Tips for Finding an Affordable Therapist

by Lauren Helm and Lucas Myers    

Are you thinking about beginning therapy? This can be an excellent step forward in creating the life that you want, but sometimes financial strain may act as a barrier to receiving the treatment that is right for you. Despite the potential challenges that you may encounter, read on for some helpful tips about how to find a therapist that you would like to work with and can afford to see.  

• Make sure that you are aware of your mindset while you are researching the available therapists in your area. While cost may be a major determining factor in your decision-making process, try to keep in mind that it may be better to commit to treatment with a therapist whom you feel comfortable with and is skilled in what they do. You may want to consider seeing a therapist that offers evidence-based treatments (EBTs), which are psychological treatments that have been found to be effective in treating a particular type of disorder. This may reduce the risk of spending time and money on ineffective therapy.  EBTs are often shorter-term treatments and thus the overall investment may be lower than you initially anticipated.
• It might be beneficial to think about whether a therapist’s level of training and expertise with a certain type of disorder or treatment is important to you. A therapist who is an expert in a particular type of evidence-based treatment may provide therapy for a higher fee, but also may offer you more skillfully-delivered treatment. However, there are also many graduate-level therapists who provide therapy under the supervision of experienced, licensed psychologists and offer low fees.
• Regardless, it is likely more helpful (and cost-effective) to make your psychological health a priority. A therapist can help you to reduce distress that may be leading to problems with work, relationships, and physical health.

  Here are a few more tips for selecting an affordable therapist: 

• Before your first appointment, ask your therapist about their fee.
• Discuss whether you are planning to use insurance and how that will be handled.
• If needed, ask if you qualify for a sliding scale.  If they seem like an otherwise perfect fit but you cannot afford their fee don't be afraid to say so.
• Ask if the therapist might be willing to see you on an every-other-week basis.  The overall cost of your treatment will remain the same, but twice monthly visits may be easier to fit into your budget than weekly visits.
• If they can't meet your budget, ask for a referral. They likely know someone that has a similar style and approach who may have a more flexible fee.
• If you don't have insurance, or have chosen not to use it, consider seeing an intern at a clinic. Although they are still relatively less experienced, many interns have years of excellent education. The best part about working with an intern is that you get their expertise, as well as that of the supervisor with whom they are working. Many cities or colleges have training institutes with interns on staff that can accept very low rates.

Remember, the time and money that is spent on therapy is an investment, and requires wise decision-making. Therapy is an important investment and may be a significant and cost-worthy step towards enhancing your health and well-being.  

If you'd like to speak with a therapist at the Center for Stress and Anxiety Management, please click here.

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego).

An Interview with Dr. Scarlet of CSAM: Superhero Therapy

By Lauren Helm, M.A.

In our blog “Modern Metaphor: Tapping into the Power of the Superhero to Turn Struggle into Triumph,” Dr. Janina Scarlet discussed how she uses superheroes and fictional characters in therapy as a way of connecting with values and inspiring healthy psychological change. Read below for an interview with Dr. Scarlet about how she uses modern metaphors in therapy.

CSAM: What inspired you to start incorporating fictional characters in the therapy room 

Dr. Scarlet: I wanted to incorporate fictional characters into therapy because I found that many clients found it difficult to talk about their own feelings or experiences and found it easier to identify with certain fictional characters, which made it easier for them to understand what they were going through. Too often, people who are going through depression, anxiety, trauma, or another difficult experience have no one to talk to and do not believe that anyone can understand their experience. Once they find a person or character they can relate to, they usually feel more understood, and that’s when healing can begin.

CSAM: How do you use superhero and fantasy characters in therapy? What might you do to help people access their inner superhero while working with them in therapy?

