Author: drstephaniesmith

Life Through the Eyes of a Psychologist

Should I Use My Health Insurance for Mental Health Treatment?

This is one of the first questions I am asked by perspective clients.  Most people would like to use their insurance if they can (“I’m already paying so much for the coverage, I want to be able to take advantage of it!”) but are sometimes hesitant to do so.  What are some of the pros and cons?

Reasons to use your insurance:

  • You can. Thanks to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act many of us can now use our health insurance for mental health treatment.  This law insures that mental health treatment is covered in the same way as physical health treatment.
  • It’s cheaper. Because treatment is covered by insurance, it ends up being cheaper for most folks.  Instead of being responsible for the entire fee, you may only need to pay a co-pay, just like when you go to your primary care physician.
  • Makes finding a provider easy. Want to use you insurance but don’t know what provider to see? Simply call your insurance company and ask which psychologists in your area participate in their panels.  They will provide you with several names, numbers, and in some cases even help you set up the appointment.

Reasons to pay for treatment yourself:

  • Confidentiality. When you use your health insurance to pay for your psychological care, you allow the insurer access to all of your records.  Though they may not always request the information from your provider, they can.  And this information can be used in the future to  determine whether other services are covered, or if you are even eligible to be covered by health insurance at all.
  • Freedom. Even though insurance coverage for mental health treatment has improved over the years, there are still limits to the number of sessions and the types of treatments and conditions that are covered.  In order to have maximum control and freedom in your treatment, it may be best to pay for it yourself.
  • It’s easier. If you have the money to do it, paying for your own treatment is easier.  When patients use insurance to see me, we have to spend at least some of our time dealing with the administrative tasks required by insurance companies.  For some this is worth it, but for others it becomes a distraction to the more important tasks at hand.

Still not sure what to do?  Talk to your provider and see what s/he suggests.

The Teacher Says My Child’s a Troublemaker, Now What?

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What do you do when you get negative feedback about your child once – or day after day from their teacher/school counselor/principal?  What happens when you hear your child is below grade level in reading, bullying the other kids in class, causing problems in music, or being distracting in social studies?  What should you do when all you really feel like doing is crying in the backseat of your minivan?

  • Take a deep breath. Often negative feedback from schools hits us when we aren’t expecting it.  There we are with a tray of cupcakes and 4 minutes to get to work, when the teacher swoops by and says “by the way, your daughter has no friends!”  Taken off guard in this way can be tough (to say the least) so the first step is to put down the cupcakes, go outside, and breathe before you move onto anything else.
  • Put the phone down. Our natural reaction to news that our kids aren’t perfect is to get on the phone and fix it.  Whether that be scheduling a conference with the school, making an appointment with a pediatrician, or finding a psychologist.  These aren’t necessarily bad moves, but sometimes it can be helpful to really digest the feedback before we launch into action.  Talk to your partner, your mom, a close friend – but hold off on making any concrete moves for at least 24 hours.
  • Ask for a meeting. Once you have cooled down and dried your eyes, call or email your child’s teacher and ask for a meeting.  If you have a partner or spouse, make sure they can be there too.  It’s best to have a couple sets of ears in the meeting, in case you mis-hear something.  For example, you might hear:

    “Your daughter will never amount to anything and is destined for a life of misery.”  When what the teacher really said was “Your daughter might benefit from a little extra reading practice.”

  • You’re an expert too. Teachers are wonderful, honorable, and well-trained professionals.  We should listen to them and be respectful of their opinions about our children.  We should also give ourselves the same respect; after all, we are experts on our children too.  Have a gut feeling that what the teacher says doesn’t fit? Get a second opinion, and trust your own as well.
  • Ask your kids. Kids are no dummies – I don’t care what their age.  They will likely know something is going on, so it is appropriate to ask their opinion.  “Gosh Jonathan, Ms. Jones said you were giving some of the kids in your class a hard time.  Can you tell me what’s going on?”  And once you ask, don’t forget to listen.  Often our kids have more insight into their “issues” than we give them credit for.


But What About Coco? Why We Care When Celebrities Split


In case you haven’t heard, Courteney Cox and David Arquette announced their separation this week.  They’ve been married for 11 years and have one daughter, Coco, and are generally recognized as one of the more successful Hollywood couples.  So, when I heard the news, I was surprised and even a little sad.  At first I chalked up my reaction to my own over-the-top sensitivity – after all I did actually shed a few tears when Jessica Simpson left Nick Lachey over Thanksgiving a few years ago.  But then I started seeing posts on Twitter from other people with similar reactions.  Thank goodness! I’m not the only one.

So why do we care? Especially when, as my husband says, “like 99.9% of celebrity marriages end up in divorce anyway?”

Their relationships correspond with milestones in our own lives. In this case, Courteney and David got married around the same year I did.  So when they split up it makes me think about my own relationship and what it might be like if I were going through a separation like them.  Maybe we have kids the same age, or won our own big award the same year they won their Emmy.  Whatever the connection, watching a celebrity go through something publicly can cause us to think about our own lives and wonder “what if it were me?”

