Blog

Depression Stress Trauma By Stephanie Insko, Ph. D 0 Comments

Life Phases and Their Impact on Mental Health

Think about the following folks and what they have in common. Hunter is a 27-year old college graduate who has just quit his third job and is thinking of going back to graduate school, citing unhappiness in his career so far. His friends tell him he’s just having a “quarter-life crisis.” Jennifer is a 48-year old working mother of three who recently moved her mother into her home following a dementia diagnosis. Her husband comments, “you bet she’s stressed out, she’s part of the sandwich generation, and she never gets a break.” And Nancy is a 72-year old retiree from the corporate world who, despite being financially secure, states, “I thought I’d be relieved to be out of the rat race, but instead I’m getting more and more depressed.”

In spite of being in different phases of life, each of the people above is experiencing a significant strain on their mental and emotional well-being. And for all of them, it’s actually the stage of life they’re in that’s contributing to it. In my practice, I work with adults across the lifespan. And for many, their current phase of life has a lot to do with the reason they sought therapy. As humans, we are constantly evolving into new life stages. When we were young, these changes were usually exciting and brought new experiences and long-awaited markers of independence. We can all remember the freedom we felt during those firsts: riding our bikes across the neighborhood to a friend’s house or getting the keys to mom’s car for a night out with friends. But what happens when we, like those in the examples above, find ourselves up against a new life stage that doesn’t bring what we expected?

As we struggle to adjust, we often find that we need to quickly develop new habits and routines that will help us navigate the uncharted territory. This is perhaps most common when the life phase comes on suddenly. Take our middle-aged mom, for instance. She might have known that her mother’s cognitive health was declining, but due to the busy-ness of her own life, she wasn’t aware of the urgency of her mother’s need for round-the-clock care. And as she began caring for both her children and her mother, she came to put herself last. She discovered, perhaps too late, that she couldn’t do it all without significant changes to her life. Gathering the practical support needed to care for both her mother and her children was necessary, but took a lot of time and emotional energy. And that took a toll on her well-being. Mental health concerns like anxiety and depression have a way of sneaking in when we’re most stressed and unable to maintain our previous levels of self-care.

But even when we have time to plan for the change, we might still have a hard time adapting. Think about our retiree above, for example. For years, she had anxiously awaited her chance to spend quiet mornings sipping her coffee and reading the news instead of fighting traffic on her 45-minute commute. She had looked forward to traveling for pleasure, as opposed to catching the red-eye for conferences. And she couldn’t wait to trade emails and meetings for school lunches with her grandkids and pickleball with her friends. Why, then, did she grapple with depression? Big life changes, even those that we welcome with open arms, are usually accompanied by some kind of loss. In our example, the retiree had lost the thing that had filled most of her days for the last 50 years. And yes, she hated aspects of her work, but overall, she did find it meaningful. She felt that her contributions to her workplace and, in a larger sense, to her field, had really made a difference. And working to readjust and find new things to not only occupy those 40 hours a week, but also to bring her the same kind of purpose, was difficult.

Similarly, the young college graduate in our examples above was experiencing loss. The transition to the world of work in a new city meant the loss of significant friendships in his immediate surroundings. Moreover, his new workplace was filled with folks in all stages of life, and he just didn’t feel a natural connection to the 45-year old parents or those nearing retirement. Add to that the learning curve of starting a new job and navigating a new city, and our college graduate felt lonely and inadequate as he struggled to find his place in his new world. Yet, he expected himself to adjust to this new phase of life with relative ease. After all, his story followed the natural progression of things for many college graduates. And on paper, his life was playing out as it was “supposed” to. That might have been precisely why he was caught so off-guard by his unhappiness.

I believe that we need to expand the conversation around life transitions. In addition to emphasizing all the good things they bring, we need to include the possibility that it might take time to adjust to any inherent losses. And perhaps more importantly, we need to remember to give ourselves extra grace as we work to become accustomed to all the newness. Simply remaining aware that mental health concerns such as depression or anxiety can creep in during adjustment periods works wonders. But even more importantly, we need to remain intentional around identifying and working to maintain any coping mechanisms that have worked for us in the past. Remaining connected to previous support systems is crucial. So is continued engagement in activities that bring about relaxation, joy, or fun. And sometimes we need others to make sure we’re staying on top of these things. Whether it’s asking friends and family members to reach out more regularly during the transition or seeking the support of a mental health professional, it’s helpful to have a system in place that can act as a bridge while crossing into the new phase of life.

If you’re struggling to adapt to a significant life transition and need some support along the way, the therapists at Brentwood Counseling Associates can help. Read more about each of us here to find out more, and if you’re interested in scheduling an initial session, reach out to our office manager.

