Deborah Gonzales

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Is Telehealth the Future of Therapy?

As a result of the Coronavirus pandemic, many therapists have had to quickly pivot and offer their clients online sessions in an effort to help them to continue to make progress while at the same time abide by the social distancing guidelines to flatten the curve.

While it seems our country and the rest of the world are slowly opening back up, many of us have learned something very important during this crisis: telehealth offers clients something very valuable, and that is therapy on THEIR terms. It’s really not so surprising that telehealth is currently a $6 billion industry that is expected to reach $20 billion by 2025.

Here are just some of the benefits of “virtual therapy”:

Privacy

Traditionally, many people, especially those that live in smaller towns and cities, refuse to seek help from a therapist for fear people will find out. With telehealth, a patient can receive help from the comfort and privacy of their own home. This can be particularly helpful for therapists who treat teens and young adults who go to the same school/college and can feel ashamed of seeking professional help.

Telehealth is a Time Saver

Not many of us ever feel we have enough time in the day to accomplish all that we need to. You will find your clients will appreciate telehealth because it saves them having to deal with traffic, scheduling in possible long drive times, and looking for parking.

Flexibility

I have found in my own practice that those clients who often require my services the most are the ones that are overworked and often have scheduling conflicts. Telehealth helps you to offer clients timeslots outside of regular hours that you may not normally have available.

Clients Show Up on Time

Therapists benefit from telehealth as well. In any given month, many clients may show up late to an appointment. When a session can begin with the simple mouse-click, timeliness is greatly improved.

Cost Savings

Online therapy means a therapist can run their practice without the need of a front desk staff or paying for office space each month. This extra revenue can greatly impact their life.

These are only a handful of the benefits telehealth offers to both providers and patients. And while it will be a bit more time before clients and therapists fully embrace online therapy, the future looks bright.

 

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5 Strategies to Calm Your Anxiety Quickly

When you live with an anxiety disorder, any moment can become one that creates a slow-rising panic within you. Life is normal one second and the next, you feel your chest tighten and your heart begin to race. You may begin to hyperfocus on future events and find yourself getting lost in “what-ifs.”

To make matters worse, you may then begin to berate yourself for allowing the panic to get the best of you and begin to believe that all of those what-ifs are indisputable facts.

Luckily there are many powerful tools and techniques you can use to manage your anxiety effectively.

Breathe Deeply

The minute you feel a panic attack coming on, the first thing to do is stop and gain control of your breath. Deep, slow breathing sends a signal to our brains that everything is safe in our environment. Controlled breathing is one of the most powerful ways to activate your body’s relaxation response. It will take your mind and body out of “fight or flight” mode and put it instantly into a calm and relaxed state.

Accept That You are Anxious

It’s important to always remember that anxiety is “just a feeling.” And like all feelings, it can go as quickly as it came. You are having an emotional reaction to a string of thoughts. Accept your anxiety because trying to pretend it’s not happening will only make matters worse.

Let’s be clear – by accepting your anxiety, you are not resigning yourself to a life of eternal misery. You are not throwing in the towel and trying to suddenly like your anxiety. Nope. You are simply living a more mindful existence, being in the moment, and accepting whatever is in that moment with you.

Your Emotions Cannot Kill You

One of the most frightening things about a panic attack is the feeling that you are having a heart attack. But you aren’t. Your brain can and will play tricks on you, trying to get you to believe that you are in physical danger. But the truth is, you are not in physical danger. You are having an episode based on emotions and it will pass. Remind yourself of that as many times as you need to.

Question Your Thoughts

When your panic attack begins, your mind begins to throw out all sorts of outlandish ideas at you, hoping some of them stick. These thoughts are intended to keep the panic attack going.

Before you take any of these thoughts as reality and truth, question them. For instance, if your mind throws things out like, “No one here likes me. I am for sure going to screw this up. I probably left the stove on. And I’ll no doubt get stuck in bad traffic on the way home and maybe even get a flat so I will then be stranded, and on and on and on…”

Questions these ideas. Are you TRULY not liked by everyone around you? Most likely not. Are you really going to screw up? Probably not. Traffic? Well, maybe but a flat tire? Chances are no.

Always question your thoughts. You will usually find the majority aren’t very realistic or probable.

