Telehealth vs. In Person Therapy: Which is Better?

You may be familiar with the image of counseling taking place in a psychologist’s office, client and therapist sitting opposite each other, or perhaps the client lying down on a couch. While this model is well known, our current-day communication technology makes it possible to access psychological services in the comfort of your own space.

Therapy has changed over the years, as has the consumer. As more information about psychological health has become readily available, those seeking treatment have become savvy customers. You value your time, money and energy and want gold-standard care. In therapy, this translates to more people looking for skills-based treatment delivered efficiently. Replacing the tradition of a therapist asking you to lie on a sofa and talk about your childhood, are therapists who view themselves as expert consultants, able to teach you the techniques and strategies needed to get what you want out of life. Therapy has become solution-focused and results-oriented, making video sessions an ideal platform for counseling.

In today’s busy world, many people find it difficult to schedule an hour plus commute to their therapist’s office on a weekly basis. Others do not want to sit in traffic, add another appointment to their day, or may want to see a specialist who is not located in their neighborhood. Telehealth provides a convenient solution.

Telehealth can provide greater ease and flexibility, and research shows it can be just as effective as traditional therapy. So which option should you choose?

How is Telehealth different from In-Person therapy?

In-person therapy means face-to-face in the same room or office with your therapist. The therapist provides the office space for your therapy session. Telehealth services are provided remotely, meaning that you and your therapist could be miles apart. Your sessions are assisted with HIPAA-secure technology, such as phone, video conferencing, email, online chat platforms, and even texts. In this model, you are responsible for making sure your space is private and confidential, and you feel comfortable enough to speak freely and be able to benefit from the session in the environment you have created.

Telehealth offers the advantage of making therapy services accessible to anyone, anywhere. This makes it easier to access the treatment you need. If the distance to travel to a therapist or the desire to see a specialist who is not in your area has held you back from therapy before, Telehealth might be a viable option to explore. If you want clear, directed, results-oriented therapy this can be easily delivered over Telehealth and help you reach your treatment goals quickly and effectively.

Teletherapy session, Telemedicine therapy, telehealth appointement

Who can benefit from Telehealth?

Anyone who is looking for results-focused treatment, in which the therapist serves as a teacher to help you gain the skills, techniques, and confidence to apply new strategies to your life and see the changes you want, can be a good match for Telehealth. In short, treatments focusing on helping you build skills to effect change are easily delivered via Teletherapy. Treatments such as Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) can help you with anxiety, depression, emotion dysregulation and interpersonal problems in an online format.

Clients who succeed with Teletherapy have the ability to provide a private, confidential space that allows them the focus needed to gain the benefits from their online sessions. Practical considerations such as having a strong internet connection, making sure your space is soundproofed enough so that you can express yourself freely, and having pen and paper handy, will ensure you get the most from your Telehealth treatment. With an online session, you do not have to lug your notebooks, writing materials, etc., to your therapy appointments. Everything you need is already at your fingertips.

Telehealth also allows you the luxury of sitting in your space, taking notes, and thinking or processing after the session has ended. Many people who have experienced face-to-face counseling know how abrupt it can feel to end a session after exploring vulnerable topics and then head out into the busy world again. With Telehealth, you have the opportunity to slowly absorb what you have learned, perhaps make a plan for optimizing your week ahead, and at your pace, slowly transition back into the outside environment.

Telehealth can also help people utilize counseling when they otherwise could not access services. This is especially true for people that live in rural areas or overseas, where they may not be able to find a therapist in their area with the expertise they need. People who have limited mobility due to health problems, age, or chronic illness can also find Telehealth helpful. Busy professionals and parents who may not have access to childcare can find Teletherapy an ideal choice. The goal is to access help with more convenience.

Does Telehealth really work?

When Telehealth was very new, there was some initial concern that it might not work as well as traditional therapy. However, research has found that remote therapy can be just as helpful as in-person treatment, with equivalent patient satisfaction scores. The benefits of convenience and accessibility make Telehealth the ideal solution in our increasingly busy and technology-driven world.

To find out if Teletherapy could be the right fit for you, speak with a therapist who specializes in Telehealth services and start shifting from surviving to thriving today!


How To Prevent Seasonal Depression This Winter

seasonal depression, seasonal affective disorder, SAD

 

Many people find it hard to get going on a gloomy day. The covers feel extra cozy and that cup of hot coffee or tea, extra warm and inviting. The urge to stay in your pajamas and curl up indoors beckons you.

You may notice the weather can influence your mood. You might feel more tired or even down and blue. It might be hard to motivate yourself to get much done. Feeling subdued is nothing to concern yourself with if it happens for a day or two. Relax and put your feet up (as much as your schedule allows) and give yourself permission to chill out and indulge. The key is to soak up the laziness and enjoy, without shirking your responsibilities or feeling pulled farther and farther into hibernation.

