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7 Ways a Counselor Helps Facilitate Change

7 Ways a Counselor Helps Facilitate Change

It is a mistake to assume that someone is ready to make a change, just because they tell you they’re thinking about it. Change is more complicated than Nike’s “Just do it!” slogan.

Counselors know that lasting change builds over time. Many counselors use a strategy called “motivational interviewing” to help clients move through the different stages of change:

  • Pre-Contemplation
  • Contemplation
  • Preparation
  • Action
  • Maintenance

Did you notice that the Action stage doesn’t take place until Stage 4?

People come to counseling in different places of readiness, sometimes entering unsure, only contemplating change. Other times, people are already mid-way through the Action stage when they decide they need some extra help. Regardless, your counselor will tailor therapy for you based on your stage of change.

In the early stages of therapy (and throughout the process) building a solid therapeutic alliance with your counselor is integral to therapeutic success. The two of you must partner together to align on your therapeutic goals. Counselors use skills like empathizing, using open-ended questions, reflective listening, and summarizing to help you make your own decisions about change.  We respect your decision-making process.

Here’s how counseling can help you move through the change process:

1. Counseling honors your resistance.

During the pre-contemplation stage, you may have some blind spots. You might not have considered changing a certain aspect of your life.  Perhaps you’ve been pressured to come to counseling by a nagging spouse, or perhaps you’re are genuinely clueless about how a certain thought-pattern is adversely affecting you. At this point, a counselor will explore your reasons for coming to counseling and directly reflect any reluctance. Maybe there is a good reason why you’ve held back from changing! It’s a counselor’s job to build trust, understand your problem, and gather factual data.

2. Counseling allows you to explore ambivalence, non-judgmentally.

In the contemplation stage of motivational interviewing,your counselor will continue using reflective listening skills to maintain a strong therapeutic relationship while concurrently emphasizing change-talk. You will work together to explore the costs and benefits of change. Clients at this stage remain uncertain about doing anything differently. That’s okay! A therapist can help break down the nature of your ambivalence, understand barriers, get to the root of your deeper values and reasons for changing, and help you to “tip the decisional balance scales” (as described in Miller and Rollnick’s book, “Motivational Interviewing: Helping People Change”).

3. Counseling prompts to refine your vision for the future.

The next stage in motivational interviewing is Preparation. In this stage, you have made an intellectual commitment to change but may not know how to translate your desired change into practice. You might need help setting clear goals and understanding your options for implementing change. Your counselor will work in tandem with you to create a practical and personalized treatment plan.

4. Counselors teach skills for the successful completion of therapy. 

Every therapist has a unique toolbox of skills, based on their therapeutic orientation (ex. Cognitive-behavioral, existential, narrative, art therapy, psychodynamic, EMDR, Acceptance and Commitment Therapy, Gestalt, etc.). Many therapists operate from an eclectic approach, pulling techniques and perspectives from a variety of therapeutic modalities. In choosing a counselor, read their bio online to see if their way of thinking about problems (and solutions) fits with yours.

5. Counselors empower you to act on your vision by taking calculated risks and overcoming obstacles

In the Action stage of change, you begin to make headway on your goals. Your counselor will help you identify potential roadblocks and prepare strategies overcoming them. You might even receive homework from your counselor, tailored to helping you take the next step toward your bigger picture goal. Throughout this process, you’ll reinforce your rationale for change. You may encounter obstacles. Keeping your reason for change in mind will help you keep your eyes on the prize, building resilience as you encounter set-backs.

6. Your counselor may help with short-term wins first.

The steps you take may be small at first, but you’ll be moving forward nonetheless. It is important to celebrate small victories. It feels great to experience progress! If improvement reaches a stand still, it may be time to re-evaluate. Maybe there’s a new roadblock? Maybe there’s an old roadblock that came up unexpectedly in the form of a traumatic memory? You will continue to troubleshoot throughout the entire change process, working toward one small “win” at a time.

