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I start to think of an issue that doesn't even matter or something bad that happened years ago. Then, I cry, pull at my hair, plug my ears, hit myself, and throw things. In loud public places, I get on edge and start being sarcastic and moody. I have an awful fear of people leaving me (which normally ends up happening) and I feel like I'm too clingy. | I've been having breakdowns for no reason at all | There is a reason you are having breakdowns.I can't agree that they happen for"no reason at all". Finding out the reason is going to be your biggest challenge because that may require you to dig deep into your past, uncover hurtful experiences, orrecognize something that would be extremely pain. However, if you don't find professional help to carefully guide you through whatever you mayconfront,the symptoms mentioned will continue and may even get worse. There is a light at the end of the road but you needsome help to find the right road to get on so you can see it. |
I have an ex-boyfriend who just lies about everything. He is super lazy. He lies to everyone that he has a good job, builds trust, and then start borrowing moneyand large amounts too. It has come to the point where he has gone through several group of friends. He is leaving a trail behind full of friends in debt because he would put on a sob story, borrow money, then disappear. He refuses to work, so he sits at home playing games all day and either lies to his mom for money or lies to his friends. I used to think his lying was due to his drug habit, but now I'm hearing from other ex-friends of his that this started even before the drugs got into his life. He would borrow anywhere from $5,000 to $50,000 from everyone and it would all disappear. He's in debt with bills. He doesn't gamble, but he spends his money on random stuff. Although he has this habit of lying compulsively and spending money, he seems to be a good person. He'll always give a homeless person all his change no matter what. My brother has epilepsy and is really antisocialmy ex-boyfriend makes an actual effort to socialize with my brother. He takes him out to the movies and plays video games with him. He drives me to school and work every day and picks me upjust basically the small things that add up to the fact that he's not totally a horrible human being. Is he just simple a pathological liar or is there something that could possibly be deep down in there? | Is my ex-boyfriend a pathological liar? | It sounds like you have some ambivalent feelings towards your ex-boyfriend that are difficult to sort out. You notice that there are both desirable and undesirable things about him, and this is true of everyone to one degree or another. One question that I would have for you is, are you satisfied with your relationship with him as it currently stands? Are you happy with the boundaries between the two of you, or would you like them to be different? Negotiating through conflict and establishing different boundaries are definitely things you could work on with the help of a therapist. Another question I would have for you is, what would it mean for you to find out what motivates his behavior? Discovering the roots of such behavior is something that he would have to work on in his own therapy and not something that you and a therapist could discover without him. |
I noticed lately that I've been thinking a lot about death. I don't want to die, and I'm not suicidal. I just think about what would happen if I died or if someone I loved died. I imagine how sad everyone I know would be. I know it isn't worth it, and I definitely want to live and have a future. I just think about it. When I'm driving, I sometimes imagine what would happen if I just let go of the wheel and kept going. | Why do I think about death? | I'll respond to your speculation that if you let go of the steering wheel while driving, you'll end up quite seriously hurt, at the very least. It is fine to play in your mind with "what ifs". People who write horror movie scripts most likely have some terrible sounding stories and suppositions.If you trust yourself to actually not follow through with an idea that may kill you, and you recognize the difference between thinking dangerous things and doing dangerous things, then go to the next step of understanding more about your thoughts on death.Since you wonder about being missed if you die, it is possible your thoughts about death are from feeling that you are metaphysically dead to people in your life whom you wish would show more interest in you.Play around with your idea as to why you'd consider how people will feel about you if you're not in their lives.This may offer some insight as to your expectations of current relationships with others. |
I was never like this. Recently this year (my first year of high school), I started getting emotional for no reason. | How can I stop being so emotional all the time over worthless stuff? | Hello Vancouver, It's really common for people to become very upset over small things sometimes. The small thing is a "trigger", and the emotions aren't so much about that event that's happening in the present; they are more connected to old events that evoked the same feeling. You've likely had too much of that feeling in your life and you've developed a sensitivity to it. Look at the small events that are triggers for you and ask yourself what same or similar emotion they evoke. If there's anger there, look underneath that. Is it powerlessness, worthlessness, hurt, shame...? Then ask yourself when in your life you've experienced TOO much of that feeling. As a child, maybe, but not necessarily.That's the first step, and combined with empathy, compassion and self-esteem, you're starting to build what I call an emotional air conditioner. A good therapist can help you with the rest of this process and with learning ways of coping with emotions daily. I wish you the best. |
I am lazy. I am very aware of the problem and try to talk myself out of it all the time, but I never seem to shake the habits. I try to think of what it is doing to me and my future, but no matter what, I keep creating excuses for myself to continue the procrastination. All I'm ever left with is regrets and a low grade. I am at an all-time low in my life, and I'm not even that old. I've always been a straight-A student, but now I'm getting C's and F's, and it hurts me to know that I am way better than that. It's not even like the work is hard. | How can I get rid of my laziness? | Possibly laziness is not the true problem and is only what appears as the problem.Since you describe your laziness as an observable quality, I assume you've not always felt or handled yourself this way.Quite possibly and more likely, the particular conditions of your current life are not ones that are optimal for feeling good about yourself and your involvements.One suggestion is to see if there is any purpose to what you're doing in all the areas in which you see yourself acting from laziness.If you're not able to notice any good purpose, then you may be mistaking "laziness" for a significant amount of stress in your life.Stress can be opened and understood. If stress is what underlies what appears as laziness, then you define the contributors to your stress.Not feeling enough support in your life, financial uncertainty, arguments w people who are close in your life, feeling misunderstood overall or by particular people, all are possibilities.Good luck in learning more about who you are! |
I am lazy. I am very aware of the problem and try to talk myself out of it all the time, but I never seem to shake the habits. I try to think of what it is doing to me and my future, but no matter what, I keep creating excuses for myself to continue the procrastination. All I'm ever left with is regrets and a low grade. I am at an all-time low in my life, and I'm not even that old. I've always been a straight-A student, but now I'm getting C's and F's, and it hurts me to know that I am way better than that. It's not even like the work is hard. | How can I get rid of my laziness? | I am sorry to hear that you are going through such a tough time. It sounds to me like you are suffering from depression to some degree. Have you seen a therapist or talked to anyone about your problems? If not, I would advise that you do so sooner than later so that you can learn what is causing you to be unmotivated and causing difficulty with breaking the cycle that you are in. It is also a good idea to get a medical evaluation from your doctor to rule out any medical causes for your current condition. Most often, difficult situations that life throws at us, along with an inability to think positively, and break bad habits are what cause depression. Somethings you can do immediately are seek help from a professional, schedule in time every day to engage in pleasurable (or once pleasurable) activities, exercise daily, and practice thinking more positively.Set a few daily goals for yourself and write them down each morning or the night before. Achieving your goals every day will give you a sense of accomplishment and can lead tofeeling more optimistic and capable. Additionally,keep ajournal to write down how you are feeling and what ideasyou have to helpfeel better. Sometimes havingthese ideaswritten down make it more real and tangible.Know that depressionismost often curable but takes work and a desire to change (which you clearly have). Once you start feeling better about yourself and your life, your grades should naturally begin to improve, as you will have more motivation and energy to focus on that particular area. Best of luck to you! |
I never get infections or scars or anything, and it doesn't bother me if it gets filled up with blood or something, but I'm concerned. | I have a compulsion to fill in holes in my skin with ink | Hi Houston, The fact that you're concerned says a lot. If I was your therapist I'd ask you questions about your worries and how this is causing a problem in your life. You're causing perhaps permanent changes (damage?) to your body, and it's likely you're trying to express something...pain maybe? A therapist can help you to explore what's going on for you and how to get your needs for self-expression met in a more healthy way. Good luck! |
I feel that I am struggling with undiagnosed bipolar disorder, and it is making my day-to-day life extremely difficult. | How do I know if I have bipolar disorder? | It sounds like you are experiencing a great deal of distress and you're wondering if it may meet a diagnosis of Bipolar disorder. There are a few different types of Bipolar diagnoses in the DSM (diagnositc and statistical manual) and the best way to find out if your experiences would meet that diagnosis would be to meet with a mental health professional. You can also look up the diagnosis online and see if what you are going through meets the criteria.One question that I would have for you is, what would it mean for you to find out that you meet the criteria for such a diagnosis? It sounds like whether or not you do, you are suffering and working with a therapist may help you get into a better place. |
How do I help my husband get over his drinking addiction? | Does your husband WANT to get over his drinking addiction? Motivation is a critical component of recovery....and it can't be just your motivation! When a loved one is immersed in their addiction, we often feel as though we have lost them. When he is ready to get help there are a lot of wonderful programs out there including: AA meetings, SMART recovery, faith based programs and online services. It is always a good idea to have a medical evaluation prior to making major adjustments to your drinking patterns as his body may literally be dependent on alcohol.In the meantime, what you do have 100% control over is what you accept in your life and the boundaries you set to protect your well being. Spend some time focusing on what you want in your life? What are some changes you can make to protect yourself? Maybe it's time you saw a therapist, joined a support group, engaged in a new hobby! And...try not to "rescue" your husband too much! Natural consequences can be a great thing for our loved ones that are struggling in their addiction. |
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How do I help my husband get over his drinking addiction? | Ultimately, your family member must make the decision for themselves that they are ready to stop using drugs and alcohol. Family members can offer support by helping to research and schedule treatment or counseling. Do not enable, set firm boundaries, and establish a united front. Take care of yourself. AttendAl-AnonorNar-Anonmeetings. While I hope that every person with a substance use disorder finds recovery, the sad truth is that not all will. However, family members still need to have their own recovery that is independent of their loved one. Family members frequently benefit from individual counseling, too. |
