What I don’t “take everyone” in my practice.

Wouldn’t it make more sense, and wouldn’t you  make more money, if you chose to have a practice where your slogan was “I see everyone.”  I suppose I used to think that was true until I tried something different.  One day I was workign and I recieved three hphone calls from poetential clients, all wanting to come and see me because of anxiety and panic issues.  I booked the client, scheduled the appointment, and then started preparing.
I knew the basic model to use when working with anxiety and panic disorder but I still didn’t feel completely confident in my work.  As my clientel was starting to change, I knew if their expectations were high, then mine had to be higher.  I started doing some research, A LOT of research. I found an author by the name of Dr. David Burns, MD.  Unknowingly, this man changed my practice.
I quickly became fascinated with this area of specialization.  I reall all his books, read lots of others’ books, spoke with some local physicians, conducted surveys, and before I  knew it I was calling this my specialty.  I changed my marketing approach, changed the structure of my sessions and my clients were seeing results.  Quickly.
Results is one of the reasons that I enjoy working in this area.  If treated correctly and with thought and care, a client can see tremendous results, sometimes immediately!  Of course the prognosis depends on many things but my own practice completely changed the way I look at anxiety.  As someone who has once suffered from panic attacks, I know how scarey they can be.  I also know the common thoughts we have about anxiety.  Most of us automatically think of life-long suffering.  What is now so liberating to me, and my clients, is to know that it does not have to be a life-long roller coaster that you can never get off of (thanks to one brave client for that analogy.)  Although the roller coaster can provide us with some security, it also negatively impacts our lives.  When you’re ready to get off the ride, you just raise the bar and step right out.
If you are suffering from anxiety and need some guidance, contact me for resources.  If you are a clinician and want to specialize your practice, I can help you with that too.

Pre-Requisites for Counselors; Lawyer & CPA

Did you know that when you decided to become a counselor, you also decided to become a lawyer, a cpa, an analyst, a consultant, a teacher, a mediator, and a banker? Guess, what? Neither did I!

Coming up in my world are two in-depth workshops on starting a private counseling practice. My colleague and I have worked diligently on developing a two-day workshop that will offer people some structure and guidance as to how to develop their vision. I’m a firm believer in knowing the ins and outs before I start teaching others how to do it. I also feel as though I am very aware of my strengths and weaknesses as it relates to my professional career. For instance, I know I am great at marketing and developing community partners. I know I’m great with numbers and understanding how to make the most money in the smartest way possible. I know that I love helping counselors identify their strengths and set them off in the direction of a niche. I also know that what I’m NOT great at, is understanding lawyer and cpa lingo!

Over the course of the past two weeks I have dove deep into their legal jargon and cpa classifications to better understand what’s it’s like to grow a business beyond a private practice. I had a hunch that somewhere in a consulting session questions would be asked and I would be clueless. Although I have no problems saying, “I don’t know the answer to that,” I’d rather have the answer for my client!

So what happens once you have an established practice but you want to change it? Improve it, merge it, partner it, re-vamp it, add colleagues, add contract workers, become something different… then what? That’s what I’ve been challenging myself to do the past two weeks and boy have I learned a lot! I also believe that once I have managed to get my head above this water, I may have just found my niche. There’s just not a lot of consultants out there that I have found who specialize in this sort of thing.

As we are all born to grow and change, our business should also have that opportunity. I plan to use this blog to answer as many questions that I run into as it relates to growing and changing your private practice! Wish me luck!

6 Year Old Vs. 56 Year Old

In my work as a therapist I see people of all ages. Recently I came across a scenario that has caused me to do a great deal of thinking. How would two people, suffering from the same issues, respond to the same treatment if one was six years old and the other was fifty-six?

For a couple months now I have been seeing a six year old suffering from anxiety and sadness. Another person, who is fifty-six has been coming for the exact same reasons. Each people has responded to the same treatment in totally different ways.