7. Counselors help you maintain gains.

In the Maintenance stage, clients have achieved their stated goals and are hoping to continue their work through ongoing lifestyle change. This is the part in therapy where you’ll consolidate gains. You might reflect on all of the steps it took to get you here. It didn’t happen on accident! You’ll take stock of the skills, mindsets, and changes to your environment that you’ve made that allowed success to take place.

Are you ready to make a change in life? Maybe you’re ready to shift out of long-standing depression, low self-esteem, or anxiety. Maybe you’re ready to change dynamics in your family or marriage. If you are thinking about a change, a counselor with Star Meadow Counseling may be able to help. Online scheduling is available on our website– www.starmeadowcounseling.com.

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Workaholism: The Hidden Epidemic

Workaholism: The Hidden Epidemic

I didn’t need to use drugs because my bloodstream was manufacturing my own crystal meth.

— WORKAHOLICS ANONYMOUS MEMBER
Workaholism is described by some as the “respectable addiction,” though its affects can be destructive and even deadly to those who are compulsively addicted to work.

 

  • How can you tell if you are a workaholic?
  • How do we distinguish workaholism from “hard work?”

 

In his book, “Chained to the Desk,” Bryan Robinson describes workaholism as “an obsessive-compulsive disorder that manifests itself through self-imposed demands, an inability to regulate work habits, and an over-indulgence in work to the exclusion of most other life activities. 

 

How is a person diagnosed as a workaholic?  Actually, workaholism is NOT a recognized mental health diagnosis in diagnostic manuals, though it might be a symptom of something bigger at play, as Dr. Robinson suggests. The urge to overwork can feel compulsive and anxiety provoking. A person with workaholism might not be able to clock-out mentally, even when they’d like to. It is a brand of achievement-oriented perfectionism, mixed with some rigidity, anxiety, and preoccupied thoughts.

 

The following is a checklist from Workaholics Anonymous (WA), useful for assessing workaholism.

  1. Do you get more excited about your work than about family or anything else?
  2. Are there times when you can charge through your work and other times when you can’t?
  3. Do you take work with you to bed? On weekends? On vacation?
  4. Is work the activity you like to do best and talk about most?
  5. Do you work more than 40 hours a week?
  6. Do you turn your hobbies into money-making ventures?
  7. Do you take complete responsibility for the outcome of your work efforts?
  8. Have your family or friends given up expecting you on time?
  9. Do you take on extra work because you are concerned that it won’t otherwise get done?
  10. Do you underestimate how long a project will take and then rush to complete it?
  11. Do you believe that it is okay to work long hours if you love what you are doing?
  12. Do you get impatient with people who have other priorities besides work?
  13. Are you afraid that if you don’t work hard you will lose your job or be a failure?
  14. Is the future a constant worry for you even when things are going very well?
  15. Do you do things energetically and competitively including play?
  16. Do you get irritated when people ask you to stop doing your work in order to do something else?
  17. Have your long hours hurt your family or other relationships?
  18. Do you think about your work while driving, falling asleep or when others are talking?
  19. Do you work or read during meals?
  20. Do you believe that more money will solve the other problems in your life?

Did you answer “yes” to 3 or more questions? According to Workaholics Anonymous, a person can be considered workaholic if they answer affirmatively to three or more of the questions.

 

Is work addiction really that dangerous?

In Japan alone, thousands people die annually from karoshi (“death by overwork”). Over-work affects people holistically. Physically, they may experience ulcers, chest pain, heart attacks, asthmatic attacks, or urges to binge eat. Psychologically, workaholism has been connected to depression, anxiety, perfectionism, stress, anger, burnout, low self-worth and low self-esteem.  Socially, workaholics may be isolated from friends, family, or co-workers. In addition, their behavior can potentially lead to marital discord, divorce, or job loss. Children of workaholics are negatively affected too; research indicates that adult children of workaholics are at higher risk for depression, anxiety, and feelings of low self-worth.

What happens in the workaholic brain? Work addiction alters the physiological and chemical nature of the brain. Workaholics attain an adrenaline high from binge-working. After the high, the person is left with a “work hangover,” which may involve heightened anxiety, irritability, or suicidal ideation. Akin to substance use disorders, workaholics often experience cognitive distortions that complicate their adrenaline addiction.

