Karen Kerschmann, LCSW

Cognitive Behavioral Therapy and Clinical Supervision

 

Kerschmann & Associates

Cognitive Behavioral Therapy and  Clinical Supervision

Kerschmann & Associates

Cognitive Behavioral Therapy and  Clinical Supervision

Top 5 Mental Health Apps

Online cognitive Behavioral Therapy in California and South Dakota

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:

1. Headspace

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.

2. Youper

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.

3. FitMind

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.

4. Sanvello

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.

5. MoodKit

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.

Can’t Meditate? Think Again: 10 of the Best CBT Hacks to Shift your Brain Into Bliss

We’ve all heard that one of the greatest ways to combat everyday feelings of stress, poor concentration and anxiety is to meditate. Research has proven that this magic state literally changes our brain, as outlined in this Washington Post article. While it’s true that meditation is a powerful antidote to many of the everyday maladies of stress, it can be a real bear to figure out how to meditate in the traditional sense. As many of us experience, sitting still and trying to ‘empty your brain’ can feel downright frustrating and often people give up on the process completely.

Fortunately, science has also found ways for us to ‘hack’ our brains into a meditative state without all that sitting around. Cognitive behavioral therapists assert that to address depression, panic, and anxiety based distress, ‘behavioral activation’, which means focusing on behaviors in the present, is much more useful than absorbing yourself in feelings of anxiety, depression and other negative emotions. Active meditation, whether that means keeping your body or just your hands busy, can be a wonderful alternative for those who struggle with staying still and will provide enough distraction to quell a worried mind. Some of these ways include exercising, music, and crafting to produce the same kind of benefits to ward off unhelpful feelings and thoughts. The ultimate purpose of this ‘flow’ state is to bring your body and mind into the here and now, and there is more than one way to achieve this:

The best ways to meditate may not be what you think

1) Knitting

As it keeps your hands busy and your mind on the task, knitting gives you a break from everyday thoughts of stress and overwhelm. Focusing on the knitting process does not leave your mind much room to worry about what is going on in your life at the moment or whatever else might be bothering you. Not only that, the creative fulfillment is a significant benefit as well. You will likely finish each knitting session feeling accomplished and relaxed.  Check out this article from Jane Brody of the New York Times in support of this evidence-based approach.

2) Taking a walk

While walking, you can achieve the same quiet observation of your surroundings as you can while sitting still, except now you’re able to stay active and get movement in at the same time. Try soaking up some nature as you stroll by answering these questions as you go: What do you see? What do you hear? What do you smell?  Focusing on the sensory aspects of the experience will bring you to the present and help anxiety and distraction melt away.

3) Coloring

Last summer six of Amazon’s top 20 texts were coloring books for adults. While this is another sit-down activity, it keeps your fingers and mind busy by deciding which colors you want to use while focused on staying within the lines. Be as creative as you would like with your coloring utensils and choose a workbook that suits your personality. Here are some of those best-selling Amazon coloring books that folks are raving about.

4) Rock climbing

My personal favorite! At 41, I tagged along on a Boy Scout trip to my local climbing gym.

A CBT therapist reducing her anxiety and stress right here in San Diego.

Your local cognitive behavioral therapist reducing her anxiety and stress

While being on the wall was (initially) scary, I also discovered that my busy mind was right there on the wall with me, focusing solely on the physical and mental task at hand. Since then it’s been one of my go to workouts, and I’ve made some great friends and muscles in the process as well!

Rock climbing, whether at a facility or in the outdoors, is a great way to meditate while keeping active. You must have a significant focus on where to place your hands and feet on each of the holds to maintain a steady ascension to the top. People from all walks of life can benefit from the low impact benefits of climbing, as you can see ages 2 – 80 scaling the slopes outdoors and in.

5) Listening to music

Relaxing music often triggers the release of dopamine in your brain, creating the effect of calming you from within. This could be either slow and soft tones, classical music, or something else entirely that makes you most relaxed and calm. Want to know the top 10 most relaxing songs deemed by neuroscientists to create a 65% decrease in stress and anxiety? You can find the playlist here.

6) Martial arts

The slow, purposeful movement of martial arts is also as beneficial as meditation. You are focused on each position change while keeping it controlled and intentional. That focus required to do all this is a fantastic method of keeping your mind and body present in the here and now.

