Is Telepsychology Right for Your Practice?



IMG_2159Technology is an awesome tool that can enhance psychological services if done by a knowledgable therapist. For many years I’ve enjoyed working with a lot of people from around the world but it’s not for everybody.

Below I provide the basic notes outlined after a popular talk I give to behavioral health professionals interested in the ins and outs of using the modality of telepsychology in their practice.

[Click here for a pdf with hyperlinks to useful articles, information and resources on this subject. Tele-Psychology  handout]

Let’s begin!

Telepsychology is a big fat subject. For the sake of organization and saving a few brain cells, this talk is divided into four parts that overlap here and there:

I. Introduction & History

II. Why do it? With Whom?

III. Ethical & Legal Considerations

IV. How Do You Do It?

Let’s start with a definition of telepsychology: The provision of psychological services given remotely using telecommunications technology.

Email, texting, faxing, telephone and video conferencing all fall in to this category. Here I mainly focus on video for direct service and email/texting for indirect service (scheduling).

Personally, I am not comfortable with the idea of providing therapeutic service in an email conversation or an instant messaging chat. There is too much opportunity for written words to be misread. I prefer telephone and video. This is a personal choice.

Even though I do believe face-to-face is best, tele-sessions can be a good-enough alternative.

Tele-sessions are very enjoyable and effective. People report satisfaction in the quality of counseling they receive via video chat. When it’s done well it can feel as if the client/patient is in the room with you.

There aren’t a lot of reliable studies that I could find but what I did find suggested that for certain situations video sessions can be as effective for long term symptom relief as face-to-face counseling.

Technology is a gift and like any gift can work for us if we have the wisdom to know how to use it, when to use it and when not to. There are incredible positives to being able to help your clients when they cannot come into the office. There are negatives which we will cover here but over all I believe having the ability to use tele-sessions as an added value to your practice and can be rewarding for you and for your clients.

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Stop Fighting Over Money & Enjoy Your Marriage!



Amy-Jo-Lauber-150x150Editor’s Note: My dear friend, Amy Jo Lauber, CFP, author of Life Inspired Financially Empowered, is holding a weekend retreat for couples! Of the big three reasons couples fight, sex, money and family, I have to say money was the usual suspect in our house. A retreat like the one Amy Jo has planned would have saved my husband and me a lot of tension and strife! Here is a reprint of an article written by Amy Jo describing the highlights of the retreat and why couples will benefit for the good of your bank account and your relationship!

~***~

It is booked! The “Couple’s Retreat for Financial Harmony” that I’m cheekily calling HARMONEY!

Since most couples argue (or at least disagree) about some aspects of their finances at least some of the time, I feel offering this retreat is a way of helping them stay married (if indeed they’d like to). Being a good steward of your resources is one way of showing love for your spouse.

Financial decisions and actions are reflections of our innermost values and priorities, so they tend to pull our triggers in ways we may not always understand. Once triggered, it’s difficult to listen to our spouse and step into a place of rational, wise decision making because we go into tantrum mode.

This is not healthy if you desire a long-term marriage and will only make you grumble at the “for richer or for poorer” vow you took. And what money-struggleabout “for worse?!” Who marries “for worse?!”

So, let’s make it “for better” and we’ll work on the “for richer” part, too.

This retreat is designed to be a sacred time and place for you and your beloved to:

  • Discover each other’s values, goals, fears and priorities
  • Foster a sense of understanding for each another
  • Learn how you complement each other financially
  • Increase your communication skills
  • Learn how to tackle your finances as a team
  • Create and commit to mutual goals & courses of action

Salsa SarahSarah Haykel (“Salsa Sarah”) will start us off Friday evening with a bit of fun, then Saturday I’ll help you discover what’s truly important to you – individually and as a couple – and how money can be your servant (and not the other way around).

Then Dr. Elvira Aletta of Explore What’s Next will give you the tools you need to communicate your needs and priorities to each other so that you can like each other and feel that you truly have each other’s back.

The retreat runs from Friday October 24th 6:30pm through Saturday October 25thth 4pm at the gorgeous Beaver Hollow Conference Center 1083 Pit Road, Java Center, NY 14082 (note this is a non-smoking facility).

$525 per couple: All meals and guest rooms included!
Make checks payable to Lauber Financial Planning, 3976 Seneca Street, West Seneca, NY 14224

A New EWN Group: Women Empowering Women In A Changing World!