 

How is workaholism different from hard work?

The big distinctions are balance and boundaries. In order to have a balanced life, a person must be engage in healthy relationships, maintain outside interests and hobbies, and demonstrate overall self-care (ex. Slowing, family time, adequate sleep, etc.). Boundaries allow a person to distinguish their work life from their home life and social life and so forth.

Thomas Merton, in his book “Conjectures of a Guilty Bystander” described workaholism and its threat to inner peace:

“There is a pervasive form of contemporary violence to which the idealist most easily succumbs: activism and overwork. The rush and pressure of modern life are a form, perhaps the most common form, of its innate violence. To allow oneself to be carried away by a multitude of conflicting concerns, to surrender to too many demands, to commit oneself to too many projects, to want to help everyone in everything, is to succumb to violence. The frenzy of our activism neutralizes our work for peace. It destroys our own inner capacity for peace. It destroys the fruitfulness of our own work, because it kills the root of inner wisdom which makes work fruitful.”

If you are feeling burned out from over-work and are ready to begin a journey toward recovery, a counselor at Star Meadow Counseling might be able to help.

 

References:

Healthyplace.com. (2018). Work Addiction Treatment | HealthyPlace. [online] Available at: http://www.healthyplace.com/addictions/work-addiction/treatment-workaholic/menu-id-54/ [Accessed 18 Sep. 2018].

Merton, T. (2014). Conjectures of a guilty bystander. Garden City, N.Y.: Image Books.

Robinson, B. (2014). Chained to the Desk. 3rd ed. NYU Press.

The Japan Times. (2018). The government’s ‘karoshi’ report | The Japan Times. [online] Available at: https://www.japantimes.co.jp/opinion/2016/10/12/editorials/governments-karoshi-report/#.W6GQkehKiUk [Accessed 18 Sep. 2018].

Treatment4addiction.com. (2018). Work Addiction. [online] Available at: http://www.treatment4addiction.com/addiction/behavioral/work/ [Accessed 18 Sep. 2018].

Workaholics-anonymous.org. (2018). Home. [online] Available at: http://workaholics-anonymous.org/ [Accessed 18 Sep. 2018].

7 Great CBT Websites

7 Great CBT Websites

Are you interested in learning more about Cognitive-Behavioral Therapy as a mode of counseling or self-help? Check out these 7 amazing online resources:

 

  1. https://llttf.com/ Living Life to the Full

Living Life to the Full is an interactive CBT website.  This free online course incorporates audio and video clips throughout the learning modules. The site includes handouts for each course topic, a moderated discussion forum, assessments tools to track progress, and an array of other self-help materials. Users can also invite a mental health practitioner to view your progress and provide feedback.

 

  1. http://www.cci.health.wa.gov.au/ Centre for Clinical Interventions

The Centre for Clinical Interventions provides information on struggles (ex. Anxiety, Assertiveness, Depression, Panic, Perfectionism, Sleep, etc.) and gives access to free downloadable workbooks, customized to that area. Each topic includes 7-12 user-friendly chapters. It is an instantly practical resource. Click on “Resources” and “Looking After Yourself” to find the resource best suited to your needs.

 

  1. http://www.suffolkcognitivetherapy.com/web/resources/worksheets/ Suffolk Cognitive Therapy

This website provides free audio recordings of mindfulness instruction, including “Progressive Muscle Relaxation,” “Watching Thoughts Drift By,” “Acceptance of Anxiety,” and “Acceptance of Thoughts and Feelings.” They also provide clinical forms for practicing cognitive therapy, including a Thought Record, an Objective Thought Exercise & Worksheet, and a Values Exploration Worksheet.

 

  1. https://www.academyofct.org/default.aspx Academy of Cognitive Therapy

The Academy of Cognitive Therapy shares CBT outcome studies, describing conditions that are treatable with CBT, including a spectrum of anxiety and mood disorders, eating disorders, and a surprising amount of medically related disorders (including insomnia, IBS, chronic fatigue, and chronic pain).