Visualize

Picture somewhere serene that brings you peace and calm. Maybe this is your grandparents’ old house or a lake you’ve visited before. Maybe it’s that fantastic beachfront condo from your last vacation. Just picture it in your mind’s eye and really put yourself there. See it, smell it, feel it. Feel how calm it feels to be in this space that is perfectly comforting and safe.

Use these techniques the next time you experience an anxiety attack. They should help you feel much calmer much sooner.

If you would like to explore treatment options for your anxiety, please get in touch with me. I’d would be more than happy to discuss how I may be able to help.

 

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How Cognitive Behavioral Therapy Can Help Us Better Understand the Black Lives Matter Movement

Most human beings have implicit biases. And that’s okay, as long as we are aware of them and aware of how our attitudes affect others.

In the United States, black people have lived through a long history of violence and social injustice. With the recent deaths of George Flynn and Rayshard Brooks, the Black Lives Matter movement has organized many protests around the nation, inspiring people from all walks of life to take a long hard look at themselves and their own beliefs.

To this end, cognitive behavioral therapy, or CBT for short, can help us all better understand the Black Lives Matter movement and how we can help heal the divide among the races. The entire goal of CBT is to change a person’s thought patterns in order to change their responses to difficult situations.

CBT combines psychotherapy and behavioral therapy. Psychotherapy emphasizes the importance of the personal meaning each individual places on events and circumstances. Behavioral therapy looks at the relationship between our thoughts, our problems, and our subsequent behaviors. Most therapists who practice CBT personalize the therapy to the specific needs and personality of each client.

Cognitive Behavioral Therapy has been used for decades to treat adults, families, children, and adolescents. It has shown great success in treating depression, general anxiety disorder, PTSD, stress, anger issues, OCD, and marital difficulties. It has been so successful in treating myriad mental conditions precisely because it helps individuals reframe what they think about a particular belief or event. It is for this reason that I and other therapists have begun to use CBT to help people understand the BLM movement and how they can help it grow and make powerful changes.

Finding the Right CBT Therapist

If you are interested in exploring CBT treatment, it’s important to look for a licensed therapist with specialized training and experience. Beyond these credentials, it’s also important to look for an individual you feel comfortable with.

If you are interested in exploring CBT, please reach out to me. I would be happy to discuss how I may be able to help.

 

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How to Set Healthy Boundaries

Relationships can only be healthy when both people have the space to be themselves and maintain their personal integrity. Sadly, many people find themselves in relationships, romantic and otherwise, with people who do not respect boundaries and feel entitled to have their needs met regardless of the other person’s. These people most likely grew up in households that were unsafe and unstable, and where there was a constant invasion of personal boundaries.

If you can relate, chances are you have a hard time creating healthy boundaries to create the life experience you wish to have. Here are some ways you can begin to do so:

Identify Your Limits

You can’t set boundaries unless you discover where it is you personally stand. You’ll need to take a bit of time to recognize what you can and cannot tolerate. What makes you happy and what makes you feel uncomfortable and stressed? Only until you have made these discoveries can you move on to the next steps.

Don’t Be Shy

People who have similar communication styles are easy to engage with. These people will quickly understand what your new barriers are. But people who have a different cultural background or personality may not easily understand your boundaries. With these people, it’s important to be very clear and direct.

Pay Attention to Your Feelings

People who have a hard time setting boundaries don’t often allow themselves to acknowledge their own feelings because they’re usually too busy worrying about everyone else’s.

You’ll need to start recognizing how people make you feel in order to know whether your new boundaries are being crossed or not. When you’re with someone, make mental notes, or even jot down in a journal how that interaction made you feel.

If, after spending time with someone, you feel anger or resentment, this is a sign that the person may be overstepping your boundaries. Reiterate to this person what your boundaries are. If they continue to disrespect you and them, you will want to cut yourself away from further interactions.

Make Self-Care a Priority

Put yourself and your needs first. This may feel strange and even somehow wrong if you’ve spent your entire life taking care of others. Give yourself permission to feel your feelings and get what you need to feel happy and well.

Speak with Someone

If you’ve spent an entire life with a sense of low self-worth, you may find setting boundaries quite difficult. In this case, it’s important to speak with a therapist that can help you discover where these feelings are coming from and how to change your thought patterns and behavior.

