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10 Ways to Get the Most out of Therapy

So you’ve decided to start counseling, or maybe you’ve been going to counseling for years. Take a look at these 10 Ways to Get the Most out of Therapy: 

 

1. Keep a journal for all things therapy and bring it to your sessions: 

A journal is a great place for you to continue processing after a session, between sessions, or during session. Keeping one journal specifically for your therapeutic journey can also help show you the transformation that you have made. 

 

3. Write down important thoughts and phrases while with your therapists - and at other times. 

This one can be especially helpful during sessions; maybe your therapist says something that really sticks out to you-make a note about it so you don’t forget. Then, you can look at your journal throughout the week and be reminded of that important thing you realized, that nugget of truth you need to meditate on, that encouragement you need to remember before a difficult conversation, etc. 

 

 

2. Make a list of things to discuss with your counselor between sessions

You walk out of your therapy session and think shoot, I can’t believe I forgot to talk about… write it down! You get in an argument with your significant other and just can’t figure out why  what they said bothered you so much...write it down! You’re stuck in traffic and you remember something that has really been bothering you...wait till you park and write it down! In all seriousness, writing down what you feel is most important to talk about between your sessions can help to make each session productive. During your few minutes in the waiting room you can look back over your list and prioritize which items are most pressing or most important to get to during session. 

 

 

 

4. Set goals for counseling-and stick to them!

At the beginning of your first session the therapist usually asks something like: “What are your goals for counseling?” It’s important to set goals so that your therapist knows how to structure sessions and promote the positive change you need.  Sticking to your goals can help you maintain focus between sessions and during sessions. It may also be important to revisit goals periodically with your therapist as you change, situations change, and your needs change. 

 

5. Ask questions

If you think of a question about the session, what you are experiencing, or about therapy in general feel free to ask! Questions are great, and getting answers can help to relieve worries or stress that have been burdening you. Also remember that sessions are a safe place to ask questions and to wonder about things--judgment free. 

 

6. Talk about what really bothering you at the beginning of the session

This is a hard one. So often clients are worried or embarrassed about something that feels huge and they put off talking about it until the last ten minutes of the session. This may feel safe, because if you feel embarrassed or insecure about the subject you know you can leave right away; however, this doesn’t allow enough time to work through the item. If you find yourself looking at the clock, itching to say something, but waiting until the minute hand hits the nine, take deep breath and let it out. Just say what you’ve been so anxiously holding in. If you know going into a session that there is something you need to share but don’t want to share, take a moment in the waiting room to prepare yourself to share it in the first five minutes. Really, once it’s out there you’ll feel relieved. 

 

7. Don’t be passive, take control of your counseling

This is your time, your session, and your life--take charge! Often we think therapy is a quick and easy fix, I go to a few sessions someone tells me what I’m doing wrong and I fix it or the therapist fixes me. This isn’t true, therapy is work, good work, and we have to take charge to do the work ourselves. Taking charge can look like: completing your homework between sessions, being actively involved in scheduling your next session, bringing up your goals in session, etc. 

 

8. Be honest, therapy is a no-judgment zone, lying to your therapist only hurts you

Lying to your therapist is like telling your significant other that you’re not allergic to gluten when you are. Now, when your significant other makes you a pasta dinner complete with homemade garlic bread, bruschetta, and a strawberry shortcake dessert to celebrate your birthday you have two options: eat the gluten and end up sick or come clean and end up embarrassed. 

 

9. Do the work outside of session: you get out what you put in

This includes doing homework, reviewing notes from sessions, and applying positive change to your daily life. While from your therapist’s perspective the session is more like Vegas (that is, what you say in session stays in session), you have to take your session home with you and continue to do the work outside of session.

 

10. Sit with the question and say what comes up (even if it doesn’t make any sense)

Your therapist asks you a question you don’t know how to answer, instead of saying, “I don’t know”, sit with the question. Give yourself time to processes what’s going on. Take a moment to think about what could be the answer and say whatever comes to mind, even if it doesn’t seem to make sense. Why do we do this? Because sometimes your brain knows more about what you need than you do and this allows you the opportunity to talk about and process what you need to talk about. 

 

 

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Stages of Change

 

 

Change can be a difficult thing deal with, even more difficult is changing yourself: your habits, your routines, and your lifestyle.  What leads a person to change? It could be a new achievement, a loss, a trip to the ER, or a mundane event throughout the day.