When I work with children so much of the success is determined by the rapport that is built in the first few sessions. Children are so eager to learn, so open minded and resilient! After building a strong and trusting relationship with this child I began to teach her mindfulness. We used feeling identification and learned the differences in our feelings and how to describe these variations. It wasn’t long before she was “naming” her feelings with words that were spot on, allowing her caregiver to better understand what she was experiencing. Shortly after gaining a better understanding of these feelings, I began teaching the child some simple cognitive behavioral strategies for reducing anxiety and sadness. We used thought stopping, thought switching, distraction techniques and re-framing. This child was able to identify negative thoughts, stop them or switch them by distracting herself and then say out loud a re-framing statement to yield more positive feelings. Now, this did take a lot of practice but it wasn’t but a couple weeks before the child’s caregiver was calling me on the weekend to express her excitement that this child was able to stop the thoughts that were causing her so much pain! In that same conversation the child told me in her own words how she is using objects around the house to distract and soothe instead of using anger and aggression to express herself. Words can’t even describe how proud I was of this child for allowing someone (me) to provide her with the influence she needed and accept it to the point to where she was able to help herself.

Just a few days after this occurred I was working with an adult who was suffering from anxiety and depression. We began to process her thoughts, feelings and behaviors and look for connections between the three. I assessed her level of emotional awareness and validated some feelings of anger, frustration, guilt, shame, etc. I then proceeded to teach her cognitive behavioral interventions (just as I had the six year old) and her response was that of confusion. She had a hard time recognizing negative thoughts and differentiating from those that cause her pain. To teach re-framing was even more difficult. When she left that day I began to think about that session and how I felt as though I had done her an injustice because of the difficulty she had with the interventions and the pure sense of confusion written all over her face.

This got me thinking about the differences in adults and children. As adults we are so set in our ways! I know that sometimes when we are suffering we want to feel better, but sometimes despite that we hang on to those negative feelings and choose not to change them. With children, our influence is so great. If a child sees that we (adults) are excited about something, they will be too. If we tell them about a strategy they can use to feel better, guess what they do? They try it! We we believe something, they believe it! When we think they can do it, they think they can do it! Even though they may not be able to communicate in the way that we can, they show their emotions through their behavior. As adults, most of our behaviors and negative habits are so ingrained into our daily routines that we become hesitant to change them! Sometimes it’s just easier for us to use this a crutch instead of being proactive and making changes.

Habits are hard to break and that’s why leveraging our influence on children is so important. If we can help to raise a child without them forming a multitude of bad habits, they will be much more likely to be free of burdens in their adult lives. I don’t know one single adult who WANTS to feel miserable but sometimes the work that it will take to change is so overwhelming. I never see children struggling with this confliction. If they want something they go after it! Today, I challenge you to be more like a child in the way that if you have a problem, change it! If it’s a big problem that is very overwhelming, set a goal to change it and take pride in making small steps in that direction. If only we were more like children in that we were open minded, easily to influence, and believed in our abilities, there is no limit for how much we could overcome.

Stressed & Depressed- Teaming Up with Doctors

When I began focusing on developing my private practice, I chose to seek out a few medical professionals to “team up” with to boost my knowledge and support my claims as using a wellness approach in my business.  While other clinicians were building relationships with schools, daycare’s, and other educational establishments, I knew that my starting force would be the medical community.  Here I am now working with some of the greatest doctors, nurse practitioners, PA’s, dentists and chiropractors in my community, and I can confidently say that they success of my clients is directly related to the interrelated care the receive between myself and my community partners!

I recently read an article titled, “Can Infection Give You the Blues?” by Erich Kasten.  This article was published in the May/June 2015 issue of Scientific American Mind.  Everything I read supported my claim to incorporating wellness into my practice which is why I wanted to share.  So many times I see clients walk through my doors complaining of adverse reactions to medication, headaches, dizziness, loss of appetite, sleep disturbance, etc.  One of the first questions I ask is “Who is your primary care physician and what other medical doctors are you working with?”  I do a pain screening, a health and wellness assessment and ask for a release of information in order to discuss concerns with their doctors.  So many times we have found the answers to problems lying in simple fixes- such as changing the time of the day the medication is taken, adding exercise to the treatment plan, or conducting blood work to rule out any infection. Without the medical professionals that I consult with day and and day out, my client’s might still be suffering. 

