Who is Your Therapist Anyway?

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I was recently interviewed in this article that came out in the Colorado Springs Gazette this weekend.  The article is long, but worth reading because it tells a fascinating story of a man who isn’t necessarily who he says he is.  Take a look.

Regardless of what is really going on with the gentleman featured in the article, the article brings up an important point:

Know who your mental health care providers are.

As a psychologist, I sometimes forget that not everyone knows the difference between types of therapists (and there are many) and the importance of understanding who might best suit your needs.  Here are a couple of things to keep in mind:

  • Being a licensed provider is important.  Licensure is important because it means the state where the therapist resides regulates their practice of therapy.  Backgrounds, education and other information has been checked by the state; and in most cases a comprehensive examination has been passed.  Many states also require continuing education credits to maintain one’s license.  So, how do you check to see if your therapist is licensed? Just ask and they should happily give you an answer and also provide you with their license number. Easy!
  • Education is important…or is it?  There are many paths to become a therapist.  There are marriage and family therapists, clinical social workers, professional counselors, school psychologists, clinical psychologist and psychiatrists.  Here’s the deal: while the differences are extremely important to me (I am a psychologist after all), they probably aren’t to you. As long as you have established that a therapist is licensed and has at least a master’s degree in something like psychology or counseling – they are probably worth checking out.
  • Trust your gut. Therapy is a funny thing: it requires you to reveal things about your life and emotions that you typically don’t.  Because of that, safety and security are hugely important.  So is goodness of fit; meaning you need to feel comfortable with your therapist.  So if something feels “off” or “weird” or not quite genuine, perhaps it is time to ask some questions to your therapist or find someone else.

Want more information about therapy, therapists and what it takes to become a psychologist? Check out these articles:

What is a Psychologist Anyway?

What a Psychologist Really Thinks About You

Psychotherapy Is Not Dead


Why Your Best Friend Can’t Be Your Psychologist

I think I might be inadvertently starting the Dr. Deb fan club.  After reviewing her superb book and interviewing her for a post earlier in the week, I came across this article.  She wrote What to Expect in Psychotherapy for Psychology Today’s blog.  It is seriously THE BEST article I have seen about psychotherapy in a long time – maybe ever.

In her article she writes about the differences between a psychotherapist and a friend (hint: it’s not just the money).  She also highlights the often-forgotten point that participating in therapy can often make you feel worse, not better – at least in the short term.  She also writes about the HARD WORK it takes to be a successful psychotherapy patient, meaning one who is able to achieve the change they seek in their lives.

Sometimes folks seek therapy thinking that their therapist will give them answers, tell them what to do, and be the best friend they may or may not already have.  Dr. Deb reminds us that this isn’t true. Psychologists are well-trained health care providers – “Olympic medal listeners” she calls us.  Therapy can be a long, arduous process.  In fact, we may not always want to go to our psychotherapy appointments (much like we don’t always want to go to the gym, or visit the dentist), but in the end – if we are committed to the process – our health improves as a result.

5 Questions with Dr. Deborah Serani

A couple of weeks ago I reviewed the book Living with Depression by Dr. Deborah Serani. I thought the book was spot-on in terms of offering a comprehensive look at depression, its causes, its treatments, and what it might be like to live with the disorder in the long term.  The author, Dr. Deborah Serani (who is not only the book’s author, but also a clinical psychologist in private practice, a professor, and a popular blogger – whew!) agreed to answer a few questions for me.  Welcome, Dr. Serani!

Dr. Deborah Serani - psychologist extraordinaire

Dr. Deborah Serani – psychologist extraordinaire

Dr. S:  You include a lot of personal information in this book. Can you talk a little about your decision-making process in terms of including so much detail about yourself? What have been the positive and negative effects of such disclosure?

Dr. D: Society gives permission to high profile people to talk about mental illness, but the waters are still rough for ordinary people to talk about depression. It’s important to be wise and thoughtful about disclosure – and I thought long and hard about sharing my experiences with depression for a few years before actually doing it.  Essentially, it was easier for me to be outspoken about living with depression because I’m my own boss. I have my own practice. I don’t have to worry about some social fallout or losing my job. But there are many people that need to keep certain issues private because stigma still makes living with mental illness a difficult subject to talk about. When making the decision to talk about my life, I knew I had to really lay it all out. I didn’t want to gloss over the despair and the scariness of my depression – or that it was a super easy journey for me to get well. For me, the disclosure has brought very positive experiences. I like seeing how my story inspires others not to be ashamed of their illness, to get help and to have hope. I like teaching misinformed person about the real facts about depression. And nothing makes me feel more proud than when I exceed someone’s expectations of what a person with mental illness should be like.
Dr. S: How does your struggle with depression make you a better psychologist?