When it comes to personal change, there are a few steps that we progress through: precontemplation, contemplation, determination, action, and maintenance which can lead to a permanent exit or often relapse. Do you think you are ready to make a change in your life? Are you finally so frustrated that your determination can push you to action? Take a look at the stages of change to see where you are and help motivate you to take the steps you need to finally make that change stick!

stages of change

 

Precontemplation is the stage where you don’t see the behavior as a problem for you, even if others do; basically, you’re not even thinking about making a change. This could be how you feel about exercise until you see a compelling Facebook post from your best friend.

Contemplation is the stage where you may be aware of the ‘problem’ but you haven’t fully made the decision to change. Those in contemplation are considering a change and weighing the pros and cons; you may even try out a new behavior without committing to a change.

Preparation or Determination is the stage where you commit to the change and start making a plan for success. This sometimes occurs as a result of some other life event; a family member diagnosed with lung cancer can encourage one to stop smoking.

In the Action stage, things start changing; you’re putting your plan into action and making a change. The new behavior is very conscious in this stage and not yet a habit (but you’re making it one!). This is the point where you start your new workout plan and are choosing to follow through with it.

The Maintenance stage requires less effort in making a change, but rather awareness to prevent a relapse. Coaches and change theorists discuss the differences between a slip or lapse and a relapse. In the Maintenance stage you are likely feeling more confident and your new behavior is a habit. Just like any habit, there are days when things don’t go as planned; in this stage you are maintaining your new habit, making sure you get back to it the next day.

Termination or a Permanent Exit is when the new habit is now a permanent change.

What stage do you find yourself in? What push do you need to get to the next level? What changes have you been avoiding that could be a huge help in your life? Maybe it’s creating boundaries in an unhealthy relationship, quitting a bad habit, cutting an addiction, making healthier lifestyle choices, spending more time with loved ones, or creating some self-care routines. We all have changes that we can make to our routines, habits, and lifestyles that can produce positive growth. It’s about time we started making some of those changes!


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Winner, Winner We Picked Dinner: Solving the Perpetual Problem of Where to Eat.

We’ve all experienced a situation like this: it’s six o’clock and there’s nothing at the house, it’s your anniversary or time to celebrate a new milestone, and you can’t agree on where to go out to eat. You really want to go to a new restaurant down the street, and your partner really wants to go to the same restaurant you always seem to go to. You’re tired of the same old thing; they don’t want something new, what do you do? It might look something like this: 

Partner: “I really want to go to 317 Burger”

You: “We go to 317 Burger all the time, I’m sick of it. I want to go to Hacienda.”

Partner: “You know I hate Mexican food, why would you even suggest that? I thought we were celebrating my promotion.” 

Now, let’s take a moment to pause here. At this point both you and your partner are frustrated, you might even be on the brink of a fight that keeps you from going anywhere or celebrating anything that evening. You don’t feel heard, your partner doesn’t feel heard, and everyone is on the defense. 

As trivial as choosing a place to eat might seem it can really become a big deal. It’s not simple because we often don’t express what we truly want and why, and we aren’t always the best mind readers either. So next time you find yourself in an all-out war about your dinner plans take a moment to find out what your partner is really saying and to express what you really mean. That could look something like this: 

Partner: “I really want to go to 317 Burger.”

You: “You really want to go to 317 Burger, what makes you want to go there?”

Partner: “A burger sounds really good today.”

You: “Oh, you’re in the mood for a good burger. I don’t really feel up for burgers tonight.”

Partner: “Well, what do you want?”

You: “Mexican food sounds really good.”

Partner: “I don’t like any of the Mexican restaurants.”

You: “Well, is there a place that has Mexican food and burgers?” 

Partner: “Umm...we really like Chili’s, they have burgers and Mexican.”

You: “Oh! You’re right, how about we go there?”

Partner: “Sounds good to me”

You go off to enjoy the best plate of fajitas you have had in a while and your partner gets to enjoy a juicy barbeque burger (with the onion strings, of course). Maybe you even share chips and salsa or some of your partners perfectly seasoned fries. To top the evening off, you and your partner split a freshly baked chocolate chip skillet cookie topped with ice cream and chocolate sauce in celebration of your partner’s promotion--certainly a fun night to be remembered. 

What’s helpful about this dialogue is that when both individuals get to express the kind of food that they really want the situation becomes a win-win; everyone is heard and valued, and the relationship is supported. Often in relationships we settle for compromise. We settle for meeting halfway between what each person wants. We settle for doing it your way this time and my way next time. We settle for poor communication. If we approach the conflict or disagreement with meaningful communication, we would both be able to walk away satisfied and encouraged in the relationship. 

 

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Are You Feeling the Post-Wedding Blues?

