Better By Monday: Courage Holds the Hand of Fear

In ancient times courage was one of four primary virtues, the others being wisdom, temperance and justice. Courage was seen as the most critical as it was thought the other virtues relied on the presence of courage before they could show up. In personal transformation work, such as counseling, courage is vital to progress. It’s not something found just in a moment of high anxiety or fear but is always there, awaiting access by any of us at any time.

“To summon our courage” is a wonderful phrase that gives away its true nature. It’s not always present, with us, but can be brought forward any time or in any situation. We DO, however, need to call for it and we DO need to pay attention to its voice.

Summoning courage has many recipes. For some it springs from commitment to something that has deep meaning. It energizes them to the point of actively (and easily, for them) demonstrating to others what they care about or what gives them purpose in their life. Without a depth of meaning you can engage some actions but they are more likely rooted in compliance, not commitment. And while there are thousands of charities or political causes with reliable supporters, not all of those people have a deep connection to their own true meaning and purpose which compels them to take time off from work to march in a demonstration or show resistance.

The other important aspect of courage worth thinking about is that it’s not at all a “me against you” concept. While dramatic literature and religion can often rely on narrative devices which emphasize courageous acts and conflict (man kills bad guy, saves girl etc. etc.) the more profound and powerful kind of courage is when we confront ourselves – who we are and what we might become – and question the whys and wherefores of life.

We can then undertake the fear-laden work of questioning the makeup of our character and embedded nature. It’s only when we summon the courage to take on our own certainties, beliefs, and long-held convictions that real change and new learning and personal growth can occur. When we stop thinking of win and lose for us in relation to others and dedicate ourselves to learning about what’s within that we can truly begin to change our wellbeing, sense of safety and self-worth, and how we engage with everyone every day – all for the better. And it’s well worth it, this tough internal work, because after this courageous journey comes contentment and compassion. And, not coincidentally, these are precursors to building the capacity for genuine love for yourself and then others.

Courage is not about being devoid of fear. Rather, it’s being aware of fear and still moving forward anyway. Contrary to popular misconceptions, it’s perfectly fine to reflect on your life and even make big decisions WHEN you are afraid, just not BECAUSE you are afraid. There’s a difference. The latter is blind reaction; the other is being fully present, focused, and committed. Best news of all is we all have the capacity to activate our own courage and let it lead us through life’s challenges – inside and outside.

Dawna Daigneault

Dawna Daigneault, Ed.S., LPC.

Better By Monday is a blog about one thing you can do, over the weekend, to feel a little better by Monday.

Zest of Life, LLC. Professional Counseling.

Better By Monday: Love Like Rain

Better By MondayThe difference between rain and love, the difference which really makes a difference, is that anyone can be a provider of consistent, caring and well-portioned amounts of love to those we love. We don’t have to wait for the right conditions to make love and kindness fall from the sky. We don’t have to pay to have it piped into the lives of people we believe should have it; we can rain love whenever we choose and to whomever we want. And if, in relationship, both partners come to learn of the wonderful release that letting go of control can bring, and the overall respect for the natural human connection that can result, it may provide for many loving seasons ahead.

There is a type of rain that is best for plants and many types that are less helpful. Crops can grow with limited rain but not well. Water can be piped in to make up the difference that a lack of precipitation causes but it costs the farmer a lot more than the natural resource. The opposite of low volume rain isn’t always a better option. The over-abundance of rain, over dry soil, is problematic because it can’t be absorbed by the roots and may even wash away protective soil from the plant. Hard, heavy, and high volume rains don’t offer much benefit to plants because so much of the water becomes run-off.

Make sure you avoid a love drought but remember that love run-off happens too. People in close relationships or in families who infrequently apply a heavy measure of love may find it is more than others can handle (or return). When love is measured out in heavy portions inconsistently it doesn’t feel welcoming or safe. When left alone the relationship soil is too dry and can’t receive the water when it becomes available – it floods or runs off without benefit to the person.

The best situation is when consistent and receivable rain soaks into the roots and throughout the soil. Love works that way too. Work too hard at it, all at once, and the benefit is lost for both the giver and receiver. Love needs a generous but not overzealous application to be most effective.

Think one new thought this weekend: How am I being loving to myself and others?

Dawna Daigneault, Eds, LPC

Dawna Daigneault, Eds, LPC

Dawna Daigneault, Ed.S., LPC.

Better By Monday is a blog about one thing you can do, over the weekend, to feel a little bit better by Monday.

Zest of Life, LLC. Professional Counseling.

Better By Monday: Can a negative feeling be positive?

