Tag: <span>Treatment</span>

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Telehealth: We love it and you will too

Therapy can greatly help people, but it is a lot of hard work; telehealth can take some of that stress away and make it an easier process for all. Because therapy can be so challenging, we want to minimize the time required to make therapy work for you. This means that you will have more time and energy to pay attention to the things that matter to you. The ease and convenience of telehealth may be the answer we’re all looking for. This post will walk you through what is telehealth, the benefits of telehealth, and if it is right for you.

Telehealth explained

By this time in the pandemic, most of us are familiar with some form of telehealth. Telehealth is simply remote healthcare provided via phone or video conferencing. Telehealth rapidly gained popularity in 2020. However, it’s been around for over a century and has a substantial amount of research supporting its use across many fields. In addition to being backed by science, telehealth has greatly improved the accessibility of quality mental health care. Along with this, we’ve noticed it has many benefits for our patients. Below we’ll discuss what providers and patients love about telehealth and if it is appropriate for you.

What we (and our patients) love about telehealth

Telehealth services for most medical and mental health care were effective long before 2020. However, for insurance, privacy, and other reasons it either couldn’t be used by providers or there was a stigma against it. Now that telehealth has been widely used with patients for years, and science firmly demonstrated that it is just as good as in-person most of the time, we want to point out what makes it so great for us and those we treat. Telehealth:

  • Makes therapy more accessible
  • Therapy is more convenient
  • Allows for patients, both adults and children, to feel safer at home
  • Provides invaluable symptom information, as many symptoms present within the comfort of one’s home
  • Allows for more time and energy to be put towards other important areas of your life


First, and possibly most importantly, telehealth makes therapy more accessible. Not only is it more accessible for many providers, it is more accessible for many patients as well. For example, patients dealing with agoraphobia or trauma may have difficulty leaving their home. Remote appointments mean they don’t have to face their biggest fears just to make it to a session. Those who are physically disabled, chronically ill, or have chronic pain can access the care they need without bringing on a symptom flare. Individuals who are deaf/hard of hearing, have a learning or other cognitive disability can greatly benefit. Remote options allow for the use of captions, screen sharing, chat functions, and more. Remote therapy options (along with legislation like PSYPACT), means we can treat patients in over 30 different states. This provides access to effective care which might not be available in many areas. This list isn’t comprehensive, but you get the idea. Remote options make accessing mental health care possible when, in the past, it might not have been an option for many.


Second, telehealth therapy is more convenient. Even if you’re close to your provider’s office, getting to an appointment once a week can be quite the hassle. Parking, gas, traffic, delays at school or work can all impact getting to your session on time. If your child is the one in treatment, convincing them to go to the office after a long day at school could be a struggle. If you’re very busy, it might be hard to find a regular time that works with your demanding schedule. This is especially true if you have to factor in the additional time for commuting. For college students, scheduling therapy between classes allows opportunities to work on mental health without compromising school performance or social life.


Third, most adults and children not only feel safer at home. Home is often where symptoms are most frequently occurring. With the type of therapy we offer at AWCC, therapy within our patients home can provide invaluable information. Working with someone where they feel safe and experience the most symptoms provides therapeutic opportunities. This allows providers to address specific symptoms in ways that are much more difficult in an office setting. In the past, working with a patient in their home meant we had to charge for travel time. The more time we spend time commuting, the less time we have to see patients. Despite being a small practice, we are passionate about helping as many people as we can. Telehealth allows us to help more patients, across various settings, in ways that work for them.

Leaves time for other things in life

Lastly, as we already stated, therapy is hard. What you get out of therapy is directly linked to what you are willing and able to put into it. Telehealth options are often more accessible, convenient, and can allow for more targeted treatment. This means leaves you with more time and energy to put in the hard work to achieve your treatment goals. Because remote sessions are easier to attend and schedule, they also decrease the likelihood that someone will cancel or miss appointments. This means they won’t be set back a week simply due to scheduling conflicts. Remote sessions also mean that you can still attend an appointment when you otherwise may not have been able. For example, if you have to watch your kids or you’re not feeling well, you can usually get to your computer/phone while at home. Therapy is only effective if someone can engage, so whatever makes it more likely that you can make it to sessions and put in the effort will make it more likely that you will succeed and start to feel better.

Is telehealth right for me?

Do you or your family member deal with symptoms of an anxiety, obsessive-compulsive, depressive, sleep, or trauma disorder? Need help managing a chronic health condition, chronic pain, or an eating disorder? Have ADHD, struggle to keep organized, have trouble keeping up with work/school, or possibly have a hoarding problem? Find that fear or worry keep you from doing the things you want to do in life?

If you answered “yes” to any of the above questions, then you/your family member might be a good fit for telehealth at AWCC.