 

  1. http://threeminutetherapy.com/    Three Minute Therapy

This website has an entire book online, free of cost. The book is “Three Minute Therapy: Change Your Thinking, Change Your Life” by Dr. Michael Edelstein. The book includes an explanation of cognitive therapy, CBT applications for a variety of topics (i.e. worry, self-esteem, anger, and overeating), and a three-minute exercise that walks users through the A-B-C-D-E-F approach to cognitive re-framing.

 

  1. http://www.rebtnetwork.org/ REBT Network

The REBT Network elaborates on Albert Ellis’ ABC Model of rational-emotive-behavioral therapy, explaining how beliefs are connected to our emotional and behavioral reactions. This website also includes forms for disputing irrational beliefs and walking yourself through REBT therapy.  You can also download free copies of “How to Conquer Your Frustrations” by Dr. William J. Knaus and “Rational Emotive Education” by William J. Knaus.

 

  1. https://moodgym.com.au/ Mood Gym

Mood Gym is an interactive website that uses cognitive therapy to treat depression or anxiety. This low-cost site ($28.15 annual fee) incorporates quizzes, worksheets, animated demonstrations, and skill building into its program.  It also tracks your progress through the workbook and helps you measure your results.

 

 

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Understanding Cognitive Therapy: The Basics

Understanding Cognitive Therapy: The Basics

Have you ever wondered how your feelings are generated? Do you understand what it is that triggers your emotions?

The fact is, there are many different answers to these questions in the field of psychology.  Let’s take a look at just one of those approaches from the world of cognitive therapy. Cognitive-behavioral therapy (CBT) teaches that all moods are generated by our thoughts and reinforced by our behaviors.

Most thoughts that occur in the heat of an emotional moment are automatic. Often, these thoughts occur spontaneously, without conscious intent; hence the term “automatic.” Thoughts that are skewed negatively can lead to amplified emotional pain (ex. Sadness, anger, anxiety, or hopelessness), which is often what prompts people to come to counseling to begin with.

A cognitive approach to counseling helps people with uncovering and re-framing negative thoughts with the assumption that changing these thoughts changes the intensity of the feelings.

What happens in cognitive therapy?

  • A counselor that uses cognitive therapy or CBT might start by asking you to describe the context in which particularly strong feelings are being triggered. What is happening? Where are you? Who are you with? What happened first?
  • The counselor might prompt you to name the different emotions happening in that specific situation. Sometimes there is more than one emotion happening at the same time. You might even rate the intensity of the feelings (Example: Shame 90%; Anxiety 55%).
  • A cognitive counselor will be especially interested in helping you identify the automatic thoughts that happened before, during, or after the situation you’re discussing. To help with this, they might ask questions like: What was running through your mind when you started feeling ashamed/anxious/sad/guilty? Sometimes there are several automatic thoughts related to a particular situation. Maybe you’ve experienced a flood of negative thoughts one after another. Sometimes thoughts can swirl around so quickly that they feel like a hurricane of negativity. When that happens, the therapist can help you address them one at a time. You might start with the thought that evokes the most painful or intense emotions.
  • You might be asked to identify and confront any distortions in your thought process. For example, noticing thoughts that are all-or-nothing, overly catastrophic, attempt to tell the future, attempt to read someone’s mind, or overly personalize things.
  • You might be asked to examine evidence that your automatic thought is not 100% true. The workbook, “Mind Over Mood,” has a wonderful Thought Record worksheet that can help with challenging those emotionally heated thoughts.
  • After examining the thought (and the evidence for/against the thought), you might be asked to try out a new thought. The new thought might not be all rainbows, unicorns, and false positivity. Instead, the new thought might be experienced as neutral, balanced, fair, and more reflective of a truth apart from emotional reasoning.
  • After trying out the new line of thinking, a cognitive counselor might check in to see how the intensity of the emotions changed as a result of changing thinking.
  • Perhaps, then, you might begin to explore how you would behave differently if the new thought were to take root.

Cognitive theory teaches that long-term thought change requires a re-examination of core beliefs.