7) Fishing

Baiting the hook, casting it into the water, and waiting for a bite is another way to hack your brain into a ‘be present’ state. It also requires a certain level of patience and concentration while waiting.

Harvard Medical School published this article discussing the empirically-based benefits of fly fishing, citing that an astounding 50% of study participants could reduce their blood pressure medication after 8 weeks!

8) Crafting

‘Creating’, whether it be cooking, putting together a scrapbook or photography, can help bring an overworked mind back to center. In one of my favorite ‘go-to’ articles, ‘This is your brain on crafting’, there’s a myriad of resources and ideas regarding things to do to shift from anxious to relaxed. As reflected in the article, active meditation has been effective not only for depression and anxiety but also post-traumatic stress (PTSD), attention deficit disorder (ADD) and attention deficit/hyperactivity disorder (ADHD).

9) Yoga

Whether you are a newbie or a seasoned yogi, you concentrate on where your body is going and how it is positioned. This intense focus distracts you from everyday life, provides stress relief, and gives your body the release it needs. As something you can do Stress and anxiety can be reduced with meditative practicesalone or with a group, taking 90 seconds or 90 minutes, this is an easy activity to fit into a ‘too-busy’ schedule. Of course, the physical benefits outside of the practice are also welcome. Increased flexibility and reduced inflammation can make a big difference in levels of chronic pain, which can often contribute to a distracted mind and of course, anxiety and depression.

10) Writing/Journaling

Writing and journaling are activities that you can take part in at any time of the day, but practicing it at the end of your day is especially helpful. As you write down the positives and the negatives, focus on the positives while reflecting on learnings within the negatives.

Of course, doodling and artwork are encouraged.

Thanks for reading! I’d love to hear from anyone who experiments with some of these ideas. Do you have other active meditation ‘hacks’ for others who want to manage their stress and anxiety? Please share!

The Remarkable Connection Between Happiness and Behavior

A cognitive behavioral approach to achieve more happiness

Positive psychologists and cognitive behavioral therapists promote certain behaviors that prime the brain for happiness.

Shawn Achor is one of my personal heroes- you may have heard of him as the author of ‘The Happiness Advantage’ or through his infamous TED Talk which you can find here. After almost a half a century in the making, positive psychology is sweeping the mental health landscape and I couldn’t be more thrilled. Cognitive behavioral therapists, educators and behavioral scientists are adopting techniques, such as the ‘happiness advantage’ to help people shift their mindset towards the good.

A Cognitive Therapist’s Answer to “Why Can’t I Find Happiness?”

Happiness’ makes many think of smiles, the sunshine, material acquisitions, and absolute bliss. People often perceive ‘happy’ as being beyond our control, that it has to do with external factors or some level of intangible success. However, when you depend on external factors to reach this mysterious state, you set yourself up for fleeting joy but also long-term disappointment, which can lead to depression and anxiety.

Contentment does not have to be controlled by external factors, what you have achieved, or what you or someone else consider the ultimate success. Rather than telling yourself that happiness is something to wait for, or believing that a partner, weight loss, or more money will lead you there, you can train your brain to be positive in the here and now. According to Shawn, if your brain is focused on positivity, it performs 31% more productively than when it is negative, neutral, or stressed. With the happiness advantage, your intelligence, creativity, and energy levels rise. That said, it makes much more sense to focus on how happiness leads to success, instead of the other way around.

It makes sense that managing depression and anxiety can be approached in a different and more effective way- by creating a new internal reality. As you learn how to become more positive in the present, the solution may not seem as hard to achieve. Training your brain to be more positive is something you’ve already taught it to do other tasks until it becomes automatic. Have you ever catch your fingers hitting the ‘F’ for Facebook without even noticing? Reaching for the snooze button? These are both common examples of automatic thoughts.

Let’s Get Happy!

Over time, reversing your formula for happiness in the now and leading your brain to focus on the present and the positive aspects is a mighty force. The trick is to act differently right now, and your brain will begin to become primed for success, which means that you will be able to work harder, faster, and more intelligently in the moment as well as long-term. One of the ways that your brain can be trained is to encourage the release of dopamine, which is a vital ‘feel good’ hormone. Dopamine has two functions: first, to make you happier and second, to trigger all of your learning centers in your brain- of course, you’ve already watched Shawn Achor’s TED Talk and know this, right?