Wedding season is winding down according to my seamstress who only has 20 dresses left to be altered. After your “I dos” and honeymoon, you may feel like you are crashing from a high, the culmination of many months (or years) of planning, being the center of attention and making all your dreams come true. Even though, you are now married to the man of your dreams and practicing signing your new last name, you may find yourself suffering from a post-wedding let down. 

Why do we experience post-wedding blues?

Marriage is real and not a fairy tale - it probably isn’t all you imagined it would be. Marriage is hard. You are going to fight and you are going to hurt. Couples who don’t live together before getting married may find their soul-mates have habits that irritate them to the core or ways of doing things that are in direct opposition to how you prefer to do things. You may be disappointed to learn some of these minor conflicts.  

During premarital counseling one of the biggest relationship stressors we discuss is wedding planning. As fun as it may be, it isn’t easy. There are appointments to be had and decisions to make, money to spend and crafts to be completed, deadlines to meet and professionals to hire. For many couples, family involvement can exacerbate this stress. Living with the extra stress of wedding planning for weeks or months has left you exhausted and lowered your immune system. You have probably be living on far less sleep than you actually need and the health of your diet may be questionable - either from stress-eating or from caloric restriction. You may look perfect on your wedding day, but emotionally you are hardly in the best place that you can be - no matter how happy the day is. Immediately following the wedding you rush off on your honeymoon adding travel stressors, jet lag, digestion problems, etc. Once you arrive home ready to start your happily ever after, things don’t get any less stressful because now you have a list of urgent tasks that you put on the back burner until after the wedding.

Now that you can cross "get married" off your list of "Life’s Major Goals", what’s next? We function better emotionally when we have something to anticipate and a goal towards which to strive. You may be left feeling like you have no purpose or any important goals in your life after completing such a major life milestone. Some will immediately start trying to start a family to avoid this feeling. While children are a blessing, research has shown that they don’t actually make us happier. 

The Post-wedding Blues occur for many brides regardless of the season, but it doesn’t help that the wedding season ends right as the seasonal depression season begins. Those who are susceptible to seasonal depression may be more likely to experience post-wedding blues.

How can you get over the post-wedding blues? 

Schedule things to look forward to doing or experiencing. The first step is circling important dates already on your calendar like holidays, traveling for conferences, etc. You may need to add some new things to your calendar as well. A spa day with your mom and/or maid of honor to thank her for all her help with the wedding is one of my favorite ideas. The massage and relaxation is good for both of you. Is it time to set a new goal like running your first 5k or half marathon and capitalize on all the hours you have invested in pre-wedding workouts. 

Don’t stop working out! You have more time now, so capitalize on your momentum. Exercise is extremely important for both physical and emotional health. The chemical release of endorphins can increase your energy and mood. It will also likely improve your sleep.

Whether it was eager anticipation that kept you awake or tying bows and stamping envelopes, you are likely at least a little sleep-deprived. Sleep is also extremely important to both physical and emotional health. Having enough physical energy helps feed our emotional energy. Without enough sleep not only is your energy lower, but your immunity is lowered, your ability to learn and remember is decreased, and your mental processing slows. Our brains use dreams to help us process through some of the difficulty mental and emotional moments in our days, as long as we are getting enough sleep. Start by making sure you are in bed for enough hours and your sleep environment is comfortable and clean. There are several behavioral tweaks you can make if you are having trouble falling asleep or staying asleep. 

Like exercise, sex and/or orgasm can release endorphins, and there are plenty of other benefits as well. Each of us needs daily physical touch anyway. You are a newlywed, you don't need another excuse; get it on. 

You may be tempted to take on another major project but make sure that everything else is in order first. You may miss the excitement of event planning, but another big project may be more overwhelming than mood improving. I am sure you have plenty of smaller projects to complete. Have you sent all your thank you cards? Returned duplicate gifts? Left social media reviews for the professionals who helped make your wedding the best day ever? Cleaned out your closets? Sold all the leftover wedding decorations? Next year you can volunteer your new event planning skills for a fundraiser for a local nonprofit or cause. 

If you need a new project, let it be your marriage. Read some relationship books and establish loving habits that will strengthen your marriage. Make dating your spouse your new hobby. Don't wait until things aren't going well to try to work on your marriage. Maybe you won't ever have to call me for couples counseling, although many happy couples do just to help facilitate difficult conversations.  

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Now Available: It's Not About You

It is a story as old as time; I saw a need, I even suggested others meet that need, but eventually I realized if it was going to come to fruition, I had to make it happen. This book is my answer to that need. It is a labor of love for me, love for my clients and love for all of those in the adoption triad. 