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How do I help my husband get over his drinking addiction? | Acknowledgment from your husband and wiling to make changes is essential first. We often try to force people to make changes hoping that they will see that we are right, even when they may not be ready. Having a willingness to work together and be supportive is fundamental in recovery. If he is not quite there yet I would snuggest individual therapy for yourself where you have an outlet and can also gain suggestions on what the next steps might be. If he is ready I would suggest you engage in therapy together and be ready to listen to him and what his needs might be. |
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How do I help my husband get over his drinking addiction? | It's not easy to be married to an alcoholic and I want to extend my support to you. Without knowing the pattern of his substance use, I'll accept your description that he is an addict.The short version is that his addiction is not in your hands. Period. However, addiction is a "family disease", so you are definitely connected to it. Most people benefit from professional help, whether they are the addict or the other person. You might read some material from al-anon to improve your insight into how addiction works within relationships. It is safe to say that you are likely to have a role as a "co-dependent" or "enabler". The most common pattern is doing overt and subtle things that insulate the addict from the consequences of their behaviors. From calling out sick for the person when they're hung-over to allowing money to pay for alcohol, to simply remaining in the relationship, these are all behaviors that make the addiction more likely to continue.Change is difficult for all of us, especially when a physical dependency on a substance may be involved. But the awkward truth is that not one of us ever made a change unless we were in at least some pain. Pain in our present circumstance is a requirement to achieve change. By "enabling" your husband, you minimize that pain. Let me state again, though, that his addiction is not in your control and it's not for you to fix. You can, however, change your own behaviors in ways that might change his odds. Even if he does not get over his drinking addiction, as a general rule, you will be happier if you stop being a participant in it.Many people find that an addiction removes the addict from the relationship -- they're not really there, even if they appear to be. At the same time, there's a third person -- the substance. Some people choose not to remain in a relationship that's constructed in this odd and off-balance way.I hope that gives you some thought-starters but I would encourage you to seek in-person help from a local provider. And I wish for you and your husband recovery and well-being. Best regards,Karen Keys, LMHC, CASAC |
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How do I help my husband get over his drinking addiction? | By being truthful with him about how his drinking affects you.People who are addicted to a substance, have tremendous emotional pain they are covering up. The only action someone who would like to help, can do, is to be truthful when loving the person.Show your love and express your own wishes on what you'd like from him. This may encourage him to try loving you back instead of drinking to feel better about himself.It also may not since addictions are the result of behavior patterns set very early in life.My best advice is to stay clear that your love is no guarantee he will want to look at his deep emotional pain, clean it out and be open to loving you and to stop harming himself with excess alcohol.Keep in mind that his problem of great emotional pain, can only be solved by him. Try not to get lost into offering more help than he is able to utilize. |
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My father is an alcoholic, and I see tendencies of that in myself. I am recently married, and I feel it affecting our relationship. I'm not sure why I do it, but I want to stop. How can I find the willpower? | How can I stop struggling with alcohol? | Congratulations on taking the first step on the road towards recovery by acknowledging the problem and asking for help! The American Society of Addiction Medicine defines addiction as "a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences." Notice that nothing in the definition speaks about willpower or motivation. That's because addiction is a disease - just like diabetes or high blood pressure. Imagine I gave a huge piece of chocolate cake to a diabetic. After he eats the cake, I say to him "Use your willpower to lower your glucose to 100." Do you think he would be successful?All addictions are behaviors. Behavior can be understood in terms of function and reinforcement. All behavior is either an attempt to get something or an attempt to get away from something. If you apply this logic to addictive behaviors, the use of mood-altering substances is an attempt to create a particular feeling or emotion, or an attempt to numb one. When a behavior is reinforced, we are more likely to engage in the same behavior again in the future. Let's assume that I'm feeling very anxious. I drink some alcohol and notice that my anxiety decreases. My brain takes note of this and the next time I'm feeling anxious I am more likely to reach for a bottle. Now, imagine this happening hundreds, if not thousands, of times.Addiction recovery is about identifying and treating the underlying reasons for the use. A qualified addiction therapist will assist you in developing a relapse prevention plan that addresses these underlying issues and helps you to identify triggers for your use. Additionally, you will learn how to avoid triggers and gain healthy coping skills to use instead of relying on alcohol.I wish you the best of luck in your endeavors. Recovery can be difficult and requires a willingness to change just about everything in your life. But the rewards are tremendous! |
This is my recovery, and I don't feel that it is okay for them to ask this. They told me it is policy due to the fact that I may run into a peer there. I am a peer counselor in the small community that I grew up in. I am in recovery myself. I was asked to come work for this organization after I was two years sober (I was in treatment in this organization). I work with mental health peers and run life skill groups. I don't work with substance peers. | The organization I work for has told me I cannot go to my 12 step meetings | You definitely want to make sure not to inadvertently create an inappropriate dual relationship with a client.In fact, it is not uncommon for state regulatory boards to determine that a clinician and client being in the same 12 step group is professional misconduct.You might want to consider attending a 12 step meeting that is located in a different community than the one you work in. Another option would be to look for one-on-one or small group recovery support. |
This is my recovery, and I don't feel that it is okay for them to ask this. They told me it is policy due to the fact that I may run into a peer there. I am a peer counselor in the small community that I grew up in. I am in recovery myself. I was asked to come work for this organization after I was two years sober (I was in treatment in this organization). I work with mental health peers and run life skill groups. I don't work with substance peers. | The organization I work for has told me I cannot go to my 12 step meetings | Hello, and thank you for your question. I know that workplaces have some latitude when it comes to requiring certain behaviors from their employees. For example, they may require you to tell them if you get into some kind of legal trouble. But this situation seems completely different. For one thing, 12 step meetings are supposed to be anonymous. I am not sure how they would know that you attended unless you or someone else told them. I agree that it seems like to cross a line. Usually each state has an office that manages complaints related to employment, such as the Department of Labor or EEOC. You may want to see which entity is in your state and contact them. It would be worth asking them to see if this is a legal practice. If it is but you still want/need to stay at this job, then you may want to look for alternate sources of support for your sobriety. There are active online support groups that would allow you to do things from the privacy of your home. SMART Recovery http://www.smartrecovery.org/ is a website that many people like. There are also online groups that specifically discuss the 12 steps. No matter what, I give you a lot of credit for doing your best to keep your sobriety and continuing to see the value in having support. Robin J. Landwehr, DBH, LPCC, NCC |
This is my recovery, and I don't feel that it is okay for them to ask this. They told me it is policy due to the fact that I may run into a peer there. I am a peer counselor in the small community that I grew up in. I am in recovery myself. I was asked to come work for this organization after I was two years sober (I was in treatment in this organization). I work with mental health peers and run life skill groups. I don't work with substance peers. | The organization I work for has told me I cannot go to my 12 step meetings | I worked for an organization that had a similar policy, although I'm not aware of it ever being enforced. Most of the employees were in recovery and active in 12-step programs. It has always been my personal practice that if I am present at a meeting and encounter a current client, I will leave. No questions asked. If I encounter a former client, I may decide to stay, depending on how involved I was in the treatment of that client, but I will not share during the meeting to avoid any inappropriate self-disclosure. I live in a relatively large city with a lot of groups, so it's possible to find meetings where I don't run into clients. This can be much more challenging in a smaller city. I understand that you don't work directly with peers in substance abuse treatment, but we know that many of our clients with chronic mental illness also have chemical dependency issues. Therefore, it is possible that you might encounter them at 12-step meetings. Perhaps you could try online meetings or consider driving to an adjacent city or town to attend meetings? |
This is my recovery, and I don't feel that it is okay for them to ask this. They told me it is policy due to the fact that I may run into a peer there. I am a peer counselor in the small community that I grew up in. I am in recovery myself. I was asked to come work for this organization after I was two years sober (I was in treatment in this organization). I work with mental health peers and run life skill groups. I don't work with substance peers. | The organization I work for has told me I cannot go to my 12 step meetings | Seems you would benefit more from legal guidance than from therapist advice.For example, I imagine policy must be presented in writing to the prospective employee prior to signing a contract of employment.If you were not given in writing the organization's policy of employees not being permitted to attend meetings, then I doubt the organization can hold you accountable for policy which you never were informed existed.There are workplace rules and regulations which your matter may be protected by.Since attorney fees are high, first look on your state's website for any agency your state government has which monitors employee rights in the workplace on being informed on policy.If you are in the right, as to having the right to not follow policy about which you never were told, then the next point to consider is whether or not to take any action based on your finding.Being legally in the right doesn't guarantee your workplace will be happy to accept they are wrong.The next step is to consider your own peace of mind working for an organization which essentially believes violating your civil right to free association, is ok.You may decide on a longer term plan on leaving this place. Usually when an employer does wrong in one area, they are also doing wrong in other areas of the workplace. |
