While most people traditionally think of therapy as involving two comfortable chairs in a fairly cozy office, psychotherapy has been offered many different ways for decades (e.g. phone therapy and even therapy by email). Over the last few years, we have seen an increased interest in video based therapy. Using software similar to Facetime or Skype, online therapy or internet based counselling is an alternative method of traditional therapy that enables one the opportunity to meet with a mental health care provider even if you are far away or when your time is limited and you want to sneak in a session during a break from your daily demands.
While video based therapies also open up the opportunity to see professionals from a larger geographic region, it is important to recognize that much of the work provided over this medium must be provided by an individual registered provincially to work in Ontario. This means that you are generally restricted to Ontario-based psychotherapists and psychologists. This can also mean that moving out of the province may make it difficult for your local therapist to service you from afar. This restriction is not in place in all regions, so you should certainly discuss with your treatment provider whether this is an option for you.
I am often asked if I think the same level of connection can be cultivated in an online session versus an in person one. I would say that video based sessions are essentially 90% the same. Whenever possible, I prefer to have at least one in person session with a client before offering to switch to online support. This allows us some time to get to know each other and build a strong rapport with all of the context of in person. Perhaps there is something special about sharing the space with your therapist or having increased presence to allow the conversation to deepen. However, for many people the alternative of online support is more feasible and therefore more helpful than getting no support at all. Differences between online and in-person care may vary from person to person, and some might even find that they are more easily able to open when discussing concerns from the comfort of their own space. For individuals that struggle to get out of the house due to mobility issues, phobias, transportation barriers, or child/elederly care responsibilities this alternative avenue for support may be essential.
Because this form of support is becoming more commonly available at clinics across the world, it is now easier to continue therapeutic relationships despite life changes instead of having to start over with someone new. This online opportunity also opens up many avenues for individuals in rural communities to access qualified support that may not be available close by or may be limited by a local clinician’s areas of expertise. Furthermore, clinics are starting to offer online structured module based psychotherapy where clients complete educational pre-recorded videos and readings, complete homework and are monitored by a therapist. These might be more suited towards individuals who are not as comfortable opening up, looking for something structured and have limited financial funds to pursue long term options.
While video therapy may not be for everyone, it has become an increasingly available and research-supported method of intervention. If you find getting to session a challenge, why not consider talking to your support team about including some video based work.
While deciding to engage in therapy can feel like a big decision, it is not the only challenge one may face prior to sitting down in the therapist’s office. A common question we hear from clients is a lack of direction when “shopping” for a therapist or therapeutic approach that is the right fit for both themselves and their area of concern.
While it may sometimes feel overwhelming, seeking a better understanding of what approach will be the best fit for you does not have to be especially difficult.
Seeking Treatments that are Evidence Based
Accessing an evidence-based approach to psychotherapy means that the techniques being applied in treatment are supported through research and have been found effective in reducing symptoms for people with a particular type of concern. There may be a variety of different options available that meet your needs, but not every “validated” approach will be the right fit for you or your particular area of difficulty.
Not all domains of therapy are easy to study in controlled research trials, meaning that not all therapy orientations receive the “evidenced based” seal of approval. Styles of therapy that are not evidenced based are not necessarily ineffective, but a practice modality that is at least informed by this research is ideal.
You will generally find that many therapists use an eclectic approach to treatment, meaning they borrow strategies from a variety of different therapeutic modalities and incorporate them into your care in an individualized manner. This is very common because it allows the therapist to choose a combination of techniques that seem right for you, rather than trying to fit you to a specific mold. What is most important is that the therapist is trained in each of these different approaches.
What if the fit doesn’t feel right?
As a client, you have every right to change your mind with regards to your consent to treatment and can stop treatment/therapy at any time. Consent should be an ongoing and collaborative process. Perhaps you try out a therapist and agree to a treatment plan, but later find that things are not moving the way you would like. It is certainly within your right to discontinue care at any time and transition to a new treatment provider, though you may also find you benefit greatly from communicating your concerns with your therapist and seeing if they use that feedback to further shape the collaborative process to meet your needs. Lastly, it is important to give it more than just a session or two before you assess fit. Keep in mind that the therapist only has the information you have provided to get things started and sometimes we need a few sessions to obtain a fuller understanding of your needs. So, give it a chance, but also recognize if your needs are not being met and consider moving on if that seems to be a hurdle you cannot cross.
Often, the demands we face at work go well beyond getting things off our task and to-do list. These demands can begin to weigh on us and consequently add a lot of stress to your plate. Stressors can come from may relate to management of the workplace, one’s workload, or difficulties with co-workers or employees. Consider the example of a team member or leader becoming aware of imbalances in how a peer or employee is pulling their weight at the office. Your first instinct likely will not be to have the person fired, but you will undoubtedly recognize that the employee needs some feedback in order to recognize that a change is needed. This is a pretty common experience, one that is even more complicated if you work with friends or family members and do not want to ruin the relationship by being critical.
