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!
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.
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’
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.
Stop Comparing
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.
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.
Like this article about CBT for weight loss? Here are a few similar blogs from the archive:
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.
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.
Part 1: Start Now, Not Later 
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.