Dr. Scarlet: Usually, I ask the client to tell me if they like comic books, movies, TV shows, etc. and ask which is their favorite and why. Often there’s one or more that people can name and usually there’s a character they feel that they can relate to. We then begin by exploring what the character has gone through, what made them who they are today, and what makes this particular character special to the client. For example, if someone likes Batman, they might like that Batman is a Superhero, that he saves other people, and that he is brave and strong. This allows me to understand what kind of person the client would like to become, to get at their values. We then explore what Batman had experienced (i.e., the death of his parents, the phobia of bats, and years of isolation) and how through the terrible pain he went through he was able to become the Superhero of Gotham that he is today. We then bring it back to the client’s values and identify ways that he or she can begin to take steps to become their own kind of Superhero.

CSAM: Is there any particular issue that you’ve found superhero-therapy to be most helpful for?

Dr. Scarlet: I think that since Superheroes tap into someone’s individual value system, that they can be used for any issue someone is going through.  I believe that the biggest remedy for emotional pain is connection with one’s values and Superheroes and heroes of works of fiction, such as Harry Potter and Frodo, lend themselves very nicely to value identification.  

CSAM: You have training in mindfulness and meditation techniques, compassion and self-compassion, and biofeedback. How might you incorporate a superhero approach when using these interventions in therapy? Do they complement one another?

 Dr. Scarlet: I think that they complement each other very nicely. For most people, what they value is helping others. Unfortunately, often people don’t know how to go about that, feel too depressed to do it, or don’t believe that their efforts matter. In addition, I often find that people burn out when they don’t know how to provide compassion toward themselves. In my “Superhero training” sessions, I teach the clients about Jedi mindfulness, as well as the magic of self-compassion, and the Superhero steps behind being compassionate toward others.

CSAM: How do you think that being a therapist who uses superhero metaphors aligns with your own value-system?

 Dr. Scarlet: The person that influenced me the most was my grandfather. He spent his life helping people every way that he could. He wasn’t only a hero, he was my Superhero. He really inspired me because he showed me that it only takes one person to make a difference. I became a therapist because it was the main way I knew how to help others, and in using superhero metaphors in therapy, I find that I can make therapy more accessible to my clients. 

 CSAM: What kinds of triumphs have you seen people create in their lives when working with you?

 Dr. Scarlet: The bravest people I have ever met are my clients. They are the ones that have been most impactful to me. They face their fears every single day, and just like Batman, they do what they can to fight for what they believe in. I was working with one client with severe PTSD and agoraphobia and I will never forget the day that he was able to step out of his house with me. This person now drives and travels and in my opinion, deserves his own comic book for everything he has been able to overcome.

 CSAM: What can you tell us about the book that you are working on about using superheroes in therapy?

 Dr. Scarlet: The book will be a self-help book, on how to become the Superhero that you would like to be and will specifically focus on overcoming anxiety. It will follow the acceptance and commitment therapy format with a chapter on self-compassion, and will primarily include metaphors from comic books, fantasy novels, science fiction, and TV shows.

More about Dr. Janina Scarlet:

Dr. Scarlet earned her Ph.D. from the City University of New York. Her clinical experience includes using Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) to help individuals with anxiety, depression, chronic pain, sleep, and other mental health and medical conditions, as well as using Cognitive Processing Therapy for PTSD. Dr. Scarlet also has experience working with a variety of mindfulness and meditation techniques, as well as compassion and self-compassion and is certified in biofeedback. In addition, she is fluent in Russian and can conduct therapy with Russian-speaking clients. Finally, Dr. Scarlet is a proud geek and is able to incorporate clients' interests into therapy, including but not limited to Batman, Iron Man, Green Arrow, Harry Potter, Lord of the Rings, Doctor Who, Sherlock Holmes, and many others. She was recently interviewed by an award winning podcast, Geek Therapy, about her use of fantasy and geek culture in therapy. Above all, Dr. Scarlet believes in establishing an active collaboration with a client and working as a team in targeting the presenting problems.

If you'd like to speak with Dr. Scarlet or another professional at the Center for Stress and Anxiety Management, please click here.

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego). 

