Tell me about licensed clinical social work (LCSW). How is your work similar or different from psychologist or psychiatrist?
A licensed clinical social worker is professionally trained to assess and treat adjustment issues, stress disorders, and all mental health conditions that may also be treated by psychologists, mental health counselors, or psychiatrists. A licensed clinical social worker has a Master’s degree in social work and two years of supervised clinical client practice. She/he has studied growth and development, mental health theory and practice, human behavior/social environment, psychology, and research methods. My work with clients stays within the scope of the counseling issues described on this website. As a licensed social worker, I am educated about the effects of psychotropic medications; however, I do not prescribe medications nor provide neurological, psychiatric, or psychological testing. I am committed to working collaboratively with your healthcare team, primary care physician and, if relevant, your psychiatrist, to provide holistic care matched to your specific needs. If either medication, testing, or a specialized service is needed, I will refer you to a trusted psychiatrist, psychologist, or physician. In most cases, I would maintain the primary therapeutic counseling relationship with you while other provider(s) contribute additional input for our work together.
What do you mean by "therapy" or "psychotherapy"? And how does it help?
The word "therapy" comes from a Greek work meaning to hold up, to attend or to take care of. "Psycho" is from the Greek root for soul or mind. Psychotherapy is healing work that attends to issues of soul or mind. Therapists are professionally trained mental health therapists, psychologists, or counselors who help clients gain insight into their feeling and thought patterns and who provide guidance for safely removing obstacles that have limited their response to life's challenges. Since my work with clients is not defined by a medical diagnosis and is not paid by insurance, you can get guidance and support for goals that go beyond mere adjustment or coping, if so desired. When emotional stability or balance is established, you are invited to explore and embrace optimal thriving or living as your best creative self. It is an exciting journey of expansion and freedom.
Therapy is based on the belief that since people are always changing, change for the better is always a possibility. My therapy work facilitates healing change in a variety of ways, including:
- Expands your perspective on a problem, a family dynamic, or other area of stress.
- Guides you in developing new ways of responding to others in relationships.
- Treats the impact of past events on your current life.
- Witnesses and supports you in handling pain or suffering.
- Educates, coaches and provides resources for making healthy choices.
Tell me about Life Coaching. How is it different from therapy?
What does a "holistic" approach to emotional and mental well-being mean?
I have pursued additional professional education to support addressing your mental health concerns from a "holistic" or "whole person" perspective. Mental health therapy or counseling from a holistic perspective takes into account your emotional, mental, physical, and spiritual well-being, and treats you as the whole person you are. My graduate education in clinical social work stressed the importance of the person in his or her environment (relationships, home, work, nature, community, culture). I have since earned a niche or specialty certification: Certified Mental Health Integrative Medicine Provider (CMHIMP). As a result my practice has expanded: I provide education and coaching on health practices that impact mental health, make pertinent assessments, and follow with a multi-faceted treatment plan, including referrals to healthcare providers or community resources. I might recommend that you start mild exercise, learn mindful meditation, or, try some foods that are known to alleviate mood instability. I might suggest that you meet with an alternative medicine practitioner (Functional or Integrative Medicine) to further assess and enhance your overall health and well-being. Although I do not prescribe medications nor nutritional supplements, I am familiar with common protocols and can help you check to avoid adverse herbal or nutritional supplement interactions with your prescriptions. I provide wellness education and evidence-based recommendations on lifestyle and nutritional practices for specific mental health issues or diagnoses. If you are already receiving treatment for conditions such as ADHD, bipolar disorder, anxiety or depression, I will gladly collaborate with your psychiatrist or physician. I can offer you proven strategies for maintaining your healthcare goals. If you are experiencing difficulty communicating with your healthcare provider, I am glad to coach you in how to talk with your provider so that your preferences for care and your needs are understood and, hopefully, better met.
What is the role of medications?
Medication is a personal choice and might not be necessary for mild to moderate anxiety or depression. Research studies show that therapy combined with lifestyle changes have better and more lasting outcomes than medication alone, for mild to moderate depression. I support my client's safety, first and foremost. I respect my client's beliefs and their treatment preferences. I teach clients research-based approaches to making and maintaining healthy habits that alleviate stress and support emotional well-being. Often, medication can help a client function better while he or she is learning better ways to cope. Unless clear brain dysfunction is present, as in mental health diagnoses such as obsessive compulsive disorder (OCD) or bi-polar disorder, medication might not be necessary. For mild to moderate anxiety or depression, medication can be very useful for a short term time, usually 3 – 6 months, while the client works on making life changes. Usually a client who has turned the corner in therapy, can with support (including monitoring by the medication prescriber) work to wean off of the medication. Medications change the balance of the brain chemistry and most uses were not intended for the long-term. Although family physicians will prescribe anti-depressants, I recommend clients obtain a comprehensive evaluation by a psychiatrist or neuro-psychiatrist. Know your medication and keep a log of any side effects that you might experience. Stay informed.
Medications can instill a feeling of calm but do not change the habits of worry or shutting down feelings. My counseling work is focused on helping clients learn from and manage their difficult feelings and accompanying bodily sensations: Anxious clients learn to identify and catch their worry or panic cycle early. Depressed clients discover their power to ride the wave of an emotional state and shift out of a negative thought pattern. Your treatment is customized to your unique manifestation of anxious or depressive symptoms. Our work is completely confidential. If you are on medication, a signed Healthcare Release of Information form permits communication between me and your psychiatrist or other healthcare professional.