Couples Therapy Therapy By Richard Gorman 0 Comments

4 Ways to Feel Better Today

When I was in my teens and twenties I loved theater. I auditioned for and acted in whatever theater productions that were available to me. (I wasn’t good–but what I lacked in skill I made up for with enthusiasm!) One of the base understandings that all actors must grasp is that you never wait for a feeling to determine your actions. If you act first, the feelings will follow. One of my teachers used to say “never feel your way into an action—act your way into a feeling.” Over time I learned that she was 100% correct. I have also learned that this is a fantastic paradigm for a first step towards feeling better in therapy: Instead of allowing our feelings to dictate our actions, there are ways we can skillfully act to help ourselves feel better. It is quite possible to act our way into feeling better.

There are 4 domains that significantly impact our quality of life. I call them the “4 Pillars of Wellbeing.” They are: “Eat, sleep, move, breathe.” This is the first thing I explore with all of my clients.

  • Eat: The food we eat and beverages we drink have a significant impact on how we feel. There is powerful reality to my mom’s old maxim: “We are what we eat.” The more we adhere to a balanced diet of whole foods–fresh fruits, vegetables, grains and lean meats–in a balanced intake throughout the day, the better we feel. Unfortunately the foods that are the cheapest and most readily available are rife with processed carbohydrates, refined sugars and caffeine. An outsized intake of these kinds of foods are akin to using muddy water to fuel a car. At some point we will feel the effects–and it does not feel good! Also, many of us are woefully underhydrated. Beginning the day with a 20 oz. glass of water (and a sprinkle of Hymalayan sea salt to help with absorption) can help counter the dehydration from a night of sleep.
  • Sleep: We are learning that sleep is the most important of the 4 pillars. Sleep expert Matthew Walker, Ph.D, has found that “the shorter your sleep, the shorter your life. The leading causes of disease and death in developed nations—diseases that are crippling health-care systems, such as heart disease, obesity, dementia, diabetes, and cancer—all have recognized causal links to a lack of sleep.” Lack of sleep also contributes to increased anxiety, depression and the inability for the nervous system to self-regulate. 7-9 hours of sleep per night is necessary for mental, emotional and physical health. One of the most important things we can do is create a “sleep routine.” With my clients I refer to this as “landing the plane.” A sleep routine begins about an hour before sleep and may include a warm bath or shower, stretching, breathwork/meditation and a relaxing activity such as reading (also, no screens, caffeine or sugar at least an hour before bedtime).
  • Move: The more we move, the better we feel. This does not mean that we have to be training for a triathlon. For example, a short walk (outside, preferably) of 30 minutes does the trick for the day. Other activities such as yoga, gardening, swimming, etc…can provide a significant boost to our mental, emotional and physical well-being.
  • Breathe: Most of us live in chronic, low-level stress response. One of the markers of stress response is clipped and shallow breathing. By simply stopping three times a day to take 10 long, deep slow breaths can help provide our bodies much needed oxygen, help us focus and help our nervous systems shift from stress to relaxation response.

I know, this feels like ALOT! The best approach to change is to make small changes that will compound over time. So: What is 1 thing in 1 domain that you can act on today? And stick with it tomorrow. And the days following?

If you would like help in not only feeling better, but also experiencing healing of your past, engaging meaningfully in the present and crafting a meaningful future, please contact me or any of our therapists at 615-377-1153.

Children Therapy By Adrienne Thompson 0 Comments

What is Play Therapy?

“Play therapy is to children what counseling is to adults. Play therapy utilizes play, children’s natural medium of expression, to help them express their feelings more easily through toys instead of words.”
(University of North Texas, Center for Play Therapy)

Play is the language of children. Just as we may sit down with one another and share our deepest worries, fears, excitements and joys, children do the same through play. It is a medium in which children can express their inner thoughts and feelings in a way that makes sense for them. Play gives their brains a method to organize confusing thoughts or experiences into something more concrete and easier to understand. And it’s not just children who benefit from play. Older teens and even adults can express and process difficult thoughts and feelings through play. In fact, current research indicates that play is a biological need for the brain which helps us make sense of the outside world. In play, either individually or with others, children can master social skills, and expand emotional tolerance and cognitive learning. Most importantly, play opens the space for vulnerability and connection, both qualities that every person needs when faced with difficulties and hardships.

Through play, the child is able to focus on their anxiety, depression, and even trauma without needing to use words. In my time working with children and teens, I have found the best moments of healing are not when words are used. Rather, it is when the person allows themselves to be open to what they are experiencing in the expression of play and art. Sometimes big thoughts and feelings are expressed through art, playing a game with the therapist, or creating a world in the sand tray. Play opens the space for connections to be made that weren’t previously there and for clients to master and understand emotions or thoughts that didn’t make sense previously.

What does Play Therapy look like?

Play in therapy takes several different forms. Sometimes the child leads the play and the therapist joins at the child’s comfort level. Other times, the therapist guides the play so the child can practice certain coping skills. Parents can even join in play therapy sessions to encourage connection to children’s processes and experiences. Play can also create opportunities for growth and learning. What might be a simple game of Uno, can easily become a lesson about turn-taking and creative problem solving. Or, a make-believe game becomes an opportunity to encourage self-esteem and emotional regulation.

