By Annabelle Parr

During this incredibly stressful time of COVID-19, we are having to make major life adjustments. With the new shelter in place restrictions, you might wonder whether psychotherapy is still an option available to you. The short answer is yes!

Telehealth, also known as video conferencing or online therapy, has been available long before COVID-19, and is an important alternative to in person care.

Traditionally, therapy is done in person. However, with the emergence of new technologies, there have been an increasing number of telehealth / video conferencing options and platforms emerging and available in the mental health field over the last decade. This means that not only do we have the infrastructure available to offer confidential, HIPAA compliant virtual therapy, but also that there is already plenty of research on telehealth and its efficacy in mental health treatment.

Prior to coronavirus, teletherapy expanded access to care to individuals who were not able to get to a therapist’s office, whether that was due to scheduling difficulties or a lack of mental health care options in their community. Now, shelter in place poses a barrier to accessing in person care for all of us. Thus, telehealth via video conferencing offers convenient access to care for everyone as we are required to stay at home as much as possible.

How effective is telemental health care?

According to the Anxiety and Depression Association of America, “from a large body of research we know that telemental health leads to high patient and provider satisfaction ratings and achieves health outcomes equivalent to in-person care across all diagnostic groups” (Yellowlees, 2020). So as long as the client is willing to engage in therapy virtually and is not an extreme risk to themselves or others, research shows that telemental health is as effective as in person treatment.

How does virtual therapy work?

Typically, telehealth involves video conferencing with your therapist using a secure, HIPAA compliant platform. No extra equipment or complicated applications are required. Clients can use their smartphones or a laptop computer with a built-in camera. Therapists are able to offer telehealth services to patients located in the state in which they are licensed. So a therapist licensed in and practicing in California is able to offer teletherapy services to patients located in the state of California. Though not all therapists were offering telehealth options prior to COVID-19, given the current situation, many have adjusted their practices to offer video counseling options to patients in need.

What should you look for in a telehealth provider?

The same things you would look for in a therapist you would see in person: you want to ensure that the therapist you choose has expertise in the areas in which you are seeking treatment for, and you want to make sure the therapist feels like a good fit for you personally. One thing we know for sure is that the quality of the therapist-client relationship is the most important factor in producing successful treatment outcomes across settings, in-person or online. This means that in order for therapy to be effective, you have to have a solid trusting rapport with your therapist. Assuming those two conditions are present, telehealth is likely to be just as effective as working with the same therapist in person.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness, and Telemental Health Services. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

by Annabelle Parr

Somehow the holidays have snuck up on us once again. Though this time of year is meant to be filled with joy and cheer, for many of us it is also filled with stress, anxiety, and maybe even sadness or pain. The holiday season does not erase preexisting struggles, and it can add an extra layer of stress on top of what we may already have been dealing with. If you are having a hard time during the holidays, you may not feel like you have permission to be anything but happy.

But it’s important to remember you are not alone if you’re feeling stressed, tired, or less than joyful. The holidays can be difficult for many people and for many reasons. Engaging in the annual holiday traditions may bring back upsetting memories for those who experienced trauma, loss, or pain at this time of year. You may feel the weight of a recent change or loss, or you may notice that things have stayed the same from one holiday season to another when you desired a change. Maybe you have a challenging relationship with a particular family member that you have to navigate during the holidays, or maybe going home and back into your family system brings up unresolved conflicts or issues. Or maybe you enjoy the holidays, but you find yourself rushing around trying to accomplish everything on your to-do list within a budget of both time and money, and as a result you are unable to appreciate a time of year that you love because you are feeling so harried.

Whether your heart is feeling full of joy or full of pain, or some combination of both, here are a list of things that you can do to be kind to yourself and manage the stress that may accompany this season.

1. Remember that “comparison is the thief of joy.” So, heed Theodore Roosevelt’s wise words, and try not to compare your holiday experience with what you see on TV, in movies, or on Facebook. And try not to set unrealistic expectations for yourself and for whatever holiday you celebrate. As Voltaire wisely put it, “perfect is the enemy of good.” Your holiday doesn’t have to be perfect to be good. So give yourself the grace for a few mistakes or snags in the plan because they are inevitable.

2. Give yourself permission to say no. There is only so much time in the month of December. Though it is easy to feel the pressure to say yes to everything holiday related, it is important to know your own limits. Setting clear boundaries for yourself, with both your time and your finances, can help to reduce stress. Giving yourself some time to rest can allow you to more fully appreciate those things that you do choose to say yes to.

3. Acknowledge your feelings. If you are feeling sad, anxious, lonely, or depressed, know that it’s okay. Allow yourself to feel those things without beating yourself up or feeling guilty for feeling this way at the holidays. Remember that we get ourselves into trouble when we try to avoid distressing feelings. And keep in mind that happiness and sadness can coexist. We can have moments of each, and even moments of both. But if we are busy trying to deny or avoid our pain, it’s going to be much harder to feel the joy at all.

4. Practice self-compassion. Self-compassion means that we “mindfully accept that the moment is painful, and embrace ourselves with kindness and care in response, remembering that imperfection is part of the shared human experience. This allows us to hold ourselves in love and connection, giving ourselves the support and comfort needed to bear the pain, while providing the optimal conditions for growth and transformation” (Neff, 2016).

5. Practice kind self-talk. Listen to the thoughts running through your mind. Do you talk to yourself the way you would talk to a friend or loved one? Or are you beating yourself up for mistakes, imperfections, or feelings you wish weren’t there? If your self-talk is less than kind, try to remember to give yourself the same grace you would give to the people you love.

6. Breathe. Frustrated with a long check-out line? Angry that someone cut you off in the parking lot? Feeling overwhelmed with your to-do lists? One of your relatives pushing your buttons? Remember to take a breath. Focus mindfully on each inhalation and exhalation, noticing your belly rise and fall with each breath. Mindful breathing exercises can help center you and calm your nervous system down.

7. Take care of yourself. You know what you need better than anyone. Taking care of yourself might mean staying active and setting time aside for exercise – whether that is a long distance run or a stroll through your neighborhood. Or maybe you need a night in, wrapped in a blanket watching your favorite holiday movie. Self-care might mean surrounding yourself with your closest friends or family, or it might look like taking some time to be alone and read a good book. Ask yourself what you need and listen to your body’s response.

8. Seek support when you need it. If you are feeling overwhelmed and everything is just too much, know that you don’t need to handle it alone. If you have too much to do, consider asking your loved ones to help you tackle a few things. If you’re feeling lonely or down, reach out to a trusted loved one to talk. If you feel you might benefit from some professional support, therapy is a good place to come work things through with an empathic, non-judgmental counselor. Talking with someone who knows how to listen and who can provide you with some coping tools can be incredibly healing.

If you or a loved one might be interested in mindfulness, acceptance and commitment therapy (ACT) or cognitive behavioral therapy (CBT) for stress, anxiety, depression, trauma, grief, weight, eating, body image, substance use, or challenges related to relationships, work, or other life transitions, Dr. Shoshana Shea can help. If you would like more information or if you are interested in setting up an appointment, please contact her at 619-269-2377 or shoshanashea@gmail.com.

References:

Neff, K. (2016). Tips for practice. Self-compassion. Retrieved from http://self-compassion.org/tips-for-practice/