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“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.” ~Anais Nin

Don’t you love that quote? I don’t know how many women I’ve met who say this quote is an all time favorite. Why does it speak to us?

Because change is scary. Because it takes a lot of guts to face the change instead of avoiding it, to take charge of our own story instead of handing it over to someone else to tell for us, to take center stage and be the star of our show instead of sitting on the side lines!

Yup, it’s all risky. ‘Cause who can tell us how it’s all going to turn out?

We have fooled ourselves into thinking we can handle it all! Society and our own perfectionistic-y egos tell us we should be able to handle it all! Yet despite all our resources we begin to get frayed around the edges. Exhaustion, sleep troubles, emotional eating, irritability…

We become the frog in the pot, cooking ourselves slowly into shadows of our former selves.

During times of transition we can all use a little help from our friends to remind us how awesome we are!

That’s where our new Explore What’s Next group comes in!

Why go it alone? Transition can be overwhelming! It’s OK to think that, even say it out loud. Coping with aging parents and children’s needs, empty nesting, illness, changes at work or in a relationship and more – sometimes all at once!

Our new group is designed to give you support on your path of change. Our goal is for you to grow out of Overwhelmed and into Empowered! We provide a safe, comfy place where you can just be you, inspired by new ideas and perspectives, validated and encouraged.

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Robin Williams, Depression & Suicide



I will not judge Robin Williams’ death. In my work I see what severe depression does to a person’s cognitive functioning, the self-loathing and hopelessness that are its hallmark. Substances are often turned to in a desperate, and yes, misguided, attempt to lessen the pain. We all know what good that does.

Suicide is *not* a selfish act. It is the horrifyingly logical conclusion of a devastating illness that takes every ounce of our self-worth away. The “selfish” act is to listen to the healthy voice, inside us, however weak and tiny that says, “Live! You deserve life’s gifts.”

If you are worried about a loved one or are suffering yourself from thoughts of self-harm call 800-273-TALK immediately.

5 Ways To Avoid Procrastination – Get Started!



My friend, Carolyn Thomas, of Heart Sisters, posted a comment on my recent article 3 Ways To Avoid Procrastination. She wrote:

Hello again Dr. A!

Sisyphus and his rock had nothing on me. This week is my daughter’s second wedding anniversary. I’m embarrassed to admit that for two years, I’ve had two (empty) photo albums I’d offered to complete for her (plus 600+ wedding photos) sitting in a big basket full of (expensive!) wedding-themed scrapbooking embellishments in the corner of the living room, all of it reminding me every time I pass that corner of the room that this task is HOW long overdue?!?!

I know, I know, I know – if I would only pull it all out onto the dining room table and just get started (as you point out in #2), I could polish off this creative project in due course – and probably actually have fun creating it.

I do have a beaut of a procrastination excuse, however. On her wedding day, her Dad became very ill. He managed to walk his only daughter down the aisle before one of our guests (a physician) insisted that he needed to go straight to the hospital, where he underwent emergency surgery and stayed in Intensive Care for over two weeks, seriously ill. So instead of leaving on her honeymoon, our daughter sat vigil with her new hubby at her Dad’s bedside for those two weeks.

As you can imagine, when we look at those wedding photos now, it brings back a nightmarish memory of a day that started off so beautifully but ended with such high drama. Hundreds of photos of her smiling a frozen little pasted-on smile, trying bravely to get through the reception, the dinner, the endless speeches, the party afterwards – when really all she could think of was her Dad who wasn’t there. I dread looking at those photos of her – and let’s face it, she’s in almost every one!

The timing of your post is near-perfect – just the boot in the bum I need. Thank you for this!
regards,

Dear Carolyn,

Thank you so much for sharing your story with me. I sincerely hope your daughter’s father is well and able to enjoy her second wedding anniversary with the family.

What a doozy of a procrastination excuse! That’s how sneaky and devious that Anxious Avoidance Voice can be. It can hit us where we live so that we’re convinced that avoidance is the right thing to do. Reading your story, anyone with a heart would say, well, of course you don’t want to look at those photos! Put them away! Don’t suffer looking at them. A lot of us can identify with your situation. I spent well over a year avoiding cleaning out my father’s clothes closet after he passed away and felt terrible about it every time I walked by.

I am so happy that the Avoid Procrastination article inspired you! It sounds like you’re determined to get your project done now! I came up with a few more suggestions (see below) that I hope will make your Sisyphean task a bit easier, not just for you but for any of us who are faced with a similarly painful, long avoided project.