They put it all out there. I know more about the private lives of some of the Hollywood crowd than I do of some of my closest friends and family members.  When these folks lay their aching heart out in People magazine for all of us to read – how could we not feel at least some sort of sympathy?

She is a Friend after all. Let’s face it, we all loved Friends and the goofy character Courteney played.  We got to know her and the rest of the cast pretty well over the years.  So, just as we might mourn the end of a marriage with a real friend, perhaps it is not too strange to hurt alongside our Friend from TV.

Kill Your Television?

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I have a love/hate relationship with TV.  If you’ve read much of my blog, you know that I love pop culture – of which TV is a big part. I even think that TV can be used as an informative and unique parenting tool.  But when I saw the reports of the study released from the University of Bristol’s School for Exercise, Nutrition and Health Sciences finding children who watched TV television or used computers for more than two hours had higher “psychological difficulty” scores, regardless of how much time the children participated in physical activity, I was not at all surprised.
So here comes the hate side of my relationship with TV.  While I have done no formal research on the issue, I can say with certainty that in both my clinical and personal life, I see the effects of too much TV everyday.  I’m not even objecting to the risqué story lines or the gratuitous violence – it’s more basic than that.  I find TV, computers, and other electronic gadgets to be too stimulating.  They wind me up and they can wind kids up too.

We might look like vegetables cuddled up on the couch when we are watching, but it has been my experience that they can over-stimulate us so that even once the TV is turned off, we have trouble turning ourselves off.  Find yourself overly anxious, worrying too much, totally stressed, or your kids spinning like a top? It might be worth unplugging for a week or two and see if it makes a difference.

Want some ideas about what to do with all your newly-discovered, unplugged time? Read the diary of my TV Free Week last spring.


Theology and Glee

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Last night’s Glee was one of my all-time favorites.  Not only were the songs (by The Beatles, Simon & Garfunkel, Barbra Streisand, REM, and Billy Joel among others) fantastic – so was the storyline.  Last night the characters tackled spirituality and religion; and so by default many aspects of human psychology.

Specifically, the cast (led by Kurt Hummel) grappled with some of the most difficult and confusing questions in theology:

  • Why does God let bad things happen?
  • Since we can’t prove the existence of God, how do we know he exists?
  • How do you pray? What should you pray for?  Who should you pray to?
  • How do we have relationships with people who believe differently from us?
  • If our prayers are answered, does that prove (or disprove) God’s existence?

It’s rare to see these topics discussed in pop culture in serious, thoughtful ways.  And it’s refreshing to see them discussed outside of politics, religious institutions, and talk shows.  Seeing life’s tough questions through the eyes of our favorite TV characters makes the questions more accessible to the rest of us.  And invites us to actually participate in the discussion – rather than just take sides.

The Wisdom of Madonna

This morning while driving my young daughter to a field trip, I popped Glee: The Power of Madonna into the CD player.  I listened to a few songs before I started to wonder if this album was appropriate for young ears.  Feeling doubtful – but not wanting to stop listening – I began to think of reasons why Madonna was OK for a young girl .  After all, I grew up listening to the Material Girl – and I think I turned out alright.

It didn’t take long before I heard true wisdom in her lyrics, and felt sure that listening to the Glee Cast’s versions of her songs wasn’t going to do irreparable harm.  In fact, I realized that some of the lines in her songs would make great jumping off points for in-depth conversations one day.  For example:

  • “Beauty’s where you find it (not just where you bump and grind it).”  (Vogue) It’s up to us to find beauty and happiness in life – we can’t count on others’ ideas of what it might be.  Is it possible to change our minds about what is beautiful and good over the course of our lives?
  • “If I died tonight at least I could say I did what I wanted to do.  Tell me, how ’bout you?”  (4 Minutes) Are you using your life wisely and doing what makes you happy?  Are there ever times when we shouldn’t do what we want?  Should we ever delay our gratification?
  • “Strong inside but you don’t know it, good little girls they never show it.  When you open up your mouth to speak could you be a little weak?”  …  “When you’re trying hard to be your best, could you be a little less?”  (What it Feels Like for a Girl) Do you think boys and girls are treated differently at home, school, soccer, church?  Do you have different standards or expectations for boys and girls in your life?
  • “You don’t need diamond rings or 18 karat gold.  Fancy cars that go very fast, you know, they never last.”  (Express Yourself) All I can say is that we should have listened to Madge 10 years ago.  Maybe our country would be in a better spot financially if we had.

Other lyrics I’m missing? I’d love to hear them!

Bullying in the Era of Facebook – Some Tips for Parents and Friends

By now most of us have heard about the rash of suicides committed in the last few weeks by “outed” teens around the country.  I was moved by the statement (above) made by Ellen DeGeneres.  In particular, I appreciated her words of wisdom and resources for anti-bullying programs.

One of my favorite colleagues, Dr. Nancy Molitor recently wrote an article about how to spot and help a child or young adult who is being bullied on the Your Mind. Your Body. – the blog for the American Psychological Association.  In her article she notes that bullying IS NOT NORMAL and should not be tolerated at any level.  She also offers advice for parents or friends of folks who are being bullied, including how to involve the school counselor or college mental health center.