When I work with clients who are looking for solutions to anxiety or depression, I make sure I focus on behaviors instead of feelings. There are several actions that can train your brain to produce more of that precious dopamine.  Shawn asserts that if you practice a positive habit daily for 21 days in a row, you can build a habit and train your brain to be more positive. Three ways to achieve this are to:

  • Journaling- Write down one positive experience in the past 24-hours, so that your brain can relive that experience and start focusing on it. This habit teaches your brain that what you do and what actions you take each day matter.
  • Meditation- Take the time to slow down and meditate, giving your brain a chance to stop multitasking and to focus more on one task, such as the matter at hand. Opportunites to meditate are everywhere and are easier that you may think, as this article by Temma Ehrenfeld discusses.
  • Random act of kindness- Completing a conscious act of kindness can increase the dopamine levels in your brain, such as writing a positive email to a friend, praising a friend for something they accomplished, thanking someone for their support, or simply complimenting someone on their clothes or hair. Personally, this is one of my favorites. A few years ago I published an article on how volunteering can battle a sour mood. Do you live in my town of San Diego? Volunteer Match is a super way to get on it!

As the exercises above reflect, CBT helps you learn skills needed to be happier and more content. Behavioral interventions can be simple and if practiced every day, these types of activities help improve depressed moods and how to be happier in the present!

Happiness is within your control and is attainable with daily practice. Building some simple habits into your daily life will help you create that positivity and happiness that you desire. If you’ve already been influenced by Shawn Achor’s work, please comment below- I’d love to hear from you! 

Staying Grounded During Uncertain Times

Ambiguity, a sense of uncertainty about what’s going on or what might happen, is part of life. We all need to be able to tolerate ambiguity, yet this isn’t always easy. This post explores dealing with the unknowns in life and how to handle it.

What in the World is Going on Right Now? 

All around the globe, people are waiting to see what will happen after the seismic shift in the U.S. Presidential election. Many of my clients have spoken about a myriad of emotions, 3283088909_dc25f2b552_qranging from elation to grief, but all agree it’s uncomfortable to not know what might happen.

Our discomfort for not knowing is well grounded in experimental psychology. Research has shown that when given the choice, most people would prefer to receive an electrical shock immediately rather than wait and possibly be shocked later.

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”.

Two Ways to Handle Anxiety:

We can’t hope to eliminate ambiguity in our lives but we can manage our reactions to ambiguity in healthy ways using one of two techniques that the best cognitive behavioral therapists employ:

– The “Worst Case Scenario” 

This CBT technique helps clients analyze their fears and address them in a logical way.  Not knowing what will happen often leads to an unhealthy level of negative thinking and anxiety. People can be too quick to imagine horrible outcomes. The ‘Worst Case Scenario Technique’ is a seven-step process that individuals can use to confront and manage their fears about the outcome of an event, big or small. The technique can be summarized this way:

1. Picture one of your worries

2. Identify worries associated with that event.

3. List the worries that come from that worry.

4. Use if/then thinking to deal with each worry.

5. Acknowledge your ability to cope with the outcome.

6. Work out how you would handle a “worst case scenario” if it happens.

7. Choose a final image or phrase to use against your worries.

–  The A.C.C.E.P.T.S  Technique

If you find that your rumination is unproductive or gets in the way of doing things you enjoy, temporary distractions can be immensely useful. When there is no way to control an outcome and you find yourself emotionally flooded, it’s time to shift course to a more productive way of doing things. Consciously choosing to focus on something for a time gives your mind some rest and relief. The acronym A.C.C.E.P.T.S stands for distraction techniques individuals can use to feel better fast:

1. Activities – Do some housework or go for a walk.

2. Contributing – Do a little volunteer work

3. Comparisons – Compare your new self to your old self, or yourself to others.

4. Emotions – Do something to evoke the opposite of a negative emotion.

5. Pushing Away – Consciously push the distressing thoughts away.

6. Thoughts – Think about anything else that you can concentrate on.

7. Sensations – Do something positive to engage your senses.

Learn to use one or two of those strategies whenever ongoing ambiguity becomes a real burden. While practicing under the guidance of a therapist can be useful, the techniques themselves are easy to understand.

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.