How can Play Therapy be helpful?

Play Therapy can be used to treat a wide range of issues; including, anxiety, depression, trauma, ADHD, and grief. It is typically used for clients who are 5-12 years old, but research also shows play to be beneficial for teenagers and adults. Play therapy is used by a trained therapist who is knowledgeable about the use and benefits of play. If this practice seems like something you might be interested in for your family, reach out to our counseling center at Brentwood Counseling Associates to match you with the right therapist.

Resources:

Does Telling Your Kids About Santa Mean You’re Lying to Them?
Children Relationships By Adrienne Thompson 0 Comments

Does Telling Your Kids About Santa Mean You’re Lying to Them?

This time of year usually seems to spark a debate about whether or not telling children about Santa Claus means parents are lying to them. Scroll through any social media platform and one can easily find some hot debates on if it is a good or bad thing to encourage Santa. And I can see the concern with both sides. Does celebrating Santa mean I am unintentionally lying to them? Will encouraging Santa mean I will harm our relationship in the future? Will my child lose trust in me forever the day they learn the truth about Santa? Is it okay to lie at all to my kids? From a child therapist perspective, I want to add some insight into this hot topic and hopefully calm those valid concerns.

First off, you will not cause irreparable harm to your child by telling about Santa and Christmas magic. But, there are a few ways in which we can continue the magic of the Christmas season and Santa while also preserving our relationship with our kids.

Don’t Use the Whole “Naughty” or “Nice,” “Good” or “Bad”

The classic song lyric, “you better watch out, you better not cry” may be a message about Santa I would encourage parents to let go of. The reason being is that when we connect our kid’s behavior to getting presents or the fun of Christmas, it places a lot of pressure for small kids to live up to. In fact, that pressure typically tends to backfire and lead to even MORE unwanted behaviors. The “naughty or nice” message can also mean that when our kids make mistakes then there’s a possibility that it can impact their self-esteem and self-worth. We don’t want our kids to think, “when I make a mistake that means I am bad”. We especially don’t want them to connect their self-worth to times of big feelings or mistakes. Instead, we want them to know that they will always be good kids even when they make mistakes because we will accept them no matter what they do or what they feel.

Frame Santa as a Magical Being, or Make Believe.

Okay, I hear the lying point. I get that idea of finding out as an older child that your parents told you all about this person who did all these wonderful things and it turned out that person wasn’t real. However, we do not need to lie to our kids to have Santa. Instead, what I would encourage for Santa is to frame him as a magical or make-believe person who brings Christmas cheer. Talk about Santa as you would about a TV character or a superhero. Refer to him as a magical being who brings the spirit of Christmas each year. Explain that Santa represents the “spirit of Christmas” by helping, giving and being kind to others. All qualities that we want our own children to one day practice.

Read Stories About Santa Together

Let’s not forget that the origin of Santa came from stories that have been passed down for generations. Reading stories about Santa together encourages that idea of talking about Santa as a fictional character. Discuss what Santa or the other characters did in the story that encourages the Christmas spirit of giving or helping others. Reading together also encourages an opportunity to connect and spend quality time with our children, which is what they will remember the most during the holidays.

Lastly, I want to add that you should always do what feels best for your family. Whether that is skipping Santa or keeping Santa. You know your family best. Talk about Santa in a way that best incorporates your family’s culture. I encourage you to celebrate Christmas in the way that helps everyone in your family enjoy the holidays.

Resources:

What are the signs your child may need counseling?
Children Relationships Teens By Adrienne Thompson 0 Comments

5 Easy Ways to Connect to Your Child

Why is it important to connect?

With the busy schedules we face as families, it is easy to get lost in the day to day grind. Between games, dance recitals, music lessons, and never ending homework, it can be easy to forget to set aside downtime to connect with our children. Why is it so important for us to set aside time to connect with our kiddos? Because connection is at the heart of what we need as humans. We are wired to connect with those we love, to remind us of our support systems in the time of need, and to feel wanted by others. As parents, it is so important to provide this to our children. Just as we meet our child’s physical needs with food, shelter, and extracurricular activities, our children also need to have their emotional needs met.

When we feel connected, secure, and safe, our brains are better able to manage all of the input they receive throughout the day. In a connected state, we are better equipped to handle big emotions and better able to problem solve when things don’t go our way. When children feel safe, loved and secure they are able to take risks because they know that someone will be there if they need them.

Now that we talked briefly about why it is important to connect, you may be thinking, “Gosh, now I have to add another thing to my do-list?” Well, thankfully, finding ways to connect can actually be quite simple. Moments of connection don’t have to be an hour-long process, it can be just a few minutes a day. I have some suggestions below, but find what works best for your family and your schedule. You can easily adapt any of these suggestions to different times of the day, or different frequencies. I typically suggest that you try at least one of these once a week. It doesn’t have to be the same each week, and you don’t have to do all of these at once. You know your child and your family best.

