How Do I Know What Kind of Therapist to Choose?

by Annabelle Parr

Choosing a therapist can be overwhelming. If you search Google or Psychology Today, you will likely find a long list of different therapists including licensed marriage and family therapists, licensed professional clinical counselors, licensed clinical social workers, psychologists, and psychiatrists. How do you know what kind of therapist will be the best for you? And what is the difference between all those different licenses?

Licensed Marriage and Family Therapists (LMFT):

An LMFT holds a Master’s degree in counseling, which typically involves between two and three years of school. LMFTs are trained to view individuals from a family systems perspective, meaning that they learn to see individuals in the context of their relationships. Relationships include family, friends, significant others, and even your relationship to yourself. Despite what their license seems to imply, LMFTs also work with individual clients; they do not exclusively offer marriage and family therapy. Their license speaks to the lens through which they view clients and the various presenting problems they may bring into therapy. LMFT’s must complete at least 3,000 hours of supervised experience before becoming licensed, and this experience must include working with children, families, and/or couples.

An Associate Marriage and Family Therapist has completed their Master’s but is still working on their 3,000 hours of supervised experience.

Licensed Professional Clinical Counselors (LPCC):

An LPCC also holds a Master’s degree in counseling. Many Master’s programs qualify students to sit for both the LMFT and LPCC licensing exams. However, LPCCs tend to work more generally, with a focus on mental health issues as opposed to relational issues, and tend to focus on the individual rather than the individual in the context of their relationships. LPCCs also must complete 3,000 hours of supervised experience prior to licensure, and a portion of their experience must be in either a hospital or community based mental health setting.

An Associate Professional Clinical Counselor has completed the Master’s degree requirements but is still working toward the 3,000 hours of supervised experience.

Licensed Clinical Social Workers (LCSW):

An LCSW holds a Master’s degree in social work. Their training teaches them to help connect clients with resources, both externally (like community resources, support groups, etc.) and internally (like coping skills). An LCSW must complete 3,200 hours of supervised experience in order to get licensed, and they must be supervised specifically by another LCSW for a portion of their hours. They may also provide individual, family, or couples therapy, but the lens through which they have been trained focuses on ensuring clients have access to all the resources they need to thrive.

An Associate Clinical Social Worker has completed the Master’s degree requirements but is still working toward the 3,200 hours of supervised experience.

Psychologists:

A licensed psychologist holds a doctorate degree, either a Ph.D. (doctor of philosophy in psychology, focused on both research and clinical work) or a Psy.D. (doctor of psychology, more clinically focused than research focused), which can take between four and seven years to complete. Licensed psychologists also require 3,000 hours of supervised clinical experience for licensure. Psychologists typically have more training in psychometric assessment and test administration than an LMFT, LPCC, or LCSW. A psychologist with a Ph.D. is prepared to practice clinical work, conduct research, and/or teach, whereas a Psy.D. is typically primarily focused on clinical work.

Registered Psychological Assistant or Postdoctoral Fellow: A registered psych assistant is still working toward the doctoral degree and receiving supervised clinical experience. A postdoc has already completed the doctorate, but is completing the supervised clinical experience hours toward licensure.

Psychiatrists:

A psychiatrist holds a medical degree, and has completed a period of residency, and fellowship. Psychiatrists are medical doctors and are able to prescribe medications. A psychologist, LMFT, LPCC, and LCSW are not able to prescribe medication. Psychiatrists are also able to provide psychotherapy services, but their training is more medically focused.

What’s the takeaway?

Ultimately, there can be a lot of overlap in the services provided by the above practitioners. They are all qualified to assess, diagnose, and treat the full range of mental and emotional disorders found in the Diagnostic and Statistical Manual (DSM). The specific license under which a therapist operates speaks to the lens through which they have been educated, and the duration of education.

However, the provider’s area of expertise and scope of practice tends to depend upon the clinical experience that they have gained. So when looking for a therapist, it can help to understand what their license means, but it is perhaps more important to understand the specific supervised and licensed experience that the therapist has. Do they have experience working with anxiety, panic, trauma/PTSD, depression, identity issues, couple’s therapy, child therapy, family therapy? What modalities are they trained in? Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Psychodynamic Therapy, EMDR, Emotion Focused Therapy, Somatic Therapy? Do their areas of expertise and treatment modalities align with your needs and goals?