In addition to wanting help managing one of the many conditions we treat, telehealth requires access to a few things. First, you need a device, such as a smartphone, tablet, or computer, that has a working camera and microphone. Second, you need an internet connection that’s stable enough for video calls. Third, you need a private space to have the sessions in. This can be a home office, empty conference room, car, bedroom, or wherever you have privacy and feel safe. 

Telehealth is a fantastic option for almost all of the patients we see at AWCC. However, it isn’t appropriate for all diagnoses and in all situations. Sometimes, people with more severe symptoms, various disabilities, and/or children younger than 10 years old may require either in-person services or a hybrid option. People with symptoms or a condition that would prevent them from being able to effectively engage in treatment via a video conferencing format are similarly unlikely to be appropriate for telehealth.

All in all, telehealth therapy is a fantastic option for almost all of the patients we treat at AWCC. Time and time again, studies have shown that Cognitive Behavior Therapy, the primary treatment we provide at AWCC, provided via telehealth is just as effective as in-person treatment for the types of patients we see and conditions we treat.


All in all, telehealth can be a great option for most of the patients we see at AWCC. Telehealth can increase access and allow you to engage in treatment where you’re most comfortable. As fall approaches, getting your child to weekly appointments can be a nightmare with after school activities and evening traffic. Telehealth can also mean fewer missed appointments, more flexibility, and more time for you to focus on getting better rather than getting to session.  Telehealth can be the difference between being able to get care or having to continue to suffer without it. Patients with a history of trauma, suffering from conditions such as agoraphobia, who are physically or otherwise disabled, or in locations with few treatment options are prime examples of this.

Most importantly, telehealth mental health treatment is proven to be effective for most, if not all, of the conditions we treat at AWCC. We have seen this first-hand with many patients over the last few years. We would not offer it if we did not believe in it.

Everyone knows video calls can suck, but so can facing the hard stuff in therapy; why not do it in sweatpants?

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What Should I Expect?

The decision to seek out therapy is often one that is not made lightly.  Occasionally, people may grapple with this decision for quite some time before actually contacting a treatment provider.  There are many reasons for this. They may:

  • be unsure what to expect
  • feel nervous about what people will think of them
  • be concerned about therapist judging them
  • have financial obstacles
  • be concerned about repercussions if insurance “finds out” about their treatment

Although the list continues, I want to provide insight into what those of you, who may be new to seeking out therapy, can expect.  The goal of this post is to give a general outline of the therapy process. Ideally, you’ll make the decision to start therapy based on your needs and not on the above concerns.  

First Contact (Call or Email)

Typically, when you call to inquire about services, my first step is to understand if I would be able to help based on what concerns you have.  For example, I am highly specialized in cognitive behavioral therapy (CBT) for anxiety, OCD and related disorders. Therefore, if you call asking for help with alcohol addiction, I would not feel like the appropriate person to help.  If the concern is outside of my skill set, I discuss that and provide appropriate referrals I have that are better equip to meet your needs.

If you are in need of services that I provide, we then discuss the process of therapy (outlined more in this blog) and logistics.  This administration discussion includes fees and payment policies, questions regarding out-of-network benefits, scheduling, and method of meeting (i.e., virtual or in-person).  Other questions and concerns are answered and addressed so you can make an informed decision about proceeding with scheduling an appointment.  

The First Session

During the first session, you will be asked a number of questions.  Most health providers in various disciplines as many of the following basic questions.  They may include:

  • Why you’re looking for treatment
  • History of what you’ve been experiencing
  • Medical/medication questions
  • Family background
  • Education/Occupation background
  • Social support system

Now, these questions may seem like a lot, but they all serve a purpose.  One of the main goals is to understand what’s going on with you and the various ways your symptoms interfere, or don’t, in different parts of your life.  It also helps me understand you as a whole person and not just as the presenting.  I do my best to make this a comfortable discussion and try to keep things light hearted along the way, as I understand it may have taken quite a bit of bravery to take this step.

At the end of this session, the assessment may not be finished. Therefore, during the next session, I finish gathering necessary information to ensure that I have a full understanding of your concerns.  I do it this way to make sure that when we set out on our treatment path (discussed shortly), something else doesn’t unexpectedly come up that would’ve been helpful to know in the beginning.  This still happens and can be addressed effectively. However, the treatment plan will be more accurate if I have most of the information early in the process.  After we wrap up, I typically ask if you’re willing to schedule another appointment.  If you don’t feel comfortable with me, there is no pressure to schedule a second appointment.  This saves the hassle of you canceling later or showing up and feel uncomfortable.  If you agree to continue, we’ll schedule and you get your first homework assignment(s). That’s right…you get homework and I’ll explain why shortly 😉

Subsequent Sessions

After the completion of the assessment/intake questions, we develop your individualized treatment plan together.  This plan is specific to your personal goals you have for therapy.  There may be times when we have to discuss the goals you set. For example, we don’t want unattainable or unrealistic goals (i.e., never be anxious again).  Typically, I like to set goals that will help us understand if we are making progress in therapy. For example, get to sleep by 10pm 5 of 7 nights per week.  