Our society has become more complex and bullying doesn’t just occur on the playground or on the walk home from school anymore.   Online bullying has become one of the most complicated and biggest challenges our children face.  And unfortunately many of us parents simply aren’t prepared to deal with this aspect of our kids’ lives because it isn’t something we had to contend with ourselves.  So beyond the advice we have gotten about preventing, spotting, and managing bullying in general, how do we deal with cyber-bullying in particular?

  • Be friends with/follow your kids online. Insist that your children make you friends with full access to their social networking accounts.
  • Check their accounts often – like everyday. It isn’t enough to just be friends with your child on Facebook (or Twitter, MySpace, etc) – you must take advantage of those privileges as well.  Check in on them often and consider posting on their wall when appropriate – they should be aware of your presence with them in cyberspace.
  • Stay current. Technology changes rapidly and – for better or for worse – keeping up with it is now an important piece of parenting.  Check out websites like the Online Mom, take a class on social networking at your local library, talk to fellow moms – whatever it takes to stay on top of things.
  • Talk a lot. Listen More. Take every opportunity to engage your children in conversations about these kinds of topics.  Ask your kids what they think of the suicides that have occurred recently.  Ask them if they have ever known anyone who has been bullied, what they would do if they were taunted online, brainstorm about ways to deal with bullies, ask them if they have ever posted anything that could have been construed as bullying.  Ask open-ended questions and aim to listen more than you talk.
  • Keep your eyes and ears open. Our lives are so busy, it is sometimes hard to notice what is going on in our on homes.  Slow down once in a while to notice if your kids are acting differently: more solemn, more isolated, more moody?  If so, take action – and quickly.

Can Britney Really Cause a Sex Riot?

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If you watched last night’s episode of Glee, then you know the music of Ms. Britney Spears was featured. One of the many story lines included cheerleading coach Sue Sylvester warning Mr. Schuester of the dangers of singing Britney songs. She advised him that exposing the students to her music could lead down a slippery slope of debauchery, deviancy, and ultimately a sex riot. And in fact, a semi-sex riot did ensue when the kids sang “Toxic” at the homecoming assembly. So my question for today is: can Britney (or pop music in general) really bring about the kinds of misbehavior of which Sue is warning us?

Not that this is a new question, parents have been accusing popular culture of sullying their kids for generations. But does it really happen? Is there a direct line, as Sue would have us believe, between risqué music and bad behavior?

I’m inclined to say no. I don’t believe that listening to a suggestive – or even explicit – song can cause kids to engage in sexually riotous behavior. And to say that it does minimizes the other, more constant, influences in their lives. Parents, teachers, friends, neighbors, classmates – all these factors have much more influence than one sexy song ever could – even if the singer is Britney.

So, if you’re a parent, don’t underestimate the influence you have with your children – even if it seems like they never listen to a word you say. And be

Seeing a Psychologist for the First Time

Making the decision that it’s time to see a psychologist can be a tough one.  Deciding who to see can be even more difficult.  I have written previously on both of these topics.  Last week I blogged about the next step – your first appointment. Specifically, I made some suggestions about what to bring.

Over the weekend I did some more thinking about that topic.  In addition to the items I have already mentioned (insurance card, form of payment, pen and paper, water, etc) another important thing to bring to your first session are questions for your psychologist.  Specifically:

1. Do you have experience treating people similar to me?

2. How often do you typically see people (i.e. once per week, twice per week, every month?)

3. Can you estimate about how long I might be in treatment? (This can be a tough question to answer but worth asking nonetheless)

4. Is there anything I can do to help make treatment more effective? Books I might read, movies I might watch (I recommend movies all the time!), TV shows that might help me (Hoarders is an example of a past recommendation).

5. How can I most easily contact you if necessary? (I like email for business-type questions and  appointment changes. I prefer phone calls for anything clinical in nature.)

Any good questions I missed? Or other things to bring to a first appointment that you can think of?

Why Everyone Should be Watching Glee

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Glee Cast - Glee on Fox TV

What are you doing Tuesday night? If it’s not watching Glee then you are missing out on something great.  And coming from me – someone who hasn’t “gotten into” a show since  Beverly Hills, 90210 (the old-school edition) – that really means something.

As a quick review, Glee is a one hour program on Fox that follows a high school show choir and the fun, struggles, and drama they and their teachers face on the quest to win a series of show choir competitions.  As a former show choir geek (or should I say gleek?) myself, I had an immediate interest in the show.  But it is the quality of the musical/dance performances, the diversity of the musical selections, the humor in the dialogue, and the depth of the story lines and characters that have me hooked.

Teen pregnancy, homosexuality, peer pressure, popularity, and cultural stereotypes are all explored in Glee – perfect fodder for a blog with a psychological bent.  So my goal during this second season will be to post my thoughts about each week’s episode.  And lucky me – next week’s guest star is someone who has inadvertently given a lot of exposure to psychology and mental health – Ms. Britney Spears. Stay tuned!