic, shy, and hypersensitive to criticism”.
10 Tricks to Keep Loneliness at Bay
Make Giving a Habit – Giving doesn’t necessarily mean money. This time of year especially, there are many opportunities to volunteer in the community.
Find Like-minded People to Connect With – Try joining a Meetup.com group, a book club, or a workout class. Eventually, you will have a community.
Stay Healthy – This includes getting enough sleep, eating healthy foods, and exercising. All of these things have been found to improve mood.
Work on Existing Bonds – We now know intimate bonds are necessary to happiness. Work on fortifying your current friendships, whether long-distance or close-by.
Learn from Your Experiences – Ask yourself what you can learn from your loneliness, and how you can put your new appreciation for connections into practice.
Mindfulness – Identify your thoughts when you feel lonely. Many times you will have self-defeating thoughts about your state of mind. Realize these are just thoughts and do not attach any significance to them.
Show Self-Compassion – Develop and nurture compassion, love, and acceptance of yourself. You can treat yourself to an act of kindness, or meditate on directing love toward yourself. In addition, you can practice self-soothing techniques.
Get Comfortable with Yourself – It sounds cliché, but in order to beat loneliness, it is important to try and become comfortable alone. Sometimes people get down about doing fun activities alone. However, if you learn to work through the self-conscious thoughts you can actually start enjoying time with yourself!
Get that Pet –Sometimes, you just have to go for what you want in the pursuit of happiness!
Plan Ahead – If you know you get lonely during the holiday season, make a plan ahead of time. List some things that make you happy or that you want to try. Then, bust out this list when you are feeling alone!
When dealing with feelings of isolation during the holiday season, it is important to remember you are not alone. According to USA Today, 20 percent to 50 percent of people in industrialized nations experience loneliness. So if you are feeling blue this holiday season, cut yourself some slack and practice some of my tips. However, if your loneliness has progressed to anxiety or depression it would be wise to see a therapist for help.
The extra demands combined with the typical stress around the holidays can cause most of us to fall into the trap rigid thinking and the belief that life should be idyllic. If you struggle with anxiety, this season can be an especially difficult time. Perfectionism is something cognitive behavioral therapists see often. Here are some good CBT-based tips on how to help yourself during the rest of 2017
Do Not Strive For Perfect
Perfectionism is a self-imposed unrealistic expectation and the subsequent stringent judgments on you, others, or a situation. You are with yourself every day and you see every mistake you make, so we tend to have quite a long checklist of our real and perceived mishaps. When you focus on self-defeating thoughts, you become hypercritical and begin to put more weight on the negative aspects of oneself. Inevitably, this leads to depression, low-self esteem, and a sense of frustration. Of course, this isn’t beneficial to you and the people who love you. When you find yourself revisiting that list of mistakes, it’s time to combat them by a CBT technique termed a ‘positive data log’. Write down events that were ‘good enough’, or events that were just fine in spite of being imperfect you begin to be more flexible, and your all or nothing mindset can be reduced.
With so many social media apps, unrealistic advertising, and other messages promoting perfectionism, it’s impossible to not compare your life with an idealized sample of others. For perfectionists, it’s not easy to remember to take a step back and assess reality. When we engage in perfectionistic comparison, we typically measure ourselves next to someone we already think is ‘better’ in some way. However, all that time comparing can have real consequences. A recent study among Facebook and Twitter users showed 62% feel inadequate and 60% feel jealous when using social media. The same study found half of participants from 18-34 felt ugly due after time online.
Are co-workers, ex’s, or family on social media fueling your feelings of inadequacy and stress? If you want to kick perfectionism to the curb, un-follow your “competition”, and kindly remind yourself that social media is not a representation of reality, even if just over the holidays.
Temper Family Expectations
Family can cause a lot of distress around the holidays, and even more so when you have lofty expectations. There is already enough pressure around this time of the year without adding perfectionism to the mix. Remember, you can’t control the actions of your family, but you can control your own. Part of walking the walk is that you can identify and reduce acting and thinking in ways that are not productive.
