On Thursday and Friday of this week, April 29 and 30, I will be attending the Iowa Mental Health Counselors Assocation (IMHCA) 2010 Annual Conference in Des Moines, Iowa. The theme this year is "Enhancing Effectiveness for Counseling Excellence" and the keynote speaker is Dr. Robert Wubbolding, Professor Emeritus of Xavier University and Director of the Center for Reality Therapy. There are also some excellent breakout sessions scheduled, including "Broken Bonds and Broken Hearts: Understanding Attachment Issues in Traumatized Children and Adolescents" (Dee A. Paddock, LMHC, NCC) and "Healthy Adolescent Development: Helping Families Work Through Difficult Teenage Issues" (Kristen DeMoss-Schloemer, MA, LMHC, NCC).
I look forward to sharing in my blog next week everything I learn, as well as sharing more about my role as Co-Editor of the IMHCA quarterly newsletter. Have a great week!
Monday, April 26, 2010
Monday, April 12, 2010
Book Review II: Marriage
This is another installation of my books reviews, and this week I want to focus on marriages. Today, while picking through my bookshelf, I rediscoverd "Fall in Love, Stay in Love" by Willard F. Harley, Jr., and was reminded was a great book it is. I like Harley's books because they can be used by anyone at any stage of marriage. I think this book is most effective when a couple wants to strengthen and grow their relationship. This book is not for the couple who has already reached the contemptuous/disrespectful stage of their marriage. Both "Fall in Love, Stay in Love, "and his earlier book, "Love Busters" contain helpful self-evaluations in the appendices, designed to give each partner insight into themselves and each other.
Here is a little more about some of my favorite marriage resources:
Chapman, Gary (2004). The Five Love Languages: How to Express Heartfelt Commitment to Your Mate. Chicago: Northfield Publishing
The Five Love Languages is a book for couples, or individuals who are married, who want to keep love alive in their marriages, and/or have a desire to love their spouse better. Chapman teaches five ways to show a spouse they are loved – or five love languages – including words of affirmation, quality time, receiving gifts, acts of service, and physical touch. Chapman maintains that if we express love to our spouse, but it is not expressed in the spouse’s love language, then love is not being received and the spouse’s love tank runs low. At the end of the book are two assessments: a profile for husbands, and a profile for wives. By completing the appropriate assessment, each spouse can learn his or her love language.
Hendrix, Harville (1988). Getting the Love You Want. New York: Henry Holt and Company
I mentioned this book last week under the category of communication. The premise of Getting the Love You Want is that marriage is often viewed as disposable. If it’s not working for us, we get rid of it and try out a new relationship. Hendrix maintains that with some work, all marriages can experience a loving, supporting, and revitalized partnership.
Hendrix proposes that our choice of mates is based on a number of variables, some of which include our childhood wounds; unmet childhood needs; our concepts of romantic love; the social exchange theory, and choosing someone we perceive to be our equal; and the persona theory, or the idea that who we are with can increase our self-esteem. Hendrix also focuses extensively on the concept of the “imago,” which he defines as a composite picture of the people who influenced you most strongly at an early age. All of these variables combined together comprise what Hendrix calls “the unconscious marriage.” According to Hendrix, it is by operating out of the unconscious mind that marriages end up in trouble.
Weiner-Davis, Michele (1992). Divorce Busting. New York: Simon & Schuster
This book is written for the client as well as the counselor, and relies heavily on the Solution-Focused Brief Therapy approach. Divorce Busting presents a very pro-active approach to working on a marriage, even if only one of the partners participates. I see the book as broken into three general sections: general SFBT concepts; questions to ask clients; and SFBT techniques. This is a great book to use if your spouse does not want to go to counseling, and you feel like you are the only one who wants to work on your marriage. I use Weiner-Davis' concepts regularly in both couples counseling, and individual counseling.