Research consistently shows that the therapeutic relationship is the most important factor in whether therapy is successful. So it’s key that the therapist you choose feels like the right fit for you personally. But it can be hard to try to figure out who might be a good match based on credentials and website information alone. A good place to start in narrowing your search is looking at the therapist’s areas of expertise and preferred treatment modalities. Once you have found someone whose specialties line up with your goals, you can reach out to the provider and ask any questions that may not have been addressed on the practice website. (If they won’t take the time to respond to your questions, they might not be the best fit!) If you feel comfortable with the therapist during the initial contact, you can schedule your first session. You will want to meet with the therapist 2-3 times to evaluate how safe and comfortable you feel working with this person. Choosing a therapist is a process, and it can feel overwhelming at first. But once you know how to narrow your search and find a provider that feels like a good fit, it can be incredibly rewarding.

Most Americans Are Stressed About the Future of Our Nation

by Annabelle Parr

Have you found yourself feeling especially anxious or stressed out in the current political climate? You’re not alone. This particular election and transition of power is unique for many reasons, not least of which is the widespread stress it is creating in Americans across the political spectrum.

According to the American Psychological Association’s most recent Stress in America survey, two-thirds of Americans report feeling stress regarding the future of our nation.

This stress is bipartisan.

Prior to the election, stress may have been divided more along party lines. Back in August, Democrats were significantly more likely than Republicans (72 percent vs 26 percent) to feel stress regarding the outcome of the presidential election. However, according to the most recent study conducted in January, 59 percent of Republicans and 76 percent of Democrats reported that the future of the nation was a significant source of stress.

Overall stress levels have increased since the election.

In the ten years since the inception of the Stress in America survey, Americans’ stress levels had been gradually decreasing. However, between August 2016 and January 2017, Americans’ average reported stress level increased from 4.8 to 5.1, on a scale where 1 represents no stress and 10 represents enormous stress. This was the first statistically significant increase in stress since the survey began 10 years ago.

We are not the first cohort to feel stressed about the future of our country.

It is important to remember that this APA survey has only been conducted for the last decade, and to keep in perspective that our country has been through numerous tumultuous and stressful times. We are not the first group of citizens to be very stressed and concerned for America’s future. History shows us that we have inevitably and cyclically encountered dark times as a nation, and that hopefully, after each struggle, we emerge stronger and maybe a little bit wiser and more just.

However, currently we are very much in the midst of the anxiety and uncertainty. We are deeply stressed, and we are not alone in that experience. There is comfort to be found in the “me too,” but it is also important that together we learn to find balance during this time.

How do we manage our stress?

Engaging in democracy.

One of the beautiful things about our country is that we are part of a democracy, where we are empowered to use our voices to speak up regarding those things that do concern us. In order to properly voice our concerns, it is important that we use our access to information to stay informed about what is going on. (However, we must also recognize when we need to disconnect. More on the importance of limiting our information intake below).

One way to try to assuage the stress we feel is to use it as fuel for action. We can spend a few minutes calling our local representatives and communicating our concerns. We can get involved volunteering for or donating to an organization whose efforts are in line with our values. We can participate in protests or marches to literally stand up for the things that are important to us. There is something very empowering about engaging in community and collective action with other Americans who share our views.

Regardless of our political views and beliefs, our stress seems to be collective. The details of our concerns may differ, but we all have the opportunity to use our voices and engage in the future of the nation.

Finding a balance between staying engaged and allowing ourselves to disconnect.

However, as much as it is important to stay engaged, we must also recognize the limits as to what we can do to help foster change. When we come together, we are strong. But individually, we cannot carry the weight of the nation on our shoulders. And as we work to remain informed, it is also important that we allow ourselves the time and space away from news.

Limiting technology and news consumption.

Between all of our technological devices, 24-hour news cycles, and politically saturated Facebook news feeds, we could allow our eyes and minds to be occupied all day long by the constant, stress-inducing updates. We need to limit our news consumption in order to allow our minds and bodies to rest. Allowing ourselves to be overwhelmed by the news will leave us feeling powerless.

Practicing self-care.