Dr. D: You don’t have to live through something to be a good therapist, but living with depression has taught me about how hard it is to endure pain, despair and helplessness. I also know how a good treatment plan and hard work with a therapist can lead to recovery and remission of depression. From knowing both sides of the coin, my experiences have led me to be a more compassionate person, and a more compassionate psychologist.

Dr. S: You have a popular blog, in addition to this award-winning book. Who is your main audience? How do you hope to impact people by your writings?

Dr. D: I started my blog back in early 2004 when blogging first launched, and slowly found it a great way to teach and reach others regarding psychology. I have always written my blog for a general audience, wanting to make sure it wasn’t too clinical or jargon-filled.  Blogging has become less in the forefront for me these days, what with faster social media tools out there like Twitter, Linked In and Facebook.  But as with all my social media, I hope that others take the articles, research and observations I note and use them personally to better their life.

Dr. S: In my blog I write a lot about creative stress management. Whether it’s baking cakes, watching Gossip Girl, or playing backgammon – I believe that there are many avenues to healthy (and effective!) stress management. What do you do to keep stress at bay?

Dr. D: I love how you join creativity with managing stress on your blog. The way that you present these strategies in your posts makes taking care of yourself fun and easy. I am a very creative person too, and I use many fun ways to help soften the hard edges of life. I’m a huge foodie, always trying out new recipes, and cooking and baking to de-stress. I like to play board games with family and friends, the sillier the better. Apples to Apples, Balderdash and Trivial Pursuit always bring the laughs.  I also do a lot of painting, drawing and writing and find those expressive arts a tremendous stress-buster. I love surfing through Pinterest and Indulgy to find motivational sayings, and find the visual aspect of those activities really soothes my soul.

Dr. S: Do you have any new projects in the works? Can we look forward to future books?

Dr. D: I am finishing my second book “How to Parent a Depressed Child,” which will be published in late 2013 by Rowman & Littlefield.  My hope is that it will be a go-to resource for parents who need guidance in raising a child with a mood disorder. Early diagnosis and intervention can make the depressive experience less intense for a child – and well, I’m all over that!

Thanks for your thoughtful answers, Dr. Serani! To order Living with Depression click here.  To read Dr. Serani’s blog, Dr. Deb, go here.

Do I Drink Too Much?

After reading this post on CNN’s health blog, The Chart, I felt like it was time to write a post about alcohol use.  Alcohol is all around us – print ads, part of TV shows (Mad Men, anyone?), movies.  Not only that, but booze is part of most social events, and liquor stores are on every corner.  It can be easy to look past problematic alcohol consumption and dub it “normal” or “fun.”  And as The Chart’s article points out, it can be easy for even medical professionals to overlook folks with problematic drinking behavior. Screen shot 2013-01-17 at 8.12.04 PM

The CDC lists alcohol consumption as the third-leading cause of preventable death in the United States. A couple of other startling notes by the CDC:

  • On average, for each death due to alcohol, an individual’s life is cut short by 30 years.
  • 79,000 deaths per year are tied to the misuse of alcohol
  • Excessive alcohol use costs the United States about $185 billion each year in health care and criminal justice expenses, as well as lost productivity.

So, how do we know if we are drinking too much?  What makes someone an alcoholic?

The official criteria for alcohol abuse (in the DSM-IV) include things like:

  • Trouble fulfilling your obligations (ignoring kids, missing work deadlines, not showing up for/cancelling appointments or dates)
  • Using alcohol in situations that are hazardous (driving, operating machines)
  • Trouble getting along with others (fighting with partner/kids/parents about drinking too much)
  • Legal problems related to drinking too much (DUI’s, etc)

The National Institute on Alcohol Abuse and Alcoholism describes heavy or risky drinking as more than 14 drinks a week for men and more than seven a week for women. When it comes to daily consumption, five or more drinks for men and four or more for women is considered excessive.

Do you think you might have an issue with alcohol? Ready to do something about it? Try SAMHSA’s treatment service locator.  Alcoholics Anonymous is another good option.  You may also want to look at your insurance company’s list of behavioral health providers.  Churches, employee assistance programs, and community centers may also have resources to help.  Effective, low-cost and/or free treatment is available in most areas of the country.  For more information about support and treatment for issues involving alcohol, click here.

Book Review: Living with Depression by Deborah Serani

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It’s not often that I am surprised.  But Dr. Deborah Serani’s book, Living with Depression, did just that – surprised me.  I was expecting a sort of boring book about depression – how it starts, why it ends – but was thrilled to discover (and within the first chapter no less!) something very different about Dr. Serani’s book!  Not only does she write about the topic as a expert in psychology (she’s a psychologist in private practice, as well as a professor), but also from the perspective of someone who has dealt with depression on a very personal level.