Better By MondayDear Pete & Kate,

Negative feelings and negative self-talk are not two of a kind. One big difference is that a negative feeling isn’t bad to have, but negative self-talk is. Negative self-talk is directed at who you are as a person. Whereas, negative feelings are a signal that something undesired is happening to you.

There are four common negative feelings that are okay to have, such as sad, mad, afraid and helpless. These feelings are good indicators of difficult life experiences which you are accurately receiving. All four common negative feelings add positive value by keeping people tuned into how the ups and downs of life roll.

There is a right time (in your life/experience) to feel all four of the basic negative feelings either one at a time, two together or all four in a sequence. Pay attention to when these four feelings show up within you.

I want you to learn how to tolerate each one of the common negative feelings. You can train yourself to handle feeling one or more of them simultaneously without being flooded.

First, name the feeling you are having. (I am sad, mad, afraid or feeling helpless)

Second, notice the flow of the feeling. Think of the flow as being in the form of a trickling stream, a swift river or a vast & rolling ocean.

Third, let your feelings flow without them over-flowing.

You can have patience with the negative feelings which stream in because they don’t take over. If the feelings are running in like a river – you may need to stop what you are doing and have a personal Time Out. Time Out for adults is much better than the kid version. If the feeling is over-flowing or like falling into an ocean and you think you can’t swim out of it alone – ask for help returning to shore. Call a friend, family member or professional as soon as you can.

All four common negative feelings can be functional and necessary for daily/weekly life. However, they all have dysfunctional possibilities such as when sad develops into depressed, mad develops into aggressive, afraid develops into anxiety and when helpless begins to feel powerless. These stronger versions of the common four can cause a constant and overwhelming flow which is hard to withstand making you feel sea sick in an emotion ocean.

Feel your feelings, let them flow, they will flow out with time and others will flow in.

Love,

Coach Mom

Dawna Daigneault

Dawna Daigneault, EdS, LPC

Dawna Daigneault, Ed.S., L.P.C.

Better By Monday is a blog about one thing you can do, try or practice over the weekend to feel a little bit better by Monday. It’s the bite-sized but professional “smart talk” that I want my kids to know because I believe it will make their lives better.

Zest of Life, LLC.

Mental Health Professional Alphabet Soup

There are so many different kinds of mental health providers available today and more are being added all the time. This results in an alphabet soup of letters behind each providers name that can seem about as decipherable as hieroglyphics to the average person. So, how does the average person decide which type of provider is right for them? This post will attempt to translate the alphabet soup of provider credentials so you can make an informed choice. Keep in mind that some of the designations, requirements and functions you read about here can vary from state to state and the contributors to this post are from the Kansas City area.

Types of Mental Health Providers

According to psychiatrist Carolina Aponte Urdaneta, MD, psychiatrists are physicians who “specialize in the diagnosis and treatment of mental disorders. In order to be able to do psychiatric residency training, one must first attain a degree of M.D or D.O. The residency is 4 years long and the experience includes comprehensive training in psychiatric diagnosis, psychopharmacology and different types of psychotherapy. Psychiatrists can therefore prescribe medications, perform psychotherapy and suggest other forms of treatment. The total amount of time required to complete the education and requirements for psychiatry is 12 years after high school.”  If you live in the Kansas City area, check out our list of local psychiatrists.

Most clinical, counseling or school psychologists have earned their doctoral degree (PsyD or PhD which will be described below) and completed a one to two year post-degree residency focusing on assessment, diagnosis, and psychotherapy. Clinical and counseling psychologists primarly provide psychotherapy, but one thing that distinguishes them from other providers is they can conduct psychological testing. Psychological testing can be useful for clarifying diagnoses and helping to generate tailored treatment recommendations. Psychologists cannot prescribe medication in most states, but with additional training they can earn this privilege in a few states. It typically takes around 10 or more years beyond high school to complete the requirements for licensure as a psychologist.

An independently practicing counselor typically has a degree that is somewhere between a masters degree and a doctoral degree as well as two years or post-graduate supervised clinical experience. According to the American Counseling Association, “Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health.” An independently practicing counselor has typically studied and trained for around 8 years beyond high school in order to become licensed.

A social worker has at least a bachelors degree, but in most states they need a masters to practice independently. They also need two years of post-degree supervised experience. According to the National Association of Social Workers, “Social workers help individuals, families, and groups restore or enhance their capacity for social functioning, and work to create societal conditions that support communities in need. Social workers help people overcome some of life’s most difficult challenges: poverty, discrimination, abuse, addiction, physical illness, divorce, loss, unemployment, educational problems, disability, and mental illness.” A social worker has typical studied and trained around 8 years beyond high school by the time they can sit for licensure.

