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

CBT for Weight Loss: Do You what it Takes to Succeed at Losing Weight?

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?

CBT is one of the best ways to lose weightYou 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:

Cognitive Behavioral Therapy for Weight Loss

Two Simple Approaches to Get Out of the Power Struggle with your Teen

positive-parentingPlenty of parents call me this time of year, exhausted and tell me, “my teen needs therapy stat!” or “I was fine raising my child but now that he/she’s an adolescent I’m at a loss”. Parenting a teenager is a new and scary experience for most, and to shift how you interact with your children can be a difficult. The good news is there are some parenting techniques for teens that can help you successfully build family harmony and a healthy, independent young adult.

As children get older, they test boundaries much more often. This can be challenging at times, and that is why it is extremely important to build structure when parenting a teenager. They need someone to guide them without being smothering. So, instead of constantly guiding them by the hand on a path that should be their own, you can see yourself to be like the railing of a bridge. You can be there to make sure they don’t crash over the side while also being the guiding force that they desperately need.

Teenagers thrive with a positive method of parenting so they feel independent, as well as heard and supported. They may not voice it, but the support and guidance you provide as a parent is appreciated. When I hear kids say their parents are ‘getting in their face’ and ‘nagging’, they often become resentful and will refuse to cooperate simply to win.. The more they feel confronted or attacked, the more they will retreat away from you. Building structure for any child often means setting boundaries and being there for them in the way that they need. As you play the role of the railing of the bridge, keeping them on the right track but not guiding them by the hand, they will figure more out on their own and gain valuable life skills.

How do you Become the Rail and Stay off the Road?

As a parent coach, here are a couple of skills my clients have reported as the most effective ways to communicate with their kiddos:

The When/Then Technique

 Using the when/then parenting skill in situations that would normally end in a power struggle and screaming match. The when/then technique was popularized by Amy McCready, founder of Positive Parenting Solutions, and works as a way of replacing the word if, with when, while directing your child to do what you request of them. “If” gives a teenager the illusion that they have a choice, while the word “when” implies that they have no choice but to comply with what you’ve told them to do. For example, saying, “When you do the dishes, then you can go out with your friends.” There is a reward built into it, which is also useful as positive reinforcement. Using this method means there is no yelling, just a simple restructuring of phrases. They will understand that when they do what you want them to do, then they can do what they want to do.

The Broken Record Technique

Applying the broken record parenting technique, especially when you want to keep your teenager safe. Instead of debating or arguing with them, you repeat the same instructions over and over until they do what they are told. This shows them that you know what is best for them, and that they need to comply before they get to do anything else. If you don’t change your request, they will come to realize that you mean business and they aren’t going to be allowed to break the rules. You are keeping them safe and happy, and showing them that you mean what you say.

Yelling and battling is exhausting- it may produce short-term results, but in the long term won’t move your child towards success. Building structure, creating boundaries, and utilizing positive reinforcement can go a long way in helping your teen become a better person and have a smoother life all around. They need your love and guidance more than anything else at this time in their lives, as they figure out who they are and what their purpose is. So in focusing on your role as the railings of a bridge as a tool for positive parenting, you will give them exactly what they need to shape themselves and learn how to function in the world.

FAQs: Receiving Clinical Supervision Online

In the State of California, most Associates (AMFT, ASW, APCC) can receive their supervision via teleconferencing. This move is allowing interns to break some of the past barriers to obtaining hours, and also grants more freedom to find a clinical supervisor that meets your needs….regardless of distance!

Am I able to receive supervision via videoconferencing?

Per the California Board of Behavioral Sciences, if you are working for a non-profit charity you are able to obtain your supervision through teleconferencing. Governmental entities, colleges, universities and most schools also meet this criterion.

The American Association of Marriage and Family Therapy (AAMFT), the National Association of Social Workers (NASW) and the California Association of Professional Clinical Counselors (CALPCC) have all recognized the value of using videoconferencing in supervision as well as therapy.

How do I know that my supervision is confidential and follows HIPAA regulations?

As with all intern supervision, a letter of agreement will be signed by all members establishing confidentiality in group sessions, with the exception of mandated reporting. Sessions will be held through VSee, a videoconferencing platform designed specifically for HIPAA compliant sessions. VSee is free for interns to download and use.