For some reason, I look at my phone, and in no time, five hours has passed. During those five hours, I'm playing games and trying to find out how to make my phone fun to use so I don't feel like I wasted my time trying to improve my phone's performance in my life. | How can I get away from my phone? | Start by spending small amounts of time with your own thoughts and feelings.Always being focused on what a phone offers keeps people at a distance from knowing themselves.As long as you make time to spend in an activity which is not interactive the way a phone is, and instead depends only upon your actions, you will be investing time and energy into your own life.Whether by consciously considering your own interests, or doing housecleaning or chores, by devoting yourself to areas which you decide to be involved in, you will increase your knowledge of your own interests.Then, to not be so involved with your phone will be natural and easy. |
I have a relative who is in his twenties. He was in a drug rehabilitation program and got kicked out for using drugs again. No one informed family that he was using drugs again. He subsequently overdosed and was found dead. Is their accountability of counselors, therapists or the halfway house for not reporting that he had relapsed? Is there a legal case for failing to report? | Is there a lawsuit for counselors and therapists who failed to report a relapse? | I'm so sorry to hear of your loss. This sounds like a really difficult situation for the whole family. Since the answer to this question will depend a lot on the applicable state laws, I would suggest talking with a local attorney. That being said, I see two competing issues here. On the one side is the duty of confidentiality the counselors owedto your relative. On the other side is the duty the counselors had to act reasonably to protect your relative from harm. Generally there is not a requiremt for substance abuse treatment centers to notify family members if an adult client relapses.A local attorney will be able to provide more specific guidance on the legal obligtions and liabilities in this situation. |
I have a relative who is in his twenties. He was in a drug rehabilitation program and got kicked out for using drugs again. No one informed family that he was using drugs again. He subsequently overdosed and was found dead. Is their accountability of counselors, therapists or the halfway house for not reporting that he had relapsed? Is there a legal case for failing to report? | Is there a lawsuit for counselors and therapists who failed to report a relapse? | I am so sorry for your loss. Generally therapists only have a duty to report self harm to ones self or others if it is expressed to them. Often times they will not report relapses due to the fact that proper releases were not signed or patient has specifically asked them not to for fear of shaming or failure again. I understand this may not be the answer you were hoping for. I would encourage the family to seek therapy themselves for help coping with such a loss. |
Can a past therapist disclose information to a current therapist that you are seeing? | Generally, the laws regarding confidentiality would require a past therapist to obtain your permission before disclosing any information about you to your current therapist.Depending on state law, there could be some exceptions to this general rule. For example, most states would allow your former therapist to provide information about you to your current therapist if he/she reasonably believed it would protect you or someone else from an imminent harm. |
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Can a past therapist disclose information to a current therapist that you are seeing? | No, not without a signed release of information (ROI) from you (the client). |
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I terminated my counseling relationship with a social worker several years ago. I am now realizing that I would like to begin counseling again. The social workers voicemail message says that he returns calls in 24 hours, but he hasn't called me back. I called him on the weekend and made it clear that I want him to call me back. Can he just ignore me? | Is it ethical for a social worker to ignore a clients phone calls? | Mental health providers should promptly return calls from current clients as well as from potential clients. This is even true if the social worker (or counselor) is unable to make an appointment with the caller. In that case the social worker should call you back to let you know that he is unable to schedule an appointment with you.In addition, mental health providers have an obligation to follow through with their own communication standards. For example, if the social worker in this case has an outgoing voicemail message that promises returned calls within 24 hours, he has an obligation to follow through on that promise.All that being said, it is also worth remembering that mental health professionals are just people too. It is possible that he had an unforeseen emergency that kept him from from returning your call promptly.In the end, I agree with Sherry's advice. If you feel this social worker is not a good fit for you, you probably should trust your gut and find someone else who is a better fit. |
I terminated my counseling relationship with a social worker several years ago. I am now realizing that I would like to begin counseling again. The social workers voicemail message says that he returns calls in 24 hours, but he hasn't called me back. I called him on the weekend and made it clear that I want him to call me back. Can he just ignore me? | Is it ethical for a social worker to ignore a clients phone calls? | Yes, your former social worker should return your phone call.It is the professional ethic to do so and plain human decency to do so.If he doesn't, there is nothing you can directly do about the fact of his ignoring you.There are formal complaints you can make, which you can consider doing.What matters most is receiving social work service.Stick with looking for another social worker who is willing to help you.The self-doubts you mention may be worth examining.They do not, however excuse the social worker mishandling himself. |
My boyfriend is in the hospital. They wont tell me whats wrong and if or when hes coming back | I know it can be really tough when a loved one is in the hospital and you aren't being told what is going on.In general, both Federal and State confidentiality laws prohibit health care providers from giving out private information about patients to non-family members.Unfortunately, you will probably just have to wait until he is released (or until you can visit him) to find out from him what is going on. |
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What do you do when a therapist and a parent drugs a child and makes up lies in order to stop the other parent's custody visitation? | Unethical Therapy Practices | This sounds like a potentially serious situation. The most important thing is to make sure the child is safe. If you suspect that a child is (or has been) harmed, I would strongly recommend that you report your concerns to your local law enforcement or to Child Protective Services. If you don't think that a child is in danger, you can still report your suspicion of counselor misconduct to the state regulatory board. |
What do you do when a therapist and a parent drugs a child and makes up lies in order to stop the other parent's custody visitation? | Unethical Therapy Practices | I will admit I am confused about this question. Are you the other parent in question or a concerned coworker of this therapist?Therapists do not prescribe or have access to medication. Most therapists won't even get involved in a custody battle. They know there is a good chance of their records ending up in court and that they themselves will have to testify in court. Of course, therapists are human and can make mistakes, but I find it highly unlikely that a therapist would knowingly and willingly do something like this that is such a major ethical violation. Not only are they losing their license to practice by doing this, they are going to face criminal charges and jail time. If their clinical judgment is that the other parent is a danger to the child, they don't have to resort to illegal means to try to prove this.If you have concrete proof that this has happened then there is a process in which you can file a report against the therapist with their licensure board. Every therapist is licensed in their state. There are different types of licensures so you would need to know this therapist's licensure.Most accusations from the other parent are expected in a custody situation because people do tend to get quite ugly. Don't accuse the therapist or the parent of anything just to try to make yourself look better and them look bad. Have evidence of wrongdoing before accusing them of this. If this has really happened then of course it needs to be reported, but don't try to ruin someone's career unless you are sure this occurred. |
They discontinued treatment for no apparent reason after they thought to diagnose me with schizophrenia. | Is it a normal practice for a team of doctors who are connected by state or profession to discontinue your treatment? | The general rule against medical abandonmentsays thst whenever healthcare providers discontinue treatment with you when you still need it, they are legally required to make sure that you have access to another provider of equal or higher ability.In this case, if your treatment team decided to discontinue your treatment based on a diagnosis of schizophrenia, they still will likely be required to provide you with a referral to someone who can provide you with treatment. If you haven't already done so, I'd recommend that you explicitly ask for a referral. |
I had a dispute with my therapist regarding an appointment cancellation. Now, she is blocking me from seeing other psychologists at the same clinic (which takes my insurance), which is also where I get my psychiatric services. There is a strict 48 hour cancellation policy, and my appointments are at 3:00 on Tuesday. I called to cancel at 4:30 the previous Friday. I was late, so we contacted my doctor to tell her that I would be out of town. She said I could do a phone in session. The thing is we do double sessions. | Is there anything I can do about my therapist blocking my psychiatric services? | My recommendation would be to try to talk to your therapist about this from your description, it sounds like you have a legitimate explanation for missing your scheduled session.Maybe if you could explain that to her she would be willing to work with you.If she is not willing to consider your explanation and if she is not willing to continue working with you, she still has an ethical obligation to provide you with referral resources to another therapist. |
Can I go see a psychiatrist without my dad finding out, even if I am on his insurance? | It might be possible, but it's difficult.First, depending on how old you are, you might be able to restrict a mentalhealth provider from disclosing your confidential information to your parents. The age at which you can do this is different from state to state (the range is generally anything from age 13 to age 18) Second, even if you are old enough to to be able to tell your provider not to give any information to your parents, they will probably find out if you use their insurance.It seems like you might have a few options. You might want to try talking to your dad about seeing a psychiatrist. He might be supportive. You could also try talking to a counselor or nurse at your school. They could also help you find some confidential options. I hope this helps. |
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I think I have depression, anxiety, bipolar disorder, and I have anger issues. I told my mom over and over again. She told me she would get me a therapist, but she never did. I just found out that my mom can't afford a therapist for me. | How can I see if a therapist if my mom can't afford it? | It can be difficult to get counseling if you don't feel supported by family members. There might be a few options. If you are in school, I'd recommend talking to a school counselor or school nurse. They often will be able to help you access freeor affordablecounseling resources in your community. In addition, depending on where you live, it's also often possible to call 211 for referrals to free or low cost counseling services in your area.I'd encourage you not to give up. You are on the right track. |
I have major depression, severe, PTSD, anxiety disorder, and personality disorder. I had an appointment with my doctor. I was very upset, and I shared with him about that particular drug. | I told my family doctor yesterday, that I am hoarding my Ativan pills. Is he legally required to tell my psychiatrist or therapist? | Your doctor might be required to tell your psychiatrist - especially if your doctor is concerned about your safety.It was definitely a good thing that you told your primary care physician about what is going on. I know that must have been difficult to talk about with him. By having that conversation, you are helpingyour primary care physician and your psychiatrist work together to best support your health. |
