Tuesday, February 9, 2016
events are unique in specifics, but often stir up similar reactions among employees.
Employees closest to the “epicenter” often have the most intense reactions,
while those in circles further removed might have less intense reactions, it is
likely the reactions/issues are similar. Being able to anticipate the most
common reactions prepares us to provide employees the right handouts and
teaching points. Experience has taught me three reactions are universal.
§ Guilt is usually connected to thoughts employee(s) have
about what they should/could/would have done differently to alter or prevent
the event. These are usually the result of “Monday Morning Quarterbacking” where
the person reinterprets their actions knowing the outcome. This is particularly
true after a suicide or death of a colleague. It is very destructive and
usually inaccurate. A teaching point is to talk about the fact that people are
in pain and “wish” the event had not happened. Understanding there is no
guarantee anything they could have done differently would have altered the
outcome is sometimes helpful.
§ Anger is usually connected to wanting to blame someone or
something for the event. If the anger is at the perpetrator, it is probably
healthy. The leadership or company is often blamed for not preventing the
incident. Anger at God or their spiritual traditions are most common and should
be referred back to their spiritual leadership for answers. It is outside our
role as interventionists to directly address spiritual issues, except to
validate them and state that they are common reactions.
§ Grief after the loss of someone they care about is easy to
understand. Disruptive events can trigger a variety of intangible losses. One most
common is the loss of sense of personal safety. People think this could happen
to me, or my family, or my friends etc. Disruptive events happen because we
have no control over them. This temporary feeling of the loss of our illusions
of control and safety can be profound. The teaching points here are helping
people understand their multiple losses, and that grief is a process they will move
through over the next few days. Providing information on understanding they are
grieving and things they can do to move through the grieving process is often
we are aware of these universal reactions and provide teaching points for them,
we help employees understand their reactions, and tap into their natural
resiliency and move toward recovery.
This is the crux of helping the employees return to work and return to
suggestions do you give to people to help them return to pre-incident
Dennis Potter, LMSW, CAADC, ICCS, FAAETS, serves
as Manager, Consultant Relations and Training for Crisis Care Network. He
is a licensed social worker and certified addiction counselor. Dennis is
recognized as a Fellow, by the American Academy of Experts in Traumatic Stress.
He was awarded the ICISF Excellence in Training and Educations Award at the
ICISF 2011 World Congress.
Saturday, January 30, 2016
a Millennial, it's hard to imagine HelpPRO once existed in paper form, like a
giant catalog. Even though I’ve been working in mental health
for a few years, the prospect of finding a new therapist overwhelms me. It seems
natural to begin to search for a therapist online, but basic internet searches
lacks the authority you need when you are looking for someone to share your
deepest thoughts and feelings with.
In effort to make the process
easier, I wrote an article “How to Find a Therapist Without Losing Your
Mind" for a new website,
Modernae.com. Modernae.com is
the daily source for smart, original content that informs, inspires and
entertains the 21st century woman.
HelpPRO’s William Blout gave
me some great tips like avoiding e-mailing therapists since it’s easy to
misinterpret tone in an e-mail. Bill also emphasized the importance of finding
a mental health pro that you can trust. As Bill said, “If you don’t trust the
person therapy isn’t going to work. ”You can read more of Bill’s great advice in the article and check out my work on Psychedmedia.com.
Ashley Womble is a writer and
champion for mental health. She is the founder of Psyched, a website dedicated to changing the way
people think about mental health, and the Communications Director at Fountain
House. Connect with Ashley via LinkedIn
Sunday, January 17, 2016
The recent Blog, “The Language of Resilience” by Dr. Les Kertay, answers the question what is Critical Incident Response (CIR) for and what is the expected outcome of CIR? Many of the events Critical Incident Response is used for are not typically thought of as a Critical Incident. Thinking in terms of “Critical Incidents” may lead us to assume pathology when the most common outcome to any stressful event is resilience. Dr. Kertay suggests a more accurate term is “Potentially Disruptive Event” as humans are developed to endure stress, manage its effects, and return to life, often more resilient than before. Providing guidance and support to this natural process of resilience is the purview of CIR.
Dr. Les Kertay is a Licensed and Board Certified Clinical Psychologist with extensive experience in mind-body health including disability medicine, chronic pain, and health behaviors as well as being a leader and consultant on strategies to manage workplace absence and a practicing clinician and industry consultant. Dr. Kertay is currently Chief Medical Officer with R3 Continuum (Crisis Management International, Crisis Care Network, Behavioral Medical Interventions).