Suggestions for connection:

1. Play a familiar game with your child

Yes, it’s as easy as playing a board or a card game with your child. I encourage you both to put away your phones and play your favorite game together. Whether it’s Uno, Candyland, or Go-Fish, playing a board game can encourage connection and communication between the two of you. I have found that teenagers even benefit from this approach, though they might appreciate a more challenging board or card game. Competition should be off the table with this approach. If you notice your child or teen becoming frustrated, take a break or switch to a new game. Board games are a great way to practice turn-taking, empathy and joy with each other.

2. Eat family dinner or meals together

Family meal time is a perfect way to encourage connection. There’s something natural about sitting around at the dinner table and sharing stories about one’s day over a good meal. Now, I know many of you may not be able to do this every night, and you certainly don’t have to. But try to sit down as a family at least once or twice a week. Again, turn off the TV or phones and simply sit down with one another.

3. Create a ritual on the drive to or from school

If your child is under sixteen, you are probably driving them to school or extracurricular activities which means you are probably in the car together quite often. Creating a ritual or a moment of connection can easily be adapted to your busy driving schedule. For example, on your way to school you can each name something you are excited for, something you are nervous for, and something you are hopeful for the day. One family I know listens to their favorite audio book together. Another idea is to play a familiar car game. Get creative, those long drives and waiting in the carpool lines can be an excellent time for you to connect.

4. Set aside screen-free time at least once a week

This one goes into the other suggestions, but I encourage all families to set aside 1-hour free of screen time at least once a week. This means no phones, no TV, or tablets. Encourage your child to play a game outside with you, or work on a puzzle together. Whatever it is, remove distractions from technology so that you can focus on whatever game or activity you are doing together.

5. Find a special way to connect before bedtime

Creating a ritual of connection before bedtime can not only be helpful for your relationship with each other, but also promote healthy sleep. If you have a young child, this can look like reading a bedtime story together or cuddling before bed. An older child or teen, this can be sitting down with them one-on-one and talking about their day.

Whatever method you choose, find one that works for your family. By being intentional about spending time with your child, you are giving them the signal that you are there for them and that you support them when they need you.

If you or your child are still struggling, you don’t have to navigate this alone. Reach out to us to find a therapist that best fits you and your child’s needs.

Suggested Resources:

The Power of Showing Up: How Parental Presence Shapes Who Our Kids Become and How Their Brains Get Wired By Daniel J. Siegel and Tina Payne Bryson

brentwood counseling associates blog
Relationships Therapy By Richard Gorman 0 Comments

The path to a meaningful future is through your past

“What do you think of when you consider your past?”

This question was posed to me by a therapist many years ago. I wasn’t sure how to answer the question. The simple truth is that I hadn’t considered my past much at all. So I stammered something about my past being a random collection of experiences, events and relationships. At the time I was too busy to think about my past. To make matters worse, since birth I had been immersed in a culture that was future oriented. In my culture, considering the past was understood to be a waste of time. If it did not contribute to efficiency and productivity it was considered useless.

Sound familiar?

But what I have learned since then is that I don’t have a ‘past.’

I have a story.

Fast forward a bunch of years. Now I get to pose this important question to clients.

And it is important.

Here’s why: Your past defines everything about how you interpret and filter every relationship, interaction and experience. To quote Faulkner: “The past is never dead. It’s not even past.”

Let’s face it: we all want to “feel better” in some way. But by engaging, learning, and studying our lives as a story, we can begin to do the hard and meaningful work of “getting well.”

Put another way, the first adventure on the path to a meaningful future is through your past.

Becoming an expert at your own story allows you to understand your life:

  • How you understand yourself and your place in the world?
  • How and why you interpret experiences the way you do?
  • Why do you do what you do?
  • What do you truly love and why?
  • What are the seats of your great loves and the anchors of your great fears?

So, where do we start?

First, it is helpful to understand that every story shares some common characteristics:

Chapters: Stories are usually divided into chapters or acts and scenes. First, divide your life into developmental chapters. For example, you may consider this framework:

  • Birth-8 years old
  • 8-12 years old
  • Middle and high school
  • College/emerging adulthood (18-30)
  • Early middle adulthood (30-40)
  • Middle adulthood (40-55)
  • Late middle adulthood (55-65)
  • Later adulthood (65+)

Feel free to use whatever framework makes sense to you and helps you to understand your life as a story.