This may be easier said than done. For some, seasonal depression is an experience that lasts all winter long.

What is Seasonal Depression?

Seasonal Depression is sometimes called “the winter blues” and psychologists give it the more formal title of Seasonal Affective Disorder (SAD). It is a set of depressive symptoms that occur with a seasonal pattern, typically emerging in the Fall, when the weather gets colder, and remitting in the Spring, with the more frequent sunshine. Occasionally, people experience the opposite, with symptoms during Spring and Summer.

Typical symptoms include having low energy, feeling tired, sad and sluggish, losing interest in activities, difficulty concentrating, and sleep/appetite changes. Additionally, with seasonal depression, you may experience irritability, agitation, anxiety, hypersensitivity, and conflict in getting along with others. Frequently, symptoms start out mild and can become more severe.

What causes Seasonal Depression?

A major cause of seasonally-based depression is biology. Your biological clock (or circadian rhythm) may be partly to blame.  Changing patterns of sunlight and less daylight affect your biological clock. Reduced sunlight can also cause decreases in serotonin, a neurotransmitter (chemical in the brain) which affects and regulates mood. Finally, the body’s balance of melatonin may be disrupted, which also affects mood and sleep.

Another cause of seasonal depression is vulnerability factors. In Dialectical Behavior Therapy (DBT), vulnerability factors are described as circumstances that make you more vulnerable to experiencing intense, unpleasant emotions. These factors may include environmental stress, a diet that isn’t supporting your needs, sleep irregularities (lack of or too much sleep), lack of exercise (or too much or the wrong kind for you), and physical illness. During Winter, as the weather and winter colds and flu make you feel tired, worn down, and depressed, you may become even more vulnerable, less equipped to handle stressors and feel greater amounts of unpleasant emotions more frequently.  When vulnerability factors are high, intense emotions can follow, making you even more vulnerable.

How to prevent Seasonal Depression?

A gold-standard and evidence-based treatment (research shows it works) for any cause of depression is called Behavioral Activation. In short, this means that as soon as you suspect depression may be on its way (or has arrived), you make a plan to get active. In DBT, this is called Opposite Action.

Specifically, identify all of the depressive behaviors you might want to engage in (e.g., call in sick to work, stay in all weekend without socializing, watch more television). Then, identify their opposites (e.g., show up early to work, make plans ahead of time with friends and keep them, have your shoes and jacket by the door ready to go for a walk after work). Next, get busy doing the opposite behaviors that you feel like doing when you are depressed.

The key is to be clear and specific about what Opposite Action you are going to take (make plans with Joe to see a movie on Sunday afternoon, not vaguely: make plans this weekend), and then throw yourself in all-the-way. Don’t expect it to be easy. Combating depression is exactly that, combat. And, do not be discouraged. It is a battle you can win with persistence and encouragement.

When engaging in Opposite Action, do not suppress how you are feeling or your desire to stay home and put your head under the covers. Instead, allow yourself to feel how you feel AND, at the same time, throw yourself all-the-way into the Opposite Action you have identified and let the skill do the work. (Do not wait until you feel like doing Opposite Action. That day may never come, and it allows Depression to take even more of a hold.) Then, do it again and again until you have gone through your list of Opposite Action tasks and Depression has been sent on his not-so-merry way. If you find it hard to get started, pick one very small step you can take, and take it! Last (and definitely not least), remember to reinforce yourself for taking each step. Reinforcement is a powerful change agent. The more you use it immediately after engaging in desired behaviors, the easier those behaviors will become.

Another way to prevent seasonal depression is by managing your vulnerability factors. Identify what is making you more vulnerable to intense, unpleasant emotions. Although this step may seem obvious, we often do not realize the number of stressors present until we say it out loud to someone else or give it some intentional thought. Once you’ve identified your vulnerability factors (e.g., not sleeping well, feeling under the weather, nutrition has been off the past week), you can brainstorm some ways to attend to them and give yourself really good cold-weather care. For example, if you know that you need extra sleep during the winter and without it, you become quite irritable, see if you can brainstorm some ways to get even just a little bit more sleep each night. Your body and emotions will thank you.

Other treatments for seasonally-based depression address the physical causes. To help combat decreases in natural light, you might use Light Therapy. This works with specially designed light therapy boxes, and research shows it can help. Some people also elect to try vitamins and supplements (in consultation with their health provider) as an alternative to psychotropic medications, such as anti-depressants.

