Anxiety Training Tips

By: Bridget Eickhoff

Anxiety, worry, and panic are felt by many of us at some point in our lives. After attending a training by David Carbonell, Ph.D. on chronic anxiety, I picked up some helpful tools that I would like to share.

The more you oppose unwanted thoughts, feelings, and sensations the worse they can become

A big reason behind anxiety symptoms is self-protection. People often interpreted anxiety as a signal for danger, meaning fight, flight, or freeze; but what if that was a false signal. What if this feeling is intense discomfort that will eventually pass if it is not forced to be silence. Next time you are experiencing anxiety check-in with yourself and if you indeed are in danger or is this discomfort? If it turns out to be discomfort allow yourself 5-10 minutes to worry, you may be surprised how different it feels to allow the worry to have its time rather than continue to suppress it.

 

The Rule of Opposites

Think of yourself swimming and trying to avoid a large wave coming your way. You may ask yourself “what is the best way for me to avoid this wave?” Your instincts may say to swim away from the wave and hope you can be faster, but in reality the easiest way to avoid the wave is to swim under it. The same can apply to feelings of anxiety and worry. During a panic attack your gut may tell you to hold your breath or take in more breaths at a time, when what is shown to help is taking deep belly breaths. Next time you find yourself beginning to feel anxiety or panic, try to recognize how your gut tells you to react and think about what the opposite might be.

 

The next time you are experiencing high anxiety or a panic attack be AWARE

Acknowledge and accept the feelings

Wait and Watch – recognize what the sensations in your body and your thoughts (this could be a good time to try doing the opposite of your usual)

Action – make yourself comfortable while waiting for it too pass

Repeat – go through steps a-c and try to think to yourself it will end no matter what I do

End of intense anxiety or panic attack

 

Our therapists at CARE Counseling are trained and competent in working with those experiencing symptoms of anxiety. Your counselor will be able to help explore with you common patterns of negative thinking, help you develop successful coping skills, and teach calming strategies.

 

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For more helpful information on anxiety click here

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Ways to Successfully Balance a Full Caseload as a Therapist

By: Bridget Eickhoff, MA, Alison Dolan, Psy.D., LP, and Andrea Hutchinson, Psy.D., LP

Being a therapist can be a fulfilling and rewarding career. However, it can be hard to remember that therapists are humans who also experience anxiety, stress, and burnout. We took a survey of 30 clinicians at CARE Counseling asking what makes them feel successful and balanced at work. Here are the main points our amazing clinicians found that help them find balance when working with a full caseload.

  • Create Boundaries and Stick to Them
    • Let your clients know your boundaries for cancellations and follow through with the boundaries you’ve set or are set by your agency. Therapy should be a flexible time for the client to address topics that are important to them; however, aspects of structure are important in therapy to keep both your clients and yourself accountable. 
    • Start and end sessions on time so that you have time to complete documentation, grab something to eat or drink, use the restroom, consult with a colleague, and/or take a moment to regroup.
  • Manage your Schedule Proactively
      • Make your life easier by scheduling clients as recurring appointments and practice confirming the next appointment at the end of the session. 
      • You probably enjoy seeing clients and it can be heartbreaking to refer them out. However, back to that accountability point, close your clients who are not following the attendance policy (or use supervision and consultation if you need guidance) and give them referrals to help with barriers (e.g., closer to home, different hours, attending to a different piece of their difficulties, etc).
      • Proactively reach out and ask for more clients if you start to notice your caseload looking low or you have inconsistent clients. 
        • Keep in mind, being proactive will help keep the number of intakes in the same week lower and documentation will likely feel more manageable. 
      • Take advantage of cancellations and catch up on documentation or check-in with a co-worker. If you are finding yourself racing towards burnout remember:
        • You can use PTO and take a day or more to feel grounded again
        • Ask if you can have a temporary block off time in your schedule to help you gain some extra time to feel like things are more manageable again
        • Talk to management to see if there are ways to contribute to the team without as many client appointments. 
  • Try to NOT Take this Very Personal Job, Personally (easier said than done)
      • For both you and your clients, use your intuition for goodness of fit. As you know, a healthy therapeutic alliance is a key factor for the overall success of therapy. At times, especially as a new clinician, it can be difficult to decipher between your intuition and anxiety. Clinicians should utilize supervision and consultation to explore types of clients who are and are not a good fit. Supervision and consultation are also helpful when you feel stuck.
      • Sometimes, it can feel pretty personal when a client cancels often or ghosts us. Keep in mind, clients will cancel appointments for a multitude of reasons ranging from weather, illness, moving, and symptoms and this happens to the best of us. 
  • You’re Not Alone
    • Consult with your peers and use supervision to feel balanced and confident with your caseload.
    • While you are likely a compassionate person, remember you too may have times when you need to check-in on your own mental health. Remember everyone can benefit from therapy!