Relationships: Aside from Tom Hanks hanging out with a volleyball on a deserted island, I can’t recall a single movie or story that did not revolve around relationships. Relationships are what define a story. The first step in understanding your life as a story is to trace the line of meaningful relationships beginning with your earliest caregivers and siblings. You may want to consider friends, teachers, coaches, neighbors and many others who you consider to have had a meaningful effect on your life. (Note: this can be both positive and negative). It is important to note that the earliest relationships and experiences tend to have a more significant effect

Experiences: Begin charting meaningful experiences as they come to mind. Again, these can be both positive and negative. Some experiences you may want to consider:

  • The birth or death of a family member or a friend
  • The beginning or end of a romantic relationship
  • Graduation from high school or college
  • Job changes
  • Illness or injury
  • A personal loss
  • Significant accomplishments

Plot twists: These are the events and circumstances that upend our understanding of how the world works. These are times when you experienced significant disorientation and disorder. These experiences almost always have a profound effect on our lives and often serve as initiation points for transition from one chapter of life to the next.

Meaning and themes: Look for themes that show up throughout these dynamics: Relationship patterns, fear, anxiety, hope and joy.

  • What events or relationships do you celebrate as meaningful and significant?
  • What do you look back on with regret and/or shame?
  • What are consistent patterns where fear or anxiety drove decisions?

This work is not for the faint of heart and should not be taken lightly. To venture back into experiences of hurt, betrayal and pain risks retraumatization. Therefore, you may want to consider being guided through this process with a skilled therapist. A therapist can accompany you and provide an empathic container to hold your experiences and partnership in creating new meaning. If you would like to learn more about this approach, this recent article will provide more information.

If you’re interested in learning more about how you can become an expert of your story, contact us at Brentwood Counseling Associates. You can find out more information about me here. You can call our office at 615-377-1153 or our office manager Jane Jenkins at jane@brentwoodcounseling.com.

surface relationships
Grief & Loss Relationships Trauma By Richard Gorman 0 Comments

Four things to keep in mind when supporting a friend in grief

My father lost his battle with cancer 15 years ago. He was 59. One of the most confusing dynamics of his death were the varied responses and reactions of my friends. Many responses were wonderful. But many were frustrating. Some were even hurtful.

One of the more challenging aspects of grief is how to support a friend or family member who has experienced intimate loss. The good news is that there are skills and approaches that we can learn in order to be more supportive and helpful for friends in grief. Here are a few things to keep in mind as we try to support a friend who has experienced intimate loss:

1. Be in touch with our own anxieties

One of the most important aspects of supporting a friend in grief is to be aware of the ways that their grief triggers our own fears. Many of us simply don’t know what to do with grief. Which makes sense because we live in a society that goes to great lengths to avoid and deny the reality of death. When someone close to us has experienced intimate loss it brings death really close to home: After all, if tragedy can happen to them then it can happen to us, right? This can be a terrifying revelation that upends our illusions of stability, safety, predictability and control. If we don’t get in touch with our anxieties then our attempts to support can degenerate to frantic attempts to make the bereaved feel better, fix the situation or avoid it altogether.

Following my father’s death, random encounters with friends in grocery stores would often result in them awkwardly dancing around the obvious situation–talking about weather, baseball, church–anything except my recent loss. I get it. We do this because we are afraid of “bringing it up” and “making it worse.” But grief can be isolating. Avoiding the issue reinforces the sense of isolation. The antidote is to be seen and known–to have one’s reality named and honored. When supporting friends in grief we need to be aware of and manage our fears. Realistic appraisal of our own mortality is not a fun process, but it can be very healthy and even liberating.

2. Don’t try to make them ‘feel better’

I attended a funeral several years ago. I overheard someone say “if you’re sad right now, you’re really just selfish and making this more about you– because he’s just fine right now!” This and many other damaging and misguided statements are said under the guise of helping the bereaved ‘feel better.’ Some of the more common phrases that fit this criteria are:

  • “You can always have another child,”
  • “They are in a better place now,”
  • “God must have wanted another angel”
  • “At least he died doing something he loved”

Unfortunately this list can go on and on.

These ill-advised statements are often an attempt to manage one’s own fears and discomfort (see point #1). The more helpful–and challenging–thing is to simply be present and say little. Statements like “I have no words” or “I love you and I am so so sorry” tend to be much more helpful–primarily because they are true. These statements give space for the person to feel how they are feeling and not feel blamed for ‘doing it wrong.’

3. There is no ‘getting over it’ or ‘moving on’

When a friend is in pain we naturally want to make it better. The hard truth is that we are forever changed by some of the things that happen to us. When it comes intimate loss there is no “getting over it” or getting “back to normal.”

In her book “It’s ok that you’re not ok: Meeting grief and loss in a culture that doesn’t understand,” grief expert Megan Devine writes: “If we talk about recovery from loss as a process of integration, of living alongside grief instead of overcoming it, then we can begin to talk about what might help you survive.” Eventually we can take steps forward–not in ‘moving past’ the grief, but in moving forward with the grief. The goal, ultimately, is not to ‘get back to normal’ but learning to eventually carry grief as we begin to move forward.