Sunday, November 29, 2015
I recently closed my therapy practice in Dallas, TX to relocate
to the East Coast to be closer to aging family members. I decided to give my 50
or so active clients 2 months notice to provide ample time for them to prepare
and for me to arrange continuity of care. Those 2 months were extraordinary!
Because I initiated the ending, I set in motion what therapists call the
“termination phase” of therapy. I had told people: “Get ready. We are going to
say goodbye”. And we did. What’s extraordinary is that real goodbyes so often
never happen for therapists. When clients are either frustrated with their
progress or are legitimately ready to end treatment, they either fade away or
Here is my advice (It may sound a little harsh, but hear me
out): tell us what’s going on, say goodbye, and don’t worry about our feelings.
If you’re ready to finish work with us, we will have feelings about it, rest
assured. We will miss you! But if we let those feelings cloud our professional
judgment, or if we take your departure personally, then we’re not keeping our
part of the bargain. Remember, when we agreed to work with you, we agreed to
ensure your best interests.
Here’s why I really want you to say goodbye when you’re ready to
leave. Goodbyes are hard. They hurt and often bring about profound expressions
of sadness and grief. In many ways, this is the essence of psychotherapy:
learning how to communicate deep and painful truths in caring ways and
developing the courage and willingness to do so. By practicing “goodbyes” in
the therapy room, you will learn how to do it successfully in life.
Furthermore, it may be time to switch therapists. If you don’t
feel comfortable telling your therapist, then there may be unaddressed issues in
the therapeutic alliance. It’s possible these issues—at least your role in
them—reflect the very things you are trying to resolve in your personal
relationships. By intentionally entering into the termination phase of therapy
and saying goodbye, you give yourself and your therapist a chance to explore
and resolve these issues, so you don’t carry them into your relationship with
your next therapist. Your therapist may also help with a referral to a
therapist who may be a better fit for you, but cannot help if he/she does not
One more thing—sometimes clients want to switch therapists
because the therapy has stagnated or become stuck. Again, bring it to our
attention. That may be just what your therapist needs to hear to get the
treatment going again. You might find it’s not goodbye after all. Maybe we just
needed a nudge!
Pawelek, LICSW, has been providing psychotherapy to adults, couples, and teens
for 10 years. He is a graduate of both the Boston University School of Social
Work and the Boston University School of Theology. He is in private practice
with the New England Pastoral Institute in Salem, NH. Prior to moving to New
England to be closer to aging family members, Aaron was the training director
and a staff therapist for the Pastoral Counseling Center of Dallas, TX. Aaron
has a variety of clinical interests including working with people with
disabilities, adults raised by parents with mental illness or addiction, people
in addiction recovery themselves, couples in crisis, and people in the GLBT
community. As a pastorally oriented psychotherapist, Aaron helps people integrate
their spiritual and religious resources into the therapy process if they wish.
Sunday, November 1, 2015
I explained to someone the other day the work we do at Crisis Care Network. We respond after Critical Incidents or trauma events to help employees “bounce back”. I was asked what kind of events we handle most frequently. I responded our three most common events are death of an employee, robbery, and staff size readjustments. Again, I was asked, did these deaths happen in the workplace? Are the robberies the type we see on TV and in the movies with guns brandished and shots fired? No, I said, they are most often natural or accidental deaths outside the workplace, and the robberies rarely involve weapons shown or anyone actually hurt in the robbery. My friend said, these are not really trauma or crisis events, but rather are events that are disruptive in the workplace!
It was then a light bulb went off over my head (if I were a cartoon character). We talk, teach about, and promote Critical Incident Response (CIR) in the Workplace as responding to a trauma event. In fact, CIR are most frequently a highly disruptive event traumatic to the families of the victims, but are far more often disruptive to the normal flow of work in the workplace due to their sudden unexpected nature.
The most common themes employees have after these unexpected events has to do with grief and loss rather than traumatic stress reactions. Employees want to know their reactions are common, but more importantly they want to know what to do about them. They want to know what to say to the families of the deceased, or to their own loved ones after the event.
Maybe we should talk about Critical Incidents as things that are disruptive to the workplace and get away from using terms like crisis or trauma so people understand better the worthwhile work we do for employees to help the workplace recover.
Dennis Potter, LMSW, CAADC, ICCS, FAAETS, serves as Manager, Consultant Relations and Training for Crisis Care Network. He is a licensed social worker and certified addiction counselor. Dennis is recognized as a Fellow, by the American Academy of Experts in Traumatic Stress. He was awarded the ICISF Excellence in Training and Educations Award at the ICISF 2011 World Congress.