Telehealth Training Day

 

Here at CARE we are dedicated to making sure that our staff members are properly trained. Telehealth allows therapy to be provided to a much larger community of people. Ensuring that our staff members are appropriately trained is important to us. We want to make sure your time spent together with your clinician is private, secure, and safe. Zoom is our new video conferencing system that we are using to conduct our Telehealth sessions. Zoom is HIPPA compliant and super easy to use!

Click here to watch our telehealth training day for our clinicians! 

Learn more about Zoom by clicking the link below:

http://care-clinics.com/about/telehealth/

Mental Health In The Workplace: The Value Of Rest

By Jennifer W. Adkins, Ph.D.

 

Earlier this week, I found a scrap of paper while cleaning that stopped me in my tracks. On it, I had written “take a year off” followed by a short list of commitments in my personal and professional life. The list included things I had entered into with excitement—like training other people in my profession and organizing community events—but didn’t have the time or energy needed to continue.

At the time I wrote the list, exhaustion was my norm. I was living with episodic and unpredictable pain, and my work was suffering. I didn’t have the energy to do all the things I normally do. I was keeping my commitments but performing poorly, which made me feel miserable.

What I didn’t know when I wrote that list was that depression would soon be a part of my life. I missed some of the early signs, but eventually it became clear that I was not well. The first clear sign came when I felt no joy during the Night to Shine Prom, an event my friends and I had spent months planning. It’s something we always consider to be “the happiest night of the year.” I thought something might have been “off” with the event, but as I saw joy on everyone’s face except my own, I realized something was “off” with me.

It was then I realized I needed a period of rest for my mental health. And along the way of implementing that rest, I learned a few helpful tips:

It Can Take A While

Some commitments are easy to take a break from, while others require more planning. After the Night to Shine Prom, I let the planning committee know that I wouldn’t be able to help plan the next prom. It was emotionally difficult, but it was quick. However, some of my other commitments took time to transition away from, as I had to identify and train a replacement before I could step down. It took months to fully cross off everything on my list, but each time, I felt a weight lift.

You May Second-Guess Yourself

Each person will face different challenges when preparing for a period of rest. I felt like I would be judged, I felt guilty for being less involved, I worried that important things would be left undone, and I didn’t want my relationships to suffer. These thoughts were common in the beginning, and I had to keep reminding myself how important it was for me to rest and recover.

People May Not Support You

Your colleagues, friends and family probably aren’t fully aware of the reasons rest is necessary for you. If their initial responses aren’t as supportive as you’d hoped for, it might mean they’re just surprised, or they rely on you and will miss your contributions. You may find it helpful to explain why you need to take a break. In some instances, though, the best thing you may be able to do is to quietly try to understand things from their perspective.

Stepping Away Is A Surprisingly Positive Process

Maybe you realize how important it is for you to cut back and have fewer responsibilities. What you may not realize is how positive it can be for other people. During the process of transitioning my responsibilities, I got to see people step up who were just as passionate about these roles as I had been. Almost immediately, the energy they brought to the roles resulted in growth and improvement I hadn’t been able to fully offer for a long time.

Rest Is Hard…

Rest is not accomplished by simply taking time off and then going back to your busy schedule. Rest occurs when you allow yourself to be fully inactive. A period of stillness and rest may be a necessary precursor to a more active mental health recovery. After a period of rest, you may find that you are more motivated to engage in activities like exercise, reading, crafting, praying, journaling or spending time with loved ones. You will be more likely to benefit from those wellness-promoting activities if you have taken time to rest first.

But The Results Are Worth It

When you’re rested, you’ll have energy to enjoy the things you love again. You’ll know you’re on the right track when your response to your personal and professional opportunities changes from “Oh no” to “Heck yes!” Even before I considered myself fully rested, I found I had more energy to be a mom, to be a wife and to commit to my work. After resting for a month, I was thrilled with the quality of my work. I even had energy left over to spend on myself and the things I enjoy.

You May Not Have All The Resources You Need To Rest

I am blessed to have the support of family and friends—and access to paid sick leave. I know these are not resources everyone has and sometimes paying the bills, getting your kids to school or taking care of your loved ones may not be things you can readily disengage from. My advice if you cannot commit several days—or, dare I say, weeks—to rest is to take advantage of whatever opportunities you can. Do what you absolutely have to do and then rest the remainder of the time. Maybe instead of committing a month to complete rest, you start by committing a month to only doing the things you need to, letting non-essential projects wait and accepting help from others when it’s offered.

I am grateful to have experienced firsthand the profound impact rest can have on mental health and work. Its positive impact has influenced me to incorporate continued rest into my regular schedule. I feel great, and I am proud of the work I am doing. I know if I want things to stay this way, I will need to intentionally make time for rest.

Coming across the slip of paper that started my journey toward rest was a shock. As soon as I saw it, memories of how physically and emotionally exhausted I was rushed in. I cried as I recalled all the moments and days I lost to pain and depression. Then I realized how much better I feel now and the role that rest played in me getting to a better place. Seeing that slip of paper strengthened my resolve to rest when I need it.