We can all probably relate to the discomfort of having these sorts of difficult conversations. You may even see the similarities to situations that are not professional related. Maybe you notice that one sibling is not helping out as much with care of your aging parents. Indeed, we all experience some sort of conflict in our lives where productivity and responsibility conflict with our relationships.
Before initiating a difficult conversation, it is important to start with a period of honest reflection, with the intention of widening your perspective to alternative explanations for the experience. Next, we must move towards an open and collaborative dialogue where both sides can have an opportunity to feel heard.
Managing a conversation where there is a need to be assertive while simultaneously attempting to minimize conflict is difficult. There are some guidelines, however, that can certainly help navigate these sorts of difficult conversations:
Have you ever had a situation where these tips might have come in handy?
While work generally is not a day full of fun and games, it should also not be an environment that completely drains you of your emotional resources. When the balance is off, assess, discuss, and act. It is quite likely that you are not the only one feeling the imbalance and we may find their are allies all around us looking to get things back on track.
Anyone can get stuck. We face problems, we know they are there, but we feel at a loss on how to move forward. Sometimes the best path forward is to have a structured way to consider and tackle the concerns we are experiencing in our lives. Marsha Linehan, the creator of Dialectical Behavior Therapy, discusses four options that can be applied to any challenging problem. These four options provide a good path to clear one’s mind and help clarify a direction when one feels utterly stuck in a difficult situation.
So the next time you feel stuck and upset ask yourself what it would look like to employ each of these four options and then decide which option will be most satisfying for you and the desired result. You may not be able to solve the problem, but you might be able to avoid staying miserable.
For many things in life, the timing of an event can be critical. When to text your date from Tuesday, but are trying to play hard to get with, now that is critical timing. But when it comes to seeking help for mental health concerns, timing tends to align more with the saying “better late than never”. For many of us, making that first appointment takes a lot of courage, and we still are not certain what we expect will come out of it. For those individuals, therapy is usually about planting the seeds for readiness for change. One might worry what the consequences of attending therapy will be, but generally, other than the financial cost of receiving private mental health support, getting support from a registered and qualified professional usually does not hold any notable risks. Therefore, the earlier you seek support the easier it is to learn ways to help prevent things from getting worse, support yourself better, cope better, or see yourself and your problems in a new light.
As long as you have a goal in mind and are open to making changes, therapy can be extremely helpful not just for those who have severe mental illness, but also those who desire to grow emotionally.
Positive psychology is a branch of psychology that focuses on the application of psychology for self improvement, rather than the resolution of illness. Therefore, its emphasis is on health promotion and focussing on what is going well rather than on pathology. As the stigma associated with therapy continues to shrink, seeking counselling/therapy services for the purpose of goal attainment and wellness rather than treatment of clinical psychopathology is growing. Seeking a regulated therapist is more like finding a “coach” who is trained to help guide you toward your goals.
One of my first posts on Wellness Wednesday tackled the ever relevant topic of attention and provided several tips to improve focus and concentration during the day. Today, I wanted to follow up on that post and explore memory, a different but highly interrelated ability. Indeed, if we do not pay attention, we definitely are unable to encode information into our memory storage systems.
In order to understand how to improve our memory we need to understand how memory works. Current theories of memory focus on three distinct stages: sensory memory; short-term memory; and, long-term memory. It is a common misconception that the briefer aspects of memory are far lengthier than they really are. For instance, sensory memory is only 2-3 seconds and short term memory only naturally lasts around 20-30 seconds. While we may be able to do a series of tricks to make those first two stages seem like they are lasting a bit longer, what you are probably most interested in is improving is your long term memory.
The best way to “improve” your long term memory is to make sure that you encode information properly so that it is stored in long term memory. You also want to make sure that the information is encoded in a manner that is easily retrieved where and when you need it.
Consider the file folder system at an old school doctors office with hundreds of patient files are filed alphabetically by last name. Our brain's memory storage is surprisingly similar to this. If we do not file information in an organized way, we will have immense difficulty retrieving the information when needed from those long-term memory stores.
Now that we have a bit of background on how memory works, let us get started on some basic memory strategies that you can use (or maybe you are already using intuitively) to help yourself be more productive each day.
Four memory strategies that you can start using today:
Give one of these techniques a try and let me know which helps your memory the most. Do you have any other memory strategies that you find help?
Several weeks ago I told you about how I was exploring my hobbies by joining a ceramics classes (CLICK HERE if you would like a refresher or missed the original post). This, as you may recall, was part of my commitment to challenge myself to learn a new skill. One course and a few colourful bowls later, I am here to share what I took from the experience.
