FYI- Many insurance companies are waiving copayments for their clients who want to receive online therapy. 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 where 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 in your 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, allowing you to contact them weekly. 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. To augment services, online therapy can fold in mental health apps as well.
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’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:
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.
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.
‘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 alone 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!
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 is a similar blog from the archive:
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’sGet 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!
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, ranging 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.
“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.
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.
alone 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. 
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. 
ranging from elation to grief, but all agree it’s uncomfortable to not know what might happen.