The author of the article stated that after working with a client for over one year treating depression, and without any significant improvement, he referred her to  a doctor for a routine checkup to rule out any underlying physical illness.  The diagnoses was chronic sinusitis and antibiotics were prescribed.  After the infection cleared, it appeared that the depression symptoms also decreased.  It has been found that inflammation in a prolonged state can cause fatigue and melancholy.  Since studies have shown that depression is the most prevalent mental illness among women, I believe it is imperative that everyone who presents with depression be referred to their primary care physican first to rule out any physical illness or infection.

How can infection and inflammation cause depression and other mental illnesses?  According to the article, numerous studies have revealed that pro inflammatory cytosines can disrupt the normal functioning of multiple neurotransmitters and dampen the production of serotonin, (happiness hormone).  As a result, even people with minor colds often lose their appetite, feel tired, seek warmth, avoid others and struggle to concentrate.  If you think about it these behaviors often look like depression to the outside world, especially if they persist. Could this mean that tooth decay, urinary tract infections and sinusitis are all examples of infections that do not always produce obvious symptoms but could perpetuate sickness for a long period of time?

Have you ever noticed that there is a direct correlation with stress and sickness.  According to Kasten, chronic stress is even more dangerous because when we are faced with some threat, the body prepares for fight or flight.  This produces the hormone cortisol which temporarily suppresses the immune system in order to guarantee that we focus all of our attention on the external danger. “If this stress endures, though, cortisol keeps the immune system offline, and we are more susceptible to illness.”

I found this article to make a great connection to how our mind, body and spirit are all interconnected and vital to our well-being.  I would also like to thank the doctors, nurse practitioners, PA’s, chiropractors, and dentists that I currently have a working relationship with for all of their expertise and care to my client’s and their patients!

Penny for Piper’s Thoughts

Hello World!  I’m Piper and I’m working towards becoming a service dog like my mom and dad, aunts and uncles!  My handler has been doing a lot of research (since I’m just 3 months old and can’t read) on why people love pets so much!  She told me a story about a man named Boris Levinson who was one of the first people to believe that humans might experience some therapeutic effects from animals.  Can you believe people laughed at that idea?  I bet they’re not laughing now!

When I get a little older and can start seeing client’s and visiting nursing homes, hospitals, and other places where people need cheering up, I will be sure to remember how much I’ll be helping others.  There’s a story about a man named Beetz who found that children who had a dog with them had the lowest levels of stress when put into a very difficult situation.  He also found that the more the children petted the dog during this stressful time, the less stressed the were as evidenced by salivary cortisol (I don’t know what that is, I’m just 3 months old, but it sounds really important).  If this is true, and it is, then imagine how much less kiddos will worry when they pet me!

My handler works with a lot of people who have Post Traumatic Stress Disorder.  One of her client’s said this about their animal, “I have PTSD.  Cats help me with my hypervigilance because they pick up on things first.  Petting them puts me at peace.”  This makes me so happy!  I can’t wait to learn more about how to be a better therapy dog!

I’d love for you to follow my blog and check back in with me as I learn and grow.  I’ll be sure to have lots of stories about my human friends as well as some canine ones too!



The Road Ahead

When I began graduate school I always knew that I wanted to own my own business.  I felt like pursing a career as a counselor could merge both my “business” side with the “helping” side and hopefully create a successful practice with an encouraging story. While the story of my life as a counselor and my business is still being written, I have never wavered in my decision to enter into this field and I am thankful for the knowledge I have gained to use in my professional life as well as with my family and friends.   When you sign up to be a counselor, its a 24/7 job (They don’t tell you that in grad school!)

This has been a tough (aka busy) week!  I have focused my new business on two things thus far; quality care to my clients, and establishing solid community partners.  I have spent countless hours in my car driving from place to place, meeting new people, establishing a specialty in my field, making connections that would help push my career to the next level.  Every now and then this catches up to me and I get a surge of new business that I can’t possibly take.  This is a great problem to have, and luckily I have a wonderful agency that I partner with to take on excess Clients.