Other favorites include:
Here is a little more about some of my favorite marriage resources:
Chapman, Gary (2004). The Five Love Languages: How to Express Heartfelt Commitment to Your Mate. Chicago: Northfield Publishing
The Five Love Languages is a book for couples, or individuals who are married, who want to keep love alive in their marriages, and/or have a desire to love their spouse better. Chapman teaches five ways to show a spouse they are loved – or five love languages – including words of affirmation, quality time, receiving gifts, acts of service, and physical touch. Chapman maintains that if we express love to our spouse, but it is not expressed in the spouse’s love language, then love is not being received and the spouse’s love tank runs low. At the end of the book are two assessments: a profile for husbands, and a profile for wives. By completing the appropriate assessment, each spouse can learn his or her love language.
Hendrix, Harville (1988). Getting the Love You Want. New York: Henry Holt and Company
I mentioned this book last week under the category of communication. The premise of Getting the Love You Want is that marriage is often viewed as disposable. If it’s not working for us, we get rid of it and try out a new relationship. Hendrix maintains that with some work, all marriages can experience a loving, supporting, and revitalized partnership.
Hendrix proposes that our choice of mates is based on a number of variables, some of which include our childhood wounds; unmet childhood needs; our concepts of romantic love; the social exchange theory, and choosing someone we perceive to be our equal; and the persona theory, or the idea that who we are with can increase our self-esteem. Hendrix also focuses extensively on the concept of the “imago,” which he defines as a composite picture of the people who influenced you most strongly at an early age. All of these variables combined together comprise what Hendrix calls “the unconscious marriage.” According to Hendrix, it is by operating out of the unconscious mind that marriages end up in trouble.
Weiner-Davis, Michele (1992). Divorce Busting. New York: Simon & Schuster
This book is written for the client as well as the counselor, and relies heavily on the Solution-Focused Brief Therapy approach. Divorce Busting presents a very pro-active approach to working on a marriage, even if only one of the partners participates. I see the book as broken into three general sections: general SFBT concepts; questions to ask clients; and SFBT techniques. This is a great book to use if your spouse does not want to go to counseling, and you feel like you are the only one who wants to work on your marriage. I use Weiner-Davis' concepts regularly in both couples counseling, and individual counseling.
Other favorites include:
Wednesday, April 7, 2010
The Art of Communication
Communication is so important. It can make or break any relationship - husband/wife, parent/child, friends, coworker/boss. So often, when two or more are gathered in my counseling office, communication is pointed to by the clients as an issue or problem that needs to be addressed.
There are three key elements to effective communication that I share with all my clients, and I want to share them with you now. They are listening; validation; and empathy.
Listening: Listening is not easy. True, active listening requires putting aside your own agenda, including your response, and attending to the person who is talking, or "sending" a message. True listening is not about the listener - it's all about the "sender." This means that as a good listener, you cannot interject or respond to the "sender" until they are all done talking. One way to show the "sender" that you are really listening is to repeat back to them the gist of what they were saying, after they are all done talking. If you receive positive feedback to your summarization, like "Yes, exactly," then you have been attending to this person, and they have truly been heard.
Validation: Validation is given after the "sender" has finished saying their piece. Validation indicates that the listener understands the logic of the "senders" message. Validation is not the same as agreeing with someone, but validation recognizes that this is truth for the "sender." As the listener, you do not have to agree with the "sender," but it is essential that the listener see the logic or truth of the "sender's" experience. The phrase "That makes sense..." is one way to communicate your validation and to tell the "sender" that they aren't crazy.
Empathy: Empathy is a way for you, the listener, to connect with the "sender" on an emotional level. Empathy is also given after the "sender" has finished talking. An example of joining someone in empathy would be to start a sentence with, "I can imagine you might be feeling..." or "I can see that you are feeling..." HINT: Feelings are best stated using one word, such as mad, sad, happy. If you use more than one word, you are probably expressing a thought, not a feeling.
Three simple points - not so easy to implement. Good communication takes practice. Don't get discouraged too quickly. Learning a new skill always takes time. But remember, we all have the potential to be effective, caring communicators.
There are three key elements to effective communication that I share with all my clients, and I want to share them with you now. They are listening; validation; and empathy.