Tags: Comic Con, ACT, Center for Stress and Anxiety Management, psychologist, anxiety disorders, CSAM, comic books, superheroes, superhero therapy

Modern Metaphor: Tapping into the Power of the Superhero to Turn Struggle into Triumph

By Lauren Helm, M.A.

“At their best, superhero origin stories inspire us and provide models of coping with adversity, finding meaning in loss and trauma, discovering our strengths and using them for good purpose.” Dr. Robin Rosenberg

Mythology has long shaped and been shaped by our human experience. Myths are stories or legends that typically include fantastic, colorful, and powerful individuals and events. Different cultures have different perspectives and ways of understanding the human experience, and thus cultural myths vary. There are unifying themes, however. Mythology makes use of symbols and metaphor, both of which represent and communicate significant, underlying meaning that may help us to understand ourselves better. They serve to illustrate a message and to explain the wide range of human experiences, on a collective or individual level, that may occur in life. In a mythical story, such as a fairytale, certain characters may symbolize different aspects of ourselves.

The journey that the mythical hero embarks on is often filled with adventure and fraught with challenges.  Many lessons are learned along the way, and growth is often the result. The mythical hero’s journey serves as a metaphor for what we ourselves may encounter; metaphor can be a guide. Joseph Campbell identified recurring, core themes that characterize both ancient and modern mythology, which tend to follow a pattern that he called, “the hero’s quest.” The hero’s quest and journey can also be seen as a metaphor for our own inner, psychological journey of growth and change.

“A hero is someone who rises above his or her fears and limitations to achieve something extraordinary ... a hero embodies what we believe is best in ourselves"  - Danny Fingeroth

Whether we are aware of it or not, mythology continues to permeate our society today, and even influence how we think. In fact, our society’s modern-day myths may even help us along the path towards healing.  Where might one look to find the mythology of our current times? We can look to our movies, our books, even our comic-books. Modern day mythical heroes take on all shapes and sizes.

Most easily recognizable are the superheroes that we find in comic books, but we also find heroes that may look differently than we expect. Mythical heroes are abundant and appearing regularly: Think of The Doctor of Dr. Who, Harry Potter of Hogwarts, or Katniss from the Hunger Games, for example.

“[Superheroes are a] modern day iteration of our ancient mythologies. There isn’t that much difference between the story of Icarus and that of Iron Man… They have seen prior incarnations in mythology to help explain the world around us or to teach instructive lessons…I think it is an important way to think about how fictional superheroes can make useful additions to our real lives. Not to literally become superheroes, but to use their context as a way to extend our abilities.” – E. Paul Zehr

Not only do fictional comic book superheroes, sci-fi, or fantasy characters represent our personal or collective values, they tend to be relatable on some level. Despite their supernatural or unusual powers or gifts, they also have uniquely human characteristics and flaws. The hero does not go through his or her journey unscathed; rather, the hero seems to step more fully into his or her power by transforming struggle into triumph. This is not done easily. There are losses, and there are gains. However, the hero continues forward, connecting to, and representing, a system of values that allows the hero to be successful.

“Some sort of strength of character (though it may be buried), some system of positive values, and a determination to, no matter what, protect those values ... the superhero—more than even the ordinary fictional hero—has  to represent the values of the society that produces him” – Danny Fingeroth

Dr. Janina Scarlet of CSAM knows firsthand the powerful role that superhero/fictional characters can play in helping certain individuals along the path to healing. The relatable nature of our current mythical heroes help us to connect with them, and access our own inner “hero.” Since the story of the modern-day hero’s journey can act as a metaphor for common human experiences, it can remind us that we are not alone in our suffering, Dr. Scarlet says. It can also provide us with a bit of a road map, helping to remind us to tap into our core values as we learn how to overcome our own life challenges and obstacles. The very idea of relating to superheroes in order to turn struggle into triumphs is what draws Dr. Scarlet to superhero mythology, and why she uses these metaphors in her practice of psychology.

