Counseling When Your Loved One Comes Out as LGBTQ+

How Counseling Can Help In Understanding LGBT Identity

The movement toward accepting and celebrating sexual and gender diversity has been a long, slow journey, but it has picked up speed in the past decade or two as more research and social activism has changed perceptions and beliefs about LGTBQ+ people. Punctuated by prejudicial ideas that sexually and gender-diverse people were mentally ill, morally corrupt, sinful, or a health and safety risk to the community, many dangerous and harmful beliefs were common in cultures around the world.

Counseling Portland Oregon area for those coming to terms with a loved one coming out LGBT.As a therapist, I still see some of these beliefs arise when I work with people who are coming to terms with the coming-out process of a loved one who identifies as LGTBQ+. It can be a stressful and emotional time for everyone. It is critical for the safety and well-being of all involved that loved ones be as supportive and affirming of those coming out as possible.

COMING TO TERMS WITH YOUR LOVED ONE’S IDENTITY
For many people, fear of the unknown is the biggest hurdle to overcome. If you have not socialized with sexually and gender-diverse people, or you have ingrained prejudicial beliefs as noted above, you may be confused about what an LGBTQ+ identity means. Stereotypes, inaccurate assumptions, and misinformation may increase your fear and worry.

If someone you love comes out, here are some ideas for better understanding what their identity means:

Do some research about what different terms might mean. For example, you may think you know what “gay,” “bisexual,” “transgender,” “queer,” “pansexual,” or “bigender” means, but do you understand what those terms mean to people who identify as LGBTQ+? For common terms, you can look at the Human Rights Campaign’s glossary.
Make a list of questions you want to ask your loved one to understand who they are more clearly. Before you ask these questions, consider how they may be received. Are these questions coming from a place of judgment or from a place of curiosity? Do these questions have a goal of trying to change the person’s mind? You might start with simply asking your loved one how you can support them, what they need from you, and how they want you to treat them in regards to their sexuality and gender.
Check out resources for family and friends of LGBTQ+ people that are affirming and supportive. The organization PFLAG (Parents and Friends of Lesbians and Gays) is a great option for finding resources and support from others who have LGTBQ+ loved ones.
It is important to learn and reflect about your feelings, attitudes, and ideas about gender and sexuality so you can be supportive and loving to the person coming out. Sometimes people inadvertently hurt loved ones by using inaccurate language, accepting prejudice from others or making prejudicial jokes, or suggesting their identity is sinful, disordered, or temporary.

IDENTIFYING AND QUESTIONING YOUR FEELINGS
As noted above, many people carry faulty beliefs about sexuality and gender that have been instilled through culture, media, religion, or experience. These beliefs can stir up a great number of difficult feelings when someone you love comes out. Although each of us is entitled to our emotional experience, it is important to question where these feelings come from, and to process and understand them in order to be as supportive as possible. Being supportive to loved ones throughout their coming-out process increases the likelihood they will experience better physical and mental health, as well as increased self-esteem (Travers, et al., 2012).

For some people, the feelings they experience when someone comes out to them are confusing and complicated, and it might be helpful to seek support from a therapist who is knowledgeable and affirming about sexuality and gender.

CHALLENGE MYTHS ABOUT SEXUALITY AND GENDER
Some common myths about gender and sexuality that have been challenged by an ever-growing body of research are:

Myth: Normal people are heterosexual and cisgender.

Reality: There is a large spectrum of sexual and gender identities that are healthy and normal. In fact, some research suggests many people fall on a continuum of sexual orientation (American Psychological Association, 2008).

Myth: People who are LGBTQ+ have a mental health disorder.

Reality: This myth seems to stem from the past classification of homosexuality and gender identity disorder in mental health diagnostic manuals. However, in part because of overwhelming research findings, homosexuality and gender identity disorder are no longer considered mental health disorders. The challenging mental health outcomes that can be experienced by LGBTQ+ people are connected to how they are treated by friends, family, and society, not to their identity or orientation. The more support and encouragement someone has, the less likely they will be to deal with depression, anxiety, or suicidal thoughts. One study found that the rate of suicide for transgender youth is reduced 93% when their family supports them (Travers, et al., 2012).

Myth: If my child is gay, bisexual, or transgender, it is because of something I did.