4. Be a “credible witness”

Grief expert, David Kessler, argues that the most important dynamic for grief to be processed well is empathic connection with another person who is willing to accompany the bereaved in their grief. Keller calls these people “credible witnesses” because they are able to be present and bear witness to the searing pain of traumatic loss without trying to fix it or “make it better.” Being with a person in pain is not easy. It forces us to confront our own fears. It is inconvenient. We may feel rejected. The truth is that nothing we do or say will make it better in the short term. A person in grief needs space to feel how they feel and to be seen and known without feeling that they are ‘doing it wrong’ or that they should feel better.

Grief is a complicated process that demands time, patience, understanding and active work for the bereaved as well as supporters. My hope is that more of us will grow in our ability to accompany friends and family through the searing pain of intimate loss. By becoming a ‘credible witness’ our friends will find a softer place to rest and be given the healing gift of empathy and presence.

Additional Resources:

There are many helpful books. Two that I recommend are:

Additionally, there are many good podcasts and Ted talks. I recommend:

  • “The messy truth about grief” – Ted Talk by Nora McInerny
  • The “Grief Out Loud” podcast by the Dougy Center for Grieving Children and Families These interviews include survivors, experts and others who have experienced grief in myriad ways.
A child sitting with his parents while a educational professional performs a psychoeducational evaluation.
Children Teens By Jackie Haslam 0 Comments

Psychoeducational Evaluations 101

Have you been told that your child could benefit from a psychoeducational evaluation? If so, you might be wondering what a psychoeducational evaluation is, why your child might need one, and what’s involved with getting one. If you’re wanting to learn more about this kind of testing, we hope you’ll find this information helpful in deciding whether it’s right for your child.

The assessment team at Brentwood Counseling Associates strives to help parents understand their child’s patterns of strengths and weaknesses, identify barriers to success, and gain an understanding of their child’s unique style of learning. We currently offer comprehensive psychoeducational evaluations and attention-deficit/hyperactivity disorder (ADHD) evaluations for children, adults, and everyone in between. Psychoeducational evaluations are useful in that they highlight a child’s intellectual abilities (including verbal comprehension, visual-spatial reasoning, fluid reasoning, working memory, and processing speed) and reveal a pattern of how they learn in their own unique ways. They also include assessment of academic achievement to assist the clinician in ruling out learning disabilities such as reading disorders and dyslexia, writing disorders and dysgraphia, and math disorders and dyscalculia. This specific type of evaluation further includes assessment of the child’s social-emotional functioning and behavior to help identify disorders such as ADHD and those related to anxiety and depression.

Perhaps the referral concern includes issues such as difficulty focusing, poor concentration, or irritability. A teacher may report to a parent that they observe their student to be anxious about their school work or that it takes them longer to complete their assignments. A parent may notice that their child struggles with friendships or that they are argumentative. The family may report to their pediatrician that their child has been more withdrawn in school and at home and that they spend more time worrying. A tutor may observe that their student struggles with retaining information and with reading comprehension. It is through careful examination of the child’s presenting symptoms, developmental history, academic performance, and data collected in an assessment (including parent and teacher rating forms and questionnaires) that our clinicians can begin to tease out concerns and make a determination about differential diagnoses (e.g., ADHD versus a learning disorder). Psychoeducational evaluations can provide answers about what specific challenges children experience and can assist clinicians in guiding academic supports such as accommodations and/or modifications if needed.

Our comprehensive psychoeducational evaluations begin with a detailed interview with the clinician in which the family can express their concerns and provide helpful information about their child’s developmental, medical, social-emotional, and academic history. This interview is followed by approximately two hours of testing during the first session and three hours of testing during the second session. During that time, the clinician works with the child to gain an understanding about the issues and to make a determination about what tests are needed. An assessment battery generally consists of individually administered, standardized measures such as an IQ test, an academic achievement test, rating scales, and a child interview. Feedback sessions occur within two to three weeks in which the parents meet with the clinician to review a detailed, comprehensive report together and discuss recommendations and potential adjunct therapy referrals. The parent is able to ask questions, and time is spent with them to make sure they understand their child’s overall pattern of strengths and weaknesses.

Contact Brentwood Counseling Associates today if you’d like to explore psychoeducational evaluation for your child.

Is Teletherapy right for you? Pros and Cons
Therapy By Tara Hammonds 0 Comments

Is Teletherapy right for you? Pros and Cons

Prior to the pandemic, teletherapy was something that was available but not being utilized to the extent it is now. The rise of COVID-19 compelled us all to explore virtual access to meet a number of our needs. Now, many more individuals have had first-hand experience of the benefits and efficacy of teletherapy. In fact, many now prefer it. Below we will explore the pros and cons of teletherapy as well as discussing what to expect in order to help you decide if it is right for you.

The Pros:

Efficacy

Does it work? A very reasonable and common question is whether or not Teletherapy video sessions are as effective as in-person therapy options. According to the American Psychological Association research on teletherapy has been ongoing since 1960. Findings show that video teletherapy is as effective as in-person sessions in treating a wide variety of psychological disorders such as Anxiety, Depression, PTSD and Adjustment Disorders to name a few. Though research is ongoing, it is safe to say that psychologists agree in teletherapy being an effective form of psychotherapy treatment.