I don’t know about you but I am a firm believer in fate, and weeks like these make be embrace it even more.  As tiring as this field can be I use “tough” weeks to reflect and validate the reason this career chose me in the first place.  When I’m feeling over whelmed or defeated I try and re-focus my attention on something positive, and that usually helps. Call it what you wish but I always try to make every effort to practice what I preach!

This week, in the midst of all the chaos, I went to my local book store and bought two magazines.  This has been the perfect kind of positive distraction for me.  Not only has it forced me to relax and breathe it has given me insight into some interesting new topics that will surely present themselves in my blog and in my practice.  I have been reading about the psychology behind pets-which is fascinating, especially since I’ve recently purchased a dog to train as a therapy animal.  I have been working to integrate wellness into my practice and have done so this week by learning about the links between depression and infection.  All the more reason to refer my client’s to see a primary care physician regularly.    Lastly, I have been enjoying some reads on kids and anxiety which I have seen so much of in the past few months.  I look forward to reviewing some of the articles with you as well as sharing some interesting facts…. Not sure how it’s related but it’s my daughter’s favorite one- A grasshopper’s blood is white!

New marketing materials have come in this week and they look great! This is a random blog but I suppose my thoughts are also random today!

Pregnant & Empowered- A Step in the Right Direction

Don’t let the “should-ers” dictate your pregnancy!  Don’t let the “must-ers” make you feel less in control! One of the million positives of being pregnant is the power you hold in your choices alone.

Speaking on a positive note, I have two children.  One is five and one is 8 months old.  With my first, I was younger, less opinionated (some people call it stubborn, I disagree) and I allowed the “shoud-ers” and “must-ers” dictate the decisions I made for myself and my baby.  So many women lack the confidence and the knowledge to make choices throughout their pregnancy that could ultimately be one of their defining moments as women and mothers. I made what I now consider as mistakes in not taking control over my pregnancy and delivery.  When it came time for baby number two I did my research and made it my ultimate goal to see my pregnancy through as a an empowered woman and mother that I was.

For the past year I have been doing extensive research on progressive parenting movements.  I have explored alternatives to the traditional approaches to parenting and shared my findings with other mothers who have been able to take control over their role as a mother. I am trilled to be able to pass along this knowledge to my client’s through Parenting Consultations so that they can feel confident about their parenting plan.

How much control do you want over your labor and delivery?  Some women do not implement their voice and allow the hospital to follow its plan.  Do you know you have choices?  Do you want the baby to have a bath right after delivery, how long do you want skin on skin contact with the baby, do you want the baby kept in the room with you the entire time, hat on or hat off, do you want your babies lab work etc to be done while she is with you…. these are just a few of the hundreds of choices that women have in their delivery process?

Do you know you have options other than a hospital?  Using a midwife is an alternative that is circling back around.  Years and years ago this was the norm and now it’s becoming more a part of the progressive parenting movement.  Midwives allow a more personalized, patient-centered process throughout the entire course of your pregnancy.  There are many myths and misconceptions about midwifery which are almost all false.  Reputable Midwife practices all have an MD on staff that is readily available should there be any complications.

Have you checked the cesarean rates and other statistics of the doctors and hospitals you are considering for delivery? You might be surprised that some hospitals and doctors average at 60% C-section rating.  I don’t know about you, but to me that’s just unacceptable!  I would advise doing your research before choosing a doctor or hospital and have a very frank conversation about your findings as well as your expectations of care for you and your baby.

Once that little bundle of joy arrives, then what!?!? How do you feel about immunizations, delayed immunizations, do you have a pediatrician chosen, are you going to breastfeed, if so, how long, are you going to use formula from the hospital, what are your expectations from when you bring the baby home, what will it’s sleeping arrangements be, what type of attachment would you ideally like to have with the baby, how are you going to utilize your supports, and are you prepared?  These are all questions that we sometimes chose to forego due to all of the other necessary things that need to be done before the baby arrives!  It’s important to spend some time planning so that you don’t feel overwhelmed at any point after the delivery.