Reality: People are born with a genetic predisposition toward who they will be attracted to, and toward a personality and traits that impact who they are as people, including their sexuality and gender. Gender identity and sexuality is a multifaceted part of someone’s overall identity, and is likely impacted by biological, social, genetic, and psychological factors (American Psychological Association, 2008). Nothing you say or do as a parent will change whether your child is gay, cisgender, or transgender. What it will change is whether they feel supported and happy, how they feel about themselves, and how resilient they are to stigma.

Myth: It would be better for an LGBTQ+ person to keep their identity private; no one else needs to know.

Reality: The coming-out process is not only important for LGTBQ+ people to experience greater happiness, self-esteem, and improved mental and physical health, but to fight pervasive prejudice and stigma about sexuality and gender (Herek, 2017). For their sake, encourage openness and support your loved one to be public with their identity if and when they are ready to do so.

If you or someone you know is wanting to understand LGBT identity, or is having difficulty with a loved one coming out; contact my Portland, Oregon area office for more information.

References:

American Psychological Association. (2008). Answers to your questions: For a better understanding of sexual orientation and homosexuality. Washington, DC: Author. Retrieved from www.apa.org/topics/lgbt/orientation.pdf
Glossary of Terms. (n.d.). Human Rights Campaign. Retrieved from https://www.hrc.org/resources/glossary-of-terms
Herek, G. M. (2017, April 23). Counting hate crimes: A Brief History of the Hate Crimes Statistics Act. Retrieved from https://herek.net/blog/category/sexual-prejudice/
Travers, R., Bauer, G., Pyne, J., Bradley, K., Gale, L., & Papadimitriou, M. (2012). Impacts of strong parental support for trans youth: A report prepared for Children’s Aid Society of Toronto and Delisle Youth Services. Trans PULSE.
© Copyright 2018 GoodTherapy.org. All rights reserved. Permission to publish granted by Laura Turnbull, MC, CPsych, therapist in York, Ontario

Courtesy of Good Therapy.

Mental Health Issues Rising Among University Students

Counseling Can Help Portland State University Students

Portland state university counseling can help rising mental health issues for students.More than 75% of mental health conditions appear before age 24, according to the National Alliance on Mental Health (NAMI). For many people, symptoms first develop in college. Now, research suggests the frequency of mental health difficulties among college students is rising. According to Pennsylvania State University’s Center for Collegiate Mental Health, the number of students seeking mental health assistance increased by 50% between 2015 and 2016.

Depression and substance use issues are common among college students. Twelve percent of freshmen say they are depressed. For some students, the stress of college life—being away from home for the first time, struggling to make friends, and juggling work and school—can trigger mental health difficulties.

Students typically have access to college counseling centers. These centers can help with diagnosis and treatment, and they can offer students the coping skills they need to manage their mental health. When they leave college, many students face a post-college mental health gap. Access to affordable, quality care is limited. After college, graduates may face high co-pays or insurance restrictions on which therapists they can see.

If you or someone you love is having mental health problems at University, contact me at my Portland area office.

Courtesy of Good Therapy.

How to Create a Couples Communication Playbook Together

Learn to Communicate With Your Partner In or Out of Couples Therapy

Mindfulness is needed for communication in couples therapy When working with couples, the first thing I assess is their communication, as this is usually a defining reason why they have walked into my office. Without clear boundaries and guidelines around communication, it is virtually impossible to dig into any issue. The WAY a person says something always trumps WHAT they are saying. In other words, STYLE always trumps CONTENT. Learning to communicate—and to communicate with care—may seem like a trite concept, but it is the cornerstone of a healthy relationship.

We learn to communicate from our caregivers. Since we were each raised differently, our communication playbooks are all different, too. When two people enter into a relationship, there are usually different playbooks in action fighting to emerge as THE playbook.

If, for example, you grew up in a family that was loud and boisterous, you likely learned to do one of two things: become loud and boisterous or avoid loud and boisterous. The way you adapted to that communication style became a part of your communication playbook.