If you’d like to explore therapy, please get in touch with me. I would be happy to help you on your journey toward self-care.

How Telehealth May Change the Future of Therapy

A while back there was a very funny television show starring Lisa Kudrow (ditzy Phoebe from Friends) called “Web Therapy.” It was an improvised show and Lisa played a therapist who treated her patients over the Internet. Hence the title of the show.

Well, back when the show was on, the idea of treating mental health patients via a webcam seemed ludicrous. And the show did a great job at poking fun of Lisa’s character and her “wacky idea” of web therapy.

Fast forward 12 years after the show’s debut, and web therapy is now “a thing” thanks to telehealth technology. Yes, psychotherapy appointments can be held between therapist and patient while one is in one building, state, or country and the other is somewhere else entirely.

Why was web therapy a joke 12 years ago but telehealth is now gaining in popularity? The shift is most likely due to the growing popularity of tech solutions among younger generations. There’s also something very attractive about the ease of telehealth; of not having to leave your house or office to get the help you need.

As younger generations have become accustomed to using apps to have food, beer and groceries delivered right to their door, they expect these same conveniences from their health providers. While it may take a few more years before telehealth becomes truly mainstream, indicators suggest that push is more than likely to happen.

Benefits of Telehealth

We’ve already discussed the most obvious benefit of telehealth to consumers, and that is ease. But what about the benefits to the therapists?

To start, telehealth means those people who would otherwise feel too uncomfortable seeking therapy in person will now be open to seeing a therapist “privately.” This means a therapist has a larger number of people to deliver their services to.

Also, since these services can be delivered from a home office, a therapist can easily reduce their practice’s operating costs and overhead expenses.

Many therapists are saying the adoption of telehealth should have come sooner, but support and guidance on telehealth are finally coming from the American Psychological Association (APA) and other psychological organizations.

Therapist Need to Get Ready for the Switch

You can’t expect a therapist who has been treating patients face-to-face for x number of years to suddenly do well sitting in front of their computer’s camera. There are some subtle but important differences in working with patients over electronic connections.

For instance, in person, when a therapist breaks eye contact with a patient to take down a few notes, there is still a connection there because they are still in the same physical space. But over the Internet, when a therapist looks away to take notes, it may seem to the patient that the client is distracted. Providers interested in offering telehealth services to their patients will have to keep things like this in mind and always assure they are paying attention.

The APA offers continuing-education workshops on telehealth at its Annual Convention, and several divisions have begun providing training in telehealth as well. Therapists can also find online courses and training offered by the American Telemedicine Association.

No one is laughing any longer at the idea of web therapy. Instead, both consumers and therapists are embracing technology to bring about positive change and outcomes.

 

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How to Find Friends as an Adult

You may remember growing up, meeting your best friend on the playground or making friends in French class. As adults, we don’t have systems built in to make friends like we did as children. We can’t even reach out to loved ones for help, because while it’s socially acceptable to say “I’m looking for a boyfriend”, its not socially acceptable to say “I’m looking for a best friend.” If you want to find a friend as an adult, it’s going to be a lot like finding a romantic partner.

Envision Your Friend

Think about what kind of person your friend would be. Think back to your childhood friends and what made them fun to hang out with. Should your friend be extroverted or introverted? Should they love the outdoors or be a movie buff? Look for qualities in your friend similar to the way you’d look for qualities in a partner.

Go Where Your Friend Would Be

Now that you know what kind of person your friend would be, think about what that person would be doing. Where are they on the weekends? Where do they shop or like to go out to eat? Go to those different places. If you’re an outdoorsy person and want an outdoor-loving friend, find outdoor meetups. Try a hiking or walking group, or sign up for a new fitness class. Keep in mind as you test the waters that you won’t find your friend on your first outing. Just as when you’re looking for a partner, it takes more than just one try. It will take a bit of time and searching.

The Big Ask

When you’re ready to ask out your potential new friend, a great way to get a “yes” is to invite them to a favorite, or to something new. For example, invite your friend to go watch your favorite sports team or over to your house to cook your favorite recipe. You can also invite them to play a new board game, or out to watch a new movie.