Trying to change others can be akin to entering a faulty debit card pin at checkout. You are in a hurry, and your code won’t work. Instead of admitting defeat, you continue to enter the same thing with growing frustration. Your blood pressure is rising, as is that of the cashier and the people behind you in line. All of this stress and anxiety could have been avoided if you simply stopped repeating the same unproductive habits and expectations.
Beat Perfectionism by Shifting Perspectives- An Experiment in CBT
On days when everything goes wrong, take a minute to consider how much worse things could be to shift your negative perspective. The following are three other tricks to engage your positive lens.
1.Incorporate a daily gratitude practice. According to CBT research, gratitude improves mental health, emotional health, sleep, and self-esteem. Each morning, night, or both write down 5 things you are grateful for, and that is all.
2. Acknowledge Your Power. Cognitive behavioral therapists emphasize that it’s vital to recognize that we all have control to choose our perspectives. We choose which thoughts to pay attention. Reorienting yourself to the positive can add more value and warmth to the way you experience your life.
In Part 3, I’ll be discussing cognitive-behavioral approaches to coping with loneliness over the holidays. As always, please let me know how these tips work for you. Other ideas? Please share. Enjoy the rest of your month and experiment with your new tools. What to know more about cognitive behavioral therapy? Click here for an FAQ: Cognitive Behavioral Therapy/CBT in San Diego
Look around in any store and you’ll find early reminders of what’s ahead of us- spending quality time with we people love, great food, awesome parties, and the list goes on. Of course, these are what we all hope our holiday season will be made of, but that’s not always the case. Even in the best of situations, people struggle with excessive commitments, unrealistic expectations, and financial pressures. If any of those sound familiar, you may be wondering how to manage holiday stress this year. In this 4-part series, you will find a way to manage the top holiday mental health concerns and start your 2018 fresh instead of frazzled.
Part 1: Start Now, Not Later
Early November can feel too early to even consider digging into holiday preparation, but if you want to enjoy some bliss this December start the ball rolling now. Planning helps you take back control, and the time to plan your upcoming holiday season is here! It is much easier to attack the extra demands on your time early in the game. Why? You are more objective when you are not in a time crunch.
Tip #1: Give Yourself Time
One of the most effective ways to kick the holiday dumps is to use planning to your advantage. An important rule to use during this time of the year is to assume everything will take 2 times as long as you think. When you pull out your planner to arrange your upcoming errands, it can be hard to remember how time-consuming many of the demands are. This can lead to overbooking and excessive commitments, which leads to unnecessary stress and anxiety.
Tip #2: Don’t Forget Yourself
This may be the most important tip on the list. It is easy to get so caught up in the swirl of holiday activities you forget to spend time with yourself. However, reserving chunks of personal time will help you keep what is important in perspective. When we neglect to care for ourselves, falling into the familiar holiday blues becomes easier. Need ideas? Check out some clever ways to enjoy the moment in front of you.
Tip #3: Prioritize
This holiday season ask yourself honestly: what and who is truly important? What can go to theside if I begin to feel overwhelmed or rushed? Although it can be hard, learn to say no to things you do not actually want or need to do. If you are having trouble figuring out how to prioritize, look to your values. Values, not external expectations, will guide you during this time. Don’t know what your core values are? Here is a great exercise to use to figure out what is truly important to you, so that you can put your priorities in order.
Tip #4: Practice Mindful Gifting
We all know this state of awareness is the best way to go about our day. What you may not have known is you can also practice mindful gifting. When we have time to be leisurely about purchasing gifts, we tend to think more deeply about the person we are gifting for. If you take this time now, the gifts you give will mean
much more to the recipient and yourself. Set aside some chunks of time as soon as possible for reflection. During this time, make a list of each receiver and write down what they truly like and enjoy. If you do not yet know, keep an eye out for clues.