As a therapist, it is an honor to bare witness to someone’s story; sometimes I am the only witness they will allow, and I know my role is sacred. It is from this privilege that this book was formed. I have sat with adoptees struggling to explain to others, particularly their parents, the need for information regarding their biological family. I have often wished for a book that they could hand to their parents that would explain how innate this drive really is. The desire for information has nothing to do with parenting or personality. I have explained this to adoptive parents, yet wished they had a resource to help them feel less alone in their emotional journey through their child’s search. I have listened to birth parents who do not know how to process a child searching for them, some fearing judgement. It is from these experiences that this book with born. 

As an editor, it is my honor to present to you a variety of stories on the topic of search, reunion, and open adoption, calling on all members of the adoption triad and those involved with both domestic and international adoptions. I present these stories to you, birth and adoptive parents, as comfort; I want you to know, understand, and find peace in the fact that it’s not about you. Those words, “it’s not about you” can be read as snotty or comforting. There are times I wanted to take a birth or adoptive parent by the shoulders, look them in the eyes, and make it clear that it’s not about you, and you need to quit making it about you because it does not help you or your (adult) child. There are just as many times that I wanted to assure some that it’s not about you and this drive to search does not mean that you made good choices or bad choices, that your (adult) child sees you as a good parent or a bad parent; you are not evaluated at all, rather this drive is inherent, expected, and natural for all human beings whether adopted or not. The title of this book can be both inflammatory and comforting. I believe different people need to read it different ways. I hope you understand it in the way that is most helpful to you.

The voices in this book include people I admire, people I have worked with, people I call friends, and some I am just getting to know. I hope this book opens the door for you to understand the depth of what adoptee search, reunion, and open adoption is about even if it is not about you. 

 

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Do You Accept Insurance? Why I don't & the Implications of Trumpcare

One common question I hear from prospective clients is “Do you accept insurance?” Or I see posts in therapist-only groups asking for someone who takes X insurance on Y side of town and has appointments at a certain time. Sadly, I see too many people choose a therapist based on insurance coverage rather than experience and expertise. There are four main reasons I do not accept insurance:

Dangers of Diagnosis

Under the Affordable Care Act (ACA) or Obamacare, health insurance plans were required to cover mental health conditions. Many prospective clients wish to utilize those benefits without considering the hidden costs. A diagnosis is required by insurance companies to fund treatment. Even if you qualify for a diagnosis it is not always necessary, and it can be detrimental. A diagnosis helps healthcare providers quickly understand a cluster of symptoms and proper treatment, but those undergoing counseling don’t often bring other providers into the mix. When a client chooses to see a psychiatrist or medical doctor for medications, that professional will do his or her own assessment and rarely ask for my input even if I have been seeing someone for quite a while. A diagnosis of Major Depressive Disorder has been known to make it difficult to impossible to obtain life insurance, even when the diagnosis is more than a decade old. While Obamacare allows for coverage of pre-existing conditions, new legislation may not, so you may be denied coverage for further treatment. If the Affordable Care Act truly does go through Repeal and Replace, there may be even more costs beyond increased life insurance premiums. Now those same diagnoses that seemed to make counseling more affordable, could increase your medical insurance premiums, costing you more each month. The list of pre-existing conditions considered for American Health Care Act also known as Trumpcare include the most commonly used diagnoses in counseling, including anxiety, depression, ADHD, addictions, etc.

Individualized Treatment

Insurance companies set limits on treatment, rather than considering an individual’s situation and needs. Years ago when I worked in a community mental health center that did accept insurance, I had to literally argue with an insurance company that was trying to require a specific type of counseling that could have been traumatic to the child with whom I was working. We are all complicated, messy, and fascinating which is one of the reasons I love what I do. It is also the reason I am aware that each client is their own case, and I will work to address their unique challenge or situation in the treatment and timetable that brings results for them. 

More Time With Clients

A therapeutic hour typically is a 50-minute hour. The left over ten minutes is not enough time for the therapist to complete the notes required by the insurance company and submit the forms requesting reimbursement. By not filing insurance claims, I have more time available per week to see clients, answer their emails, meet with other professionals who may be helpful to my clients in times of crisis, and yes, I work on my books. It also affords me the flexibility in scheduling extra time, such as 90 minute appointments, or fit in an urgent counseling need. I utilize a full hour (or 90 minutes) for appointments. 