What is EMDR? EMDR stands for Eye Movement Desensitization Reprocessing. I offer EMDR to clients following a safety assessment that helps us decide together if EMDR is the right treatment for you. I am also able to provide Virtual EMDR for clients who are appropriate for EMDR but unable to meet in-person. I can also offer education about evidence-based body-mind treatments, such as EMDR and ART, and make referrals that best suit your therapy goals.
EMDR is an evidence-based protocol that safely relies on current brain science's understanding of how memories are stored in the body and mind. Perceptions of ones current stressful situation link into earlier feelings, thoughts, and sensations stored within the memory of past distressing experiences. “The past is present.” Your EMDR trained therapist fully prepares you for your time travel and stays with you as a guide and present-moment support person. You are in-charge, at all times, a witness, with your therapist as your guide. You can stop processing at any time you want. The processing in the brain, whether stimulated through eye movements, tapping, or alternating sounds, lessens the emotional charge of the stuck memories, releasing its power over your present life. EMDR processing supports new insight and inner peace, while offering a new experience of being supported. It is an effective treatment, by itself, or along with talk therapy, for the treatment of PTSD, anxiety, panic, depression, phobias, identity crisis, unhealthy relationship patterns, and other distressing experiences. If you have a goal of peak performance the full processing will include distressing past events, present triggers, and then install a future template to support sustainability of new learning. When processing is complete, usually after 5-15 sessions, you can expect to experience more vitality, calm, decisiveness, and confidence as well as a notable reduction in distorted thoughts and unhealthy behaviors.
EMDR, developed in the late 1980's, was initially applied to the treatment of post-traumatic stress disorder in combat veterans. It is an established evidence-based treatment for PTSD. Current research studies and client feedback shows EMDR to also be an effective treatment, by itself or as an adjunct to talk therapy, in the treatment of anxiety, phobias, panic, depression, complex grief, identity crisis, perfectionism, procrastination, unhealthy relationship patterns, and other distressing experiences. For further information, see Shapiro Library: www.emdr.org.
"Trauma is not what happens to you. Trauma is what happens inside of you, as a result of what happened to you." ~ Dr. Gabor Mate.
How are forces in society, such as feminism and racism, related to therapy? Feminist therapy addresses the power structures that diminish the value of women and minorities in intimate relationships, families, cultures, and society at large. A feminist therapist acknowledges her/his own areas of personal and professional privilege while actively working to establish a therapeutic relationship with you that shifts the power dynamic of conventional mental health. You can expect to be listened to and to have your growth supported. Working with a feminist therapist can be particularly empowering to persons who have been marginalized due to gender, race, or sexual orientation. Whether you are a woman, man, or trans-gendered person, you will be encouraged to examine the social factors that contribute to your distress and to develop your own unique strengths in response to disparities of power and opportunity.
How long does counseling last?
Your counseling experience is unique to you! At your first session, I will make a recommendation for how frequently to meet and provide an estimated time frame or number of sessions anticipated for achieving your goals. Most clients start with weekly or bi-weekly sessions, and increase or decrease as needed. Sometimes clients complete their goals and want to work on a new set of goals. It is different for everyone; however, as your therapist, I am not a friend for hire. I utilize my professional training to help you learn self-compassion and to utilize researched tools that can help you live fully as your own best self.
What if I my situation doesn't improve?
You can expect to start to experience some small changes early on, and the changes should expand from there as we explore your patterns and work to remove any barriers to transformation. If you don’t experience improvements after your first few sessions, let me know, so we can plan the next steps to take. We may need to adjust the treatment approach together, add on community resources, or take other steps. I work actively in collaboration with you, and appreciate your feedback -- especially if it’s about something that’s not working for you! I usually ask at the end of a session: how was today's session and what will be your take-away? Sometimes written feedback is appropriate. I am committed to using a range of diverse tools to help you with your therapy goals and will do my best to provide service that is attuned uniquely to you, as a complex individual. Often there is therapeutic growth from processing differences that can arise between therapist and client, however, if you are not satisfied with the "good enough" aspects of our therapist/client match, I will gladly refer you to a trusted colleague for continuation of your therapy. I ask that clients attend a final session after giving notice of ending therapy. This allows time to reflect and affirm the positive changes you have made as well as receive resources and guidance if you wish to connect with additional community services at a later point in time.
How can coaching help me and when is it appropriate?
My coaching services focus on providing guidance and individualized support for making sustainable changes in behavior. Coaching is appropriate for forming new habits, maintaining healthy habits, and making lasting changes in areas of health, work, time, energy, and other self management needs. Examples of coaching might include implementing a personal wellness plan, learning new interpersonal skills, changing one's livelihood, replacing ineffective habits with more sustainable ones, exploring lifestyle options that align with your personality or temperament, and taking steps to fulfill your dreams. Coaching is appropriate for persons who anticipate having specific behavioral goals to optimize well-being. Coaching differs from mental health therapy, which is more oriented towards healing past patterns in order to function better in the present. Coaching is focused on making specific changes that support your ability to thrive at your personal best now and also to move closer to your desired future. If you have been in therapy, I am interested in hearing what you learned about yourself and your change dynamic, so we can build from there. My coaching practice is collaborative, goal-driven, and personalized.