Once we have agreed on the treatment goals, I will educate you on what we’ll be doing.  We will likely spend about one full session on cognitive behavioral therapy (CBT). This gives you a good understanding of why we will approach your treatment goals using those techniques.  I’ll also teach you about anxiety/OCD/other presenting problem(s), again so you can see how CBT works toward meeting your specific treatment goals and better managing your symptoms.  

After we’ve developed the treatment plan and done the education, we begin with the treatment.  Treatment looks different for everyone based on individual symptoms and goals.  However, there will almost always be a homework component.  

Use of Homework in Therapy

Homework is a very useful tool for building new skills and learning new ways to respond to things.  Ultimately, CBT is a very active treatment process and homework helps you develop your skills between sessions.  As most of us know, the more you practice something, the better, and easier, it usually gets.  We apply this same idea to the skills and strategies learned in therapy as well.  Ideally, homework encourages treatment progress, so you can spend less total time in treatment.  

Getting Started

This may sound like a great plan, but it can still be pretty overwhelming to figure out where to start.  There are many ways to approach this daunting task.

  • Talk to friends or family who you know have been/are in therapy.  Even if their therapy focuses on something else, they can ask their therapist for an appropriate referral.  This way, you’re getting a name from a trusted source. 
  • Conduct an online search in your area.  This will provide a large number of responses, which can be difficult to sort through.  To narrow the results, put in specific search terms that detail the type of therapy you’re looking for (if you have this information), or the type of problem you’re experiencing. 
  • Post for a recommendation on a neighborhood/city social media page or email listserv if you have that available. 

Regardless of how you connect with a therapist, please ask them questions to make sure they are competent in what you’re seeking.  No matter who you see, you can always ask for, or look for, a new therapist if it isn’t a good fit.  This is your treatment and your life! As a therapist, most of us truly want to help you reach your goals and live the life you want!


The Magic Behind CBT

CBT?  What’s that?  And what do you mean, magic?

Cognitive Behavioral Therapy (CBT) is one of the most evidence-based, well-researched psychotherapies out there.  Honestly, if you search it, you will be bombarded with an insane number of results.  Having so much information available on such a life-changing topic is actually a fantastic thing!  However, it can be problematic for a consumer, as it might simply be too much.  It may be overwhelming to figure out where to start or what you even want to know about it.  That’s where this easy-to-digest piece on the basics behind CBT, what it is and how it works comes in.  

What is Cognitive Behavioral Therapy? 

CBT is a type of therapeutic intervention that focuses on thoughts, feelings, behaviors, and physiological sensations.  Any time we experience a situation, we have thoughts and feelings associated with it.  Then, we may also notice, or not, physiological sensations in response.  Once our body very quickly processes these pieces of information, we react/respond (behavior).  This sounds extremely simple because it really is.  It is not a complicated process once we understand it, but that does not mean that if we are stuck in a maladaptive cycle that it is easy to get out of it.  Let’s run through an example to give real-life context.  We will use the same situation and go through it with two different “people” to show just how much a person’s internal CBT cycle plays a role, even when the situation is the exact same. 

CBT Cycle in Action

The Situation
Someone is holding a dog in their arms.  Picture a dog in someone’s arms; there are no obvious signs of aggression and the dog is small enough that it is possible for their owner to hold it.  

Person A: Adaptive/Positive Experience
Person A sees this dog in the arms of its owner and has an automatic thought about it.  This thought could be something like Oh, look at that cute dog, Isn’t that sweet, or even I hope that dog is okay.  These thoughts will elicit some type of feeling, which could be happiness, joy, care, or others.  Along with these more positive emotions, Person A probably wouldn’t notice anything physiological; however, they’d likely have calm muscles, a normal heart rate, regular breathing patterns, etc.  Behaviorally, Person A may want to approach the dog/owner and ask to pet it or tell the owner they have a cute dog, but at the very least, they may have a slight smile (yes, that’s also a behavior).  Because they left this situation in a positive mood and mindset (and potentially positive feedback from the dog or owner), they are likely to repeat this cycle the next time they encounter a similar situation. Not a problem; there’s nothing wrong with this cycle.