Listening: Listening is not easy. True, active listening requires putting aside your own agenda, including your response, and attending to the person who is talking, or "sending" a message. True listening is not about the listener - it's all about the "sender." This means that as a good listener, you cannot interject or respond to the "sender" until they are all done talking. One way to show the "sender" that you are really listening is to repeat back to them the gist of what they were saying, after they are all done talking. If you receive positive feedback to your summarization, like "Yes, exactly," then you have been attending to this person, and they have truly been heard.
Validation: Validation is given after the "sender" has finished saying their piece. Validation indicates that the listener understands the logic of the "senders" message. Validation is not the same as agreeing with someone, but validation recognizes that this is truth for the "sender." As the listener, you do not have to agree with the "sender," but it is essential that the listener see the logic or truth of the "sender's" experience. The phrase "That makes sense..." is one way to communicate your validation and to tell the "sender" that they aren't crazy.
Empathy: Empathy is a way for you, the listener, to connect with the "sender" on an emotional level. Empathy is also given after the "sender" has finished talking. An example of joining someone in empathy would be to start a sentence with, "I can imagine you might be feeling..." or "I can see that you are feeling..." HINT: Feelings are best stated using one word, such as mad, sad, happy. If you use more than one word, you are probably expressing a thought, not a feeling.
Three simple points - not so easy to implement. Good communication takes practice. Don't get discouraged too quickly. Learning a new skill always takes time. But remember, we all have the potential to be effective, caring communicators.
Monday, March 29, 2010
Book Review 1
As I've already blogged about here on this site, I love to read and I love books. So what would be more appropriate than sharing some of my favorites and my thoughts about them? I've started today with just some of my favorites in the category of depression/anxiety/self-esteem. These books would be appropriate for the counselor, and well as a self-help book. I hope these books help you as much as they've helped me.
Depression/Anxiety/Self-Esteem
Burns, David D. (1999). The Feeling Good Handbook. New York: Plume
The Feeling Good Handbook is a companion piece to the author’s Ten-Days To Self-Esteem. This is a self-help book with the goal of helping people overcome depression, conquer anxiety, and enjoy greater intimacy in life. The first third of the book runs parallel to the self-esteem workbook, with chapters addressing and explaining symptoms of depression, anxiety, and panic; explaining how to change the way you feel; conducting mood inventories; illustrating ways to untwist distorted thinking and negative self-talk; revealing self-defeating beliefs; explaining how cognitive therapy works; and dealing with procrastination. This portion of the book can seem quite redundant to anyone participating in the self-esteem support group. However, the redundancy also serves as a good memory device for learning to concepts and skills.
The last two-thirds of the book differs from the self-esteem workbook somewhat, while incorporating much of that learning. There are chapters that address the fear of death, public speaking, interviewing, test and performance anxiety, dealing with difficult people, depression and anxiety medication, and good and bad communication, which are not addressed in the workbook. Each chapter integrates tools and techniques learned in the workbook and in the support group. However, these chapters apply the techniques to other areas of life and work not addressed in the workbook.
Burns, David D. (1993). Ten Days To Self-Esteem. New York: Quill
Ten Days to Self-Esteem is a workbook for groups developed by Dr. Burns in the Pennsylvania Medical Center in Philadelphia and used with inpatients in a psychiatric hospital. The concept is based on the cognitive approach, and links depression, anxiety, and relationship satisfaction to self-esteem and how a person feels about themselves. Originally developed as a ten-day treatment program, the workbook is now used with group over a ten-week period. The participants are asked to commit to group meetings and the homework each week. They are also required to complete three mood inventories each week, measuring progress in the areas of depression, anxiety, and relationship satisfaction. Each week focuses on a different dimension of self-esteem: procrastination, perfectionism, self-defeating beliefs, distorted thinking, and the idea that there is no such thing as self-esteem at all. The material is also centered on the idea that individuals can live successfully with depression and anxiety without the use of medication. The underlying premise of the curriculum is that you can change the way you feel by changing the way you think. This is one of my favorite resources and I use it in its entirety, as well as using individual chapters.