Monday, July 6, 2015
You will find all sorts of blogs and checklists out there of what to look for in a therapist. These can be incredibly helpful. However, the DO NOTs of therapy deserve some attention, too.
There are many obvious things a therapist shouldn’t do (see: psych central blog).
Here are some less obvious problems that should raise a red flag.
They fail to seek your informed consent.
Any therapist you see will have you sign a consent form at the beginning of your relationship. This is good, ethical practice. However, they should continually seek your consent as you move forward. Before any exercise, whether it be written, verbal, art or something else, they should check in with you to ensure you’re comfortable with what they are asking. You are always allowed to say no.
They do not ask for feedback from you (or can’t accept it).
Your therapist will be asking about how you are doing and what your experience is with various interventions and conversations. This is good. If they’re not asking, tell them. If they don’t listen, get a new therapist.
Manipulate you into remaining as a client.
Assuming you are attending therapy voluntarily and are not a danger to yourself or others, you have a right to decide who you see for therapy and how long you see them. (Patients in hospitals and in involuntary treatment have rights, too, but that’s a different conversation.) Signing a consent form is not a contract for length of services. You are free to leave whenever you want. If a therapist does not feel like a good fit for you, you can decide to see someone else.
Talk to other people about you.
Your therapist should never talk about your case with anyone. Exceptions do exist to this rule including: you give written permission, the therapist receives a court order, you are suicidal/homicidal or discuss child/elder abuse. This also applies to your written therapy record. If these boundaries are crossed, it is inappropriate and grounds for you to file a complaint against the therapist with their licensing board.
Try to be your friend, business partner or lover.
This is a big no-no. Your therapist is expected to follow the ethics of their profession regarding personal relationships with clients. These rules go something like this: No personal relationship with a current client is ever appropriate. Some professions allow for relationships if your therapy ended 2 years ago. Many professionals err on the side of keeping that boundary in place permanently. If your therapist is making sexual advances, suggesting you grab a drink or asks to borrow money from you, stop seeing them immediately and call the licensing board in your state. This is completely unacceptable behavior.
There are countless wonderful, ethical therapists but there are also a few bad apples. Keep an eye out for these red flags to protect yourself when you see a therapist.
Bethany Raab is a licensed clinical social worker in Denver, Colorado. She owns a private therapy practice where she works with teens, families and young adults.
Tuesday, June 30, 2015
The obvious value of online scheduling is efficiency and convenience. Therapist and patient do not need to talk with each other to schedule their appointments.
Since our entire method of professionally offering service relies on talking to people, what, if any, areas of our work are affected by utilizing online appointment scheduling?
The initial phone contact from the patient was once referred to as an “intake”.
This was a chance for the therapist to assess an overview of the case and whether they or their agency, would be able to handle the level of care required.
This was also a way for a prospective patient to get a firsthand feel of working with either the particular therapist or the overall view of how the agency would address their matter.
The question for therapists to consider is whether the demographic and “check the box” information of online scheduling, is an equal substitute for a phone assessment intake.
Maybe in fact the first in person session has become the former phone intake.
Only now we have a hopeful new patient sitting in front of us who may not be a good fit for the type of therapy work we do.
What if, when scheduling an initial appointment, instead of prioritizing time efficiency and convenience only, we limit our online scheduling gadgets to situations which do not actively require our professional skills?
Sherry Katz, LCSW is clinically trained in systems relational therapy, and practices marriage and family therapy in her solo practice located in Ridgewood, NJ. Comments and questions are welcome www.newviewsfamilytherapy.com.
Friday, June 12, 2015
Is one of your reasons for starting therapy because every approach you’ve tried in a particular relationship increases your frustration, hurt, and sadness?
And after explaining your outlook and reasoning to this person many times, the relationship patterns are still the same?
Therapy will give your sincere and heartfelt effort and concern, a new direction.
Step One is accepting the profound realization that you are only able to change yourself.
Despite your many good ideas and earnest care, the other person in the relationship, whether partner, sibling, adult child, any meaningful family member, may not want to understand your point, or want to agree with it.
The deeper problem is not necessarily that you have bad ideas or that the other person is intentionally being difficult.
The discontent you are facing in the stressed relationship, is a pathway to knowing more about your own standards and satisfactions in relating.
If you are upset because the other person does not accept your suggestions, instead of inwardly disapproving, utilize this feeling of rejection as a sign of how highly you value that your advice is followed.
If the other person criticizes what you consider key points in your value system, then allow yourself to appreciate that you have a clear value system.
If the other person dismisses your feelings, then this is your moment to be even more aware that your emotions are a way to express yourself.