Maybe the most important thing that we can do at this time of great national stress is to take care of ourselves. Self-care is vital to our mental, physical, spiritual, and emotional well-being. And if you have felt that your nation (or perhaps its commander in chief) has failed to care for you, or sent you the message that you are unworthy of care, maybe your greatest act of protest and defiance will be to choose to take care of yourself in spite of this.

Self-care will not fix the national situation, of course. However, wouldn’t it be powerful to have a nation filled with citizens who know how to care for their own well-being, and as a result they have the energy to stay engaged in their democracy?

How can we practice self-care?

Good self-care is unique to each individual. What is relaxing and healing for one person may not be as helpful to another. It’s important to pay attention to those things, those rituals, that calm and center us. That signal to our psyche a time of rest or peace. Here are some ideas to help inspire you:

1. Set aside some time to walk each day and focus on breathing the fresh air in your lungs and feeling the ground under your feet with each step.
2. Practice yoga.
3. Find a mindfulness meditation to practice every day. This doesn’t have to take more than five minutes. Check out this link for some suggestions: http://marc.ucla.edu/mindful-meditations
4. Not a fan of meditation? Try focusing on your breathing. Take a minute to practice some mindful breaths. Check out our blog post on breathing for some tips: http://www.anxietytherapysandiego.com/blog/2016/6/8/the-power-of-breathing
5. Turn off your devices. Allow yourself to unplug entirely. Maybe consider deactivating your automatic news updates, or deleting the Facebook app from your phone. Set limits on your news consumption by mapping out a given time to check the news each day.
6. Find time for humor. Is there a show that makes you smile or laugh? Laughter is healing and helps relieve stress.
7. Spend time with loved ones. Share your experiences and your feelings, but also make sure to find time to talk about things unrelated to the current political situation. It’s healing to talk with others who feel the same way that we do and to know that we are not alone. But it is also important to have fun and to remember that we can still enjoy the sweet things in life even when there are reasons to be concerned.

In conclusion,

In order to manage the stress that so many of us are feeling, seek balance. This means finding ways to be proactive about the things that you can change or that you have control over, but also accepting the things that are beyond your control. And in the midst of it all, remember to take care of yourself in the ways that work best for you.

Source URL: https://fundingforgood.org/fundraising-and-the-serenity-prayer/

If you find yourself feeling overwhelmed by the stress or anxiety that you feel, and you need some extra help, a therapist can help you to process your feelings. They can give you a space to feel heard, which in itself can be healing and empowering. They can help give you tools to manage your stress so that it doesn’t leak into other areas of your life or prevent you from leading a healthy day-to-day. Sometimes the best form of self-care is knowing when we need to reach out for external support.

CSAM IS HERE TO HELP

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

References:

(2017, Feb. 15). Many Americans stress about future of our nation, new APA Stress in American survey reveals. Retreived from: http://apa.org/news/press/releases/2017/02/stressed-nation.aspx

Depression: The Autoimmune Disease Of the Mind

Written by Marnie at http://www.lovebutblog.com/depression-the-autoimmune-disease-of-the-mind/

Depression: The Autoimmune Disease Of the Mind

I’ve seen so many great tributes to Robin Williams in the past 24 hours. I hope he knows how much he affected others in a positive way. That, despite his inner torment, the fact that he made people laugh was able to penetrate the immense sadness he must have felt and give him some sort of peace … even if only for a little while. In fact, peace is something those of us with depression rarely feel.

I hate the word “depression”.  Frankly, it’s depressing. And I hate the commercials about it. You know those Cymbalta commercials? Depression hurts; Cymbalta can help. They show these scenarios of people having trouble getting out of bed, or not even wanting to play ball with their dogs. The truth is, sometimes depression probably does look a lot like that. But sometimes it looks like Robin Williams. Sometimes it looks like comedy, as that is one of the many coping mechanisms people with depression use. Sadly, with people like Robin, it masks something much deeper and darker. Sometimes it looks like a busy schedule. Sometimes it looks like forgetfulness. Sometimes it looks like the person standing up on the podium, accepting an award. As Glennon Melton from Momastery said in a recent post, “People who need help sometimes look a lot like people who don’t need help.”