Hollander, Eric and Bakalar, Nicholas (2005). Coping with Social Anxiety: The Definitive Guide to Effective Treatment Options. New York: Henry Holt and Company
As I work with many clients who live with anxiety disorders, I have found Coping with Social Anxiety to be another good resource in this area of mental illness. Coping with Social Anxiety covers the familiar ground of who, what, when, where, and the why of anxiety; current resea
rch findings; treatment options; selecting the best treatment; and the link between depression and anxiety. The book spends time explaining the difference between shyness and social phobias, and includes shyness inventories, such as the Social Phobia Inventory, the Liebowitz Social Anxiety Scale, the Social Thoughts and Belief Scale, the Social Phobia and Anxiety Inventory for Children, and the Brief Social Scale.
Other good reads in this category not yet reviewed:
Depression/Anxiety/Self-Esteem
Burns, David D. (1999). The Feeling Good Handbook. New York: Plume
The Feeling Good Handbook is a companion piece to the author’s Ten-Days To Self-Esteem. This is a self-help book with the goal of helping people overcome depression, conquer anxiety, and enjoy greater intimacy in life. The first third of the book runs parallel to the self-esteem workbook, with chapters addressing and explaining symptoms of depression, anxiety, and panic; explaining how to change the way you feel; conducting mood inventories; illustrating ways to untwist distorted thinking and negative self-talk; revealing self-defeating beliefs; explaining how cognitive therapy works; and dealing with procrastination. This portion of the book can seem quite redundant to anyone participating in the self-esteem support group. However, the redundancy also serves as a good memory device for learning to concepts and skills.
The last two-thirds of the book differs from the self-esteem workbook somewhat, while incorporating much of that learning. There are chapters that address the fear of death, public speaking, interviewing, test and performance anxiety, dealing with difficult people, depression and anxiety medication, and good and bad communication, which are not addressed in the workbook. Each chapter integrates tools and techniques learned in the workbook and in the support group. However, these chapters apply the techniques to other areas of life and work not addressed in the workbook.
Burns, David D. (1993). Ten Days To Self-Esteem. New York: Quill
Ten Days to Self-Esteem is a workbook for groups developed by Dr. Burns in the Pennsylvania Medical Center in Philadelphia and used with inpatients in a psychiatric hospital. The concept is based on the cognitive approach, and links depression, anxiety, and relationship satisfaction to self-esteem and how a person feels about themselves. Originally developed as a ten-day treatment program, the workbook is now used with group over a ten-week period. The participants are asked to commit to group meetings and the homework each week. They are also required to complete three mood inventories each week, measuring progress in the areas of depression, anxiety, and relationship satisfaction. Each week focuses on a different dimension of self-esteem: procrastination, perfectionism, self-defeating beliefs, distorted thinking, and the idea that there is no such thing as self-esteem at all. The material is also centered on the idea that individuals can live successfully with depression and anxiety without the use of medication. The underlying premise of the curriculum is that you can change the way you feel by changing the way you think. This is one of my favorite resources and I use it in its entirety, as well as using individual chapters.
Hollander, Eric and Bakalar, Nicholas (2005). Coping with Social Anxiety: The Definitive Guide to Effective Treatment Options. New York: Henry Holt and Company
As I work with many clients who live with anxiety disorders, I have found Coping with Social Anxiety to be another good resource in this area of mental illness. Coping with Social Anxiety covers the familiar ground of who, what, when, where, and the why of anxiety; current resea
rch findings; treatment options; selecting the best treatment; and the link between depression and anxiety. The book spends time explaining the difference between shyness and social phobias, and includes shyness inventories, such as the Social Phobia Inventory, the Liebowitz Social Anxiety Scale, the Social Thoughts and Belief Scale, the Social Phobia and Anxiety Inventory for Children, and the Brief Social Scale.
Other good reads in this category not yet reviewed:
Monday, March 22, 2010
The ABCs of Counseling
I thought I would take this opportunity to review some basics about counseling, or therapy. I often assume (incorrectly) that because counseling has become more exceptable in recent years, that most people know what it is and how it works. So this is a refresher course for all of us today.First, a clarification of terms. A counselor is a professionally trained person who provides services for people who are in need, like a Rehabilitation Counselor, Marriage and Family Therapist, School Counselor, or Mental Health Counselor. A psychologists refers to a professional who applies knowledge about the mind and the brain to areas of human activity, including issues related to daily life - family, education, and work - and the treatment of mental health problems. A psychiatrist is a physician who specializes in treating mental disorders.