In the state of New York, is it legal for someone to record a counseling session without telling the counselor or the other person in the session? | In New York (like most states), the law generally is what's called a "one-party consent" rule. This means that in most cases it is legal to record a conversation as long as consent has been granted by at least one person involved in the conversation.It probably would not be illegal for a client to secretly record a counseling session without the consent of the counselor. Since only one person's consent is required, it would be sufficient that the client consented.On the other hand, it would probably be illegal for a third party to record a counseling session without the consent of the counselor or the client.Similarly, it would be a violation of ethical standards (and maybe a violation of law) for a counselor to secretly record a session without the client's consent. |
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How do I, a LPC, start an online practice? | This is a great question - especially since technology assisted counseling is definitely the current growing edge of the field.There are a few things you'll want to look into before starting an online practice:1) Check out your state laws regarding online counseling - keep in mind there are different terms used in different states Including "technology assisted" or "distance" counseling. So it might take a little searching to find your state's rules. Some states have extensive regulations regarding the scope of practice, informed consent, documentation, etc. Other states do not have any specific laws or policies regarding online counseling at all.2) Next, it's a good idea to review the 2014 ACA code of ethics and the 2015 AMHCA code of ethics. Both have extensive new sections addressing the ethics of online counseling.3) Lastly, you'll need to look into the law in the state(s) where your potential clients are located. This is really important since nearly every state considers counseling to occur in both the location of the client and the location of the counselor. For example, New York has a law that specifically requires any counselor who is providing online counseling services to a client in the state to be licensed by New York. |
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How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | There are typically three reasons why therapy is terminated:1) Client has met therapy goals2) Client is not progressing3) Therapist is not a good fit for clientIn order to properly assess whether therapy is helping and what progress is being made, the therapist needs to have ways of consistently checking in with clients sessions-by-session to determine what is helping, what isn't, and where the client is at in relation to their original therapy goals. When a client has met their goals, that is a good time to end counselling sessions unless the client has new goals or simply wants to check-in periodically to make sure that they are still on track (sometimes referred to as relapse prevention).When a client is not progressing, and feedback has been taken and attempts have been made to make the therapy more helpful for the client but to no avail, than it is considered unethical to continue to work with the client. In these circumstances, referring out to another therapist who may be a better fit is a good idea. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | It is usually time to end counseling sessions when it is clear to both the client and the counselor that therapeutic goals have been reached and enough improvement has been made that the client can continue without that support. There are exceptions to this rule, but for the most part this is when counselors begin termination. For some clients, this is an easy process that marks the achievements they have made in working through their emotions and difficulties. For some other clients, however, this is a difficult process in which they are losing a valuable support and are understandably anxious about what life will be like without the frequent meetings. Ultimately, termination is different for everyone, and there are many ways that termination can be healthy and helpful. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | Hopefully both the client and counselor would together decide when to terminate counseling sessions. It's really helpful for the client to leave counseling with a solid sense of what he or she has accomplished in counseling, so it can be a good idea to spend some time acknowledging that in the last session or sessions. Sometimes, however, a client has needs beyond the scope of the counselor's expertise. That's a good time for a conversation about those needs and ideas of how best to meet them, whether by adding in care with an additional mental health professional or transferring care entirely to a new mental health provider. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | From the very beginning of counseling sessions I emphasize that the work will and must end at some point.In counseling there is an arc to the process. A beginning, middle and end.I am always digging, searching and exploring.There comes a point where things come to there natural ending.I always leave an opening for continuing counseling in the future. At least as a check in. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | There can be many reasons why?Client has reached their goals they hired the coach/ counselor forClient is not progressing or taking a path forward.Client is not a good fit |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | For most: When the money/insurance runs out.When best: When the job is done... and you're feeling much better. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | To be able to identify a clear ending to a counseling relationship, we must have a clear understanding of the goals and limitations of treatment. Usually, during the initial evaluation, I identify my clients short term and long term therapy goals. As therapy progress, we verify goals on a monthly to a quarterly basis, depending on the frequency of the appointments. Once the therapy goals have been met, there is a closing session, the counseling relationship is ended, and the client can stop attending sessions. In some cases, the client can also establish new goals and determine if I am a good fit for their therapy needs or if they need a new provider, in which case I provide multiple referrals.The counseling relationship could also end due to other factors like noncompliance= when a client is not committed to the agreed treatment process, or when the clients or a counselor violates the counseling relationship. Either the counselor or the client is able to end counseling. Although, as mental health providers we need to provide a reason for terminating our therapeutic relationship and referral options, as a clientno explanation is needed, a closing session is highly recommended. Cmo termina la terapia?Cmo un consejero decide cuando terminar las sesiones de consejera o terminar de trabajar con un paciente?Para poder determinar el final de la relacin del consejero, debemos comprender las metas y parmetros de la terapia. Usualmente durante la evaluacin inicial se identifican metas a corto y largo plazo con el cliente, y se discute con el cliente como esas metas sern alcanzadas. Durante el proceso de terapia el consejero revisa las metas mensual o trimestralmente dependiendo de la frecuencia de las citas. Ya que las metas de terapia son alcanzadas, hay una sesin de cierre y el cliente puede terminar la terapia. En algunos casos el cliente puede identificar nuevas metas para la terapia y determinar si el mismo consejero u otro consejero le pueden asistir. La relacin de consejera tambin puede terminar por no conformar o violentar los parmetros establecidos para la terapia. Tanto el consejero como el cliente pueden terminar la relacin de terapia. Como proveedores de salud mental los consejeros estamos obligados a proveer un razn para la conclusin del tratamiento y proveer referidos segn aplique, los clientes no necesitan proveer una explicacin, aunque es recomendable discutirlo en una sesin de cierre. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | As a therapist who believes in client self-determination above most other elements of the process, I want to as much as possible leave it up to the client to determine when they are finished. In the case of a termination because a client's distress has resolved, I might periodically check in with the client about how therapy has been going, and if we want to re-evaluate where we are.The more unfortunate situation would come about if I felt that I wasn't the best fit for the client. I would offer that in words, and ideas of therapists (with names) of who I thought might be a better fit and why. It still is up to the client whether to continue, however should they want to keep seeing me, a part of the work would be about that want (to see someone who professionally doesn't believe they can help as much as someone else.)I also find it perplexing when I hear a client (or on a personal level) tell me that their therapist said they "didn't need therapy." I don't know that I buy into that scenario all that much, because I do believe that yes, not everyone NEEDS therapy, but that everyone CAN benefit from therapy and I don't believe it is the therapist's job to deter someone from ever seeking out help of any kind. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | Ideally, termination should be a mutual process. It's not that the therapist kicks the client out at some point and says, "Okay, you're done." Rather, over time the client will decrease the frequency with which he/she comes to session so that it may start off as weekly, then decrease to biweekly, then perhaps once every three weeks, then once/month and so on. Throughout this process, the therapist and client should have had regular check ins about progress toward goals. If the client feels good about where he/she is in life, he/she might decide to suspend therapy for now. That being said, the therapist should make it very clear that if the client ever decided to return for "maintenance" therapy or a check in, he/she would always be welcome.There is no hard and fast rule to ending or a particular time period in which it must end. What matters most is that the client feels good about it and knows that the therapist will always be there should he/she wish to return. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | For a therapist, deciding to end counseling sessions or terminate working with a client is a thoughtful and intentional decision. One that is not entered into lightly.While there are many considerations counselors take into account, to help answer this question, I'll offer an example of two areas that counselor's take into consideration when ending counseling sessions:Does the client need different or more specialized care than the current counselor can provide? This requires the counselor to determine whether referring the client to another therapist or health care provider is needed.And, has the therapeutic relationship reached treatment goal(s)?While this question is specific to the counselor, I'd like to also add that a client, at any time, can end counseling. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | In general, I usually let the client decide when this should occur, sometimes with some clients it will be a joint agreement, but even in that case it should weigh mostly on what the client feels. In short, therapy ends when you feel your done.C |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | I will work with clients and continually review progress with them and determine if counseling is helping. If a client appears to have less to talk about in sessions, appears more stable for a period of time and has reached therapeutic goals I will talk about termination. Some clients however I may continue with on a monthly or bi monthly process to allow for check-ins to see how they are doing and if they need more help at that time. