Thoughts About Sexual Orientation Change Efforts

Have you been reading the Colorado Sun? If you live in Colorado, I suggest you check it out. Here’s a a bit about them from their site:

“The Colorado Sun is a journalist-owned, ad-free news outlet based in Denver but which strives to cover all of Colorado so that our state — our community — can better understand itself.”

Recently, the folks over there published a story about a “conversion therapy” bill that had been introduced to the Colorado Legislature. I thought the reporting was great, but they missed a mental health professional’s perspective on why Sexual Orientation Change Efforts (SOCE) are not only unhelpful, but also damaging. So I wrote a letter to the editor. Here it is:

Dear Editor:

I am writing to add some information to the article Colorado lawmakers for a fifth — and likely final — time will weigh whether to ban gay “conversion therapy”

While I appreciate the balanced approach you attempted to take in explaining the history and effects of “conversion therapy,” I think you missed an important voice: licensed mental health professionals who have long been opposed to the practice.

Sexual orientation change efforts (SOCE, also commonly known as “conversion therapy”) operate under the assumption that there is something wrong, bad, abnormal or disordered about identifying as lesbian, gay or bisexual. In fact, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (the gold standard in mental health diagnoses) stopped identifying homosexuality as a mental health disorder in 1973. Since 1973, all mainstream health and mental health organizations (American Academy of Pediatrics, American Psychological Association, etc) have come to understand that lesbian, gay, bisexual and questioning adolescents are simply a part of the normal spectrum of human sexual expression.

But not only does every health and mental health organization oppose SOCE, I, as a clinical psychologist have seen first hand the harm lack of support, understanding and evidence-based mental health treatment can do to a young person struggling to understand who they are. Shame, guilt, low mood, anxiety, self doubt, trouble concentrating – these are all potential outcomes for a young person who is told they aren’t “normal,” “healthy,” or worthy of respect and acceptance exactly as they are. Sadly, this is exactly the message SOCE sends.

Adolescents who identify with a same sex orientation or are questioning their sexual identity can face enormous challenges – during a time in life when things are already pretty hard. In addition to trying to figure out everyday things associated with adolescence: What classes to take, how to get homework done, what to do after high school, who to hang out with – they can also be met with lack of support (at best), discrimination, prejudice and violence (at worst) by family, friends, and community members. We know youth who identify as lesbian, gay and bisexual have higher rates of substance abuse, emotional distress and suicide attempts. We also know that some of the reason for this is because of the lack of support and genuine acceptance these kids find in homes, schools and society as a whole. We, as adults and caregivers, need to do all we can to guarantee that these kids will have access to safe places to express themselves and receive appropriate, effective mental health care that will be accepting of all pieces and parts of the wide range of human sexual expression.


Stephanie S. Smith, PsyD
Licensed Psychologist

Coping With the Tragedy in Paris

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Even though we’re thousands of miles away from Paris, many of us still feel a sense of pain, loss and fear after the horrible violence that occurred a few days ago.  Watching coverage of the events and the people who lost their lives, some of us begin to remember other, similar tragedies:

  • 911
  • Columbine
  • Sandy Hook
  • Aurora

The memories and constant news coverage of the event can start to have a real effect on our mood – even if we weren’t personally affected or involved.

The American Psychological Association offers several tips for coping with tragedies and mass shootings.  My go to? Turn off the TV, internet, social media on a regular basis.  Information is good, but emotional overload can happen quickly.  For more tips check out APA.

Talking to Kids About Suicide

Suicide is a topic that no one likes to talk about, but it’s one we need to discuss – and not just when it affects a celebrity we love. I recently wrote a post for the American Psychological Association‘s blog, Your Mind. Your Body.  In it, I offered some tips for talking to your youngest family members about this tough topic.  Here’s a peek:

Don’t Be Afraid to Say It: Even when news of a celebrity’s death by suicide isn’t on the news, it is a part of everyday language. Kids are hearing about it at school, on the radio and online. So be brave and ask clear questions like: “Have you ever thought of suicide?” or “What would you do if you had thoughts of suicide?” It does no good to beat around the bush.

For more tips and strategies for talking to kids about suicide, check out the full post on Your Mind. Your Body.

Even when news of a celebrity’s death by suicide isn’t on the news, it is a part of everyday language. Kids are hearing about it at school, on the radio and online. So be brave and ask clear questions like: “Have you ever thought of suicide?” or “What would you do if you had thoughts of suicide?” It does no good to beat around the bush. – See more at:

Don’t be afraid to say it.

Even when news of a celebrity’s death by suicide isn’t on the news, it is a part of everyday language. Kids are hearing about it at school, on the radio and online. So be brave and ask clear questions like: “Have you ever thought of suicide?” or “What would you do if you had thoughts of suicide?” It does no good to beat around the bush.

– See more at:

Don’t be afraid to say it.

