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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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The Hidden Cost of Using Insurance to Fund Counseling

Did you know that depression can increase your life insurance premiums?

While seeking counseling no longer seems to have the stigma that it once did, insurance companies are still behind the times. Over the past few years, mental health conditions were more easily covered for many patients thanks to the Affordable Care Act (ACA) or Obamacare. While that seems to be a positive development, clients had to be given a diagnosis in order to receive coverage through their health insurance. It may not seem like a big deal, but they may not have realized that a diagnosis of depression in a variety of forms can impact life insurance coverage as well.

Life insurance companies consider those diagnosed with depression as having a greater chance of death from serious accidents, destructive self-medicating, and even suicide. Depression is often a general term for a number of possible emotional disorders and can be carefully reviewed by insurance underwriters, whether the diagnosis is due to environmental factors or organic origins such as a neurotransmitter imbalance. The life insurance underwriter will want specific information on the type of depression you were diagnosed with, when your episode(s) occurred, and whether the depression was successfully treated. They will also want to know if your therapist is concerned that you would commit suicide. They may seek this information in your permanent medical record. 

When you utilize health insurance benefits to fund counseling, the insurance company will require a diagnosis and treatment notes to support the need for ongoing counseling which is all included in your permanent medical record. In terms of securing life insurance, this kind of documentation is just part of the information requested by the life insurance company. You may experience delays in acceptance of your application, additional screenings and most often, higher than normal rates for premiums you continue to pay throughout your life if your medical records indicate treatment of various mental health diagnoses including depression. 

Now that the Affordable Care Act (ACA) aka Obamacare is likely to be repealed there will no longer be protections for pre-existing conditions. This can mean that you will be denied health insurance coverage based on the diagnoses in your permanent medical record or have to pay higher health insurance rates every month. It potentially could also mean that pre-existing conditions whether related to mental health or physical health will simply not be covered at all by your health insurance. It is so important to guard what is reported to insurance companies for yourself and your children. 

Rather than accepting insurance reimbursements, I offer a Fee Reduction Contract (link to scale available at the time of publication). I will provide a discount on my services based on annual household income and the number of people in the household. In the long run, I believe that paying for counseling “out of pocket” will be less expensive for my clients than utilizing insurance benefits. I do not want to give a diagnostic label to anyone who does not meet criteria and will not benefit from that diagnosis. 

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The Intentional Love Challenge: Helping You Improve Your Relationship

As you look to 2017 and potential resolutions, is creating a closer, more loving relationship something you would like to do? Would you like to do a better job of loving your partner? Or maybe you want to inspire your partner to be more loving? Or maybe you are at the end of your rope and feeling something must change for this relationship to be saved?

So many New Year's Resolutions don’t create lasting change. Too often we start out energized, but give up on the practice before a habit has formed. This year, I would like to help you stay on track with your resolution of working toward a closer, more loving relationship. 

In 2017, I am forming a group of select participants to practice Intentional Love Challenges. Every few weeks, you will receive a new challenge of something you can do to improve your relationship. A brief pre and post survey will help you see the difference the challenges have made in your relationship, although I think you will see changes fairly quickly. Whether this is your last ditch effort, perhaps even an attempt to prove to yourself that this relationship cannot be saved - or you are as happy as a newlywed and simply want to be intentional about loving your partner - or somewhere in between, the Intentional Love Challenge is for you, and I would love to have you join us!

Participants in the Intentional Love Challenge will receive challenges by email every few weeks. They will also receive brief surveys by email and be invited to join a private/closed group on Facebook where you can get support from other participants. By participating in this challenge, you will very likely improve your relationship*; you will also be contributing to research that will help others strengthen their relationship in the future. I intend to write up the results in a book which participants (who join in from the beginning) can purchase at cost (plus shipping). Participants will also have the opportunity to shape the challenges provided by sharing what they most want to improve in their relationships.

The format is simple. The intended impact (for your relationship) is huge. You can improve your relationship without dragging your partner to therapy (although I would love to see you). You can improve your relationship without your partner’s participation. You can improve your relationship without your partner even being aware. While you are welcome to share this with your partner, I am most interested to see the results and relationship changes for those who quietly accept the challenges without telling their partner what they are doing or why. 

What questions do you have about the Intentional Love Challenge? Would you be interested in joining in this adventure?

 

*some variables like mental illness can impact results

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Brainspotting: A Powerful Therapeutic Technique for Trauma and More

Have you ever noticed yourself simply gazing or staring at some spot on the floor or wall or ceiling? Have you noticed yourself looking away or up or somewhere else when really thinking about something you are saying or want to say, particularly when the subject is loaded emotionally? As a therapist, I notice this all the time. Clients often become unnecessarily self-conscious about it and force themselves to make eye contact with me. While their gaze continues to drift back to these spots, they do not allow themselves to hold the spot. What they don’t realize is that rather than avoiding eye contact, they are intuitively helping themselves to process by accessing deep neural connections and memories in the subcortical brain. 