 

Jennifer Adkins is a wife, a mom, and a psychologist. Her professional interests include treatment of anxiety disorders, improving family relationships, and reducing stigma associated with mental illness. 

 

https://www.nami.org/Blogs/NAMI-Blog/August-2017/Mental-Health-in-the-Workplace-The-Value-of-Rest

How Do I Know If My Therapist Is Effective?

By Laura Greenstein

 

It can be a challenge to find the “right” therapist for you. You might come across someone who has a degree from an impressive school, writes extensively on psychology and mental illness, gives lectures and talks, and still isn’t an effective therapist. And while it is important for therapists to be educated, trained and up-to-date on current practices, there is so much more to a good therapist than just their background and education.

Because the science of therapy is subjective, it can be challenging to tell if your therapeutic relationship is truly “working.” Here’s a list of how effective therapists practice to help you determine whether you’re receiving the best possible care.

Do They Guide You To Your Goals?

Be wary of any therapist who makes promises like: “I can get you to recovery in six months” or “I can help you get rid of your anxiety.” Therapists should guide you towards reaching your goals, not make guarantees about when and how you will reach them. How you improve should be at your own pace. Additionally, they are not there to set your goals for you. This is your treatment—you’re in the driver’s seat.

Do They Show Acceptance And Compassion?

It’s one thing for your therapist to show concern or recommend against certain behaviors, but you shouldn’t feel judged or ashamed after a therapy session. Christine, a young adult living with Borderline Personality Disorder (BPD), tells a story of when she felt shamed by a therapist:

“I went to a therapist to talk about a relationship I was having a hard time getting over. I told her I would do outlandish things to keep this relationship alive, even though this guy made it clear he wanted nothing to do with me. This therapist responded by saying, ‘Christine, men don’t like clingy women. You need to be coy and play hard-to-get.’ She completely invalidated that my fear of abandonment had been triggered; to her, this situation had nothing to do with BPD, I was just making myself too available.”

The most effective therapists make you feel accepted and validated, showing understanding and sympathy/empathy for whatever you’re going through. They will approach you with compassion and kindness, and build enough trust for you to share your darkest thoughts and memories with them.

Do They Challenge You?

It’s important to recognize that therapy is not synonymous with friendship. An effective therapist will challenge you and help you see things from a different perspective, even if it’s hard to hear. They will give you homework that you may not like. For example, when I feel anxious, my reaction is to try to get rid of that anxiety any way that I can. So, my therapist often tells me to “sit with anxiety, accept that anxiety has visited you and observe how you feel.” She pushes me out of my comfort zone to help me overcome my fears and work towards my goal of managing anxiety.

Do They Check-In With You?

It’s important for your therapist to check-in with you about how you think therapy is going. After giving me challenging homework, my therapist will often ask me how it went or if I found it helpful. Since each session is tailored to you, a good therapist should adjust treatment based on your feedback. For instance, if you feel like they pushed you to do something you weren’t ready to do and you say you want smaller, more achievable steps, your therapist should take this into consideration for future exercises.

Do They Help You Learn?

An effective therapist offers different ways to help you learn skills (such as managing difficult emotions, handling stressful situations or practicing acceptance), understand yourself better and encourage healthy communication with the people in your life. “One therapist helped me see that when I like a person, whether it’s a relationship or a friendship, I have a hard time seeing red flags,” says Christine. “She helped me realize this about myself, and now I push myself to see people in a more realistic way.”

At the same time, this doesn’t mean telling you what to do each step of the way. Rather, they help you learn how to handle the stressful situations life throws at you. It’s problematic if you feel dependent on your therapist.

Do They Practice Cultural Competence?

Therapy should be tailored to your specific culture, background and needs. A good therapist is understanding of any cultural barriersyou face and should keep those in mind while advising you. “When I met with my therapist in the first couple sessions, they were interested in learning about my culture and how it has impacted my experience,” says Ryann, a person with lived experience. “Culturally competent therapists say validating statements rather than questioning my upbringing.”

Do They Treat You As An Equal?

An effective therapist works with you and supports you. They’re your partner in bettering your mental health. They’re not the teacher instructing the “right ways” to behave or the parent asserting discipline over a child. There shouldn’t be any kind of power struggle or “doctor-knows-best” attitude in their demeanor. While it is important to respect their wealth of knowledge, you shouldn’t feel inferior to your therapist.

Therapy is one of the few parts of life that is all about you. Therapists are not there to express their own needs—they are there to help you reach your goals. Like any other worthwhile endeavor, the benefits of therapy don’t happen overnight, but over time you should feel like your therapeutic relationship is nothing but beneficial to your well-being.

https://www.nami.org/Blogs/NAMI-Blog/February-2018/How-Do-I-Know-If-My-Therapist-is-Effective