Take the Quiz

Life is full of suspense….. Public reactions to the 2016 presidential election make it clear that uncertainty about the future can throw the best of us. We all face personal circumstances that create unhelpful worry and stress. If so, using distraction techniques or working out the worst case scenario and how you can respond constructively can be key cognitive behavioral therapy interventions that you can use to help you feel more grounded and engaged with the real world.

Cognitive Behavioral Therapy for Anxiety

Can Cognitive Behavioral Therapy (CBT) Treat Anxiety?

Anxiety is a feeling of worry, restlessness or uneasiness that typically occurs when we are faced with an imminent situation or one that we have little control over. While it is normal, and even helpful, to experience some level of anxiety from time to time, problems occur when anxiety is out of control, causes phobias or makes it difficult for you to live a productive and healthy life, hold a job or maintain important relationships.

Anxiety causes emotional strain on the individual, and it can also manifest physically in a variety of ways including causing shortness of breath, an irregular heartbeat, gastric and intestinal distress, insomnia, sweating, trembling and dizziness. In some cases, these physical conditions can only be controlled with medication, but in most cases, they can be effectively treated by managing your anxiety by enlisting a cognitive therapist.

Cognitive Behavioral Therapy for Anxiety

When a cognitive behavioral therapist addresses anxiety we approach the problem from many different angles and target three areas in particular:

  • Our emotions
  • Our behaviors
  • Our thoughts

In addition to addressing the biological and environmental components of one’s life, Cognitive behavioral therapy (CBT) is an effective intervention that addresses all three of these areas. It helps individuals to become aware of their negative thought patterns and self-doubt, learn how to behave proactively when faced with anxiety-inducing situations and feel empowered to utilize their most effective coping strategies as well as develop new ones.

Cognitive Components that Impact Anxiety

Cognitive behavioral therapy provides clients with opportunities to openly examine their own thoughts and uncover beliefs that may be unhelpful. Examples of this include realizing that you think you will fail at a job interview before it begins (catastrophization) or believing that a car crash is imminent anytime you get behind the wheel (fortune telling). This discovery process provides opportunities for change which through confronting one’s faulty logic. Cognitive recognition also provides clients with a clearer understanding of how beliefs influence their mental and physical state when certain situations present themselves. It can also alter ‘self-talk’ and replace it with kinder, more loving and forgiving dialogue that decreases anxiety and increases opportunities for success.

Behaviors and Anxiety

Cognitive behavioral therapy examines how individuals act when faced with a specific situation. The goal is to identify and shift maladaptive habits that people with social anxiety or other anxiety disorders tend to repeat and sabotage potential. Clients are then provided with behavioral experiments to change behavioral patterns and adopt effective coping mechanisms to use in a variety of anxiety-inducing situations.

Changing Emotions

Cognitive behavioral therapy offers opportunities for clients to consider how their thoughts and actions make them feel. By changing how you think about an anxiety-provoking situation and how you act when faced with it, you can change the way that you feel about that situation and sometimes, turn it into a situation that you can turn down the volume of your anxious feelings. This can be a powerful discovery and one that teaches clients how to actively participate in choosing how they will react and what their path will be.

Reach Goals Sooner with Cognitive Behavioral Therapy

With cognitive behavioral therapy, clients often see results in as little as a few sessions. This is a major advantage because it has the potential to increase their confidence level and cause them to believe that they can overcome unhealthy anxiety. With their newfound hopefulness, many move forward in a more positive direction and achieve a sense of calm when faced with situations that previously triggered intense anxiety.

Trust and a Strong Client / Therapist Relationship

For cognitive behavioral therapy to be the most effective, it is important that the client is comfortable with the psychotherapist. This is especially true for clients who are prone to extreme anxiety when situations leave them feeling uncomfortable. The highest level of comfort often develops naturally when the therapist treats the client as an equal and an integral part of the healing process. Effective therapists include clients in developing their treatment plan and ask for feedback after every therapy session. Therapists must also realize that each client is an individual, and no one treatment plan will work for every person. This type of attitude fosters mutual respect and cooperation between the therapist and the client. It also increases feelings of hopefulness and curiosity about the potential for therapy that can reduce the number of sessions it takes to reach the client’s goals of reducing or eliminating anxiety and increase opportunities for success.