Warmest wishes, Elvira

~***~

1. Know that getting started is the hardest part. There’s this thing called entropy. It’s a physics thing but I believe it applies to emotional energy as well. When NASA needs to blast a satellite into space, it takes massive amounts of rocket fuel to push out of the pull of Earth’s gravity. That huge effort then dissipates once the satellite is in orbit. Procrastinating anxiety wants us to think that the same huge effort it takes to get started will be needed throughout the execution of the task. That is just too much for anyone to bear! The truth is that once you are out of the sticky pull of doing nothing, the energy needed to keep your momentum, to keep on course, is nothing compared to the initial, getting-started effort.

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12 Ways To Break Through Loneliness & Make Friends



“There are no strangers here. Only friends you haven’t yet met.” ~William Butler Yeats

Friendships are a big factor in health and happiness. People with active friend circles apparently live longer and report higher levels of life satisfaction. Sure, that makes sense.

But as we get older the usual routes to making friends peter out. How hard is it to make friends when your kids no longer need you to help out with school field trips or to accompany them on play dates where you could bond with the other moms?

Really, really hard!

How does a person no longer in college make friends?

Last year this was a big thing on my radar. With my youngest in her first year of college I was officially an empty nester. Without my daughter’s presence available as an easy distraction, the absence of a solid girlfriend circle was obvious. I wanted to actively do something about it. This is what I came up with:

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3 Ways to Avoid Procrastination



What if Sisyphus wasn’t being punished by the gods? What if he was an avoider? A chronic self-saboteur? What if Sisyphus rolled that huge boulder almost to the top of the hill and thought, “Screw it, this is just too hard!” and he steps back and lets it go?

Unhappy Sisyphus

He’d feel instant relief. “Oh, man, that feels so much better!” He’d stretch his back, roll his neck, maybe sits down to enjoy the view from the top of the hill, watch the glorious Greek sunset.

Then, when he walks down the hill, all la-dee-da, whistling, he sees the dreaded boulder, waiting for him at the bottom of the hill, mocking him.

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When something makes us anxious, avoidance works to lower anxiety. All procrastination is avoidance. And it’s a damn hard habit to break because avoidance works to lower anxiety. So is thinking everything else is more important than the thing that makes us anxious. We’ll do anything but not the thing that makes us anxious.

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Get Up Off Offa That Thing!



Reap the Benefits of Physical Exercise!

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What? Go for a run when I have a million other things to do? Who has the time for that!

This is a typical thought that passes through my mind more frequently than I would like to admit. However, I am aware of it and I refute it with a positive statement to motivate myself to go such as “I will feel better after, I always do, so just do it.”

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Anne Lamott (my latest girl crush) On Perfectionism



anne_lamott_credit_sam_lamott_final_small_custom-7e5d0b9ab1f825f3b80131f7594ab88e8c3f9039-s6-c30Sometimes you run across a quote or a passage that makes you stop, read it again, maybe one more time and think, ‘That’s it. That says it all.’

Anne Lamott’s book Bird by Bird, Some Instructions on Writing and Life, is full of bits like that. The paragraph below opens her chapter entitled ‘Perfectionism’. It doesn’t matter if you’re a writer or not, if you are reading this blog I think you will find what Anne says here totally relatable.

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Our Marriage Do-Over



UnknownYears ago I heard Harville Hendrix, author of Getting the Love You Want, speak at a psychotherapy conference in L.A. He was there to demonstrate Imago Therapy, a couples therapy model that teaches deeper communication to enhance mutual understanding and compassion. Basically, if a couple really uses the Imago techniques, they will still need to work out their differences but they don’t have to butt heads over it so much.

That’s all cool, but what really caught my attention was Hendrix’s theory of why we marry the people we do in the first place. Why do we make that particular choice?

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3 Steps To Self-Care



IMG_1977Self-care is essential for any care-giver. Vacation is wonderful but it’s usually only a once in a while thing. We all need time to float, by ourselves, on a daily basis. Whether it’s simply time to take a nice long, hot shower, which for the new mother is nothing short of heaven, take a walk or finding respite care for aging parents so that you can take a day to go to a spa or just sleep-in. These are not selfish indulgences. Self-care is essential like food or oxygen.

What it boils down to is giving ourselves permission to be alone to do what is meaningful for us alone, permission to drink from the well by ourselves. Permission to take care of ourselves because no one else is going to do it for us.

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