There have been other psychologists who have written about their own struggles with mental illness, but I found Dr. Serani’s candid admissions and forthcoming attitude about her mental health history to be not only refreshing but intriguing. I found myself wishing she had written more about herself and her family (full disclosure: While Dr. Serani and I have never met in “real” life, we have had several conversations via social media in the last few years).  And while it’s been done before, integrating personal and professional knowledge about depression made the whole book a quick and informative read.

In addition to recounting her own story, Dr. Serani also does a great job outlining all aspects of depression from the mundane (insurance coverage for treatment) to the academic (how psychiatric medications and psychotherapy actually work), to the most basic (what depression is, exactly).  I was most impressed with her discussion of what psychotherapy is and isn’t, and what one should and should not expect from it.  For example, psychotherapy patients should expect to work hard, be challenged, and make a real commitment to the process.  They should not expect to be given advice, get a “quick fix,” or find meaningful change in their lives without a bit of internal struggle.

I also love that Dr. Serani mentioned some (not very glamorous) but important aspects of treating depression, including getting enough sleep, eating a healthy diet, engaging in meaningful relationships, exercising, and maintaining a relatively tidy, organized home.  It’s not often that we see these things mentioned as part of an overall plan for the treatment of depression, so I was thrilled to see them get some air time in her book.

Living with Depression is a book that I will be glad to have on my shelf.  I highly recommend it for practitioners and lay people alike.  It is a quick, relatively easy read and individual chapters can serve as references in isolation. Check it out here.

The Holiday Season & Mental Health Emergencies

As I noted in my last post, the holidays can be tough.  For some of us it can be a season of financial stress, sugar-cookie and waistline anxiety, and family annoyances.  For others of us, this season can be a time of very serious depression.

I was recently in San Francisco and took this picture:

I had never seen anything like it before – a sign for crisis counseling?!? I immediately saw the reason (notice the Golden Gate Bridge in the background), but also started to wonder what it would be like if there were such services available everywhere.  What would the world be like if we were never more than a mile or two from someone who could really help?  A better, less lonely, less isolated world I say.  One where I would like to be.

If you, or someone you know could use an ear this time of year, here are a few places where you can find someone to talk to:

American Psychological Association, Psychologist Locator

The Trevor Lifeline (Specializing in LGBTQ Youth) 866-488-7386

Kristin Brooks Hope Center 800-442-HOPE

National Suicide Prevention Hotline 800-273-8255


If you are a business owner or school leader, consider posting a sign with the above information for those in need this holiday season – and all year ’round!


Psychotherapy Is Not Dead

Last weekend What Brand Is Your Therapist was published by the New York Times.  Lori Gottlieb, the author, interviewed me and a couple of other psychologists for the piece.

In her article Ms. Gottlieb writes about her journey as a new therapist setting up a practice in the congested California market.  As she struggles to find clients, she looks to other, more established clinicians for advice.  Some say find a specialty area, others tell her to focus on consultation and/or coaching work rather than traditional psychotherapy, still others (me) tell her to increase her social media presence.

With this advice in mind, Ms. Gottlieb wonders if Americans have moved past the need for psychotherapy, citing statistics indicating that fewer people have sought talk therapy in recent years.  She also wonders if our super-fast, I-want-results-now culture makes the slower paced psychotherapy process outdated.

After stewing about it for a few days, I have gathered my thoughts, and offer this response proving that psychotherapy is not dead, in fact, it is alive and well.  With this caveat: it is essential that we change (at least a little bit) with the times.  Here goes:

Having been married to an architect for nearly 15 years, I have come to know a bit about that profession.  While it may not seem that a psychologist and an architect would have much in common professionally, I have come to realize that we do – and more than it would seem.  In addition to the arduously long training process involved in both fields, many of the current dynamics and changing business models are similar.  Take a look:

Fads Come and Go.  Colonial, craftsman, beaux arts, mid-centurn modern – these are just a few of the hundreds of styles of architecture around us.  While I might like classical design, others might prefer more contemporary; the one thing we can be sure of is that styles, tastes, and fads will change.  This is a good thing in architecture – it makes our communities more interesting.  What is critical, however, is that the structure underneath is sound.  Any architect would agree that a comprehensive understanding of history, as well as a mastery of structural and construction principles is necessary before good design can emerge.

The same is true for us in the field of psychology.  There is nothing wrong with new ideas, and unique and innovative treatments – so long as there is first a fluency in psychological science.  New treatment strategies, rooted in sound science and disciplined training, can (and should!) be constantly flowing into our daily practice.  Would we accept stagnant, non-innovative care from any other field?

Gray and Green – The New Black?  Some architects have continued to design and draw only by hand, have resisted integrating technology into their firms, and have refrained from embracing environmentally sustainable design and materials clamored for by clients.  Guess what has happened to those architects in this tough economy and competitive world? They are no longer practicing – or at least not at the level to which they would like.  Successful firms have had to innovative, be responsive to the marketplace, and have had to find a way to stay productive and flexible in a time when their clients demand more, have shorter time frames, and more restricted budgets.

