(360) 952-3070 [email protected]
A Guide to Self-Advocacy in Therapy

A Guide to Self-Advocacy in Therapy

If you have been in therapy before or are currently looking for a counselor, know you are not alone if it feels like an intimidating process. The therapy world comes with many acronyms (CBT, DBT, EMDR, ACT, etc.) and it can be daunting to identify what it is you look for in a therapist. Research over the past 50 years has shown that the quality of the relationship between therapist and client, known as the ‘therapeutic alliance’, is the strongest predictor of successful outcomes in treatment. Given the importance of the therapeutic alliance, it is important that you feel seen, heard, and respected by any clinician you work with.
 
 
When meeting with a therapist, whether entering treatment or after care is established, you reserve the right to ask questions. Here are some you might ask to help yourself identify if they are a good fit for you:
 
  1. Do you have experience providing therapy to people with similar issues as mine?
  2. What are the different therapy approaches you practice, and which do you think will work best in our work together?
  3. How do you collaborate with your clients throughout the therapy process?
  4. How do you collaborate with other treatment team members (medication providers, case managers, etc.) when appropriate?
  5. Which types of coping skills do you normally help your clients learn and practice?
  6. How do you measure progress?
  7. What can I do if I feel the treatment isn’t working for me?
  8. How will I know when to stop or pause therapy if I am doing well?
  9. What is your training (what certifications or degrees do you hold)?
  10. Based on what you know about me so far, do you believe we’re a good fit? Why or why not?

 

 

 

Asking your therapist questions about their work to ensure goodness of fit empowers you to make an informed choice about your mental health needs. Not only does this help you decide if a therapist is right for you, you are already taking a step toward autonomy and practicing empowerment. What matters most in your mental healthcare is ensuring you feel seen and heard.
 
 
Some self-reflection in identifying if your therapist is a good fit:
  1. Do I feel respected by my therapist?
  2. Do I resonate with my therapist’s approach to treatment?
  3. Does my therapist listen attentively to me?
  4. Do I feel validated by my therapist?
  5. Is my therapist transparent with me about their treatment approach, and do I understand it?
  6. Does my therapist check in with me about progress and my experiences in treatment?
  7. Is my therapist an ally to me?
  8. Is my therapist open to my feedback about what works and what doesn’t?
  9. Is my therapist a safe person for all pieces of my identity?
  10. How am I feeling about working with my therapist so far?

 

Remember, you are the expert in how you feel. Check in with yourself often about what is going well, and what is not as helpful, as you progress in therapy.

 

 

 

 

 

 

 

 

Journaling and Mental Health

Journaling and Mental Health

If you have ever had a conversation with your therapist about coping skill development, you have probably received a recommendation to begin a journaling practice. Understandably, sometimes journaling is met with skepticism – What does writing about my emotions solve, and why is writing so widely recommended?

 

Processing Emotions

  • Putting emotion on paper engages the prefrontal cortex – the part of the brain which puts language to emotion, grounds us in the present moment, and assists in regulating emotion.

 

Memory Consolidation

  • Put simply, memory consolidation is a process by which information in short-term memory is transferred to long-term memory. Writing about your experiences – positive or negative – strengthens the parts of the brain associated with this consolidation. What this means is that, over time, we become better at accessing various parts of a memory (sound, taste, touch, smell, thought, etc.) and this allows us to better make sense of memories that may be difficult or traumatic in nature.

 

Stress Reduction

  • Journaling has been found to activate the parasympathetic nervous system (the “rest and digest” response/the antithesis of fight/flight/freeze). Cortisol levels drop, breath deepens, heart rate begins to slow. Suddenly, the writer is able to be more present with themselves as they process.

 

More than what researchers have shared with us about how journaling impacts the brain (as noted above), put simply – writing with and for ourselves fosters an internal relationship. We are in relation with ourselves more often than we are anyone else, yet rarely are we taught what it means to interact with self or how to do so in a compassionate way.

 

If you are interested in exploring journaling but are unsure where to start, here are some prompts to explore:

  1. I feel __________ about journaling because…

  2. My relationship with myself could be described as…

  3. I want my relationship with myself to be more…

 

Remember, journaling is as individual as you are. Let there be spelling mistakes, run-on sentences, scribbles, and even drawings. Humans are gritty and messy; let the way you cope be gritty and messy, too.

7 Skills to Try When You Feel “Overwhelmed”

7 Skills to Try When You Feel “Overwhelmed”

Have you ever felt completely overcome by an intense emotions? Have feelings at times felt challenging to manage and overcome? The experience of being “overwhelmed” is uncomfortable and impactful in your life at work, home, or school.   Defining "Overwhelm" Emotional...

5 Ways to Cope with Anxiety as a Parent

5 Ways to Cope with Anxiety as a Parent

The hard work and unpredictability that makes parenting so rewarding can also cause a great deal of anxiety. Here are some simple ways to bring yourself to a place of calm.   Make a To-Do List Ruminating on worries can cause lots of stress. Clear your mind by...

10 Awesome Mental Health Apps

10 Awesome Mental Health Apps

According to statistics from the National Alliance on Mental Illness, each year about 1 out of every 5 Americans adults suffer from one form of mental illness or the other. Mathematically, that works out to 48.3 million of the total American adult population, and with...

Be a Better Mental Health Ally: 7 Stigmatizing Phrases and What To Say Instead

Be a Better Mental Health Ally: 7 Stigmatizing Phrases and What To Say Instead

Chances are, you’ve either said or heard each of these phrases. While not typically used with ill-intent, imagine for a moment being someone who experiences the mental health challenges described, and how you might interpret these statements. Small, intentional changes to the words we use can have a huge impact on others, so let’s go through some common phrases, why they might be harmful or contribute to stigma, and an easy alternative for each. 