A counselor - also knows as a therapist, a Marriage & Family Therapist, or a mental health counselor - should have an Bachelor's or a Master's degree in the counseling, or a counseling related field, such as psychology. They may or may not be licensed. If they are licensed, they will often have a long list of initials after their name, like LMHC, LMFT, LISW, or LMSW. It is highly recommended to ask your counselor these questions before entering into a therapeutic relationship. It is not impolite to have this information before you get started. In fact, if your counselor does not want to give you this information, that should raise red flags.
Counseling is for anybody and everybody. Anyone can benefit from counseling if they are truly interested in change and personal growth, or if they are experiencing difficult times. The way I think about it, there are three different ways or categories in which counseling can help. The first category is severe or diagnosed mental illness, such as Bipolar Disorder, Schizophrenia, clinical depression, severe anxiety (ie. PTSD), eating disorders, substance abuse, and childhood disorders (autism, etc.). It is not uncommon for a therapist who specializes in one of this disorders to work together with a psychiatrist or physician to help manage symptoms.
A second area in which counseling can help is in maintenance and wellness. This is a category is characterized by problems such as situational depression or anxiety (ex. empty nest syndrome, post partum depression, etc.) or a life skills refresher (ex. organizational skills for an adult with ADD, cognitive exercises and coping skills for those with depression and anxiety symptoms, etc.). These may be people who at one time fit the criteria for the first category, but have learned to manage their disorder, and check in regularly to monitor and improve their situation.
Finally, there is the category that I call "normal people going through difficult times." This group can apply to most people, and characterizes most of my clientele. This category can look like grief or bereavement, divorce/separation/loss, career guidance, self esteem, anger management, stress, life transitions (ex. relocation, new job, etc.), parenting, and spiritual growth.
I am a firm believer that all people can benefit from counseling at some point in their lives. I think most of my clients would tell you, a year after counseling ended, that the best thing about the experience was having a place to vent and someone to listen to them. Other ways that counseling can help include helping to process information and make a decision; brainstorming; support and encouragement; receiving guidance from an impartial third party; and experiencing personal growth. Counselors are trained to ask appropriate questions and introduce new problem solving strategies. Counselors are also trained in communication and listening skills, so it's not just like talking to a friend or family member.
Make the most of your counseling hour by making sure your counselor is the right fit for you and your personality - interview your counselor, ask questions, and find out more about their professional background. It is always important to view counseling as a tool for change and to bring the right attitude to counseling. Even if you don’t want to be there, you are the customer, so ask yourself - how this can work for me? Be open minded about it and who knows - it might be the best experience of your life!
Thursday, March 11, 2010
Divine Questions
A couple weeks ago, one of my supervisors presented a topic for discussion: "What makes Christian counseling Christian?" Strangely (or not, if you believe, as I do, that it's a God thing) that same question was presented to me by my Bible study group just the week before. So I've been giving it some thought lately, and this is what I've come up with...
I was taught, and have come to believe, that by nature of the fact that I am a Christian, I bring God with me into the counseling setting. And if nothing else of a spiritual nature happens during that hour, it is Christian counseling. However, because I believe that God is with me everywhere I go, including the counseling office, I tend to draw Him into the experience because that is what my faith is to me - active and personal.
Many clients seek me out, not because they have an active faith, but because "Christian" counseling sounds nice and safe. For these clients who are not interested in having faith, spirituality, or Christianity integrated into the counseling session or into how they think about their life or their problems, at the very least, I pray for them. I pray for them silently during the session, and I remember them in prayer between sessions. Some clients are very clear and adamant that God not be mentioned, and that's fine. My job as a counselor is to meet the client where they are at, in a non-judgmental way.