Convenience

Who doesn’t love a convenient option? Many people struggle with finding time to schedule sessions due to busy work days or school conflicts. Teletherapy increases access to many by eliminating commute times. Many people are able to find an hour in their schedule to make time for a session while avoiding the time commitment of travel time.

Access

Limited therapy access in your area? Rural areas sometimes have limited access to therapy services and are forced to undergo long travel times to find accommodations for themselves or their children. This can interfere with work and school responsibilities making the therapy process unnecessarily stressful. Unforeseeable instances of inclement weather or minor sickness can sometimes create barriers for therapy attendance. Teletherapy can provide a solution to these issues through creating access.

Comfort

Feeling anxious about your first session? While this is completely normal, feeling anxious about your first therapy session can sometimes be enough to cause people to forgo treatment altogether. Being able to curl up on your couch, with your dog and still have a session with a professional can make the process seem less daunting for some. As long as you are able to secure a private location in your home or office for an hour you are able to have a confidential and comfortable teletherapy session.

The Cons:

Therapeutic environment

You are responsible for creating your own therapeutic environment. Sometimes people are distracted during a session by their dog barking in the background, children coming into their room to ask a question, the load of unfolded laundry in the corner, etc. It can be tempting to multitask during sessions and this can unfortunately interfere with therapeutic connection and/or progress. These distractions can usually be problem solved however, for some, this a deal breaker no longer making teletherapy the right choice.

Difficulty finding a private location

Similar to the issue described above, some feel anxious about having a private location to talk with their therapist virtually. Therapists are legally and ethically bound to comply with HIPAA privacy guidelines, which ensures they are the only party present in their location during your sessions. However, sometimes adults and teens feel as though they are unable to ensure their own private location away from listening ears.

Technology

One of the expected downfalls of internet communication is that there is always a chance of poor connection or even lost connection all together. This can definitely make it difficult to build rapport or work through therapeutic content when it occurs. Even if your telehealth therapist has a plan in place in case you do get disconnected, such as continuing over the phone or troubleshooting the issue, it can still be a frustrating barrier to treatment if it occurs consistently. Having a strong internet connection in general is a necessity to be able to participate in teletherapy services and should be considered.

May not be appropriate for all presenting issues

A very important item to note is that teletherapy is not appropriate for everyone who is seeking teletherapy services. Some psychiatric illnesses may be too severe or require more thorough monitoring making teletherapy insufficient to meet their needs. This is something that a teletherapist should be able to assess at the initial session in order to determine whether they can continue to see you based on presenting issues. At this point your teletherapist will be able to refer you to someone more appropriate to meet your needs.

What to expect in your first session?

The first step is to reach out to a therapist you’ve identified who offers teletherapy to set up an initial intake appointment.

In that first appointment your therapist will review confidentiality, potential barriers to teletherapy treatment and how to troubleshoot connection issues. The therapist will then begin getting to know you and gathering presenting issues, background information and what you may be looking for from treatment. This will ensure you and the therapist are a good fit.

Follow up appointments will be scheduled at the end of sessions and payment will most likely be collected at the end of the appointment. In some cases, a clinic manager may have already asked to place a card on file for you to aid in the convenience of payment.

If you are interested in beginning teletherapy services Brentwood Counseling Associates would love to assist you. We have a number of therapists offering both in person and teletherapy options. Whether you are seeking services for yourself or for your child it’s likely we have someone who can help. For more information or to schedule your first session please give us a call at 615-377-1153 to talk to our office manager, Jane Jenkins. Jane has been with the practice for more than 20 years and is great at helping you think through your needs and choose an appropriate therapist.

A woman standing on a dock overlooking a lake on a sunny winter day.
Anxiety Depression Grief & Loss Relationships Stress Therapy By Stephanie Insko, Ph. D 0 Comments

Maximizing Wellbeing During the 2020 Holiday Season

You might be wondering if that’s even possible. 2020 has been a challenge, to say the least. There’s no doubt that it’s left a lot of us feeling increased loneliness, isolation, worry, boredom, and frustration. Nothing about this year has felt normal, and most of us have had to make at least some adjustments.

Fortunately, it’s gone relatively well for some. But others have seen their mental health decline due to the lack of social support, fears about health and financial security, and the prolonged loss of our old way of life. And for those who’ve lost loved ones or jobs due to the pandemic, or have worked the front lines non-stop, things might be feeling particularly hopeless. Anxiety and depression are on the uptick, both for those who’ve wrestled with them previously, and for those who never have.

Under normal circumstances, the holidays can serve as a buffer against emotional struggles, offering folks the chance to spend meaningful time with family and friends and renew their hope and optimism for better things to come in the new year. But this time of the year can also be challenging for those who don’t experience joy during this season. For people who’ve suffered a significant loss, for example, or who are grappling with ongoing illness, addiction, or strained family relationships, the holidays only serve as a reminder of the things they don’t have.