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | There are several reasons for a counselor to decide to end counseling. A major reason to end counseling is if the counselor feels that he or she does not have the skills or experience to work with the client. This may happen during the intake process or after working with the client for some time. If the clinician feels that the client is not benefitting from the therapy, it is ethical to suggest that the client terminate the therapy. The process of termination must not injure the client and, if necessary, the clinician may need to refer the client to other treatment modalities. Another reason to terminate working with a client is if the client needs a higher level of care. If the client has a crisis or is at risk of hurting himself or someone else, he or she may need a higher level of care. In this circumstance, the clinician may need to involve outside services such as a crisis unit. A third reason to terminate with a client is if the clinician feels that he or she cannot remain professional with the client relationship. For example, if the issues that the client is working on bring up something significant for the clinician and the clinician feels that he is unable to separate that from the professional relationship. In this instance, the clinician should refer the client to another therapist. Finally, if the client has reached her goals for therapy and no longer needs treatment, the clinician and client should terminate treatment. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | Counseling ends when the client has received the maximum benefit from the therapist. Even if the therapist believes the client is not making progress, the client may feel they are improving and receiving a benefit. And the therapist may see a benefit and the client does not. It is best to have ongoing dialogue with the client to determine when termination is appropriate. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | In the best case scenario, it's a mutual discussion and decision. If not, I've had the discussion initiated both ways, by me, when I sense the client has gone has far as they want, by lack of interest in accepting or completing homework assignments, missing or cancelling appointments, usually at the last minute, lack of participation during sessions. Client initiates by asking me pointed questions about why the need for homework assignments,, by forgetting their calendar, or their checkbook :) , by suggesting that we make appointments over longer intervals (once a week to once a month, for example). I rarely have had to terminate a working relationship--that's why I don't charge for the first visit, so we know if we are a good fit before we start working together. Then I periodically ask whether the client feels we are making progress, moving in the right direction, talking about the most relevant issues etc. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | In my therapy practice the decision to end therapy is mutually made together with the patient.Otherwise, the person can end up with a sense of tremendous rejection and abandonment.The way you'll both know therapy is coming to a close is that the discussion will feel lighter and move easily.The person's mood will be better, they will smile more, sit in their seat in a more relaxed way, look more at ease, take better care of their appearance.One of the ways to end therapy is to gradually decrease the frequency of the sessions.Sometimes people who are in my practice start to come each three weeks, then monthly, then every three months.This gives a sense of security, friendliness, and casualness to the therapy, and de-medicalizes it as though the person was treated for a medical symptom and the symptom stops completely one day.Talk therapy is about life and life problems usually end gradually.I end my therapy in a way which mirrors the life process in which many interaction and situation problems show their effects gradually and show different effects over time. |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | Hi there,There are a number of reasons why a therapeutic relationship might end including, but not limited to the client reaching their goals, the client reaching a place of acceptance where they wish to remain or even a breach within the relationship. The last aspect should likely be taken to supervision in order to be fully processed. All of these things could happen, and usually happen organically (again, except for the last example).Your question, however, was about the counselor ending treatment. This is a bit more difficult and can be very nerve-wracking. It may be beneficial to take this with you to supervision, as well. It's important to understand why you feel the need to end or terminate with the client, as well. Do you feel that they would be better suited for another therapist, have they achieved their goals or is it something else?In regular, open-ended sessions, I try to make a point of checking in with the clients fairly frequently. In these check-ins, I use the time to ask the client how they feel about the sessions and if there is anything they wish to focus on more astutely. I also ask if they have any immediate goals that they would like to prioritize. In goal-oriented sessions, I check in more frequently to ensure that both the client and I remain focused and, should they wish to shift their focus, that they recognize it is part of my responsibilities to make sure we move back to the desired goal.Often, especially in longer term therapeutic relationships, we as clinicians can see that the client has reached their goal, however they are apprehensive about ending therapy. This is actually a great place to go with them; why would they feel unable to handle issues in their external or internal environment without you? Often, having this open discussion can increase empowerment and mastery. That said, it could also highlight other issues which the client may have been apprehensive about going into within therapy and now, as the relationship seems to be ending, feels more confident in bringing these up.In the case where the relationship is a toxic one, terminating with a client may be the best option for both of you. It's a difficult conversation, but recall that part of the role of the therapist is to model that these discomforts can be managed.I hope that this brief response can assist you going forward! |
How does a counselor decide when to end counseling sessions or to terminate working with a client? | How does counseling end? | This is a question that is very specific to each person. There are definitely some variables, but I can give you some general ideas for when counseling might end:When a client has met all of their goals, at least to a degree when they feel that they no longer need to work on them with the assistance of a counselorSometimes a decision is made that a client is no longer benefiting from counseling at a certain timeSometimes clients have to remain in counseling in order to receive medication. This depends on agency policy, but sometimes it is a requirement. If the medication is necessary and cannot be prescribed by a primary care physician, frequency of sessions is usually decreased greatlyI'm not sure why you are asking this question, but it is also something that is often discussed at the beginning of treatment. Oftentimes "discharge goals" change as treatment progresses because more is known about clients, their goals, changes in their goals, and many other things. Changes are normal, but your counselor probably has discharge goals in mind, at least generally, from the beginning. I strongly encourage you to ask about it! |
My therapist is gay so there are no sexual issues here. However, my therapist for six years has made me believe that he cares about me and that we are friends. I have loaned money to him many times, and he always paid me back. I had a medical emergency last weekend and I was heavily medicated. I knew that this therapist came into my home and wrote down my credit card information so he could pay back what he owed me, but this therapist dropped me off and never came again. I don't know what to do. | My therapist betrayed my trust | I'm sorry to hear that this hashappened.Counselors are legallyand ethically required to make sure that they always put the wellbeing of their clients above their own interests.In addition, counselor ethical rules, and the laws in just about every state, make it illegal for counselors to take advantage ofa client financially.A counselor borrowing money from a client (even if the counselorpays it back) wouldusually be considered to be taking advantage of the client.There are a few options you have at this point ifyou can't (or don't want) to continue to try to contact him directly. You can file a complaint with your states' regulatory board and let themknow what has happened.An investigator will then look into the situation for you. Another option would be for you to find a different counsleor who can provide you with an independent and netural point of view to help you figure out how you want to handle this situation. |
My therapist is gay so there are no sexual issues here. However, my therapist for six years has made me believe that he cares about me and that we are friends. I have loaned money to him many times, and he always paid me back. I had a medical emergency last weekend and I was heavily medicated. I knew that this therapist came into my home and wrote down my credit card information so he could pay back what he owed me, but this therapist dropped me off and never came again. I don't know what to do. | My therapist betrayed my trust | Do you want this therapist to have your credit card information?If not, then cancel the credit cards that you believe may now be accessible to this therapist.Therapists are expected to keep very clear boundaries between the therapy work and not have other relationships, such as "friend" or "money lender" with someone who is their patient.Therapists are never "friends" with their patients.Letting you believe that you are the therapist's friend, is a violation of professional ethics and almost definitely, a violation of the Consumer Protection laws in your State.Start by dropping this person as your therapist. He has broken too many ethical standards to be worthy of offering therapy.Think over if you'd like remaining friends with this person, whom you describe as lacking integrity and stealing from you.If you need help getting back money from him, then contact the police and talk to a detective about what has happened so far. The detective will advise according to the laws in your community and State, whether to file a police report, and what steps are necessary to utilize the Court system to get back your funds.If you'd like doing future patients who may be treated to similar ways by this therapist, a favor, go online and file a complaint with the therapist's Licensing Board.Good luck! |
My therapist is gay so there are no sexual issues here. However, my therapist for six years has made me believe that he cares about me and that we are friends. I have loaned money to him many times, and he always paid me back. I had a medical emergency last weekend and I was heavily medicated. I knew that this therapist came into my home and wrote down my credit card information so he could pay back what he owed me, but this therapist dropped me off and never came again. I don't know what to do. | My therapist betrayed my trust | Therapists, regardless of the discipline (i.e. licensed professional counselor, social worker, psychologist) are expected to put the health and well-being of the client first. Each professional discipline does have a code of ethics as well as a licensing board in each state. In order to get licensed the therapist must agree to abide by the highest standards of conduct including state, local and federal regulations in addition to the code of conduct. You do have the option of reporting this person to the appropriate licencing board in your state. The other concern is if this person has unauthorized access to your credit card. If you did not give it to him or authorize use this becomes a legal matter that you can also report to the legal authorities in your city or town. Therapy and counseling are effective because professionals gain the trust of the client. Betrayal of that trust by crossing boundaries and developing a relationship outside the therapist/client relationship is hurtful. Please know that the vast majority of counselors are highly ethical individuals who put the welfare of the client first. |
I just wanted to get to know one so I can hear about their college experience and the courses they took. I also wanted to know if they enjoy their job and how long they were in school. | I'm in high school, and I want to be a psychologist | It's a great idea for you to reach out to find a psychologist to talk to if this is a field you might be interested in pursuing.Regarding the length of schooling, it generally takes 4 years of college and an additional 4 to 7 years of graduate school to earn a doctorate degree to become a psychologist.There are also other similar professions, including counseling that don't require a doctorate degree. Licensed counselors generally completed 4 years of college and an additional 2 years of graduate school.If you are thinking about a career in psychology, the local APA chapter would be a good place to start to find a local psychologist to talk to. Here's a link to the NJ APA chapter:https://www.psychologynj.org/ |