Even when news of a celebrity’s death by suicide isn’t on the news, it is a part of everyday language. Kids are hearing about it at school, on the radio and online. So be brave and ask clear questions like: “Have you ever thought of suicide?” or “What would you do if you had thoughts of suicide?” It does no good to beat around the bush.

– See more at:

Boston Marathon: Managing the Memories

The comfort dogs rest in Boston, April 2013. (Courtesy Lutheran Church Charities K-9 Comfort Dogs)

The comfort dogs rest in Boston, April 2013. (Courtesy Lutheran Church Charities K-9 Comfort Dogs)

People around the world will turn their eyes to Boston on Monday for the first anniversary of the marathon bombing.  This will obviously be a difficult time for those who were directly affected by the attacks; and even those of us who have no connection to Boston or the running community may find ourselves feeling sad, anxious or angry next week.

If you do find yourself struggling in the days ahead, check out some of the resources below for tips and ideas about how to cope in healthy ways:

The Boston Marathon Attacks and Coping with Traumatic Events – via Dr. Stephanie

Managing Your Distress in the Aftermath of a Shooting – Via APA Help Center

Psychologists Prepare to Provide Support at Boston Marathon – via APA Practice Central

Comfort dogs are returning to Boston for marathon weekend – via Yahoo!

Helping People After the Unthinkable – Via APA Monitor

Helping Your Teen Manage Stress

Stress? Who me?

Stress? Who me?

The American Psychological Association’s annual Stress in America survey was released yesterday.  The results indicate that Americans are pretty stressed overall.  We worry about work and money in particular, and struggle to manage it with healthy strategies.  Instead we reach for cookies, cigarettes, video games and participate in other sedentary activities – even though many of us know more active, healthy strategies are better for us and often more effective.

That’s pretty bad news.

But it gets worse.

The survey also found that American teenagers are experiencing stress at levels they feel is unhealthy.  In fact, their stress levels rival those of adults.  Yesterday I wrote a post about why we need to worry about it.

Today I’m focusing on what we can do to help teens manage their stress more effectively. Here it is:

Let them watch us manage stress in healthy, effective ways ourselves.

  • That means, instead of guzzling beer and M and M’s in front of the TV after a tough day, perhaps we should take a walk or dance around the kitchen
  • That means, instead of logging into Facebook and ranting about our boss, perhaps we should play a game with our teen or get a manicure
  • That means, instead of zoning out and playing Minecraft, perhaps we should read a book or phone a friend

Kids learn from watching us. It’s a big responsibility for parents to be constant role models.  But it’s also a big relief because it means we can have a positive, lasting impact on our kids’ health.

For more information about talking to teens about stress check out the American Psychological Association’s tips here.

For more information about whether your child could benefit from seeing a psychologist, check out my article here.



Americans Are Stressed…So What?


The American Psychological Association released their annual Stress in America report today.  Not surprisingly, it found that Americans are pretty stressed. In their survey, they found that the average adult rated their stress a 5.1 on a scale of 1 to 10.  More noteworthy is that 42% of adults reported their stress has increased in the last 5 years, and 62% say they have tried to decreased their stress during that same time frame.

But the big finding from this year’s survey was stress in teens.  It appears to be on the rise, and currently rivals that of adults.

So why should we care?

We’re all stressed, right?

Life is tough, complicated – perhaps we all just need to buck up?


It’s something to think about.  But what concerns me is not so much the stress itself, but the effects of stress over the long term.  For example, did you know that prolonged stress can negatively affect every system of the body?  That’s right.  Stress not only affects our mood, our eating and our sleep patterns, but it can also affect our cardiovascular and musculoskeletal systems as well.  Reproduction, metabolism and even our cognitive abilities can also be negatively impacted by high levels of stress.


And when we start thinking about stress in kids and teens, the picture becomes even more worrisome.  If kids are reporting high levels of stress (5.8 in this survey) at a time when life is supposed to be relatively stress-free, what does that mean for the future?  Will their stress levels keep going up and up as life gets more complex (mortgages, jobs, marriages, their own kids)? How will their bodies respond to these high levels of chronic stress? What will that mean for the health care system?

It’s a lot to think about. Check back tomorrow for some coping strategies. In the meantime, check out the full Stress in America survey here.



How to Help a Depressed Friend

So many of us have been there: watching a family member or friend spiral into a pit of depression, addiction or anxiety.  It’s tough to watch, and even tougher to know how to help.  It can be tempting to either:

  • ignore them
  • tell them what to do and get mad when they don’t do it
  • talk to our other friends and family members about them

It’s clear to see that none of these options are useful, but not so clear to see what is.