This perspective is mirrored by other psychologists who use superhero mythology as a way of understanding the human experience. In a similar fashion to Joseph Campbell’s identification of core psychological themes and processes that underlie most mythical stories, psychologist Dr. Robin Rosenberg writes in her Smithsonian magazine article that “superheroes undergo three types of life-altering experiences that we can relate to. The first is trauma, which lies at the heart of Batman’s origin story, in which Bruce Wayne dedicates himself to fighting crime after seeing his parents murdered. In real life, many people experience ‘stress-induced growth’ after a trauma and resolve to help others, even becoming social activists. The second life-altering force is destiny. Consider Buffy the Vampire Slayer, about a normal teenager who discovers she’s the ‘Chosen One’—endowed with supernatural powers to fight demons. Buffy is reluctant to accept her destiny, yet she throws herself into her new job. Many of us identify with Buffy’s challenge (minus the vampires) of assuming a great responsibility that compels her to grow up sooner than she wants to. Lastly, there’s sheer chance, which transformed a young Spider-Man, who was using his power for selfish purposes until his beloved uncle was murdered by a street thug. Spider-Man’s heroism is an example of how random adverse events cause many of us to take stock of our lives and choose a different path.” When we identify with these characters, we may better come to understand our own difficult life experiences, and what we want to stand for. It may lead to increased insight, growth, and healing.

“[The story of The Doctor of Dr. Who] is about love, it is about courage, it is about honor, and it is about pain - deep, emotional, psychological, inexplicable pain, that many of us, despite not having been in exactly the same situation can still very much relate to on a very deep, very personal level. And through this connection, we heal.” – Dr. Janina Scarlet

Indeed, the use of metaphor as a tool for psychological healing can be powerful. Metaphor is regularly used within Acceptance and Commitment Therapy (ACT), a modern behavioral  theoretical orientation, as a way of assisting people in achieving a greater understanding and experience of the core processes that comprise ACT. These 6 core processes (acceptance, cognitive defusion, mindfulness, self-as-context, values, and committed action) are theorized to lead to psychological flexibility and optimal well-being (read more about the 6 core processes here). Since language (i.e. verbally thinking, explaining, or talking about these concepts) can interfere with direct experiencing (and learning and true integration of these processes into one’s life), metaphors and symbols can serve to bypass this issue and help us to dive into the underlying meaning and message that the metaphor communicates.

Superheroes or modern-day fictional characters often embody or live out the 6 core processes of ACT, acting as a guide or compass, and helping us to better understand what ACT is all about. A major piece of ACT is committing to live a life that is guided by your values (i.e. what is truly important to you) instead of living a life guided by avoidance of fear or discomfort. Our values also act as a compass, showing us the way to go, and what action to take. This is easier said than done, however. “ACT allows you to be the kind of person that you want to be…. [but] ACT is a bit abstract and people can get overwhelmed when they are asked to talk about their thoughts and feelings. They have a difficult time identifying what they are going through. However, most people have seen or read Harry Potter. People understand what he is going through when he has the flashback of his parents dying. He has a really hard time coping with that, and this is where the concept of acceptance may be introduced….Depending on the patient and which favorite character they relate to, I will use The Hunger Games, The Golden Compass, or Harry Potter to help them understand these core processes. For example, in the Hobbit or the Lord of the Rings, the main characters are really nervous, but they valued completing their mission and they did so. [This illustrates how] ACT allows people to see that you don’t have to be brave in order to act bravely if you value something, such as helping your friends and helping get the treasure back from the dragon,” Dr. Scarlet says in her interview with Geek Therapy.

Thus, Dr. Scarlet regularly incorporates superhero-informed metaphors in her therapeutic approach. Superheroes and other modern-day mythical heroes can be used as metaphors in therapy in a uniquely useful way because they remind us that “in our deepest darkest moment when we feel like no one gets us, when we can find someone to relate to [like a superhero]; we then feel less alone, we have hope to go on, and we feel more connected to others,” Dr. Scarlet says. Superhero metaphors can be a way of accessing ourselves, when we don’t yet know how to. They can even act as a roadmap for becoming our own superhero.