The baby is here, and she’s getting SO big!  Have you been thinking about feeding alternatives, how about baby-led weaning as an alternative to purees and baby food, at what age will you introduce solid foods, will you skip purees all together, will you feed cereal or not, do you know that research behind giving babies cereal, and how can you incorporate baby meal time into your lifestyle?

You certainly have a bond with your little one by now, but how do you communicate?  Do you plan to anticipate your baby’s every coo, have you considered baby sign language, will signing delay speech, have you read the research backing up this theory, how much time will this take for babies to learn and implement, can my other children participate?  Baby signing is another component of progressive parenting that babies are fully capable of!  I have seen babies communicating over 30 words through sign by 7 months old!

Are you feeling overwhelmed?  If so, that’s totally normal. There are so many things to consider when becoming a parent that it can easily become overwheling.  My goal as a counselor and parenting consultant is to offer others the knowledge to feel empowered in their role as a mother.  Everyone could benefit from a parenting consultation to discuss their options in parenting!  Consultations also make excellent gifts to mommy’s-to-be! Give them the greatest gift you can give-knowledge. Contact us if you would like more information!

Never a dull moment…

We are all inspired by something…. Sometimes it stems from our senses; what we see, what we smell, the sounds off in the distance, and sometimes it comes from the backseat of the car in early morning school traffic.

In addition to being a clinical counselor, I am also a mother of two little girls ages eight  months and five years old.  There’s just something that is special about those early morning car rides with a sassy five year old and a baby that loves to laugh at her sissy! This morning was no different, as I listened to her elaborate plan for a vacation to Disney World.  In the same conversation she was asking for a dollar to buy ice cream.  My response was that I didn’t have any money on me but that she could use the $1 she was taking into school for a fundraiser.  She matter-of-factly told me that she had made a “tommittment” to donate that dollar and that’s what she was going to do-not buy ice cream!

This statement got me thinking about all the things we as parents say that we are going to do and then for whatever reason, don’t follow through. I remember talking to friends about the things I would NEVER do as a parent and guess, what?  We all do what we say we’d never do!  Life gets hectic, we get tired, and our high standards fall right down with us.  This is a truth that I try so hard to use as a positive in my work as a counselor.  I can empathize with parents and their struggles and I enjoy working towards solving problems and challenges that people face.

I truly look forward to sharing personal parenting experiences as well as professional scenarios that we could all benefit from.  If you have a parenting question or would like more information about a particular subject please feel free to contact me and I would be happy to share!


Top 10 Strategies for Temperamental Children

We’ve all heard that term “temperamental” thrown around when discussing children.  It typically has a negative connotation and is associated with behavior problems. Temperament is actually a set of inborn traits that characterize one’s behavior and personality.  Some indicators of this would be sensory sensitivity, easily overwhelmed, rapid or intense mood swings, difficulty calming down, incredibly focused or easily distracted, difficulty with transitions or needing to know the plan for the day as soon as they wake up!

Based on my experience in clinical practice, here is a list of the top ten strategies I have found for parents encountering temperamental children.

1. Have a clear, well established behavior plan.  This is so important.  These children need to know exactly what to expect if they choose to have bad behavior. If you do not have a behavior plan I would suggest creating one or working with a professional to develop one for your family.

2. Consistency is key.  You must be consistent with this plan at ALL times.  This means no allowing the child to manipulate, debate, dispute, or negotiate.

3. Never tell the child to do something if you are not fully prepared to give them a consequence if they don’t do it.  We call this task demands.  You should always follow through with whatever it is you tell them to do.  This may sound easy but it’s actually not.  If you are not prepared to implement a consequence then I would suggest not placing the demand at all.  Think of all the times you are out in public and you ask your child to do something and end up not following through because you don’t want to make a bigger scene.  In this situation you must evaluate whether or not you even want to give the demand.

4.  Incorporate the child in the behavior planning process.  For example, in my home the child is allowed to choose her privileges for the week.  She works to earn the privileges she chooses that week and then the next week is able to choose new ones.  This keeps children feeling as though they have skin in the game and at control over their own outcomes.