After evaluating automatic thoughts over a period of time, many people find patterns in their thinking that reflect deeper beliefs that are at the center of their distress. Once exposed, you can dispute those beliefs and act against them.  This is when “schema” change takes place. According to Dobson & Shaw (1995), cognitive schemas reside in the long-term memory, serving as a “vulnerability factor” for their negative thinking. In order for enduring change to take place, individuals must create new lenses from which to see themselves, others, and their environment.

Cognitive counseling helps people develop an awareness of the unhelpful thoughts that are contributing to intense feelings. People really can learn to replace destructive thoughts with more functional thinking. In cognitive therapy, there is hope for a new perspective on life.

Interested in learning more? Check out the resources listed below or read additional articles on our Cognitive Behavioral Therapy page.

References

Burns, D. (1980). Feeling Good. New York: Signet.

Dobson, K. & Shaw, B. (1995). Cognitive therapies in practice. Comprehensive Textbook of Psychotherapy: Theory and Practice. New York: Oxford University Press.

Dozios, D., et al (2009). Changes in self-schema structure in cognitive therapy for major depressive disorder: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77 (6).

Froggatt, W. (2005). A brief introduction to rational emotive behaviour therapy. Handout.

Greenberger, D. & Padesky, C. (1995). Mind Over Mood: Change How You Feel by Changing the Way You Think. New York: Guilford Press.

Jones, S. & Butman, R. Modern Psychotherapies: A Comprehensive Christian Appraisal. Illinois: InterVarsity Press.

Wenzel, A, et al (2009). Cognitive Therapy for Suicidal Patients. Chapter: Cognitive therapy: General principles. Washington, DC: American Psychological Association.

Answers to 3 Questions about Boundaries in Counseling

Answers to 3 Questions about Boundaries in Counseling

1. How does confidentiality work in therapy?

Seeing a counselor is sort of like being in the witness protection program. Even the fact that the counselor knows you is kept private and confidential. That means that when they run into you out in public, the counselor does not flag you down and say– “Hey! It’s me, your therapist! Remember me from counseling?” (How awkward would that be!?)

Instead, therapists wait for you to initiate “hellos” and are usually glad to say “hi” right back. Counselors don’t ever want to put you in that uncomfortable position where you have to explain how you know them to the people you are with.

As you may have heard, there are some exceptions to confidentiality, especially when safety is at risk.

  • If you talk about children, elderly people, or disabled people that are being abused or neglected, your counselor is considered a mandatory reporter.
  • Your counselor would also break confidentiality if you disclosed plans to harm someone else. Counselors really don’t want anyone to be murdered! (That’s a good thing, right?!)
  • Counselors often see clients with thoughts of suicide. That really doesn’t freak us out. It’s more common than you’d think! When we DO break confidentiality is when that person is losing the ability to keep themselves safe. Because teens are a high risk population when they have thoughts of suicide, it’s common for therapists to seek coordination with family supports whenever risks of harm are involved.
  • Counselors are required to provide you with a copy of their privacy practices where you can read in more detail about how confidentiality works in this unique setting.

 

2. Why can’t I be Facebook friends with my counselor?

Counselors have to abide by professional standards and ethical guidelines. The 2014 ACA Code of Ethics introduced a requirement asking counselors to separate their professional and personal social media profiles. Those ethical guidelines do not permit counselors to communicate with clients via personal social media accounts. Counseling is unlike other relationships in your life, different from friendships and different from family connections. Part of what makes it effective is that separation and neutrality. Those boundaries help make therapy a safe place to express yourself without worrying about what your therapist is going to think, which can be triggered by social media comparisons. It’s for these reasons that your counselor cannot connect on Facebook or similar platforms.

 

3. What should I get my counselor for Christmas?

Okay, this was a trick question. Please don’t get your counselor anything for Christmas (or any other special occasion). Our ethical codes discourage counselors from receiving gifts from clients. We see some very generous people come through the door who love to show appreciation and gratitude by gift giving. When counselors decline your gift, know that it is not a personal rejection. It is instead another one of those professional boundaries drawn from the ACA Code of Ethics, which advises counselors to remain mindful of putting the therapeutic relationship first. More than anything, your counselor wants to avoid any situations that may cause a conflict of interest.