Stay tuned for our next blog, which will interview Dr. Scarlet about how she uses this innovative approach to therapy, and about her upcoming book! Dr. Scarlet will also be featured on a panel at Wondercon in Anaheim on April 19th.

You can also follow Dr. Scarlet on Twitter @shadowquill!

More about Dr. Janina Scarlet:

Dr. Scarlet earned her Ph.D. from the City University of New York. Her clinical experience includes using Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) to help individuals with anxiety, depression, chronic pain, sleep, and other mental health and medical conditions, as well as using Cognitive Processing Therapy for PTSD. Dr. Scarlet also has experience working with a variety of mindfulness and meditation techniques, as well as compassion and self-compassion and is certified in biofeedback. In addition, she is fluent in Russian and can conduct therapy with Russian-speaking clients. Finally, Dr. Scarlet is a proud geek and is able to incorporate clients' interests into therapy, including but not limited to Batman, Iron Man, Green Arrow, Harry Potter, Lord of the Rings, Doctor Who, Sherlock Holmes, and many others. She was recently interviewed by an award winning podcast, Geek Therapy, about her use of fantasy and geek culture in therapy. Above all, Dr. Scarlet believes in establishing an active collaboration with a client and working as a team in targeting the presenting problems.

If you'd like to speak with Dr. Scarlet or another professional at the Center for Stress and Anxiety Management, please click here.

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego).

References

Cardona, J., & Scarlet, J. (2013, October 18). Episode 25: ACT and Using Fantasy in Therapy. Podcast retrieved from http://www.geektherapy.com/2/post/2013/10/episode-25-act-and-using-fantasy-in-therapy.html

E. P. Zehr (2012, September 28). The Superhero in You. Psychology Today. Retrieved from http://www.psychologytoday.com/blog/black-belt-brain/201209/the-superhero-in-you

Fingeroth, Danny. Superman on the Couch: What Superheroes Really Tell Us about Ourselves and Our Society. New York and London: Continuum, 2005. ISBN: 0-8264-1540-7

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

J. Scarlet (2014, March 04). What's wibbly wobbly, timey wimey, and goes EERRWhooSShhEEERWhooSShhhEEEEERRWhoooSShhhWhoooshhee. Retrieved from http://shadowquill.com/1/post/2014/03/whats-wibbly-wobbly-timey-wimey-and-goes-eerrwhoosshheeerwhoosshhheeeeerrwhooosshhh.html

J. Scarlet (2013, August 22). Geeky Therapists Take Over Comic Con. Retrieved from http://shadowquill.com/1/post/2013/07/geeky-therapists-take-over-comic-con.html

R. Rosenberg (2013, February). The Psychology Behind Superhero Origin Stories: How does following the adventures of Spider-Man and Batman inspire us to cope with adversity. Smithsonian Magazine. Retrieved from http://www.smithsonianmag.com/arts-culture/the-psychology-behind-superhero-origin-stories-4015776/#yLSvAEA5qhzq4oKK

The Case for a Value-Driven Life

By Lauren Helm, M.A.

“Values are what you want your life to be about, deep in your heart. What you want to stand for. What you want to do with your time on this planet. What ultimately matters to you in the big picture. What you would like to be remembered for by the people you love.” – Dr. Russ Harris

What guides you in deciding how to act from moment-to-moment, and day-to-day?  When you come to a fork in the road, how do you decide which direction to go?

Many of us may be unaware of the processes that underlie our daily actions and the forces that shape how and why we make the decisions that we do. Often we may just go through the motions, paying little attention to what we are doing and what is happening around us. We go through the routines:  get up in the morning, have breakfast, brush teeth,  go to work, come home, make dinner, go to sleep…and repeat. Sometimes we may reflect on the day and wonder where our time went, feeling almost as though we were not really there. Have you ever driven somewhere, only to realize once you’ve arrived that you barely remember driving at all? It can be as though we were merely on automatic-pilot, with little attention devoted to “steering” ourselves throughout our lives.