Holiday Stress and Depression
Holiday stress and depression can extend into your new year if not dealt with sooner than later. The aforementioned tips and tricks have helped me answer the question of how to manage holiday stress through planning. However, there may be times when you need more help to deal with your anxiety. Finding the best cognitive behavioral therapist for you can be another important tool in your box when dealing with the holiday blues.
Earning your clinical license opens up a world of possibilities, so you want to begin gaining ASW supervision hours as soon as possible. Regardless, the process can be confusing for the best of us. Throughout my years of providing ASW and LCSW supervision, there are certain questions that I’m asked on a regular basis. Here’s a nice compilation of many of these inquiries, as well as one vital tidbit that is often overlooked:
I have all of my hours, but I’ve been putting off the exam for months/years. Is there a timeline?
So, there are a couple of key points to remember:
The 6-Year Rule-
You can spend 10+ years earning IMF/ASW supervision hours, however, the only ones that count are the ones accrued during the last 6 years.
Abandonment of Application-
You don’t want this to happen! The consequences of abandonment can range from paying a new application fee to starting from square one. Per the BBS website, the criteria for abandonment are the following:
Associate Social Worker does not submit the remaining documents or information requested in the application deficiency letter within one (1) year from the date of the deficiency letter
Applicant does not complete the application within one (1) year after it has been filed
ASW does not sit for an examination within one (1) year after being notified of initial eligibility to take the examination
Applicant does not take an examination within one (1) year from the date the applicant was notified of failing an examination
The applicant fails to pay the initial license fee within one (1) year after notification by the Board of successful completion of ASW requirements.
I’d like to obtain my ASW/LCSW supervision through video conferencing. Am I eligible?
Per the California Business and Professions Code section 4996.23 videoconferencing can be used for LCSW supervision when an intern works/volunteers at one of the following:
Any government entity
A school, college, or university
An agency that is both charitable and non-profit. You can find out if your workplace meets these criteria by checking if they are considered a ‘501(c)(3); by the IRS
The ASW supervisor is responsible for ensuring client confidentiality, including a HIPAA compliant platform for video sessions. Skype is not HIPAA compliant, but there are other programs that are- your supervisor should be able to tell you what platform they are using and how they know it’s in line with privacy regulations.
My hours are complete, and my exam is scheduled! Am I still required to maintain weekly LCSW supervision?
Until you have your license in hand, you want to complete an hour of individual or two-hours of group LCSW supervision.
Do I really have to sit for the Law and Ethics exam? Is this something I need to retake annually until I earn my license?
Yes! There are no loopholes on this one- no matter how much training and classes you have taken.
Once you pass the Law and Ethics exam, you have completed your requirement as long as you keep your license active. Get this done quickly, as you may not be able to complete your annual renewal without a passing score.
Which study guide do you recommend?
The majority of my interns recommend the Therapist Development Center (TDC) programs for both the exams. TDC not only provides materials on content but also test taking strategies that will help IMF/PCCI/ASW interns approach the exams in a logical and educated manner.
When can I start collecting LCSW Supervision hours?
It’s exciting to finally earn your graduate degree, and you’re probably chomping at the bit to start collecting hours. Many have contacted me and said, ‘I’m waiting for my BBS number, but I want to start supervision this week!’
In this case, patience is the key. Don’t spend time and money on clinical supervision until you have that intern number in hand, as hours won’t count until then.
My former supervisor can’t be found. How can I verify my hours?
At the beginning of ASW intern supervision, it’s critical that you and your supervisor create and sign the following documents, all located on the BBS’s website.
Supervisor Responsibility Statement
Any letters of agreement or other documentation agreeing to the ASW Supervisor/ Intern relationship.
Just as important, discuss how you plan to document logged hours. I encourage all of my supervisees document their hours in detail and have me initial and sign it each month.
As soon as your time with each supervisor is complete, print out the Experience Verification Form and complete this together.
ASWs are fully responsible for all original paperwork. If you follow these guidelines, you will be in good shape if for any reason you can’t connect with your previous supervisor(s)
I am the only social worker/counselor at my job. How can I earn my hours if I don’t have a clinical supervisor at my agency?