 

  1. I’m so OCD about _____.

 

We all have things we like a particular way, or feel some level of discomfort with if they are not done “properly”. However, OCD is a debilitating disorder that goes way beyond preferences or a bit of discomfort. While some people with OCD have obsessions and compulsions related to cleanliness and organization, there are many different themes, and reducing OCD to fixations on cleanliness dismisses these. 

 

Instead try: It’s really important to me that the kitchen be clean, I feel uncomfortable when it’s messy!

 

  1. Everyone is a little ADD/ADHD.

 

Everyone is forgetful sometimes, struggles to focus on tasks sometimes, and struggles to find motivation sometimes. However, people with ADHD experience symptoms like these (along with many others) every single day, to a level that interferes with their functioning. Again, saying that “we all” have some level of this downplays the challenges people with ADHD face.  

 

Instead try: Wow, I am so forgetful today!

 

  1. They’re so crazy/psycho!

 

People often use these terms to refer to someone displaying erratic or concerning behavior, whether or not it is related to a mental health diagnosis. It’s even used to refer to behavior we just don’t like, or to discredit someone. It is rarely, if ever, used with compassion, and if we are referring to people who are experiencing psychosis, delusions, mania, etc. it’s dismissive of the very real and terrifying experiences these people are going through. 

Instead try: They seem to be struggling to stay connected to reality, I wonder if we can connect them to support?

 

  1. I also experienced ______ and I’m fine!

Trauma affects everyone differently, and we do not get to decide what is traumatic to someone. Research has shown that two people experiencing the same event (car crash, natural disaster, etc.) can have wildly different responses. Your brain’s response does not negate another brain’s different response.

 

Instead try: That sounds like it was terrifying for you, how can I support you?

 

  1. It’s been _____ months/years, you’re not over that yet?

 

Trauma also has no timeline, and isn’t something we “get over”.  With help from tools like therapy, medication, and peer support many people can make incredible strides in healing from what happened to them, but trauma has lasting effects on the brain and nervous system. 

 

This also applies to knowing someone has been managing a mental health diagnosis (OCD, Depression, Anxiety, etc.) long-term. Many people do experience significant improvements to a level where they no longer meet diagnostic criteria or identify previous challenges as a concern, but many people experience chronic mental health challenges that require lifelong management. 

 

Instead try: I know this has been hard, let’s talk about how we continue supporting you. 

 

  1. That person/the weather here is so bipolar!

 

While there are scientific uses for the term bipolar, most people more commonly use this term to casually refer to something/someone that changes rapidly and without warning. Again, speaking this way is dismissive of the intense and terrifying experience of shifting between manic and depressive episodes. 

 

Instead try: The weather changes so quickly here!

 

  1. Kill me/I wanted to die!

 

For people who have experienced suicidal ideation or attempts, hearing other people casually or jokingly say things like this can contribute to the stigma that often stops people from seeking help. If you are experiencing suicidal thoughts (even passive ones!) it’s important to mention them so you can find help, but if you’re trying to find an impactful way to describe frustration, embarrassment, or shame, there are better options. Suicidal thoughts are more prevalent than you might think, and shouldn’t be the punchline in a joke. 

 

 Instead try: That was so embarrassing I wanted to run out of the room!

Now that you’re aware of the potentially harmful effects of these phrases, you might be surprised to notice how often you hear them used. To be a better mental health ally, first start but just noticing when you use them or when they come up for you, then try to consciously replace or correct yourself with something like the alternatives listed. Small changes make a big impact!

 

 

 

How to Practice Self-Compassion

How to Practice Self-Compassion

From a young age, most of us are taught how to be kind, considerate, and compassionate toward others. But rarely are we told to show the same consideration to ourselves. This becomes even more true for individuals brought up in hyper-critical or neglectful homes....

4 Reasons We Judge Others and How to Break the Habit

4 Reasons We Judge Others and How to Break the Habit

One of the things most of us are taught as children is to never judge others. “Don’t judge a book by its cover!” And yet, despite our best efforts, many of us fall into the trap over and over again. Why do we do it? Here are four common reasons that explain this...

Burnout Risk: 10 Signs You’re Addicted to Working

Burnout Risk: 10 Signs You’re Addicted to Working

We live in a society that worships the overachiever. Burning the candle at both ends and denying yourself pleasure until the work gets done is seen as honorable. And while having a good work ethic is definitely key to living your best life, it is also important to...

5 Ways to Cope with Anxiety as a Parent

5 Ways to Cope with Anxiety as a Parent

The hard work and unpredictability that makes parenting so rewarding can also cause a great deal of anxiety. Here are some simple ways to bring yourself to a place of calm.   Make a To-Do List Ruminating on worries can cause lots of stress. Clear your mind by...

10 Awesome Mental Health Apps

10 Awesome Mental Health Apps

According to statistics from the National Alliance on Mental Illness, each year about 1 out of every 5 Americans adults suffer from one form of mental illness or the other. Mathematically, that works out to 48.3 million of the total American adult population, and with...

Anxiety: Your Friend?

Anxiety: Your Friend?

Anxiety and panic attacks are uncomfortable. Sometimes anxiety is so physically uncomfortable that people experience heart palpitations, nausea, chest pain, dizziness, difficulty breathing, or faintness. Sometimes anxiety symptoms worry someone so much that they call...