A friend of mine recently broke my heart with a Facebook status update that said something about how she has an autoimmune disease and that, while she might look happy and healthy on the outside, the pain can be unbearable. It was such a simple statement and yet really had an impact on me, as my mother has had chronic pain her whole life but, to the outside world, she looks fine. In fact, she’s gotten dirty looks and even comments from people for using her Handicapped placard.

Depression is the same way. It’s an autoimmune disease of the mind. For all intents and purposes, many of us who have it look fine on the outside. We might even be somewhat, if not very, blessed by our life circumstances. Abby Heugel put it perfectly on her recent Scary Mommy post, saying, “These are the times that I should reach out, but the thing about depression is that it comes with the sense that you shouldn’t have it to begin with, that it’s a bunch of self-indulgent navel gazing and not an actual illness like those that everyone can see looking in.”

Despite everything good in our lives, the negative thoughts persist in our minds and hearts. Its attack on ourselves feels silly, embarrassing, ridiculous, hateful, awful, confusing, shameful, and a whole bunch of other emotions. When I’m tired, it attacks the most, sensing the weakness within.

Physically, I’d consider myself one tough mother f*cker. In fact, when I was little, I had an unusually high pain tolerance. I went to bed once on a broken wrist that my parents didn’t even know about until they saw me the next morning with an arm that had swollen to twice its size. I once let a man stand on my fingers at a baseball game until they were completely flattened because I didn’t want to say anything. I sprained my ankle a week before my first marathon but ran it anyway, having to stop and get it taped about three times. And yet the feelings of melancholy can crush me like I’m a cancer-ridden 100-year-old.

I hate saying but the truth is I suffer from depression. Some days are great and others are horrible but, you know what, that’s life. I have to learn to accept myself the way I am and not be afraid to talk to others about it. And if you need someone to listen, I’m your gal. In the meantime, when you’re out and about doing your daily deeds, remember that things are not always as they seem. Be kind. Be gentle. Be aware that others might be suffering beyond belief despite that fancy, new car, perfect hair, or insanely clean house. Give meaningful hugs and warm smiles. You never know what those could do for someone who is feeling at the end of his rope.

RIP, Robin Williams. You were loved.

Photo credit: Godfreydaily.com

Tags: anxiety, Cognitive Behavioral Therapy, psychotherapy, depression, suicide, Robin Williams

10 Tips to Stop Sleep Anxiety: More Rest, Less Stress (Part 2 of 3)

by Lucas Myers

With people juggling work, school, friends, families, and the 1,001 other things we've got to do everyday, Americans are not getting enough sleep. This week we continue our 3 part series 10 Tips to Stop Sleep Anxiety: More Rest, Less Stress.

4. Practice good habits

Having the same bedtime ritual night after night teaches your body when to expect sleep and eases the transition into a drowsy, bed-ready state. Bright lights, especially those from TV's computers and other electronics promote alertness, so try to avoid them before bedtime. Instead, try reading a book, taking a soothing bath or shower, listening to relaxing music and dimming the lights as you get ready for bed.

5. Eliminate distractions

The bedroom should be your sanctuary for sleep, so avoid watching TV in bed, bringing the laptop to bed, or engaging in any other activities. You want your mind to associate this setting with relaxation and rest rather than stimulating daytime activities. Consider setting limits on children or pets sleeping in your bed with you.

6. Get comfortable

Find bedding that feels comfortable to you. If you share your bed, make sure it is large enough for both of you to sleep comfortably. Most mattresses last 9-10 years; make sure to replace them when they exceed their life expectancy because a good mattress should be comfortable and supportive. Your pillow should support your head without straining your neck. Make sure your bedding is allergen free.

7. Set the mood

Dark curtains can help prevent light from inadvertently resetting your internal clock. Even the tiny light from an alarm clock can be disruptive so seek ways of limiting light pollution. Even small noises can interrupt sleep. Earplugs are helpful for some. A fan, or a free white noise app on your phone can help cover the sounds of noisy neighbors, car alarms, traffic and other disruptive nighttime noises. To keep your bedroom from becoming too hot or dry for comfort consider a fan, air conditioner, or humidifier.