I just wanted to get to know one so I can hear about their college experience and the courses they took. I also wanted to know if they enjoy their job and how long they were in school. | I'm in high school, and I want to be a psychologist | Mental Health is an exciting and rewarding field. I hear you saying that you want to be a psychologist, and that is one path to working in mental health. You could study psychology,social work or counseling to become a practicing therapist. I am a Licensed Professional Counselor Associate and a Licensed ClinicalAddiction Specialist. I currently provide assessments and supervise several counselors in a large clinic in Asheville. I also have a private practice online. I studied Sociology and Interpersonal Communication as an undergraduate, and then I received a counseling masters degree. My master's degree was comprised of several supervised practice courses and theory courses. I really enjoyed my education, and I find my career equally rewarding and enjoyable. If you are considering working in the field, I recommend emailing several counselors, social workers, and psychologists in your area and setting up an informational interview. Not everyone you contact will be willing to give you their time, but many may. This will help you determine which path to therapy may be right for you. Licensing restrictions and abilitiesvary state to state and a local practitioner may be able to provide you with a specific list of challenges/triumphs about their particular license and education. Psychologists are usually PhD level practitioners and require more education to begin. LCSWs , LPCs and LMFTS can practice with a master's degree. Best of luck! This is an exciting time. |
I am an international student, and it is my first semester in graduate school in the United States. I faced a cultural shock, and I was so depressed when I arrived here. My counselor in the university was my savior. He helped me a great deal. Now I am going back to my country for a vacation. I was thinking to get him something special with my country's name on it, and I remembered that he likes wine. My country is known for that. Is it appropriate to give him wine as a gift after Christmas? | Is it appropriate to give my counselor a bottle of wine for Christmas? | This is a great question.In general it is not appropriate for counselors to accept gifts from their clients.There are some exceptions to this general rule - including a recognition that there may be a valid cultural aspect to this type of gift giving.It might be best to simply offer your counselor a holiday card as an expression of your feelings. You could also talk to your counselor about the gift and ask if him it if would be appropriate.In the end, I know he would most appreciate just knowing how much the counseling meant to you. |
I am an international student, and it is my first semester in graduate school in the United States. I faced a cultural shock, and I was so depressed when I arrived here. My counselor in the university was my savior. He helped me a great deal. Now I am going back to my country for a vacation. I was thinking to get him something special with my country's name on it, and I remembered that he likes wine. My country is known for that. Is it appropriate to give him wine as a gift after Christmas? | Is it appropriate to give my counselor a bottle of wine for Christmas? | I don't think it's appropriate to give your counselor a bottle of wine. Your counselor helped you and supported you, which is great, But a gift is inappropriate. I can understand that you want to show your gratitude. There are many other ways to do that. You could drop your counselor a note or card, thank him in person, or tell him how much he helped you. These small gestures can be very meaningful for both of you. |
I am an international student, and it is my first semester in graduate school in the United States. I faced a cultural shock, and I was so depressed when I arrived here. My counselor in the university was my savior. He helped me a great deal. Now I am going back to my country for a vacation. I was thinking to get him something special with my country's name on it, and I remembered that he likes wine. My country is known for that. Is it appropriate to give him wine as a gift after Christmas? | Is it appropriate to give my counselor a bottle of wine for Christmas? | Hi,Different therapists are guided by the ethical guidelines of their own associations or colleges when it comes to receiving gifts, so this may differ a bit from therapist to therapist. It's important to me that I be sensitive to cultural norms, and to my client's needs. In Canada, and the US, it is customary for people to sometimes express gratitude with a small gift, and I have from time to time received small tokens of appreciation because I believe it would be rude to refuse this. It is never necessary to give a therapist a gift, but if you wish to express your gratitude in this way, I don't think it's inappropriate. |
What is the proper procedure if your child's therapist is leaving the practice to work elsewhere? | Generally speaking therapists are obligated to help their clients connect with a new therapist should they require ongoing support and the therapist is no longer able to continue working with them. This may simply mean that the therapist provides some names and numbers for other therapists or agencies that may be appropriate for your child.If the therapist is leaving one practice for another and is able to continue seeing the client than that may be arranged and is often the most desired outcome for the sake continuity. Sometimes partners or employers in the original practice may expect and require clients of the practice to be transferred to another therapist within that practice instead of being taken to a new practice. |
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What is the proper procedure if your child's therapist is leaving the practice to work elsewhere? | I would recommend other providers who accept your insurance. Once you choose, I would ask you to complete a release of information so I could discuss your child's case and send records so that the new therapist is aware of the general treatment issues. |
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What is the proper procedure if your child's therapist is leaving the practice to work elsewhere? | Hello Largo,This is a great question. There are several options when a therapist is transferring to a new practice. If the practice is in the same general area and the therapist does not have a non compete agreement they can let clients know where they are going. Generally if a therapist has a planned exit from an agency or practice they will inform their clients, and offer or provide transition sessions or suggest new therapist options. At times, unforeseen events arise and and there is no transition process with the therapist. While this situation is not ideal for any client, it does provide an opportunity to utilize learned coping strategies and resilience. |
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What is the proper procedure if your child's therapist is leaving the practice to work elsewhere? | There may be differences in Sate laws, and differences based on the particular license of the therapist, on this question so try googling your question for your State.Generally, the therapist should have given you whatever the standard practice is for your State, notice in advance. And, the therapist was expected to tell you and write you their care plan for the child patient.Are you the parent who is legally responsible for this child?If not, then the therapist may have already communicated properly with whoever is the legal parent responsible for the child.Also, insurance corporations who have contracts with particular therapists, have their own timeline standards of expecting therapists to give proper notice in advance of leaving a practice. |
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What is the proper procedure if your child's therapist is leaving the practice to work elsewhere? | Ask the therapist first. They will either tell you how to continue with them in the new job or give you a referral. They also will help your child with the transition. If that fails, ask the agency where your child sees the therapist about next steps. There's an agency director or equivalent who will probably be happy to help you.If that fails, and I hope it doesn't, consider finding a therapist on your own. If the therapist is not helping or is behaving unethically, contact the state agency which issues the therapist's license for help and to let them know about your experience. That will protect the next parent. Good luck. ~Mark (www.MarkMorrisLCSW.com and www.LivingYes.org) |
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What is the proper procedure if your child's therapist is leaving the practice to work elsewhere? | When terminating employment, counselors need to make sure they don't abandon their clients.There are several ways a counselor can avoid abandoning a client. First, the counselor can refer the client to another clinician at the place of employment. Second, the counselor could refer the client to another clinician outside of the place of employment. Third, the counselor could continue to work with the client in the new place of employment.In the end, the best interest of the client should be the the basis for which option is selected. |
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I have an eating disorder of binging. I've had gastric sleeve surgery. I need help with issues of abuse as a child, addiction, and abusive men. I have been in therapy for five months and get no feedback from my therapist. | Should I get a new therapist? | It can be really frustrating to feel like your counselor is not providing you with the help you need.My recommendation in a situation like this would be to let your counselor know how you feel. Specifically tell Your counselor that you don't seem to be getting the amount of feedback you would like.If this doesn't help, then you might want to look for another counselor who will be a better fit for you. |
I have an eating disorder of binging. I've had gastric sleeve surgery. I need help with issues of abuse as a child, addiction, and abusive men. I have been in therapy for five months and get no feedback from my therapist. | Should I get a new therapist? | Hi Anaheim,Relationships with therapists have some things in common with other relationships; they work best if there is dialogue about what your hopes, thoughts, emotions and needs are. Are you letting your therapist know what your goals are? It's okay to say "I'd really like us to focus on this piece", or "I'm looking for specific direction about how to manage this part". Your therapist is wise if they ask questions that determine what your needs are, but they can't read your mind.Not every therapist will be a good fit for you. I know I'm not a good fit for everyone I meet. We have different styles; some are more passive and focus on listening. This might be the type of therapist you have. For some people this is what they want, but maybe it's not for you. Maybe you want someone who digs at you more, asks more questions, gives you strategies, lets you know what they think... someone more active. If this is the case, it doesn't mean s/he's a bad therapist...it's just not what you're looking for.Sometimes people think they can't end sessions with their therapist; they might be worried about hurt feelings. But, in the end, you don't owe your therapist anything if you feel it's not working or it's not a good match. Just move on and try someone new. Maybe ask them questions first about their style, even.Best of luck! |
I'm worried I should see a therapist due to past events and current mental status. I'm just so unsure of how to ask my doctor about seeing someone. | How do I approach my doctor about seeing a therapist? | Having this kind of conversation with a doctor can feel difficult. But remember, you are the expert on you. Any good medical professional will recognize that.You are absolutely right to think about the importance of being your own health care advocate. Generally, the best approach is simply to be honest. Let your doctor know what you are concerned about and tell your doctor what you think might help. If there is a specific issue that youd like to address in counseling, let you doctor know about it. And dont hesitate to directly ask for a referral.I know this may all feel a little overwhelming. It might help to bring a family member or significant-other with you to provide support when you talk to your doctor. Its great that youve already taken this first step to reach out. Youre on the right track. |