Some clients may not have an active faith, but they have a church background or attend church reguarly. These clients are more open to my mention of prayer or the Bible as good ways of coping with life's challenges. I believe that the Holy Spirity prompts me to be more open and candid about my belief system with certain clients, and have not offended clients at the mention of church or faith. For those clients who are believers, or Christ-followers, very often we incorporate God's story and character into their story, and connect together as counselor and client on a different spiritual level.
Because of my faith in Jesus Christ, my way of thinking about people - their value, their worth, their eternal significance - is going to be different. However, regardless of where the client is in their life and in their walk, my relationship with the client is the first priority. Christian counseling does not mean that I preach at anyone. If I can't connect with the client and build trust and rapport, there is no counseling period, let alone Christian counseling.
This is how it works for me: Yesterday I happened to come across II Peter 1:5-15 while I was waiting for a client. Not just a happy accident. "So make every effort to apply the benefits of these promises to your life. Then your faith will produce a life of moral excellence. A life of moral excellence leads to knowing God better. Knowing God leads to self-control. Self-control leads to patient endurance and patient endurance leads to godliness. Godliness leads to love for other Christians, and finally you will grow to have genuine love for everyone. The more your grow like this, the more you will become productive and useful in your knowledge of our Lord Jesus Christ...I plan to keep on reminding you of these things - even though you already know them and are stainding firm in the truth..." (NLT) This passage has stuck with me as a reminder of how God and His word apply to my work, and my life. Made me sit up a little straighter - and wonder how God would be "reminding" me.
Monday, February 15, 2010
National Boost Your Self-Esteem Month
February is National Boost Your Self-Esteem Month, and in recognition of this designation, I thought I would spend a little time on self-esteem this week. Self-esteem is a topic that is close to my heart, as I have led numerous Self-Esteem Support Groups over the years. There is a wide variety of information available on this topic, some of it is very realistic and practical.Regardless of our own personal definition of self-esteem, I believe that we all arrive at our self-esteem cognitively – which means that our self-esteem is directly related to how we think about ourselves. I believe that how we think about an upsetting event effects how we feel and our mood; therefore, you feel the way you think.
Three components are closely linked to self-esteem: depression, which measures how bad you feel about yourself – it's like an emotional thermometer; anxiety, which indicates a level of fear; and relationship satisfaction, which is how satisfied you feel in your relationships. As depression and anxiety levels rise, relationship satisfaction goes down, and self-esteem dips.
There is also a strong connection between self-esteem and stress. Look at this (for more see The Stress Owner's Manual by Edmond W. Boenisch and C. Michelle Haney):
• Study after study has found that increasing someone’s self-esteem will reduce the amount of stress they experience. If your self-esteem levels start out low, however, stress will often reduce them even further.
• If my self-esteem is high, I’m less likely to just tolerate things I find stressful. Instead, chances are I’ll do something about them – either find out how to fix them or avoid them – simply because I believe I deserve better than to have to suffer them. In a very real way, higher self-esteem causes behaviors that reduce stress.
• How much stress people feel themselves experiencing is closely associated with their own sense of self-esteem. The most influential factor in determining response to stress may be your own perception of yourself.
• Research seems to indicate that because women are relational beings, when their support and social systems sprout cracks and begin to crumble, self-esteem lowers and anxieties creep in. Many stressors can trigger these situations: balancing work and family, pregnancy and postpartum issues, body image, and societal and personal attitudes toward women.
• When women are experiencing strained relationships with significant others in their lives, they can ward off anxiety and related disorders by maintaining their self esteem.
So how do I do this, you may ask? How do I maintain or increase my self-esteem? Following are a few tips that I have seen in action in the Self-Esteem Support Groups that I lead:
- Be your own best friend. Instead of tearing yourself down when you are disappointed with yourself, encourage yourself - the way you would a good friend.
- Take baby steps. Don't bite off more than you can chew, or set too large of a goal for yourself. Break each goal down into it's most basic parts, and then tackle them one by one. The sense of accomplishment is huge!
- Learn to accept yourself. This is a hard one, I know. But I believe that God's design of us is not a mistake, and that each person was designed for a purpose. By incorporating your weaknesses, as well as your strengths, into your entire self concept, you can more easily learn to accept yourself.
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