REMEMBER: Having an occasional sleepless night is normal, but if you are experiencing a pattern of restless or sleepless nights, don't hesitate to seek an expert, especially if lack of sleep is beginning to interfere with your normal daytime functioning. Contact your doctor to determine whether physical causes may be contributing to sleep problems. If your physical health is sound, contact a psychologist with experience treating sleep problems. Cognitive behavioral therapy and other evidence-based treatments are highly effective for improving sleep. If you are in the San Diego area and you would like to speak with one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com.

Want more tips? Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss Parts 2 and 3 of our 10 Tips to Improve Your Sleep and articles on other hot topics such as stress, anxiety, depression, OCD, PTSD, and more. 

References

Dement, William C; Vaughan, Christopher (1999). The promise of sleep: a pioneer in sleep medicine explores the vital connection between health, happiness, and a good night's sleep. New York: Delacorte Press. ISBN 0-385-32008-6.

Dement, WC (2005). "Sleep extension: getting as much extra sleep as possible". Clinics in Sports Medicine 24 (2): 251–268, viii. doi:10.1016/j.csm.2004.12.014. PMID 15892922.

Kryger, Meir H; Roth, Thomas; Dement, William C (2011). Principles and practice of sleep medicine (5th ed.). Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6645-3.

Sleep Tips: Seven steps for better sleep. Mayo Clinic Staff. Retreived on November 25th, 2013 from: http://www.mayoclinic.com/health/sleep/HQ01387

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Encouraging Family & Friends to Seek Psychotherapy

by Jill Stoddard 

It is difficult to see friends and family members suffer. Even if you are a great friend or relative, always lending an ear and your support, there is only so much that you can do. If you have a friend or family member who is suffering from anxiety, depression, or other mental health concerns, it may be best to encourage your loved one to seek professional help. Remember that any time that you think your loved one is a danger to him or herself, or to someone else, it is crucial that you seek immediate medical attention to ensure everyone's safety. But in the event that your friend or family member has no intention of harming anyone, but is exhibiting psychological symptoms that are interfering in his/her functioning, the best thing to do is gently encourage the individual to seek psychotherapy.

This can be a very difficult process, as such attempts are sometimes met with resistance or even hostility. To your friend/relative, it may feel like you "think they're crazy," or, "don't know what you're talking about." But in the end, therapy can help your loved one get his/her symptoms under control so s/he can live a fuller, happier life.  Although it may take some time, patience, and hard work, the benefits of therapy will certainly outweigh the costs. 

When encouraging a friend or family member to seek psychotherapy, here are some important things to keep in mind:

DO begin by emphasizing how much you care and how worried you are. It is not that you are tired of listening, but that you recognize your limits, and are concerned that you are not proiding the appropriate care. 

DO NOT confront them or shout at them regarding some of their behavior or choices, as this will only lead to the person feeling ashamed, cornered, and defensive. Instead, keep the emphasis on your concern for them and your desire for them to live a happy life. 

DO get the advice of local professionals, and consult their research or pamphlets when considering how to express your concern. Local support groups, psychotherapy clincs, and community centers are almost always willing to help.

DO NOT take this approach for the wrong reasons. Are you genuinely concerned about this person's welfare, and not trying to put him or her down in any way? Are you upset about how this person's behavior is affecting his or her life, or merely your life? Make sure you have sorted out your own motives before attempting to talk to this person. If not, they will likely see through your attempt, and it may damage your relationship.

DO realize that this is not the least-confrontational course of action, and may impact your relationship if the individual does not take the suggestion well. This is a serious solution, however when necessary it is a crucial one. Mentally and emotionally prepare yourself--try going through the different ways that the conversation could play out, and consider your response in each case.  

DO NOT be impatient. Even if your friend has a non-negative reaction to your suggestion, he or she may not reach out for help right away.  Be supportive, keep listening, and be patient.  Continue to encourage your loved one, even if s/he doesn't feel totally ready.

DO offer to help this person seek therapy, whether that means finding a doctor, booking an appointment, or just giving him or her a ride to an appointment. The support of a loved one will encourage the individual to follow through. 

If you are in the San Diego area and would like to speak to a professional at CSAM about helping a loved one seek therapy, please contact us.

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Tags: anxiety, anxiety therapy san diego, ocd therapy, anxiety therapy, acceptance and commitment therapy, Cognitive Behavioral Therapy,psychotherapy