Degrees

Most states require some sort of licensure in order for a mental health provider to practice independently, but first there are educational requirements that must be completed that lead to a variety degrees. For example, in most states you have to earn a doctoral degree such as a PhD or PsyD to apply for a license to practice psychology independently.

The following are some of the most common degrees people earn on their way to becoming a mental health provider:

BA, BS, BSW
The Bachelor of Arts, Bachelor of Science and Bachelor of Social Work degrees typically involve about four years after high school of higher education including a core curriculum of general requirements plus electives and courses related to the major. For the most part, mental health providers cannot practice independently with a bachelors degree.

MA, MS, MSW
The Master of Arts, Master of Science, Master of Social Work degrees, etc. typically involve two years of additional education beyond the bachelors degree. Independently practicing social workers and counselors typically have this as their terminal degree.  In a few states, psychologists can practice with a masters and there are still some masters level psychologists who are “grandfathered in” practicing locally.

EdS
The Education Specialist (EdS) degree is meant to provide additional training beyond the master’s level that allows students to develop their leadership skills, broaden their knowledge and skills, and prepare for professional certification. According to professional counselor Martha Childers, EdS, “Most programs require around 30 credit hours above and beyond a masters degree. The EdS is a terminal degree, but sometimes it is earned along the way to a Doctor of Education (EdD) degree.”

PsyD
The Doctor of Psychology (PsyD) degree typically involves four additional years of study beyond the bachelors degree plus a one year supervised internship. It differs from a PhD in that hands on clinical practice is emphasized over conducting original research. Although there are opportunities in many PsyD programs to conduct original research, more importance is placed on understanding, knowing how to critique, and being a good consumer of research.

PhD
The Doctor of Philosophy (PhD) degree also involves an additional four years of study beyond the bachelors degree and a one year internship. It differs from the PsyD in that the emphasis is on learning how to conduct original research. The dissertation is often the capstone of PhD programs.

MD
The Doctor of Medicine (MD) degree involves four years of medical school beyond the bachelors. After earning their MD, most physicians complete a four year residency in their area of specialty. Psychiatrists are often MDs who completed a residency focusing on psychotropic medication and the assessment, diagnosis and treatment of mental illness.

DO
The Doctor of Osteopathic Medicine (DO) also typically involves four years of medical school beyond the bachelors and a four year residency in the chosen area of specialty. They differ from an MD in that they receive additional hours studying “manipulative” or hands-on medicine and the musculoskeletal system. Some psychiatrists have a DO rather than an MD.

Licensing & Beyond

Once a potential mental health provider earns their degree, they must apply for licensure if they wish to practice independently. Licensing usually involves providing proof of education and supervised experience, examinations on knowledge of the field as well as ethics and state laws, there are fees to be paid, and sometimes there is a face to face interview. It is interesting to note that psychologists are currently required to have a one to two year residency after earning their degree in order to apply for licensing.

Psychologists and physicians typically do not have to have additional designations beyond their degree to show they are licensed, but they cannot practice independently without a license. The letters after their names just have to show the degree they earned, such as PhD or MD. Social workers and counselors typically have letters after their names that denote their licensure status, such as LPC or LCSW.

Providers can also gain certifications and earn specialty board designations that add additional letters at the ends of their names after the degree or licensure designation, such as Jane Doe, PhD, ABPP or John Smith, LCSW, RPC.

The following are some of the most common licenses and certifications mental health providers must earn in order to practice independently:

LSCSW or LCSW
According to social worker Evalyn Van Valkenburgh, LSCSW, who has held these credentials in several states, the Licensed Specialist Clinical Social Worker (LSCSW) or Licensed Clinical Social Worker (LCSW) designation and requirements vary by state. She says in Kansas where she currently works, “A LSCSW requires a minimum of a Masters degree in Social Work with 4000 post graduate hours of supervised clinical work experience and a passing score on the clinical competency test. An LSCSW is required for Social Workers to engage in the private, independent practice of psychotherapy.”

LMFT
The American Association for Marriage and Family Therapy describes Licensed Marriage and Family Therapists (LMFT) as “mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems.” They have “graduate training (a Master’s or Doctoral degree) in marriage and family therapy and at least two years of clinical experience.”

LPC, LCPC
According to the Kansas Behavioral Sciences Regulatory Board (KSBSRB), a Licensed Professional Counselor (LPC) must have earned a Masters degree in counseling which includes 60 hours, with credits distributed among the 9 core areas of professional development, and includes a supervised practicum. They must also pass a nationally standardized competency exam. In some states, the Licensed Clinical Professional Counselor (LCPC) designation requires specific coursework supporting diagnosis and assessment in their educational programs. The KSBSRB defines the Licensed Clinical Professional Counselor (LCPC) as someone who is licensed as an LPC and has 4000 hours of supervised clinical experience under an approved clinical training plan.