My goal is to help you and your partner come up with a common, collaborative playbook that feels good for both of you. Here are just a few suggestions and recommendations:

  1. There MUST be care in your words. This is a deal-breaker. Figuring out how to speak with care when angry, sad, shamed, or guilty requires vulnerability and accountability. It takes mindfulness and practice.
  2. Overt no-nos: yelling, name-calling, bullying, threatening, and attacking.
  3. Covert no-nos: nagging, pouting, stonewalling, lying, being a martyr, and zingers.
  4. No sarcasm. Sarcasm is a passive-aggressive (indirect) way of saying what you feel without being clear and direct. The Greek translation for the word sarcasm is “tearing of the flesh.” It is hurtful. Being funny and using sarcasm are two different things. If something is funny, you both laugh. If it is sarcastic, chances are only one of you is amused.
  5. Don’t start talking about an issue until you have “contracted” with the other person. Too many times, you may begin delving into an issue before the other person is ready, able, and available. It may be as simple as, “I would like to talk about ‘X’; are you available?” Contracting sets the tone, creates intention from both parties, and lets you know you’re both present and attentive. If, for example, you want to talk in bed at night, be certain the other person is agreeable and not falling asleep. Setting a time limit is another aspect of contracting. If it’s not a good time to talk, in addition to saying so it’s a good idea to provide some alternative time options.
  6. If a conversation gets heated, take a time-out. If you take a time-out, it is your responsibility to say when you will come back to finish the conversation. Leaving a conversation without a restart  time may be interpreted as abandonment and lack of care. If someone needs a time-out, respect it, stop the conversation, and don’t push or punish. Knowing there is a restart time may allow you to look at what has happened to get the two of you into a time-out situation. Both parties should ask, “What is my part in the dysfunction in this conversation?” and be willing to own it when you resume. It’s much easier to point a finger at the other person, but does nothing to get closer to solutions.
  7. Listen. You will know you are listening if you can tell the other person what they just said. If you are evaluating their content and waiting for your turn, you aren’t listening. Think of listening as the most caring thing you can do for your partner. Put your needs on hold. Try to gain an understanding of their perspective. Communication is not about convincing. Listening is an act of love.
  8. Remember, you are on the same team. When teammates have conflict, the energy of the conversation is much different than when adversaries go at it. Again, it goes back to care with your words. Sometimes I will ask, “Would you talk to your next-door neighbor the way you are talking to your partner right now?” This is actually a parenting tip from Foster Cline’s book Parenting with Love and Logic, but I use it frequently with couples. It’s called the “good neighbor policy” and is an effective and easy way to help reset communication during a conflict.

These are just a few suggestions for helping couples create a common communication playbook. Having rules and guidelines both partners have had a hand in shaping allows for more accountability and collaboration, which can increase satisfaction levels when working through issues.

Start your couples therapy journey by making an appointment at my Grant Park area office.

Courtesy of Good Therapy.

What Makes Therapy Good: The 4 Pillars of Counseling

How to Begin Healing in Counseling

pillars of good counseling take the past into account.What is good therapy? I recently wrote about tips for identifying the best counselor for you. I’d like to shift the focus a bit and talk about the role of relationships and what I call the four pillars of counseling: trust, respect, positive regard, and open-mindedness.

While these concepts may seem straightforward, fostering them within a healing therapeutic relationship can be challenging depending on the quality of previous relationships you’ve
experienced, whether you’ve been able to form trusting relationships in other areas of your life, how open you are ready or able to be, and how truthful you can be with yourself. I believe these  things form the foundation of the relationship needed to help you meet your goals.

I’ve been a counselor for a long time, and I’ve had counseling with many different therapists. Some of it was very good and helpful and some wasn’t. None of it was bad or meant the therapist wasn’t qualified. I believe the connection between the counselor and the person seeking support is the most important part of a therapeutic relationship. Creating a strong relationship with a counselor is affected by personality, age, gender, race, life experiences, and other factors. There must be a good fit in order for therapy to be effective.

While the relationship between the counselor and the counselee is important, the relationship you have with yourself is equally important. From the moment we are born, our relationships begin to form everything about us—from our beliefs to our behaviors, traditions, and rituals. The strength of our earliest relationships directly impacts the strength of our relationships in the here and now, which directly impact the relationship with the counselor you choose to work with.

When relationships in early life aren’t nurturing and supportive—which can happen for many reasons, including abuse, neglect, or the inability of parents to emotionally bond with a child—the impact can be long-lasting and prevent people from developing healthy connections. It can take a long time to experience trust in a relationship if you have experienced broken relationships or abandonment, especially in childhood.

Whatever the challenge in a relationship, the first step of therapy must be to identify and name that pain. That takes courage, regardless of how scary it may feel.

Good therapy addresses the pain that brought you into therapy and helps you develop solutions to the issues you are experiencing. It focuses on the goals you have set and the challenges and limiting beliefs that may prevent you from reaching those goals. Recognizing these beliefs can occur when there is trust and respect between you and the counselor. If you sense the counselor is open to your challenges, you may be more open to addressing them using tools the counselor provides.