And yet, there are times when life really DEMANDS our attention; when it quite literally forces us to focus on the issue at hand. Life is full of flux and change; there are sorrows and pain, joys and celebration. What then? How do you decide how to respond?

When we have little conscious awareness of who we are and who we want to be, we can act quite haphazardly. Automatic-pilot does not necessarily turn off.  If something stressful or threatening happens, we may react reflexively. Perhaps a loved-one makes a comment that rubs us the wrong way, and we lash out. Maybe we have been assigned an important project, and the deadline looms in the near-future, but we automatically procrastinate and avoid thinking or doing anything about it until the last minute because it is anxiety-provoking.

In a sense, automatic or reflexive behaviors can be thought of as “mindless.” There is little conscious or intentional thought behind them. They are like habitual ways of responding to life. However, not only does a “mindless” approach not create the fullness of life that many people desire, it also can get us into trouble when challenging situations arise. For example, most of the time we automatically avoid uncomfortable or painful situations. It makes sense that human beings would avoid pain. Avoidance of pain or threat has allowed us to survive as a species –  avoidance of tigers and bears kept us alive. However, in our modern age, we rarely, if ever, encounter predators that threaten our survival. Threat and discomfort tends to show up for us in our jobs, relationships, traffic, social activities, etc. What if “mindless” avoidance of discomfort costs you a sense of meaning in life? What if it interferes with or prevents you from engaging in activities or life experiences that are deeply rewarding to you, albeit challenging or difficult at times?

If this has been your experience, it may be time to pause and clarify your values. Your values help define who you want to be in each moment. What you value is what gives your life meaning. When we are disconnected from our values, we can go through life somewhat aimlessly and “mindlessly.” But when we take the time to learn about what is really important to us, we can give ourselves a great gift. By knowing your values, you can begin to craft your day-to-day experience in a much more conscious, intentional way. In a way, it can be a creative process. You get to decide during each metaphorical fork in the road, who you want to be and what you want your life to be about.

“What if what was at stake is a kind of self-liberation -- the liberation to be about what you most deeply would choose to be about--- not to avoid guilt, or get applause, or otherwise objectify yourself but just to be in the world how you choose to be in the world.” - Dr. Steven Hayes, co-developer of Acceptance and Commitment Therapy

Dr. Jill Stoddard likes to ask, “What is this in the service of?” This is an exceptionally helpful question to ask yourself during the mundane activities of life, and during the momentous ones. Is what you are doing serving to avoid discomfort? Or is what you are choosing to do serving you in living a valued-life? The practical nature of identifying your values is that you can begin to create action-plans and goals that line up with your values, instead of goals that purely focus on fending off the pain that inevitably is a part of life. The fact is, pain IS a part of life, and so is joy. Life is a myriad of experiences. We can live meaningful lives when things go smoothly, and even when life feels like a bumpy ride. It is up to us, however, to decide if we want to consciously respond to life and take back the steering wheel. We can begin with our values. Who do you want to be today?

If you'd like to speak with a professional at the Center for Stress and Anxiety Management about clarifying your values and living a more meaningful life, please click here.

Check out these free resources on values and related topics: 

http://media.psychologytools.org/Worksheets/English/Values.pdf

http://www.thehappinesstrap.com/upimages/the_complete_happiness_trap_worksheets.pdf.pdf

http://www.thehappinesstrap.com/free_resources

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego). 

References

Harris, R. (2007). The happiness trap: Stop struggling, start living. Exisle Publishing.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

Tags: acceptance and commitment therapy, ACT, Center for Stress and Anxiety Management, values, steven hayes, CSAM, meaning, fulfillment, mindful, pain, life, Russ Harris, personal values, mindless, avoidance, automatic pilot

Unified Protocol: Cutting Edge Treatment (2 of 2)

by Lucas Myers

Today, we continue our introduction to a powerful new therapeutic treatment for depression and anxiety disorders... ALL of the anxiety disorders.