RPT
A Registered Play Therapist (RPT) is a licensed mental health professional who has earned a certification documenting that they have a certain level of experience providing play therapy to children, which is a type of treatment in which the therapist helps children express their feelings and resolve conflicts through play. The Association for Play Therapy grants and oversees these credentials. Providers must be licensed and have earned at least 150 hours of instruction in play therapy as well as 500 hours of play therapy specific supervised experience plus 50 hours of concurrent play therapy specific supervision. They must also maintain 18 hours of play therapy specific continuing education every three years.

ABPP
According to psychologist Emily D. Warnes, Ph.D., ABPP, “Board Certification by The American Board of Professional Psychology (ABPP), is intended to certify that an individual psychologist has completed specific educational, training and experience requirements of a particular specialty area (e.g., Clinical Psychology, Clinical Child and Adolescent Psychology, School Psychology). Certification involves an extensive examination process designed to assess the competencies required to provide the highest quality services in a given specialty area.”

Continuing Education

Most licensed mental health professionals must also complete a certain number of approved continuing education credits each year or two in order to maintain their licenses and practice independently. The number of hours required and the types of credits approved differ according to state and type of license.

For example, in Kansas, Psychologists must accumulate 50 hours of approved continuing education credits every two years, 3 of which must include professional ethics and 6 of which must be related to the diagnosis and treatment of mental disorders. Social Workers must accumulate 40 hours every two years, with the same requirements for ethics and diagnosis. Professional Counselors must accumulate 30 hours every two years, with the same requirements for ethics and diagnosis.

Tracy Ochester, PsyD is a psychologist in independent practice in Leawood, KS. She specializes in cognitive behavior therapy, mindfulness informed practices, and psychodiagnostic testing. Dr. Ochester also teaches at the university level, supervises aspiring psychologists, and provides consultation services to the community.

Finding the Mental Health Services You Need

When life concerns seem fairly typical and routine, it may not be all that difficult to find help.  If it’s just a check-up that’s required, we often go to our insurer’s provider list and pick the closest general practitioner in-network.

But, what about when your needs are unique, complicated, or confusing? What if “treatment as usual” hasn’t brought desired results? Sometimes picking the most convenient provider from the top of the insurance list doesn’t get us what we need.  When the stakes are high, it is important to get the best help available.

In the world of mental health care, finding a provider you really click with is of utmost importance.  Research has shown that your relationship with your counselor is one of the most important factors in treatment success.

It is also very important to have a provider who understands your particular concerns and has experience treating them.  Depression and anxiety are very common and most mental health practitioners get a lot of experience working with these disorders.

But some disorders are relatively rare and some concerns are highly sensitive, so it may be harder to locate a provider who has the experience and open-mindedness needed to effectively address them. In addition, some disorders have only one or two methods of treatment that have been supported by research.  In that case it may be important for you to find a provider who is experienced with that particular form of treatment.

For adults, there are empirically supported treatments for Attention Deficit Hyperactivity Disorder, Bipolar Disorder, Borderline Personality Disorder, Chronic Pain, Depression, Eating Disorders, Generalized Anxiety Disorder, Insomnia, Obsessive-Compulsive Disorder, Panic Disorder, Post-Traumatic Stress Disorder, Schizophrenia, Social Phobia, Specific Phobias, and Substance Use Disorders. For children and adolescents there are empirically supported treatments for many of the same disorders as well as Disruptive Behavior Problems like Oppositional Defiant Disorder and Conduct Disorder.

Fortunately most mental health providers now have websites where you can read about their credentials, experience, and approach.  Many of us maintain blogs where you can get to know our views and get a taste of what it might be like to work with us.  Most of us are also willing to speak with you over the phone for a few minutes to introduce ourselves and answer your preliminary questions.

You can find mental health professionals in your area through any number of online therapist locators such as those hosted by the American Psychological Association, Psychology Today, Network Therapy and Good Therapy. Lower cost and subsidized services are also available for those with financial need, so no one should feel that professional help is beyond their reach.

Tracy Ochester, PsyD is a psychologist in independent practice in Leawood, KS. She specializes in cognitive behavior therapy, mindfulness informed practices, and psychodiagnostic testing. Dr. Ochester also teaches at the university level, supervises aspiring psychologists, and provides consultation services to the community.