If you challenged yourself to take part in a new hobby or activity during 2019, take some time to reflect on what you were able to take away from the experience. Did you get anything out of it that you did not anticipate? What sorts of activities and opportunities could lay ahead for you this year?
Last week we discussed how writing down one’s resolutions and creating a SMART goals structure can help one get started on some actionable changes for the new year. While a lot of us are pretty good at getting started, keeping these resolutions can be a bit more challenging.
It is pretty clear that gyms are busier in January and then go back to normal by March. We need to acknowledge that it is hard to keep resolutions and sometimes we fall off the “perfect streak” we have been striving for.
It is important for us to accept that we must revisit our resolutions throughout the process and alter them once we have a better sense of how realistic they are. Go back to the SMART goals framework and ask yourself… “was it really that realistic for me to commit to going to the gym every day?”
There is a difficult balance between choosing a resolution that is a challenge and simultaneously realistic.
Media often postulates that it takes about “30 days” to form a habit. Challenging yourself to reach that 30 day point might, in fact, be exactly what it takes to let that goal become part of your lifestyle routines. When trying to maintain motivation, I think it is best to look at things day-by-day instead of reminding yourself that you need to maintain this change forever. If you can focus on doing your best each day, after 30 days it might not feel so difficult.
But what happens if you do slip up during that first month? I would suggest that you try not to let that “slip” lead to you giving up entirely on your goals. Remind yourself that you are human and that changes to lifestyle routines are difficult to implement and maintain. You may also want to determine whether you set too many goals. Try focusing on one behaviour change at a time.
Most importantly, do not shame yourself for slip ups, but rather use it as a behaviour marker to improve upon (e.g., “I made it 8 days on this streak, let’s start again and see if I can beat it”).
If you have not already started a resolution for the new year, here are ten ideas that don’t include the obvious diet and exercise goals:
Last week we discussed the importance of looking behind us and trying to be open to honest feedback before looking ahead. Today we explore what looking ahead really entails and how to set goals for the new year.
Making resolutions is something that is commonly associated with the start of a new year. Seeing as this year is also the start of a new decade, it is definitely a good time to set some goals and plan out how you are going to work towards reaching them.
I find that writing things down helps to make goals and intentions a stronger commitment, at least to yourself. Sure, your personal journal is not a formal contract, but seeing things in writing can be helpful in making you feel more accountable.
In the past, I have written down both short and long term goals. I find that having both are important to consider, as short term goals can help momentum, while the long term plans can give you a direction to aim for.
While some of us may feel more comfortable working towards these goals privately, the push of a supportive group of peers can also help move you towards success. An increasing trend is to get together with a few peers, perhaps with some optionally healthy snacks and drinks, to make a fun evening out of goal setting for the new year.
Goals can be as common as going to the gym, eating healthier, taking that exam you have been putting off, or as unique and personal as having the resolution of being more mindful of others feelings when in family settings.
What is important when writing down your resolutions is to have in mind the framework of SMART goals: Specific: Measurable; Attainable; Relevant; and Timely. If we are clear on why a resolution is significant to our lives and how we plan to go about working towards it, it is much easier to assess our progress and start turning that goal into action.
This year, as I contemplate my own resolutions, I am asking myself what change will lead 2020 to be a better year than 2019.
As we approach a new year and begin to think about our goals for the year ahead, it can be helpful to reflect on the year that has passed. This reflection should highlight our successes, how we have grown, and what we have learned, but should also include considerations of areas where we could continue to seek positive change.
While we can all be critical of ourselves from time to time, we also can have blindspots and may struggle to be attuned to the flaws that others have even explicitly identified in us. Thus, it can be helpful to take the time to reflect on the feedback of others and to challenge ourselves to accept what others are saying.
Accepting constructive feedback can be tough. It may feel like rejection, because it reminds us that we are far from perfect. When someone else points out our flaws, even in the most constructive and sensitive way, it can still make us cringe and result in us reacting defensively.
We should recognize that it is natural to respond defensively and say “but what about all the times that I wasn’t like that”, but letting go of that initial response is necessary to facilitate growth. Indeed, it can be really difficult to fully hear another person’s critiques and see that they are giving us this information because they have not given up on us and think that this information can be invaluable in moving us forward as a person.
My resolution this year is to be more open to feedback, listen when it is given to me and try to take something away from it other than anger.
Why not ask yourself what feedback have you learned from in the past and how this allowed you to grow. Then, ask yourself if there is more recent feedback that you have been trying to discount that may help you grow even further.
Jessica is a member of the clinical wellness and learning support team at FLEX Psychology. Jessica started Wellness Wednesday out of a desire to provide further opportunities for her clients to extend their wellness journey to all avenues of their life. You can learn more about Jessica by clicking here or by learning more about her and the clinical team at FLEX Psychology by clicking here.