I'm worried I should see a therapist due to past events and current mental status. I'm just so unsure of how to ask my doctor about seeing someone. | How do I approach my doctor about seeing a therapist? | Thanks for your question. I'm glad you realize that you need extra support and are being proactive. Simply explain to your doctor the feelings you have been experiencing and how you feel that speaking with a mental health therapist would be beneficial. However, keep in mind that you do not have to go into detail about your personal feelings. You can simply state that you are feeling down, overwhelmed, stressed, or whatever it may be.I'm sure your doctor will be glad to direct you from there.Best of luck you you! I hope that you will be feeling better soon! |
I need help dealing with stress. How can I handle it all and feel less stressed out? | How can I be less stressed? | How can we handle stress in healthy ways? Eat and drink to optimize your health. Some people try to reduce stress by drinking alcohol or eating too much. Try and find if you do certain things or are there triggers when you do. Exercise regularly. In addition to having physical health benefits, exercise has been shown to be a powerful stress reliever. ... Stop using tobacco and nicotine products. People who use nicotine often refer to it as a stress reliever. ... Study and practice relaxation techniques. Taking the time to relax every day helps to manage stress and to protect the body from the effects of stress. Lastly channel your creative energy try my adult coloring book it might help |
I need help dealing with stress. How can I handle it all and feel less stressed out? | How can I be less stressed? | In case you feel some relief to know you're feeling the tone of our times.We live with crumbling of our values which then gives rise to insecurity everywhere. If someone doesn't know what their values are then its difficult to do anything, and right now everyday we hear uncertainty in what used to be our basic assumptions.You're more normal for noticing and feeling stressed than if you imagine life felt fine the way it is!One road to take is to accept that there are no clear roads forward. This means to change long term goals into shorter ones.Also, in general the more focused you can be as to your particular wishes, motivations, interests, and people about whom you care, the greater will be your sense of confidence that your personal world is as secure as it can be for right now.And, it helps too to know that nothing lasts forever, eventually all of what is up in the air will start to land in a much more clear way. |
I need help dealing with stress. How can I handle it all and feel less stressed out? | How can I be less stressed? | Part of handling stress is making sure that your perception of the stress is accurate. Sometimes stress can seem more than it really is. One thing that I encourage my clients to do is to ask themselves, "What is this stressor really about?" Simplifying stress is a key to minimizing stress and leads to feeling less stressed out. |
I need help dealing with stress. How can I handle it all and feel less stressed out? | How can I be less stressed? | Unfortunately we can't escape stress in this life. Some stress is good and it motivates us to take needed actions. Or stress may paralyze us, cause sickness, and upset relationships. Stress affects every area of your life; physical, emotional, social, cognitive and spiritual. You may experience physical symptoms such as headaches, stomach upset, or sleep disruption. It may affect your ability to learn new things or concentrate. Further it may cause you to question previously held beliefs and heighten your emotions. You can take a holistic approach and focus on those 5 realms to reduce your stress. As examples, exercise as approved by your MD to reduce muscle tension and lift mood, journaling or art to channel your emotions, spending time with positive people, staying away from negative people if you can, and be aware of thoughts that increase your stress. This does not need to take a lot of time out of your busy schedule. Taking 3 minutes throughout the day to walk, journal and take deep breaths helps. A therapist can help you identify specific stressors and help you to problem solve solutions. |
I need help dealing with stress. How can I handle it all and feel less stressed out? | How can I be less stressed? | As a general disclaimer, in any area of mental health there is no "one size fits all" response, as each concern addressed in therapy is unique to you and your life situation. With regard to stress reduction, it can be useful to take an inventory of the emotional, cognitive, and physical manifestations of stress with your psychologist, and to identify the context, history, and triggers related to the stress. This can help in establishing clear treatment goals with well defined targets for stress-reduction interventions, of which there are many. Basic examples of interventions to address manifestations of stress include: cognitive reframing techniques for manifestations of cognitive stress; assertiveness communication training, activity pacing, and mindfulness meditation for emotional manifestations of stress, and good sleep hygiene and lifestyle modifications (e.g., with nutrition, exercise, etc.) for physical manifestations of stress. This is by no means a comprehensive list of interventions, but hopefully will provide a sense of some of the options that could be available for you to work on with your psychologist. |
I need help dealing with stress. How can I handle it all and feel less stressed out? | How can I be less stressed? | There are many causes for feeling stressed out. Between a demanding job, family responsibilities, and everything else that can come up, stress becomes more and more part of our everyday life. One of the best ways to combat the toxic effects of stress on our bodies, social lives, and overall well being is to engage in self-care. But not the self-care that most people think of like vacations or massages. The best self-care is the kind that helps you live the life that you already have rather than escape it. You see, the reason why vacations and massages don't work long term in reducing stress is that they allow you to escape from what is causing the stress without truly fixing it so you just return to what already stressed you out. So, instead you need to find ways to help live with the stressors that you already have. They can be things like creating a more manageable schedule, introducing healthy eating or exercising, financial planning, and even learning a few simple relaxation skills. The key to combatting stress is to make small but consistent changes to your life so that it becomes more manageable and more enjoyable. |
I need help knowing how to deal with stress. What can I do? | How can I be less stressed? | What are five ways to reduce stress?Here Are 5 Important And Effective Ways To Reduce Stress And Anxiety 1.Practice deep breathing exercises2. Just lie down on the floor 3. Focus on an object to help calm your breathing 4. Take a break and listen to some music 5. Smile even when you dont feel like smiling |
I need help knowing how to deal with stress. What can I do? | How can I be less stressed? | Finding the root of your stress, what stresses you most? Finding techniques to combat that, and many have found release, relief in acupuncture, and emotional freedom techniques. |
I need help knowing how to deal with stress. What can I do? | How can I be less stressed? | Some great stress busters are: any type of physical exercise that you enjoy, journaling, reading, doing things you enjoy by yourself or with others, listening to good music, having a great laugh and good conversation, relaxing and mediating like deep breathing, and trying your best to be in the moment! |
I need help knowing how to deal with stress. What can I do? | How can I be less stressed? | Something different works for each of us.There are the outward answers of self-pampering and making your home and work environment as pleasant as possible.A deeper level way to decrease stress is through exercise or alternative practices like yoga or tai chi.If the stress is more deeply rooted than temporarily feeling irritated for a few days, then give yourself some time to reflect and clarify what the meaning of the stress is to you.Self-understanding and appreciating your efforts to know yourself may decrease stress because you'll be more focused and attentive to who you are. This will influence you overall to make good decisions for yourself and these will naturally be ones which decrease stress as much as possible. |
I need help knowing how to deal with stress. What can I do? | How can I be less stressed? | Our body reacts to stress typically by breathing more shallowly, increasing our heart rate and tensing our muscles - so one thing that I find really effective is to try to do the opposite of that, which sends the signal to our mind that we are relaxed. So that means, taking slower, fuller breaths and trying to relax any areas where we might be gripping our muscles. Check out meditation apps such as 'Breathe', which can talk you through a relaxing breath exercise. I recommend using the app daily, whether you feel stressed or not, and then also using it when you re feeling particular moments of stress - that way you are practicing the skill when you feel calm(wish) and it'll be ready and able to help you when stress hits hard. |
I need help knowing how to deal with stress. What can I do? | How can I be less stressed? | Learn how to meditate. I recommend a Mindful Based Stress Reduction MBSR program. |
I'm in my late 20s. I have two jobs right now, I'm in school, and I feel like I just have a lot under my belt right now. I get stressed out really easily. I tend to worry and over-think. I'm just worried about money and everything. | How do I relieve stress and find balance? | A good start is to pay attention to some basic issues: sleep, nutrition, exercise and socially supportive relationships. A great car on an empty tank will not get you very far. |
Is it a type of fetish, or is it normal? | Why do I get aroused when women call me "gay"? | Maybe it is a way to secretly satisfy your own wish to be or to live life gay. |
Why do I have sexual urges for my sister? | Without knowing more details about your personal family dynamics and your age, I am only able to guess.Maybe the reason is because she looks attractive to you. Whether this means anything more than a fleeting fantasy moment or if it is more serious, depends for how long you've felt this way toward her.Sexual urges are sometimes hidden wish to be nurtured. If your sister reminds you of a loving presence then your sexual urge for her may really reflect your need to be nurtured, not necessarily sexually satisfied.Basically, give yourself the mental freedom to let your mind wander as to your own theory on your question.When the find the answer which feels accurate you'll have a sense of having reached your answer. |
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I am a young adult, and I was sexually assaulted by an older man when I was a teenager (which has really intensified the guilt/shame). However, I've been attracted to much older men since I was even younger than that. | Is there a reason I have always been attracted to men much older then me? | Sometimes the reason for being attracted to older men is because of growing up with a father who was distant.If you grew up having enough interaction with your dad to know you'd have liked more and didn't receive this, then maybe your longings of childhood are still active within you.It is ok to like older men.Just be sure you're not idealizing them, or anyone else.Because regardless of age, a relationship is based on who the two people really are, not how we'd like imagining them. |