Person B: Maladaptive/Negative Experience
Person B sees the exact same situation and their initial thoughts might be What if they put the dog down?, Did it try to hurt someone and that’s why they picked it up?, or It doesn’t look friendly.  Based on the nature of these thoughts, you can probably assume that they would likely have a different set of emotions.  Person B likely experiences fear and anxiety.  Based on this, they may notice physiological symptoms of an increased heart rate, sweating, muscle tension, upset stomach, etc.  It is highly unlikely that Person B will respond with the same behaviors as Person A. Instead, they may try to quickly walk past the dog/owner, cross the street if that’s possible for them, or even turn around and escape entirely.  When they leave this situation, they will no longer be experiencing fear or anxiety; instead, they will experience a sense of relief and safety.  Because they experienced this relief, they will also be more inclined to repeat this cycle when they encounter a similar situation. This, however, can turn into a problematic response if this happens every time they see a dog.

What’s wrong with escaping an anxiety-provoking situation?
It is sometimes encouraged to escape certain anxiety-provoking situations. In fact, there are absolutely certain situations that escape is necessary for survival! However, when our need to escape less threatening situations starts interfering with our lives, it becomes problematic and we need to learn how to respond differently. 

How does CBT help?

The whole idea behind CBT is learning how to respond differently, while challenging the negative thoughts along the way.  When we do this, we start to learn that our thoughts are not always facts and may or may be true.  We also begin to learn that those negative emotions and unpleasant physiological sensations we’re experiencing, don’t stay around forever!  Once this is understood and learned, a person becomes much more empowered and can look at various unpleasant situations through a new lens.  Not sure what I mean? Let’s get back to the example of Person B to show it more clearly.

Person B: Breaking the maladaptive/negative cycle
Person B will still see the dog and begin their initial thought process.  In turn, they will experience the distressing emotions and physiological sensations.  However, instead of running away or escaping, they respond differently and approach the situation.  At this point, Person B makes a conscious decision to go toward the dog/owner.  As they approach, their anxiety and fear may temporarily increase; however, if they stop to chat and/or even keep moving at a calm pace past the dog/owner, their anxiety will slowly begin to decrease.  Now, this might not seem like a big deal at all, but it was actually a great educational moment.  Instead of avoiding something they feared, Person B chose to actively approach it and they were able to learn a few things. 

  • Their emotions ebb and flow and they can tolerate those changes 
  • Their physiological symptoms ebb and flow as well 
  • They can respond in a different way
  • Their thought was just that…a thought! 

The dog didn’t get down, the owner didn’t “sick” the dog on Person B and everything turned out okay.  This would not have been experienced had Person B resorted to avoiding the situation like they usually do.  Instead, they are starting to put some cracks in the thought that this situation (and others like it) are threatening.  If they continue to use an approach strategy as often as they can, they will soon learn that their fears about this type of situation may have been exaggerated compared to the actual threat of a situation.  

That’s great, but what if something bad does happen? 
I won’t go into significant detail here, but I’ll do a quick explanation and example.  One could easily argue that driving in a car is dangerous and threatening, but most adults of driving age take that risk daily.  However, if we end up in a car accident (as many of us have or will), why don’t we stop driving?  After all, the danger was just proven to us and something bad did happen!  Well, for a few reasons.  One is that we have had many more times driving when we didn’t get into an accident, so we’re able to see that, although it’s possible, it does not mean it is highly probable.  A second reason is that we may lose our job, social life, family, etc. if we allow this anxiety to prevent us from driving.  Another reason is that we learned that, although it was unpleasant and uncomfortable, we tolerated it!  We were able to handle the situation, problem-solve as necessary and move forward with the understanding that what happened was the exception and not the rule.  So, if Person B experienced the dog getting down, barking at them, or even biting them, they would have learned that they can handle the situation, even if they didn’t like it.  Scary things happening to us doesn’t have to be a bad thing.  They are wonderful learning experiences, even when it’s hard to see that in the moment.  

So, where’s the magic? 
Well, that’s just it…there isn’t any.  We don’t need any magic wands or smoke and mirrors; rather, we simply need to make an adjustment in our actions to make the magic happen!  We are retraining our body and our brain by responding differently and approaching situations instead of avoiding them.  This process alone begins building new pathways in your brain, getting you closer to taking control of your anxiety and fear.  Even though it is a simple process, it can be difficult depending on the severity of the negative emotions and thoughts.  It will take time, patience and practice, but with those things, CBT can do wonders for making significant life changes toward a happier lifestyle!  My challenge to you is this: the next time you’re faced with a fear that you would usually avoid, try looking at it from a new perspective and approaching it instead of avoiding it.  Maybe it’s a phone call you’ve procrastinated, or an assertive discussion you’ve been debating, or even looking at a bug outside.  Whatever it is, see what happens if you approach it.  Good luck!