Psychologists are no different.  To stay relevant and helpful (that is our mission after all) we must also innovate and find new ways to give people what they want (psychological help) and need (psychological health).  A colleague of mine, June Ching, PhD, recently wrote: “I see a…theme with the ‘old ways’ juxtaposed to the newly emerged technological advances. If the mission is still the same, perhaps joining forces with the ‘grey’ and ‘green’ is a viable option.”

Merging The Old School (“gray”) with the New School (“green”) is the only way to continue to provide the type of help and care we all desire.

Everyone Deserves Mental Health.  Most of us can’t afford to live in a house designed by an architect.  Instead, most of us live in houses that were mass-produced by a CAD-wielding draftsman employed by a large construction company.  Yea, it’s kind of a bummer from a design perspective, but guess what?  The roof still keeps out the rain and the walls still keep us warm at night.  And the price is right.

Again, the similarities with psychotherapy are striking.  Therapy is kind of a weird thing.  Sitting in a room with a stranger spilling your guts week after week, while learning little to nothing about said stranger.  Bizarre.  Not to say we strangers don’t have a lot to offer – we do! But psychotherapy isn’t for everyone.  It’s a significant commitment in terms of time and money, and frankly not everyone is helped by talking about their problems.  Some folks prefer the self-help methods of reading books or watching Oprah to aid their mental health.  Others might find comfort at church or in a peer support group.  Still others may prefer to use pharmacological treatment.  Guess what?  That’s OK!

Psychotherapy has never been a treatment utilized by the masses, and my guess is that it never will be.  The great thing is that it gives us lots of opportunities to reach out to folks who will never sit on our couches.  Podcasts, books, blogs, talks, articles in the New York Times – these are all means by which we can get the word out about the importance of psychology and good mental health.  Realizing that the 50 minute psychotherapy hour isn’t our only means of providing solid, responsible, and useful mental health care should make us feel excited and energized to meet folks in need – wherever and whoever they are.   Because in the end, everyone deserves mental health, not just those who meet us on our own, narrow terms.

It is my opinion that psychotherapy is enjoying a particularly robust period in its history.  The stigma against treatment is down, the access to care is up (thanks to changes in the insurance industry, as well as technology) and psychology, mental health, and emotional wellness are a part of the language of everyday life.  Psychotherapy is far from dead – it is very much alive and growing.  It is up to us to determine how and when to best maximize this growth, for our clients and ourselves.

New York Times: What Brand Is Your Therapist?

This article came out in yesterday’s New York Times.  In it the author, Lori Gottlieb writes about some changes and innovations in the field of psychotherapy.  I was lucky enough to be interviewed for the article and have a quote in the middle of the article.  Check it out here.  I am still working on writing up my thoughts about the ideas presented in the article.  Hint: I’m not sure I agree with Ms. Gottlieb’s conclusions.  Stay tuned!

New York Times: 11/25/2012

The Side Effects of Psychotherapy

The other day I posted a YouTube video by the American Psychological Association (APA) extolling the virtues of psychotherapy. Here’s another video with a similar message: namely that psychotherapy with a licensed psychologist is an effective and safe way to treat depression, anxiety, and other mental health issues.  The bonus is that it doesn’t have the side effects that medications do: no dry mouth, too-much-caffeine feelings, sexual problems, to name some of the most common.  Here’s the clip:

As I noted previously, I am a big fan of APA, but don’t totally agree with the assertion that there are no side effects of participating in psychotherapy other than a better, healthier life.  While I certainly believe that can be true, it is also true that some people notice that their mood goes down a bit before improving when starting psychotherapy.  The thought behind this is that sometimes unhappy, painful memories are discussed in the therapy session.  Sometimes “stirring the pot” of sad experiences, emotions, etc can have the “side effect” of causing a low mood.  Of course the hope is that new, healthier coping strategies will be learned and improved mood will soon follow.

Overall these videos are awesome – I love the message!  Just thought I would point out that while psychotherapy is an under-utilized and highly effective treatment option, it is not entirely without a downside.

Psychotherapy: It Works

Full-disclosure: I work closely with the American Psychological Association (APA) as the Public Education Coordinator for Colorado, and in other capacities.  I think they are generally a great organization which does important work for psychologists AND the public.  APA works for mental health treatment, and stands up for the rights of psychologists in the US (and Canada, actually).  As awesome as I think the organization is, it rarely has a sense of humor.  So imagine my delight when I watched this new video.  Funny, a bit irreverent, and right on the money in terms of psychotherapy vs. meds – it is worth a minute of your time.