Here’s where the American Psychological Association‘s newest YouTube video comes in.  The third in a series of the same weirdly-pill-shaped-characters, I think this spot is my favorite yet.  It tells the story of Clara, a spunky cat-loving-race-walker, who is concerned about her friend Tom.  He has had some trouble at work and has recently taken up drinking and sleepless nights.  Clara wants to help Tom, but isn’t sure how.  She tries a couple of tactics (see above, with the addition of involving his mother) and after some failures, slamming of doors, and screeching cats, she succeeds in helping him find professional assistance (with a Dr. Smith nonetheless!).

It can be hard to make psychology funny (for psychologists anyway). So I especially love the light-hearted and funny tone of this really informative clip.  Check it out:

What Glee Taught Me About Resilience

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I have to admit that I have asked that question…what is resiliency in mental health and psychology?

It’s a concept that is mentioned in mental health all the time.

Here’s what I knew before tonight:

  • It’s something we’re supposed to build
  • It’s something that can protect us from experiencing mental illness in some cases
  • Having resilience can help us cope with the ups, downs, traumas and tragedies in life

I knew these things. But I didn’t really know what resilience looked like.  Until tonight.

Gleeks will know that tonight was the season premiere of Glee; and the first episode after the death of it’s star Cory Monteith.  We all knew it was going to be a tear-jerker. But what I didn’t anticipate is that we would get to see psychological resilience personified in Lea Michele as she opens the show by singing Yesterday by The Beatles.

It must have been difficult; returning to work after her co-star and boyfriend’s death.  And it must have been a struggle to sing; let alone sing a sing so filled with meaning.  And I can’t even imagine the strength it took to do it all, in front of all of us.

But she did.  And that’s resilience.

Thank you Glee and Lea Michele for teaching me something about psychology tonight.



The Boston Marathon Attacks and Coping with Traumatic Events

As I was brushing my teeth this morning I was thinking about whether and what to post about the attacks in Boston yesterday.  Like everyone else, I am dismayed and grieved at the trauma endured by the athletes and their supporters.  I can’t help but reflect on the multitude of traumas our people have endured over the last few years.

Is this normal?  Have these sorts of incidents increased?  What can be made of all this violence, injury and death?  I don’t know the answers to these questions.  But, I do know that it is normal to feel lots of emotions following tragedies like the one yesterday.

The American Psychological Association offered some tips on how to recognize and cope with traumatic stress.  Check out their tips here.

In looking over APA’s info, I was struck by a couple of points:

  • People respond to tragedies differently.  Some folks might feel nothing, others may cry, still others might have trouble tearing themselves away from news coverage.  I notice many folks turning to social media as a way to cope with their own grief and fear.  Still others may simply want to retreat and withdraw.  No response is right or wrong.  Just different.
  • Re-establishing routines is important.  I’m big into routines, so this tip really rang true for me.  Routines can be comforting to all of us – especially kids – so getting back to a normal schedule can go a long way in helping cope with traumatic events.  Maybe this means going back to your regular dinnertime, enjoying your favorite TV shows, or getting back to your typical workout schedule.  Even if it feels awkward at first, getting back into the swing of your normal routine can help minimize stress, fear, and uncertainty.
  • Avoid major life decisions.  This tip is new to me, but I think it is pretty interesting.  Traumatic events can produce big emotions.  Sometimes those emotions are grief and fear, but they can also be passion, anger, or excitement.  These emotions can be so intense that we may feel driven to make decisions about our relationships, work, and family lives.  APA suggests we avoid these decisions in times of high stress.

For more information about coping with traumatic events, check out the American Psychological Association.


Depression, Pregnancy, and Psychotherapy

A  study in the journal Human Reproduction recently concluded the following:

Antidepressant use during pregnancy is associated with increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn and possible longer term neurobehavioral effects. There is no evidence of improved pregnancy outcomes with antidepressant use.

This is an important study for several reasons:

  • Pregnant moms who are depressed can be at risk for not taking care of themselves or their unborn baby (not eating well, not taking prenatal vitamins, not going to OB visits).
  • Moms whose depression is not well managed during pregnancy are at a greater risk of developing postpartum depression
  • Moms who are depressed risk other physical and mental health problems
  • As most families know, mom’s mental health and mood has an impact on everyone else in the family

So what do the results of this study really tell us?  Antidepressant use during pregnancy needs to be evaluated carefully.  But to me (as a psychologist, of course) the more important conclusion of this study is this statement right here:

There is some evidence that psychotherapy, including cognitive-behavioral therapy as well as physical exercise, is associated with significant decreases in depressive symptoms in the general population; research indicates that some forms of counseling are effective in treating depressive symptoms in infertile women.

In fact, psychotherapy can be highly effective for many mood disorders, including for depression before, during, after pregnancy.  This is great news because, unlike medication, psychotherapy has few (some would say zero) side effects.  An effective and safe treatment option for moms and their families – now that is an important conclusion.

Fore more information about finding and visiting a psychologist, go here.