Anxiety disorders can take over your life and have a crippling effect on your ability to realize happiness but are also one of the most treatable conditions in the mental health spectrum. You can take positive steps to change how you react to stressful situations. As a licensed psychotherapist in San Diego, cognitive behavioral therapy is one solution that I most often recommend to help clients with anxiety walk the path toward happier, more productive lives. If the time is right to realize positive change in your life, contact me to schedule a consultation.

Individual Therapy in San Diego- CBT

Adults Face Challenges and Seek Solutions: Individual Therapy in San Diego

Today, adults encounter numerous challenges in their daily lives. Demanding schedules, the constant effort to maintain work-life balance, and rising mental health concerns drive more individuals to seek individual therapy for support. With the guidance of a skilled mental health professional, adults can tackle their problems, refine coping techniques, and leverage their strengths to lead healthier, happier lives.

A Journey to a Healthier, Happier Life

Many people avoid individual therapy, associating it with weakness or inferiority. In reality, seeking help demonstrates strength and a willingness to take responsibility for life’s challenges while pursuing positive change. An adult therapist offers valuable support and insight, helping clients identify their strengths and overcome barriers to happiness.

Cognitive Behavioral Individual Therapy: A Proven Method

Cognitive Behavioral Therapy (CBT) consistently proves effective in addressing adult mental health concerns. This collaborative approach between therapist and client builds on empathy, warmth, and authenticity. CBT focuses on clearly understanding problems and creating actionable steps to resolve them, breaking negative patterns.

Goal-oriented, directive, and time-limited, CBT encourages individuals to actively work toward solutions. Studies show CBT often yields significant improvements in 16 sessions or fewer, delivering results faster than many other therapeutic methods. Successful CBT fosters positive life changes, helping adults build a more fulfilling lifestyle.

Adults Face Challenges and Seek Solutions

Today, adults encounter numerous challenges in their daily lives. Demanding schedules, the constant effort to maintain work-life balance, and rising mental health concerns drive more individuals to seek therapeutic support. With the guidance of a skilled mental health professional, adults can tackle their problems, refine coping techniques, and leverage their strengths to lead healthier, happier lives.

A Journey to a Healthier, Happier Life

Many people avoid therapy, associating it with weakness or inferiority. In reality, seeking help demonstrates strength and a willingness to take responsibility for life’s challenges while pursuing positive change. An adult therapist offers valuable support and insight, helping clients identify their strengths and overcome barriers to happiness.

Applications of CBT

Initially developed to treat depression and anxiety, CBT now addresses a broader range of issues, including eating disorders, substance abuse, sleep disorders, PTSD, and ADHD. The process begins by identifying harmful thought patterns.

For example, someone with ADHD might believe they are “not good enough” due to academic struggles. A person with anxiety may assume constant danger. CBT challenges these thoughts, helping clients adopt realistic perspectives and develop healthier self-images. Through this process, clients reshape thoughts, feelings, and behaviors, creating lasting positive change.

Empowering Change Through CBT

As a professional psychotherapist in San Diego, I have seen firsthand the transformative impact of CBT on adults. My goal is to empower clients to recognize and overcome barriers using their inner strengths. If you are ready to address life’s challenges and embrace a happier future, contact my office today to schedule a free CBT consultation. Together, we can build a brighter tomorrow.

Goal-oriented, directive, and time-limited, CBT encourages individuals to actively work toward solutions. Studies show CBT often yields significant improvements in 16 sessions or fewer, delivering results faster than many other therapeutic methods. Successful CBT fosters positive life changes, helping adults build a more fulfilling lifestyle.

The Role of a Skilled Individual Therapist

To maximize CBT’s effectiveness, clients should work with an experienced therapist. A qualified professional conducts an initial consultation to identify barriers and then tailors sessions to address those challenges. This personalized approach empowers clients to feel confident and successful throughout therapy.

Integrating CBT with Other Treatments

CBT may be used alone or alongside medications, depending on individual needs. Consulting a qualified mental health professional ensures clients receive the right therapies to achieve the best results.

Empowering Change Through CBT

As a professional psychotherapist in San Diego, I have seen firsthand the transformative impact of CBT on adults. I aim to empower clients to recognize and overcome barriers using their inner strengths. If you are ready to address life’s challenges and embrace a happier future, contact my office today to schedule a free CBT consultation. Together, we can build a brighter tomorrow.