Whatever the holidays mean for you under normal circumstances, you’ll likely have to adjust to a different – 2020 – version of them. If the year has already left you feeling stressed, you might be wondering how you’ll get through this season with your wellbeing intact. Here are a few ideas.

Connect with Yourself

When was the last time you checked in with yourself about how you’re doing? We’ve all been burdened with a keen awareness that things aren’t right this year, and the holidays will probably only serve to reinforce that. But how often do you examine and identify exactly what you’re feeling, and more importantly, allow yourself to express it? This kind of emotional catharsis is key to good mental health because it keeps things from building up and boiling over, or showing up in the form of depression or anxiety. It can also prevent unhealthy coping mechanisms such as addiction, which often arise through efforts to numb difficult feelings.

You might choose to deeply connect with your feelings on your own by journaling, or with a trusted friend or family member or a helping professional. Or you might find that you resonate more with an artistic form of emotional expression such as painting, singing, or dancing. However it is that you get in touch with your feelings and move them outside of yourself, try to prioritize doing it. And remember to take good care of yourself afterward. Emotional work is hard work, and you deserve to reward yourself. So make a plan to do something rejuvenating as a follow-up. This will replenish your emotional reserve, and make you more likely to engage in such emotional catharsis again.

It’s important to note that if connecting deeply with your emotions leaves you feeling in immediate crisis, please call the Tennessee Statewide Mental Health Crisis Line at 855-CRISIS-1 (855-274-7471).

Connect with Others

During this time of suggested isolation, it’s more important than ever to prioritize quality connection with others. You might not be able to physically be with family and friends this holiday season, so you’ll need to be extra intentional about making your virtual interactions meaningful. Whereas moments together in “normal” years might have been filled with small talk and shared activities where you’re not really connecting very deeply, consider packing your shorter interactions with more meaningful communication. A stronger emotional closeness such as this could go a long way in making the physical distance more tolerable.

For example, you might ask those you care about to share with you what they’ve truly been through this year; find out about their struggles and where they’ve found unexpected joy. Ask them if they consider this year to be the hardest one they’ve lived through, or if some other circumstance in their past was more challenging. Share with each other your coping mechanisms and explore what you wish you were doing a better job with.

Or tell someone who’s really important to you what you’re grateful for in your relationship with them. You might not often do this, but it can give definition to the more ambiguous good feelings you get when you’re with them. It will give them some insight into the special qualities they bring to the relationship, and help you understand the things you find essential in one. You’ll both likely learn a lot about yourselves and about your relationship, too.

With older relatives, consider finding out more about their childhood or what their lives were like when they’re the same age you are now. Or ask what their younger hopes and dreams were, or how they ended up following a particular career path or hobby. Find out if there’s anything they wish they’d known at your age or done differently. In learning so much about someone else, you might be surprised to find that you also learn something about yourself.

Cut Yourself Some Slack

Since there’s not been much normalcy this year, why expect the usual things of yourself? Especially during the holidays, it’s easy for our self-expectations to become perfectionistic in nature. Instead, strive toward making them as realistic as possible. And given that it is 2020, after all, perhaps even expect quite a bit of deviation from the norm. If old holiday traditions are scrapped, try to consider this year as an opportunity to develop new ones – and look forward to future years when you can reflect on this one and be grateful that you made it through.

Practice gratitude around the things you’re thankful are still a part of your life. Remember that this season of our lives is temporary. It’s easier to maintain flexibility when we have faith that at some point, things will return to normal. And break your forward-thinking into manageable chunks – get through one afternoon or day at a time instead of thinking in terms of weeks or months. You’ll feel much more accomplishment and much less overwhelmed.

And if you’re grieving a significant loss this season, allow yourself to feel the sadness around it. Remember to engage in plenty of replenishing self-care, and give yourself permission to do this holiday season differently than usual. Remain flexible, doing only the holiday activities you have the energy and emotional reserve for – not necessarily all the ones you’ve done in the past. And consider honoring the loss as part of your holiday tradition this year. Acknowledging it, as painful as it might feel in the moment, can be a significant part of your grieving process.

If you’ve tried everything you can think of and you’re still feeling burdened with the weight of 2020 this holiday season, don’t hesitate to reach out to someone in the helping profession. Our therapists at Brentwood Counseling Associates are currently offering both in-person and virtual counseling sessions to support you during this time. Sometimes it’s just too hard to do it all on your own, and that’s where we come in. So please reach out and let us know how we can help.

Life Phases and Their Impact on Mental Health

Think about the following folks and what they have in common. Hunter is a 27-year old college graduate who has just quit …

4 Ways to Feel Better Today

When I was in my teens and twenties I loved theater. I auditioned for and acted in whatever theater productions that were …

What is Play Therapy?

“Play therapy is to children what counseling is to adults. Play therapy utilizes play, children’s natural medium …