Stoke the Fire

You’ll need to nurture your budding friendship by spending more time together. Just as in dating, take it slow and steady, and don’t take anything too seriously at first. Too much too fast could set you up for a friendship that’s not going to work, or might make the other person feel smothered.

You can deepen the friendship by working on goals together. Find out what your friend dreams about. How can you help them meet their goals? How can they help you with yours? Maybe they can help you get ready for a summer swimsuit, and maybe you can help them organize their garage. Find ways to work on things together.

Do you find yourself struggling in social situations? A licensed therapist can help you overcome shyness and improve your social interactions. Give my office a call today, and let’s schedule a time to talk.

Pets Are Better Than Medication

“Dogs have a way of finding the people who need them, and filling an emptiness we didn’t ever know we had.”

– Thom Jones

For many of us, our home is just a house unless there is something with four legs and a tail sharing the space with us. Our pets are not only cuddly and cute, they give us unconditional love.

But it turns out our pets actually offer us more than “just” unconditional love; they seem to also have the ability to help our physical and mental well-being.

Research has found that the bond we share with our animals can do everything from improve our cardiovascular health to lower our cholesterol and decrease our blood pressure.

Beyond these physical health benefits, our animal companions can help our mental and emotional life as well. Here are some ways your pet is better than medication.

Our Pets Teach Us Mindfulness

Have you ever just watched your dog or cat find a swath of sun as it streams into your house in the afternoon? They seem to luxuriate in the warmth and energy of the sun in those moments. Nothing else matters to them but enjoying the feeling of the sun on their body.

Our pets can teach us how to be more mindful and enjoy every moment of our life if we let them. Studies have shown that mindful meditation, which simply means to be fully in the present moment, helps alleviate stress and anxiety.

Let your pets be an example and try and spend more time just “being” instead of “doing” so much.

Pets Relieve Stress

Let’s face it, each of us faces our fair share of stress in life. But research has shown that our dogs and cats act as de-stressors. This is why a growing number of companies such as Atlantic Health System, Mars Inc., Amazon, and Etsy, to name a few, are allowing employees to bring their dog to work.

College students are a segment of the population that also feels a lot of stress. When the University of British Columbia brought therapy dogs on campus, allowing a group of 246 students to pet and cuddle them, the students reported their stress levels decreased significantly after the interaction.

Pets Offer Empathy

There are numerous accounts of war veterans who, when they experience pain and agitation, are comforted by their service dog who will run into the room, somehow sensing their need for empathy.

Recent findings from the University of Vienna suggest that dogs can sense emotions and even differentiate between good and bad ones. There are numerous reports of cats living in nursing homes, sensing when someone is about to pass and going to lie on their bed.

The long and short of it is, when we are feeling tired, scared, sad and alone, our pets are there to remind us that we are not alone and that they love us very much. For those of you who have pets, hold them tight and show them your appreciation. For those of you that don’t have pets, it may be time to take a trip to the local shelter.

 

How to Ask for Help in Times of Need

You probably remember a time in school or out shopping when you wanted to ask for help, but stopped yourself. You might have even had a prompt from the teacher: “Does anyone have any questions?” or from an associate “Is there something I can help you with?”. Still, even when it’s their job (or their joy) to help, you might hesitate.

It can be even more difficult when you’re going through difficult times and can really use another set of eyes or hands. If you’re overwhelmed with work and home life, or if you’re going through some tough emotional business, sometimes you just need someone to help.

Why Is It Hard to Ask for Help?

If you look back to your past, you might see where the roots formed that made it more difficult for you to ask for help. Your parents might have made you learn to figure things out on your own, then given you great praise when you did. As a child, you may have been met with resistance or anger when you reached out for help. Maybe you had a parent who modeled the “do it yourself” attitude, always refusing to ask for help. These early formative experiences can leave you with the impression that asking for a help is a deficiency. You might also have difficulty asking for help because you don’t want to surrender control to an outside person, or because you don’t want to feel like you “owe” anyone anything.

How to Ask for Help

If you have difficulty asking for help, you may have learned some less than optimal coping mechanisms over the years. You might try to make someone feel guilty or feel sorry for you. Or in your haste, you may ask the wrong person; instead of someone who would be better able to help you, you choose someone who’s more likely to say yes.