I have been experiencing a lot of sexual tension with a lot of the guys that I talk to nowadays. I keep imagining having sex with them. I have never had sex before, nor have I had a boyfriend. I feel lonely and empty. I feel like my body is not okay, and I am missing something. I talk to so many boys in school, and I always fantasize about half of them. I want this feeling to stop because it is interfering with my time to study since most of the time, I am busy thinking about sex. | How do I deal with sexual tension? | Hi Montreal, I'm glad you wrote. What you're experiencing is normal. We're sexual beings. We have a built-in desire to connect sexually with others, because it feels good, to keep procreation going, and mostly to "connect" with other people, because connecting with others makes us feel fulfilled and valuable. Sexual desire is a healthy part of you. Maybe your body is telling you it wants to dive into that water and taste it instead of just staring at it? It sounds like you're beginning to explore yourself sexually, and that's okay.At your young age, you also have another innate burning desire, and that is to know yourself. I see both of these desires burning and competing in you. It's a bit of a crazy time...you want to connect with others but you're not sure who you are or what you want from them. You want to know yourself but you can't learn about yourself in a vacuum.It's okay to trust your instincts. It's okay to connect sexually with others, as long as you're preventing disease and pregnancy and you know how to protect your boundaries. But even as I write this, I think maybe I'm being controlling and overprotective of you; it's your body and you're in charge of what happens to it! (But I do want you to be safe...whatever that means to you). Maybe talk to someone you trust.With each encounter you have with other people (sexual or not), you will learn more about yourself and what you want, both sexually and just in relationship or friendship. You will develop a sense of who you are.Have you tried to get to know yourself sexually? This is a super place to start, and knowing how your own body works can give you confidence when you eventually connect with others. When you explore your own body, what feels good? What brings you to orgasm?I wish you well as you explore both who you are and how it feels to connect with others safely. :) |
Back in high school, my friend and I used to masturbate around each other. I hate even talking about it now because it's so weird. We didn't even realize how messed up it was at the time. One time, it escalated and we ended up doing it for each other. It wasn't supposed to be a gay thing, but it sure sounds like it now that I talk about it. I pushed this away until it recently came up in my head again. I'm having a lot of trouble. | How can I get some closure on an experience I regret? | Writing about your high school masturbation times with your friend, is itself a form of acknowledging the full picture of who you are. You are doing well to reflect on your actions in the truthful way you are doing.Also positive is that you have perspective, that at your age and social maturity, you were innocently doing something that in adult terms, would be considered in a negative way.Maybe through your more mature mind's eye of today, you can feel some compassion and understanding for your high school self. This way your sense of self-judgment may start to dissolve a little bit more. |
Every time I send a message to someone or a group message on Instagram, iMessage, or snapchat people will read my messages but then they won't answer me. Could it be that there is something they don't like about me? I don't understand why they won't answer my messages. How do I get people to respond to me? | Why do I always get ignored by people? | You are not alone. SocIal media marketing is and can be tricky. Today to feel validated it is to receive a like , comment or follow. When friends or family members are interacting on their pages but not yours it can be frustrating. Law of Attraction might help. Contact me or visit my profile to learn more. |
Every time I send a message to someone or a group message on Instagram, iMessage, or snapchat people will read my messages but then they won't answer me. Could it be that there is something they don't like about me? I don't understand why they won't answer my messages. How do I get people to respond to me? | Why do I always get ignored by people? | Stand in your power and ask for your needs -in this case, an answer-, to be met. You are valid. People often feed off our energy, so exude the energy of standing in your power and making your voice heard. Knowing what you say is worthy of being heard and receiving a response. You could also look into working on your throat chakra which deals with speaking your truth, self-expression, being heard. |
Every time I send a message to someone or a group message on Instagram, iMessage, or snapchat people will read my messages but then they won't answer me. Could it be that there is something they don't like about me? I don't understand why they won't answer my messages. How do I get people to respond to me? | Why do I always get ignored by people? | I understand the feeling of not being liked due to not having any responses on the sites you list.More than likely the non-response has less to do with liking you than w liking the way you write your messages.Have you tried asking a question in your posts? This would be one way to invite people to answer your post.When you write, imagine yourself as the reader of the post.If you think about the wording of a question which would motivate you to respond, then this formula will very likely be the same for many others who read your post.Good luck! |
Every time I send a message to someone or a group message on Instagram, iMessage, or snapchat people will read my messages but then they won't answer me. Could it be that there is something they don't like about me? I don't understand why they won't answer my messages. How do I get people to respond to me? | Why do I always get ignored by people? | Sorry to hear your friends aren't responding to you. If these friends are in-person as well as online, perhaps going to them in person and asking talking to them about your concern. Perhaps it's the way you send messages or the way they are receiving them. if they say no, then a simple request to respond to your messages. Measure the result and notice if there are even small differences.Also understand, why this is so important to you. Ask yourself, why it's so important for you to receive these messages from friends. What does it mean when they don't respond. |
Every time I send a message to someone or a group message on Instagram, iMessage, or snapchat people will read my messages but then they won't answer me. Could it be that there is something they don't like about me? I don't understand why they won't answer my messages. How do I get people to respond to me? | Why do I always get ignored by people? | I'm sorry that you are having a difficult time.I wonder about how your friendships are in person. If you get along well with people and have effective conversations with them face-to-face, there could be some kind of technology-related problem.Have you tried gently talking to people about how you send a message and they didn't answer? If you can phrase it in such a way that they recognize that you are asking for information and not blaming them for not answering you, that could be effective.I'd also encourage you to consider how much this is bothering you. If it is causing a significant amount of anxiety (say, more than 5/10 if 10 is really anxious), I would suggest talking with a local therapist.In the meantime, consider talking about this with someone you trust to whom you can get more details to get a more specific answer. |
These "jokes" are made about everything. They seem to have the need to say something "funny" about everything. It's not funny, just awkward. | Why do some people try to make a joke for everything and laugh at everything? | I agree, it is awkward when people make jokes about subjects which may not be funny at all. And, if a person only jokes, then after laughing and realizing the person has nothing of themselves to offer, this can also be quite tedious.Realize that you are more aware of human interaction having many levels of expression. You could start avoiding people who irritate you by the way they behave. |
It's really hard to not have negative feelings about friends who don't put any effort into nourishing our relationship. | My friends don't put effort into our relationship | One thing I would ask is "why are you still hanging with those {friends}?" A relationship needs to be nurtured by both parties, it is a dynamic fluctuation between two people. I would ask you to question why you continue to remain together as friends, I always believed that a relationship should emit positivity towards all parties involved, if your in a relationship that is one-sided, it is inevitable that it will start to de-compensate. Never travel with the circus, never travel with fools, everything in life should have some positive payout, will things at times be negative, of course they will, but in order to keep something or someone in your life there should be more positivity than negativity.Hope this helps, C |
It's really hard to not have negative feelings about friends who don't put any effort into nourishing our relationship. | My friends don't put effort into our relationship | Interpersonal relationship (either positive or negatives) need to or more persons who give and receive: attention, dedication, time and communication. But what makes friendships special is that they last trough time, at least with those who we call our true friends, those who know us well and whom we have a special connectionand those from whom we disconnect at times, without fear of losing them.Consider what is that you are going trough yourself and with your relationship, talk to your friend about your concern; let him (her) know that you would like to spend more time together. Plan an activity that you both enjoy or try to discover a new hobby. If your friend is not enthusiastic or engaged, give him (her) some time and focus your energy spending time with other friends or enjoying activities in solitude. After a waiting period, call again to let your friend know how you are and that you are still a friend. If you continue feeling rejected, analyze why you value this relationship so much and consider if its worth to maintain it.Mis amigos no ponen esfuerzo en nuestra relacin.Es muy difcil no tenerles sentimientos negativos a amigos que no se esfuerzan en cuidar nuestra relacin.Las relaciones interpersonales (negativas positivas) necesitan dos o ms personas que den y reciban: atencin, dedicacin, tiempo y comunicacin. Pero lo que tienen de especial las relaciones de amistad es que perduran a travs del tiempo, al menos con los que llamamos nuestros verdaderos amigos, los que nos conocen bien y con quien tenemos una conexin especial, y de quienes nos desconectamos en ocasiones, sin miedo a perderlos.Considera que est sucediendo contigo y en tu amistad, conversa con tu amigo(a) sobre tu preocupacin, djale saber que te gustara pasar ms tiempo juntos. Planifica alguna actividad que les interese a ambos o descubran algn nuevo inters. Si la respuesta de tu amigo(a) no es positiva o entusiasta, dale tiempo y acrcate a otras personas que compartan intereses en comn, o dedcate a hacer cosas que disfrutas en solitud. Despus de un plazo, vuelve a comunicarte para saber como esta, y dejarle su amigo(a) de siempre est ah. Si sientes que tu amigo(a) no tiene ningn inters, buscar hacer nuevas conexiones, y enfcate ms en ti y en otras actividades. Si tu amigo(a) no responde, analiza porque valoras esta relacin, y si conviene mantenerla, aun cuando tu amigo(a) no responde a tus esfuerzos. |
Because we are on opposite coasts, we try to talk early mornings, but she is constantly interrupted by visitors. I suggested setting aside some time, but she has made it very clear she has no intention of changing her lifestyle. She is also drinking beer every day on antipsychotics. | Should I pull away from my best friend? | The answer depends on how satisfied and happy you feel in being part of this friendship.From what you write, there aren't any statements as to what gives you happiness about being a friend to this person.Since you already made a request of. your friend and she isn't following through, you could ask if she is willing to work with your suggested plan.The friendship may take a new format, depending on your friend's response.Its possible to be in contact more spontaneously, when either of you feel like contacting the other.What matters most is your own dissatisfaction with the current relationship status.Even if you change to a, birthday and holiday only conversation, or some other style of interacting, at least it will be the result of the effort from each person, not just one, who is you, designing arrangements which only you are willing to keep. |
My best friend and I were pranking her friend, and I told her to tell him that she likes him. She said no, but I forced her. After she told him, he told her that he likes her too. Their friendship is ruined because of me. She won't forgive me, and I feel really guilty. I feel like crying. | How do I repair my friendship? | In order for your friend to forgive you she'd need to trust you understand the damage you introduced into her relationship with her friend.Its possible if you offer your friend expressions of your empathy toward her over an extended time, possibly she'll forgive you.You're certainly learning relationship lessons on how to treat people and the effect of betraying another person, which will last forever.Maybe this was meant to be the outcome. |