Ethics & Honesty

Beyond the hidden costs of adding a diagnosis to your permanent medical record, I find it unethical to give a diagnosis to someone who does not qualify for a diagnosis simply so the insurance company will fund counseling. Most insurance companies will not fund marital counseling for couples. To receive reimbursement from the insurance company some therapists will identify one partner as the client and report a diagnosis for him or her and bill for family therapy with the patient present. I am not interested in working the system. I want to spend my energy working with my clients. 

More than ever, I believe not accepting insurance reimbursements better serves my clients and allows me to provide services to a wider range of clients regardless of their coverage.  Many are surprised to learn that seeking treatment without insurance reimbursement or paying “out of pocket” is affordable and allows for greater flexibility in terms of treatment schedules and length of care.  My clients are always welcome to apply for direct reimbursement from their insurance company for out of network benefits. I accept payments via cash, checks, credit cards, and HSA (health savings account), and I offer a fee reduction based on household income, as well as the opportunity to work with interns under my supervision. The most current Fee Reduction Contract and sliding scale can be found here. It is also possible to deduct medical expenses, including counseling, from your taxes. 

Regardless of the future of the health insurance structure, your best possible option may be direct pay. It allows you to be in control of frequency, length of treatment, and selecting the best provider for you.

 

 

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Brainspotting vs. EMDR: Differences in Power Therapies

Brain-based therapy techniques can help clients experience unique breakthroughs during their sessions - especially when traditional “talk therapy” methods are at a standstill.  Sometimes referred to as “power therapies,” these newer methods work to unlock creativity, process through past trauma, and otherwise make some truly significant progress with your therapist.

The “power therapies” EMDR and Brainspotting have been developed around the client’s line of vision. EMDR utilizes eye movements, while Brainspotting focuses the eye on a fixed gaze position. The position of your eyes, or where your gaze is directed, can actually unlock some deeper insights that have not yet been recognized. Therapists who are specially trained in these practices often help clients make leaps and bounds with their healing process. It is all about approaching things from (quite literally) a different perspective!

What is EMDR?

Today, EMDR is a fairly common form of treatment in therapy. It stands for “Eye Movement Desensitization and Reprocessing” and has been used by therapists since the 1980’s. There is much research surrounding EMDR and much can be found about it from both supporters and proponents.

EMDR helps individuals tap into parts of their brain where nonverbal information is stored. Because EMDR relies on rapid eye movements, it may not be a suitable form of treatment for everyone. Some people find EMDR to be overstimulating, which can lead to other problems, including the (slight) risk of seizures.

What is Brainspotting?

Brainspotting was discovered by David Grand, growing out of his EMDR work. As a new interaction, it is even more powerful and more flexible than the previous EMDR methods. Due to the flexibility, how it works for each client may look slightly differently.

In a nutshell, here’s how it works: The therapist and client work together to find the “brainspot” or eye position that corresponds with a specific emotional response or incident. Once on that “target,” the therapist and client simply allow the client’s brain to make the connections needed to continue processing this event. This works a little differently for each client; however, Brainspotting also allows the therapist to utilize resources in session if it ever feels too intense for a client without stopping the process. 

Benefits of Brainspotting

Overall, Brainspotting tends to yield faster and deeper results over standard EMDR methods. This seems to happen because Brainspotting is much more adaptable. Therapists can be flexible with the approach, thus finding the right iteration for you and your needs.

  • More Flexible than EMDR?
  • More Appropriate for Children & Teenagers?
  • Helps Access Emotions on a Deeper Level?
  • Works as an Add-On to Current Therapy?
  • Can also be utilized for performance enhancement ?
  • It does not require the client to verbalize their trauma - Brainspotting sessions can occur without the client speaking?

EMDR might be better known because has been around for a longer period of time, but Brainspotting is widely believed to be much more appropriate for working with adolescents. It’s less likely to overstimulate, which makes it a great fit for individuals (at any age) who struggle with feeling overwhelmed. Plus, Brainspotting doesn’t require much conversation. You can talk as little or as much as you want with this type of therapy—so it is especially useful for those who don’t want to talk to a therapist.

Finding the Right Therapy

As a therapist, I partner with my clients to find the techniques that are right for their needs and current situation. Because counseling is such an individualized process, there’s no one-size-fits-all solution. Whether you are already working with a therapist, or just looking to get started, Brainspotting can help customize your treatment.

If you would like to learn more, please contact me. We can always schedule a 15-minute teleconference to see if my services would be a good fit for you, or your family. 

 

Therapists and students interested in learning more about Brainspotting are encouraged to join us for Brainspotting Phase I training in Indianapolis in June for 21 CEUs.

 

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