  • Be Specific: To ask for help, it’s best to be straightforward. Know in advance exactly what you need, and be specific with your request.
  • Go to the Source: Instead of going to people who are easy to talk to, or people who are more likely to help you, seek help from those whose help you need.
  • Offer an Exchange: It may be easier to ask for help if you offer something in return. For example, if you need someone to pick up your child at daycare so you can work late, offer a playdate in return.

Are you having trouble juggling work and home life? Are you struggling to deal with some tough emotions and need some support? A licensed therapist can help. Please give my office a call today, and let’s schedule a time to talk.

When to Worry: Recognizing Signs of Trauma in Your Loved Ones

Over the past several years, there have been numerous traumatic events all across the country. From incidents of mass violence to devastating natural disasters, hundreds of thousands of Americans have experienced or witnessed a disastrous or life-threatening event. In addition to tragedies such as these, anyone who has experienced a shocking or dangerous incident (such as a car accident or a robbery) is at risk of developing Post Traumatic Stress Disorder (PTSD).

PTSD is a serious mental disorder that requires medical treatment. PTSD can have devastating effects on every aspect of a person’s life, from their marriage and family, to their friendships and career. If you’re concerned that a loved one may be suffering from PTSD, here are some signs to look out for.

Reliving the Trauma

Someone with PTSD will have repeated, involuntary re-experiences of the event. They may experience bad dreams or flashbacks. They’re also vulnerable to certain triggers that remind them of what happened, such as sounds or smells.

Angry Outbursts

Someone silently suffering from trauma may be prone to anger, agitation, or sadness. Feeling irritable, the sufferer may be prone to outbursts of anger that they can’t control. If you’ve noticed your loved one frequently losing control and lashing out in anger, this is a sign that they’re suffering emotionally and require treatment.

Withdrawal

People suffering from PTSD will avoid people and situations that are reminders of the situation. As the victim continues to isolate themselves, how their friends and family react to their withdrawal will likely further isolate them, causing additional emotional distress.

Substance Abuse

It’s not uncommon for people with PTSD to self-medicate. Seeking an escape from high levels of stress and difficult emotions, they may turn to drugs or alcohol. The painful trademark of substance abuse is the growing need for more of the drug to produce the same high. If left untreated, as substance abuse grows, the abuse will turn to addiction and eventually dependence. This can have devastating effects on every facet of a person’s life.

 

If you’re concerned that a loved one is experiencing symptoms of trauma, the most important think you can do is encourage them to seek professional diagnosis and treatment as soon as possible. You can help by contacting offices and vetting therapists on their behalf, and volunteer to take them to an appointment. Assure them of your love and support throughout the process.

For additional guidance and recommendations from a licensed professional, call my office today.

Counseling to Military Active Duty and their Families

Military families are uniquely affected by work and life stressors. Deployment, pre-deployment training and preparation, as well as reintegration can affect not only the service member, but their spouse and family.

Service Members

While Posttraumatic Stress Disorder (PTSD) receives a great deal of attention and discussion, transition stress is another affliction affecting veterans that’s often overlooked. According to a 2018 study published by Clinical Psychology Review, many veterans struggle with the transition back to civilian life. The excitement and purpose of serving in uniform, the sense of belonging, and the camaraderie of their squad can cause transitioning veterans to feel a loss of identity as they shift back into civilian life. Difficulty finding new employment and re-establishing relationships with family and friends after deployment can also present unique challenges. Left untreated, these issues can lead to anxiety, depression and other disorders.

Spouse

Being married to a service member uniquely affects a spouse. With their spouse’s expected long-term absence comes the stress and responsibility of maintaining a home and family alone. Uprooting from one home to another is stressful and exhausting, and presents the military spouse with numerous challenges to overcome as they support their deployed spouse, a home and family.

Family

Every child reacts differently to a parent’s deployment. However a child reacts, they will likely struggle with the change in their family dynamic. Children are emotionally vulnerable to the effects of deployment. Studies have shown that young children with a deployed parent are more likely to exhibit behavioral problems, as well as experience depression and anxiety.

There are many difficulties military families must face in selfless service to our nation’s security. Our counselors are experienced in supporting military families as they cope with the unique challenges presented by the military lifestyle. Our organization is proud to provide effective, comprehensive mental health services tailored to military active duty and their families.