One of Dr. Michelle Lopez's clients was astounded to learn that the very techniques she was using to reduce her anxiety in the moment were actually increasing her anxiety in the long term, making it even more difficult to manage. Her initial reaction “This is so counterintuitive!” was soon forgotten as the multiple anxiety disorders including generalized anxiety, panic disorder, and PTSD that she had been living with for years began to lose their grip on her life.

So how does the UP work? There are a number of skills that a client learns from the therapist that cumulatively comprise treatment. The client will learn to record experiences, set goals and maintain motivation, understand emotions, recognize and track emotional responses, observe emotions and reactions to these emotions, understand how thoughts influence feelings, understand the connection between behavior and emotions, learn to identify and change unhelpful patterns of avoidance, and recognize and master physical sensations. Although this might sound like a lot, the truth is that these skills are all interrelated and as therapy goes on, the client learns to combine new skills in order to face unpleasant emotions in the context in which they arise.

Emotions are responses to our thoughts and environment that motivate us to behave in certain ways. These emotion driven behaviors are adaptive in both nature and function, but can sometimes develop in harmful ways. During therapy, patterns of context, behavior, and consequences are identified. As the therapist and client work together to understand how uncomfortable emotions arise, reactions to these emotions can be replaced with more healthy and adaptive responses.

Next, client and therapist work on building motivation for change. As motivation increases, an increased sense of self-efficacy leads to empowerment and the client is ready to practice non-judgmental emotional awareness, learning to focus on the here and now and observe both the emotion and the reaction which follows it. This increased awareness allows a critical evaluation of the emotionally loaded beliefs and assumptions that lead to problematic behavior. This leads to more flexible thinking and sets the stage for breaking the negative pattern of distress. The client is now ready to actively start countering the maladaptive emotionally driven behaviors. After polishing skills to overcome harmful patterns of behavior, the therapist will prepare the client to start testing and practicing these skills by gradually exposing the patient to stressful situations that evoke distress. In the final stage of treatment, the client and therapist review all the new skills that they have learned and practiced, discuss continuing challenges, and put in place plans to maintain treatment gains.

For many clients, the end of this 12-16 week treatment program is just the beginning of change experienced as a result of the UP. Consistent with scientific research on the UP, Dr. Lopez's clients report that they continue to improve well after they completed treatment.

How can the UP be effective in treating so many conditions? The genius of the UP is that every step is designed to be flexible. An expert therapist like Dr. Lopez can emphasize specific skills to tailor the treatment to every individual client, situation, and range of symptoms. Likewise, the UP targets the shared aspects of emotional disorders, making it effective across anxiety and mood disorders.

The UP can be used as a preventative treatment for those more susceptible (i.e., family history of anxiety or depression) as well as for those with mild, moderate, or severe symptoms of anxiety who have postponed seeking treatment. The point is that it’s never too early or too late to learn the skills necessary to overcome anxiety and/or depression.

Remember, if you or someone you know suffers from an anxiety disorder, such as social anxiety, panic, agoraphobia, generalized anxiety, PTSD, OCD, or depression, professional support is available. If you are in the San Diego area and you would like to speak with Dr. Lopez, or one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com. To learn more about Dr. Lopez, read her bio in the “About Us” section. To see a list of other mental health conditions that we specialize in, click here.

Want more? Subscribe to the CSAM RSS Feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss articles on other hot topics such as stress, anxiety, depression, phobias, OCD, PTSD, and more.