 How much does supervision cost?

Most LCSW intern supervision can be completed online in California

ASW Supervision throughout California

One hour of individual supervision is $100

Two hours of group supervision is $80

How many hours can I complete under group supervision?

For Associate Social Workers (ASWs), Marriage and Family Associates (AMFTs) as well as Associate Professional Clinical Counselors (APCCs), groups will satisfy up to 52 of the 104 required weeks of supervision.

What is covered in the group process?

Most interns I have worked with come with various levels of competence and needs depending on their professional responsibilities and career trajectory. I create a plan with you at the beginning of supervision to establish your professional goals and what skills are needed to reach them, as well as how to know when they have been met. Each plan addresses all of the following areas of competency: Biopsychosocial and risk assessment, ICD-10 and DSM-5 diagnostics, treatment plan development, cultural competency, therapeutic interventions, developmental theories, community resource coordination as well as legal and ethical standards.

The California Board of Behavioral Sciences Board Examinations is broad and covers what each LPCC, LCSW and MFT should know as a licensed practitioner. The general content in each exam is addressed consistently throughout our work together. It’s strongly encouraged that you use one another to build ‘study teams’ when you are six months away from your first test.

What are the expectations of each participant?

The goal of supervision is to increase your clinical acumen and skill; my job is to ensure that you receive a rich and collaborative environment to do so. Group work provides a unique opportunity to receive constructive feedback and ideas from a diverse group of peers. It is expected that all participants will take turns presenting case consult as well as provide helpful input during to others. There will be times that either one of us may request an individual session as appropriate.

My goal for all interns who come for supervision is to create a stimulating, safe environment that encourages open thought and professional growth. Group supervision is a place where you can feel free to ask questions and to come to a better understanding of how to best help your clients. You can be assured that we will work specifically on cases that you bring to the session and address the clinical issues of your clients, and help you reach your goals.

Interested in reading more? Click on these links below for additional information:

Clinical Supervision for ASWs and IMFs

LCSW and MFT Supervision: 8 Answers to Common Questions

MFT – LPCC – LCSW Supervision

Frequently Asked Questions about Cognitive Behavioral Therapy

FAQs about Cognitive Behavioral Therapy (CBT) in San Diego

Frequently Asked Questions about Cognitive Behavioral Therapy

Over the years, I’ve found that there are some frequently asked questions about Cognitive Behavioral Therapy and how it works. Here are the most popular inquiries.

What is Cognitive Behavioral Therapy (CBT)?

The theory behind cognitive behavioral therapy is that the relationship between thoughts, behaviors, and feelings dictates how we function. By identifying unhelpful thoughts or habits and replacing them with more helpful messages, positive changes are created.

Other modalities under the CBT umbrella are Dialectical Behavioral Therapy (DBT), Trauma-Focused CBT (TF-CBT), Acceptance and Commitment Therapy (ACT), Cognitive Therapy (CT), Behavioral Therapy, Mindfulness-Based Cognitive Therapy (MBCT), and Integrative Couples Behavior Therapy (ICBT).

Is it a good fit for my needs?

Research has established that cognitive therapy is useful for a large array of issues such as depression and anxiety, phobias, obsessive-compulsive disorder, insomnia and pain management. Trauma-focused CBT has been proven effective for PTSD and is used in many counseling programs.

What is the research regarding CBT’s effectiveness?

Ongoing and substantial work continues to reflect efficacy for a multitude of mental health issues.  Funded by the National Institute of Health, a review of the research on identified therapeutic approaches asserts cognitive behavioral therapy is one of the most effective interventions for short and long-term benefits.

The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses (2012)

How does CBT help me in the long term?

The reason that cognitive therapy fares so well in long-term studies is that it provides tools that the client can generalize to future challenges. Most people report finding that using the techniques in other aspects of their life becomes quite natural after practice.

How long until I see results?

When you see a cognitive behavioral therapist, you and the clinician work as a team to help you change your presenting problems. The more you work outside of the sessions by doing your homework, the faster you will make improvements. Many clients report a shift within the first week.