There are a lot of ASWs in a position where clinical supervision is not readily available. Fortunately, your intern supervisor does not need to be employed by your agency.
If you are the lone ranger in your company, I recommend searching out some group supervision to expand your support system, increase your exposure to new opportunities, and see what others in the field are doing. Several of my interns that were in group have helped connect one another to jobs, resources, and even have partnered in private practices!
There’s one question I’ve never been asked, but what everyone should know……
The 104- week rule
Several years ago, an ASW Intern I had been supervising for a year came to my office to get her last hours signed. She had been working with several supervisors throughout her time and worked hard to get her hours wrapped up as soon as possible, often putting in 60+ hours a week so that she could meet that 40-hour clinical max.
As we were finishing up her paperwork, we came to the realization that although she had easily met 3200 clinical hours, she was two months under the 104-week requirements. She was terribly disappointed, and we spent two more months getting those last few weeks in.
The story has a happy ending- Margaret Miller, LCSW now has a thriving private practice at my office- you can check her website out here. So now you know- in addition to the 6-year window, interns have to meet a minimum of 104 weeks of ASW supervision, so expect to spend between 2-6 years gathering your experience.
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It’s sunblock and swimsuit time in San Diego! Most of us are making sure we have our summer essentials in place, and pretty soon it will be time do your favorite summer activities! Like clockwork, my clients begin to express anxiety about an upcoming pool party or BBQ where they may be wearing a lot less than they have in the last few months. I’m getting the annual calls asking, “Can I use CBT for weight loss?”, and more often, “I can lose the weight but gain it right back, how can you help me?”.
If you’ve never lost a pound or if you’ve successfully lost weight only to gain it back, you are certainly not alone. Cutting calories, exercising more, and watching your carbs is not enough on their own. Almost everyone knows what they need to do to lose weight, but may not be clear on how to make it happen. The most powerful aspect of moving towards a healthy body is a change in mindset. Knowing that each individual has their own reasons for wanting to change, what works for one client will almost certainly not work for everyone. Creating a specific plan, tailored to your unique thought process, can make a significant difference in effective weight loss.
What is the best diet plan for weight loss?
You can use any reasonable diet you want- when you pair it with new habits of thought you will see it work. The question is not simply ‘What is the best weight loss plan?’, but rather- ‘How can I think differently about myself and my health?’. This is where cognitive behavioral therapy (CBT) comes into play, as it guides you to focus on changing your perceptions of yourself and replace sabotaging thoughts, which can lead to massive long-term changes in your health.
Do this first before anything else….
One of the first exercises I complete with clients is to create an ‘advantages’ card, which is outlined with more detail in Judith Beck’s book outlining CBT for weight loss, The Beck Diet Solution. When you write down the reasons you want to lose weight, it can really add a boost to your motivation. Looking at it a couple of times a day can build excitement in reaching your big goal. The advantages card is your ‘eyes on the prize’ reminder, and whenever you hear yourself saying “One donut won’t hurt”, you pull out your handy card out to kindly remind you what you truly want. The more you conquer your cravings, the more confident you will become in knowing you can do this!
Messed up? Excellent!
Relapse is part and parcel of changing any habit- it’s also one of the most exciting opportunities for change. Now is when your new CBT for weight loss skills are put to the test, as you begin to see how to shift your behaviors and habits that combat those negative, self-sabotaging thoughts. We only change when we are uncomfortable, so when you are struggling or simply doubting yourself this is when the magic happens. Most of us are much more capable than we give ourselves credit for; imagine how pushing yourself through this challenge will confirm strong you really are. This is the time to use your supports to boost you up and let you know you can do it!
If you’re reading this, it’s likely that you’ve already discovered that establishing weight loss plans on without outside help often doesn’t produce the results you aim for. Evaluating and making shifts in the way you look at your problem can create a long-lasting solution that will not only help you lose weight, but also help you recognize skills and resources within you that can be useful in any aspect of your life.
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