I am super excited about Brainspotting as a new (to me) technique. It is a therapeutic technique for processing traumas, negative cognitions, and difficult emotions. Brainspotting was developed out of EMDR, discovered (as all the best therapeutic theories and techniques are) by paying attention to clients. It is also related to sensorimotor psychotherapy, somatic experiencing, lifespan integration, mindfulness, and even internal family systems therapies. It is considered a process that provides deeper and accelerated resolutions that are more powerful and comprehensive that other techniques, including EMDR. In fact 90% of clients have shown significant improvement in just three sessions (Hildebrand et al., 2014). 

One child declared “it is awesome” as he progressed from anger to happiness in just five minutes. An adult client was wowed in her brief introduction to Brainspotting, saying, “this really works” and “this is spooky”.

While Brainspotting can sound and feel like magic, there is a lot of science behind it. I have always loved neuropsychology and studied it just because I loved it, although I won’t likely be able to name all of the many different parts of the brain involved in Brainspotting. Luckily it is a “physiological approach with psychological consequences” that allows us to access our self-healing potential via bypassing the thinking of the neocortex and “promotes organization and integration through coalescence of hitherto separated information files”; “a Brainspot is a stored oculomotor orientation to a traumatic experience which has failed to integrate” (Corrigan & Grand 2013). Who doesn't to feel like Wolverine and discover the confidence of knowing you have the capability to heal? I also very much appreciate that it is an “open, integrative, ever-evolving model” and the humility of the founder David Grand, Ph.D. In addition, I chose to study Brainspotting rather than EMDR because it is appropriate for more clients, particularly those who can be overstimulated; it is flexible allowing us to find the specific iteration of Brainspotting that works best for you. 

For more information check out the video beland the other videos at Brainspotting International

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Introducing Amy Liptak, intern at Brooke-Randolph.com

I am excited to introduce you to Amy Liptak who will be working with me as an intern over the next several weeks. When Northwestern contacted me, I was happy to consider taking on an intern, but I was thrilled to find they wanted to send me someone like Amy. If you are interested in working with Amy, please contact her at intern@brooke-randolph.com Because she is still a student, appointments with Amy will be offered for only $25 per hour. 

 

Mental health is a critical part of our human experience. Many factors shape our mental health, including our early family environment, genetic propensities and the social world in which we grow and develop our personalities. For many, there is an especially profound affect on an individual’s mental health when they are raised in a family where there is dysfunction and abuse. This environment can leave a lasting scar of pain and confusion on a person throughout his or her lifespan. I keenly relate to how complex that experience is, and I know I’m not alone. I made a choice many years ago to strive to understand my own dysfunctional family life and find strength and clarity in the chaos. I am passionate about sharing my story and sharing with others what I have learned, because that is when understanding, healing, and change can happen.   

One of the most determinative moments of my life was when my younger brother was diagnosed with bipolar disorder. I was in my mid-twenties and he was two years younger. My family and I struggled to understand and cope with his erratic behavior, alcoholism, arrests, and hospitalizations, but at least we had a grasp of his disease.  After his death a few years later in a car accident while he was heavily intoxicated, I was numb with depression and grief. It was then I knew I needed to understand mental health better and how it affects our life experiences and relationships. I began to read and educate myself, and I spent many hours in the public library and learning about my own family dynamics. I began a career as a firefighter/paramedic, and for the next nine years I thrived in a career where I had the opportunity to help others in their time of need. 

Later, after my children started elementary school, I returned to college to finish my undergraduate degree in psychology, and the desire to move forward in the psychology field was solidified in me. Studying through the intellectual concepts and theories of psychology facilitated further understanding of my own life experiences. More fully understanding the physiology of my brother’s addiction and illness, as well as the personalities of other family members was certainly a turning point in my life. But truly developing emotional understanding and incorporating that in to my day-to-day life has been far more complex. Navigating healthy relationships with those that are dysfunctional has been infinitely more multifaceted than reading a textbook, and goes way beyond intellectually understanding psychological theories. It is that very journey that I feel passionate about helping others to navigate too.  

For the better part of the last year, I have had the opportunity to be a group facilitator for an adolescent domestic violence support group at Prevail, Inc., an advocacy center that helps victims of crime and abuse manage their circumstances and navigate through the court system. Our group consisted of approximately 8-10 kids for 12 week cycles of weekly workshops focusing on the affects of trauma and dysfunctional family dynamics, and how to develop coping skills. As I have spent time working with adolescents who are experiencing the same pain and confusion at home that I did, I have become even more passionate and confident that I have positive skills to make a difference as a counselor. Learning from the staff and clients at Prevail was extremely educational, and I feel grateful I had the opportunity to be part of such a great team of people.  

I am looking forward to using my skills and life experience to make a difference in my client’s lives. When asked why I want to be a counselor, it is easy to say “because I want to help others.” While that is absolutely true, more specifically I want to help individuals rewrite their life story, find the peace and understanding that they deserve, and learn to find the strength and courage to move past difficult circumstances. Each one of us has a valuable, meaningful life experience, and sharing our stories with each other is what keeps us connected and moving forward with understanding and tolerance. I strongly believe we need to make mental health discussions a comfortable topic in our communities and families, because the more we talk, the less stigma and more healing there will be. 

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