All of these interactions are painful and tiring to some degree.
Your reason for talking with a therapist is to stabilize and ground your perspective, believe in your right to be who you are, and strengthen your confidence in handling your part in a relationship that is currently stressed, and any relationship that develops in your world.
Sherry Katz, LCSW is clinically trained in systems relational therapy, and practices marriage and family therapy in her solo practice located in Ridgewood, NJ. Comments and questions are welcome. www.newviewsfamilytherapy.com
Thursday, December 11, 2014
In this age of connectivity, clients expect therapy to be accessible. I continue to see unmet demand for video therapy. Few therapists offer this service which I started doing a few years ago. My clients benefit from video therapy in many ways. I have clients traveling who want to keep their appointments. I use video to meet with college students who return home for the summer and breaks. I use video to meet with clients during snow days, transportation problems, forgotten appointments (just log-on for a session so the appointment time can still be used) and for those whose illness was contagious, yet they needed their session because they felt so bad, both mentally and physically. I also have business people who want their session, but cannot afford the travel time on account of their busy schedule.
It is difficult for rural residents to get services. Video sessions make this easier. Rural clients, however, often do not have a fast enough internet connection, but this will improve in time. Some rural clients have a high quality cell signal, which allows them to hold a session, but this cuts into their data allotment. I have had success relying on a phone call for the audio and tolerating a lower quality video feed.
In my experience offering the option for video sessions helps me give my clients a higher level of care and means my clients are more likely to keep their appointments. If the client is comfortable with the technology, it works well. If their internet connection goes out, then the phone is a backup. There are many clients not comfortable with video sessions and choose to only come to the office. This is OK too. Over time I believe more people will be comfortable with video sessions.
There are some situations where video sessions are not appropriate. Examples include clients who pose a high risk, such as homicidal and/or suicidal ideation, psychosis, or who simply need a more intense services. I never use video sessions with someone who is court ordered or having problems with denial. I don’t feel video sessions are powerful enough in this situation. However, if someone is looking to better themselves and is higher functioning, video sessions are often ideal.
Remember, it is important for both therapist and client to have a history of using video conferencing services and have quality internet, a high quality router and computer, and good lighting. We need to ensure the technology adds to the therapy experience.
Therapy must embrace technology to remain relevant and to help clients. If licensed therapists do not embrace video therapy, those in need of therapy will seek less qualified people who are using video services. Lets not let our profession be left behind.
Buck Black LCSW, CST is a therapist who has several years of experience using video conferencing with clients to address anger, stress, and relationship issues. Therapy appointments are also available at his office. His information is at www.BuckBlack.com Follow him on twitter @BuckBlack
Saturday, October 18, 2014
Seek wisdom before, during, and after a big decision, but remember not everyone has your best interest in mind! People often filter advice through their own experience; depending on personal comfort levels:
It sounds reckless and dangerous! Don’t do it!
It sounds adventurous! Go for it!
Others might benefit directly/indirectly from your decisions and advise accordingly. It’s common to guide to gain - with “enmeshed” and “codependent” relationships forming as a result:
Stay here (and keep me company) while you figure out what you want to do.
I should stay (you pay for rent and food) while I figure out what I want to do.
When advised from the two categories above, say “thank you” – without explaining, defending, arguing - and seek wisdom elsewhere; preferably from outside your circle of influence. However, even counselors, coaches and pastors can have a “tint on their lens.” Look for someone who has:
1. Nothing to lose or gain from your decisions.
2. Statistics (not opinions) about the risks/gains of each options.
3. Insight into what’s in your best interest.
4. Ability/willingness to be honest.
Say “thank you” – without explaining, defending, arguing -- and for big decisions, seek advice from at least three wise sources – and then move forward. Yes, move forward. Even the wisest decision can end up in a tangle. If you do a good job of seeking/receiving sound advice but struggle with moving forward, check back later for more on Fear of Failure!
Julie Davis uncovers and clears up deeply embedded beliefs and unresolved emotions that keep people stuck (www.rapidresolutiontherapy.com) and coaches people how to stay clear, calm and strategic in everyday life with healthy ways of thinking, feeling and behaving (www.juliedavismft.com). Get free weekly insight and guidance by joining Julie’s Tuesday Email service. Send “subscribe” in subject line to: firstname.lastname@example.org. Julie is a Certified Rapid Resolution Therapist, Licensed Marriage and Family Therapist (North Carolina, California; New York – pending), Board Certified Hypnotherapist, and New Life Network Christian Counselor (www.newlife.com). 704-807-1101.