Tags: PTSD, San Diego, depression, anxiety disorders, OCD, agoraphobia, social anxiety, panic, generalized anxiety

Unified Protocol: Cutting Edge Treatment (1 of 2)

The can't-miss treatment from psychology's cutting edge (Part 1 of 2) 

by Lucas Myers

Many sources of emotional suffering, such as social anxiety, panic, agoraphobia, generalized anxiety, PTSD, OCD, or depression share common characteristics. One of the challenges of treating psychological distress is quickly diagnosing and effectively treating the patient. Stories abound of friends and family members who found a therapist or doctor with a good reputation but later found that they were misdiagnosed, incorrectly treated, or in the worst of cases, even harmed by a well intentioned but inappropriate approach to care. In an environment where even trained professionals can occasionally be wrong, what chance does the average patient have of finding solutions? No amount of library research, WebMD, or advice from friends and family is likely to yield reliable answers.

Doctors, patients, and healthcare organizations all benefit from ensuring that the most effective care is available for any given problem. In order to ensure that patients are receiving the highest quality care, many professional organizations are now recommending that psychotherapy be evidence based. In other words, the treatments being used should have research backing their efficacy. One such treatment is the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Barlow et. al., 2011).

The UP is a structured, skill-based treatment that works by targeting anxiety and mood disorders simultaneously. This includes all of the anxiety disorders and depression: social anxiety, panic, agoraphobia, generalized anxiety, PTSD, and OCD. Incorporating only the latest and most effective methods of treatment, the UP represents the highest standard of evidence based practice.

Powerful and intense feelings like fear, anxiety, panic and depression can be so uncomfortable they get in the way of daily living, compelling a person to avoid activities or turn to destructive tactics (e.g., drug or alcohol abuse) in the pursuit of relief. Life can feel out of control as unwanted emotions disrupt work, relationships, important events, goals and plans. These symptoms can feel as though they increasingly draw focus away from the things that make life happy and meaningful. The UP is designed to apply to all emotional disorders, even if the symptoms aren’t easily categorized or more than one disorder is present. One of the goals of the UP is to provide the skills necessary to help clients learn to confront their emotions and respond in adaptive ways. With this increased ability to manage emotional reactions, stressful thoughts and situations lose their power and patients are able to stop avoiding and start living.

As one of the first to be trained and certified in this cutting edge therapeutic method, Dr. Michelle Lopez is becoming established as one of the foremost practitioners of the UP in the Southwestern United States:

“Obtaining certification in the UP has been a turning point in my career as a clinician. I feel privileged to help my clients master skills that go beyond coping effectively with anxiety and depression. The UP is really a set of life skills that can bring new balance and meaning to many life events.”

All of the conditions that can be treated by the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders follow a pattern. Some people are born more vulnerable to developing an emotional disorder. When these people are exposed to highly stressful, unpredictable life events they may struggle to manage their feelings . Over time overwhelming thoughts, feelings, and images can become the new “normal.” Sometimes failure to learn to cope with unpleasant feelings results in attempts to avoid, control, or suppress emotions, leading these very feelings to remain and even intensify. The UP responds to these overwhelming emotions and avoidant responses by helping the person in treatment to identify reactions to stress that are not helping and replacing them with coping skills that work.

Want more? Subscribe to the CSAM RSS Feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss Part 2 and articles on other hot topics such as stress, anxiety, depression, phobias, OCD, PTSD, and more.

Remember, if you or someone you know suffers from an anxiety disorder, such as social anxiety, panic, agoraphobia, generalized anxiety, PTSD, OCD, or depression, professional support is available. If you are in the San Diego area and you would like to speak with Dr. Lopez, or one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com. To learn more about Dr. Lopez, read her bio in the “About Us” section. To see a list of other mental health conditions that we specialize in, click here.

References

Barlow, D.H., Ellard, K.K., Fairholme, C.P., Farchione, T.J., Boisseau, C.L. Allen, L.B. & Ehrenreich-May, J. (2011). The unified protocol for transdiagnostic treatment of emotional disorders: Client workbook. New York, NY: Oxford University Press.

Tags: PTSD, San Diego, depression, anxiety disorders, OCD, agoraphobia, social anxiety, panic, generalized anxiety