5. Ignore.  Ignore.  Ignore.  This is such an important component of disciplining temperamental children. Children will go through multiple stages of behavior before the eventually hit their extinction burst (the worst behavior you’ll see before it gets better). Ignoring will need to be written into your behavior plan and used when indicated in the plan. For example, during timeout session a parent is to ignore ALL behaviors unless at child is trying to harm themselves or someone else.  At this point you would just remove them from that particular situation or environment without any engagement and follow through with the time out.

6.  Know how to do a correct timeout.  Timeout is useless an ineffective if you are doing it the wrong way!

7.Use modeling of your own behaviors in front of your children.  Let’s say anything cant set your child off.  She is trying to put on her sweater and is having a difficult time get her arms in the right way and her head through the hole.  She explodes and has a tantrum due to low frustration tolerance.  When you begin to have difficulty putting on a item of clothing, in front of your child, begin to to say something like this, “I am having a really hard time getting my sweater on.  I think I am going to breathe deeply and try to relax.  If that doesn’t work I think I’ll sit down and wait for 10 seconds.”

8.  Set a strict limit to how many times you will ask you child to do something, I say 2.  This is crucial.  Your child needs to know that if he/she does not comply and you get to the number 3, they have earned a consequence.  They must comply before you say 3 or they will be disciplined according to the behavior plan.

9. Use feeling identification regularly.  If the child is sharing a feeling or thoughts about a particular event that occurred, use reflective listening to indicate a feeling word.  For example:  Child: Today my friend hit me with a ball.  She told me she didn’t like me anymore.  Parent:  What did that make you feel like?  Child:  I don’t know.  Bad.  Parent: It sounds like that probably hurt your feelings and made you feel a little sad and confused.  You do this to make them feel heard and understood!

10. Understand your own triggers, pet peeves, and stressors.  As a parent we are not always equipment with the personality to best deal with our children.  Being mindful and self-aware of our own struggles will allow up to implement a behavior plan with these in mind.

Angry Teen??? NO WAY!

Sometimes I think the terms anger and teen should be synonymous!  As parents we sometimes see our teen as argumentative, moody, defiant, manipulative, just to name a few.  It’s virtually pointless anymore to try and imagine the connection to what we were doing, thinking, and feeling when we were teens and what teens experience now because so much has changed.  What IS relevant to teens in this day in age compared to what was relevant 10-15 years ago bears minimal resemblance.  Sometimes I look at my five year old and shutter to think of what I will be facing in a few short years!

Most of my teen clients come to me at the request of their parents because “something is just going on with them” their parents will say. Many try and read between the lines and figure out the mystery but often times I am used as the detective in this situation!  Ever too quickly I generally discover an underlying theme of the teen’s low mood, anger outburst, social isolation, sexual identity questions, and we can work towards alleviating some of the negative feelings associated.  One common thread to all of these teen issues is Anger!

Whether anger is stemming from built up resentment towards a friend or family member, a relationship gone bad, pressures in the home, academic success, worry about the future, or a troubled past, anger will always be present and will manifest itself in some form or fashion.  I always like to start out my sessions gathering information and collecting data that I can use to show intensity and frequency of the anger the client is experiencing. Once I am able to grasp their anger then I put together a plan of action to tackle it with the client’s involvement, of course.

Upside & Downside of anger- upside, it is usually just a symptom which can easily be treated with interventions and cognitive behavioral approaches.  Downside, since it is just a symptom, there will likely be a more hearty underlying issue that is causing the anger to present itself.  Getting to the root of this issue and addressing it is a much more difficult task!

So, if you have an “angry teen” and you find yourself asking the questions “what have I done wrong, what can I do better, is it too late to change this, this is so unlike them, what can it be….” what should you do???  First and foremost decide upon a way to communicate to your teen that you care and when and if they are ready to talk to you, they can. Discuss the natural supports in their lives reminding them of who they can turn to when they need help, and always, if their behavior escalates or you are fearful that it will escalate, ask for help from a professional!