If you have noticed that your mood shifts as the season changes, you may find it helpful to seek out therapeutic support in learning to manage it. Therapists can teach you how to send depression into remission, and then prevent or drastically reduce the likelihood of a relapse. Dialectical Behavior Therapy (DBT) is one helpful approach. DBT offers techniques to help you identify your unique vulnerability factors, engage in self-care to reduce and manage them, and notice earlier when they may be affecting you so that you can take steps to mitigate depression. If you think DBT may help you, contact a qualified therapist and start shifting from surviving to thriving today!

 


Where Does Anxiety Come From?

We’ve all experienced stress, worry, and anxiety from time to time. For some of us, or at certain times in life, it occurs frequently and can feel overwhelming. At its worst, anxiousness can even impair daily functioning. A lot of factors work together to cause the experience that we call anxiety. Let’s take a look at some specific ways that it develops:

From Chronic Stress Conditions 

Most of us equate stress with anxiousness, and oftentimes, these two do go together. However, when we talk about anxiety as opposed to a passing stressor (a stressful life event that comes and goes rather quickly), there is a lot more to it than just feeling stressed. Some people grow up or live in incredibly stressful environments (e.g., low-income households, experiences of neglect and abuse), and these long-term stressful conditions can make people more vulnerable to anxiety, and in some cases, weaken their ability to handle stress. If your system is already taxed by dealing with chronic, daily stress, your ability to manage more stressors thrown your way will very likely be compromised. A buildup of chronic stressful situations that do not go away quickly can lead to an experience of anxiety.

From Reinforcement

Have you ever heard someone say, “You don’t need to worry,” and you want to answer with, “I do need to worry!”? When we are experiencing anxiety, we often believe it’s helpful, because it gets reinforced. When we feel anxious about something and spend time ruminating and worrying, often everything turns out just fine. We can then believe that anxiety helped achieve the desired outcome. There is an old quote by an unknown author that goes, “Worrying works! 90% of the things I worry about never happen.” We continue to feel anxious and sometimes become almost fearful that if we are not anxious, things will not work out. Most of the time, this isn’t even a process we choose. The cycle gets reinforced, and the brain keeps it going without our intent. Reinforcement is brain food; when a behavior is reinforced, it is likely to occur again.

 

Anxiety, anxious, anxiousness, worry

 

From Avoidance

One function of anxiety is that it helps us to avoid other issues. This can be the most puzzling reason for anxiety. Most of us hate the experience of anxiety, and at first glance, it does not make sense that we would use anxiety to avoid anything. Rather, we want to avoid anxiety! Think of it like this: Anxiety gives our mind something to chew on. We may not like it, and it may not feel pleasant, but it occupies us, nonetheless.

Anxiety tells us that something is wrong and we need to fixate on it, wring our hands, figure it out, look up facts, check out others’ opinions, etc., and it keeps us very busy. Sometimes it keeps us so busy that we can’t focus on much else. If we are having an uncomfortable emotional experience or find ourselves in a painful situation that cannot be solved (e.g. a job we cannot quit, the death of a loved one), sometimes we are so overwhelmed that anxiety jumps in to try to give relief. We may prefer (on some level) the experience of spending our time figuring out an unfixable problem than sitting with the feeling of grief or helplessness.

 From Other Emotions

Another function of anxiety is its ability to hide other, more difficult emotions, because it is a secondary emotion. Anxiousness (or any secondary emotion) happens when the primary emotion is not sufficiently experienced and processed. In other words, your anxiety serves as an avoidance (see above for more explanation on this). When we experience it, we don’t feel the underlying emotion. Our way out of anxiety is to feel this primary emotion. When we resolve a primary emotion, the secondary emotion regulates.

 From Itself

One of the most unpleasant aspects of anxiousness is that once we are aware of it, we can start to feel anxious about our anxiousness. The more we work to avoid it, ignore it, fight it, or self-criticize it, the more space it takes up in our mind. We end up feeling anxious about having anxiety and sometimes anxious about the rare times we do not feel anxiety. We may also experience additional concern about others noticing or criticizing our anxiousness.

If you struggle with anxiety, consider seeking therapy. Therapy can help you safely address and resolve unrelenting anxiousness. A therapist who practices Dialectical Behavior Therapy (DBT) is a good choice. DBT can help you build skills to address any vulnerabilities you have, to identify and cope with primary emotions, and to make more effective choices than avoidance. They can also teach the skill of Radical Acceptance, which is learning how to accept things that cannot be changed, rather than adding to your suffering by fighting it or feeling more anxious. If you could benefit from these skills, contact a qualified therapist and start shifting from surviving to thriving today!


© 2017 Amanda Gale Bando Phd · Designed and Developed by D-Kode Technology

Dr. Amanda Gale-Bando

Dr. Amanda Gale-Bando