When early life relationships are inadequate, a person’s ability to trust can be severely impacted. Without trust between a counselor and a person in counseling, therapy can be ineffective. It is the counselor’s responsibility to work with you to develop trust though open-mindedness, communication, consistency, and compassion. Your responsibility is to try to meet the counselor in this process as best you can.

Because you are so deeply impacted by your relationships, both past and present, you must examine them as a part of the therapy you seek even if you believe they are unrelated. We are interconnected to everyone we have ever interacted with in a good or not-good manner. Like it or not, our relationships help determine who we are and how we are in the world. This truth must be acknowledged and honored in order to begin the journey of healing in counseling.

Courtesy of Good Therapy.

Trolls & Toxicity: Surviving Online Harassment

Harassment Counseling : Whether at School, University or Home

Online harassment, sometimes called cyberbullying or cyber abuse, has become more prevalent as internet use has increased. According to 2017 statistics, 41% of American adults have experienced online harassment.

These figures increase when looking at cyberbullying in youth. In a 2014 review, between 20% and 40% of adolescents said they experienced some type of online harassment. However, since not everyone who experiences harassment reports it, the actual prevalence of harassment may be somewhat higher.

Online harassment can have serious mental health consequences at any age. Just because the abuse happens online does not make it any less real.Portland state university counseling cyber bullying.

TYPES OF ONLINE HARASSMENT
Among adults who’ve experienced harassment, 18% report serious harassment such as stalking, threats, or sustained harassment campaigns. Women are more likely than men to experience sexual harassment and receive sexually explicit images. More than half of women between ages 18 and 29 report receiving unwanted sexual images online. Research also suggests gender and ethnic minorities experience online harassment at increased rates.

Online harassment can take many forms. Common types include:

Trolling: Making some type of negative or hurtful comments meant to upset, humiliate, or discredit someone.
Message bombing: Sending an extreme number of texts, chats, instant messages, or emails with the intent of blocking access to the account. This is often done with the help of bots.
Doxxing: Sharing someone’s personal information online, such as a phone number or home address. Sometimes this is done to facilitate identity theft. Other times, information is shared so that people can harass the individual in physical spaces as well as online.
Revenge porn: Sharing sexually explicit photographs or videos of an individual without their consent. Around 41 states have laws against revenge porn.
Swatting: Making a false report to the police about illegal activity occurring at someone’s home. At best, this can be extremely inconvenient. At worst, it can put the person swatted, and their family or roommates, in danger.

THE SERIOUS MENTAL HEALTH EFFECTS OF ONLINE HARASSMENT
Today’s society is grounded in technology. It’s often difficult, if not impossible, to avoid using internet, email, or social media apps each day for work, school, or personal reasons. But people who have dealt with online harassment may feel anxiety and stress when they have to do these ordinary activities. This distress can lower one’s performance at school or work. Serious or persistent harassment can contribute to depression, suicidal thoughts, and even suicide attempts.
“When our sense of emotional safety in the world is compromised, so too is our psychological health,” Allison Abrams, LCSW-R says. Some groups may be particularly vulnerable to harassment. “Those with certain risk factors, such as a history of trauma, previous depressive episodes, or a family history of depression, etc., are especially vulnerable. In some of these cases, online harassment can be a trigger for a clinical depressive episode. Being humiliated publicly can engender or certainly worsen feelings of worthlessness, isolation, and low self-esteem—all contributing factors in clinical depression.”

One 2017 study looked at the effects of cyberstalking among the 100 individuals. The study participants reported feelings of fear, anxiety, depression, and helplessness. Many of them changed jobs or altered their daily lives significantly as a result of cyberstalking.

Other research suggests 40% of people who experience online harassment develop lower self-esteem. Around 30% of people worry their lives may be in danger.

Multiple studies have shown the risk for mental health symptoms increase in youth who have experienced cyberbullying or online harassment. These may include depression, isolation, anxiety, and dissociation, among others. Adolescents who experience online harassment are three times as likely to have suicidal thoughts.

Negative effects may worsen if harassment continues, but victims of online abuse often find it hard to get help.

REPORTING ONLINE HARASSMENT
Not everyone reports cyberbullying or harassment. Those who do often aren’t believed, which can compound the distress they experience. Even when people who report harassment are believed, free speech is protected by law, so a legal gray area surrounds certain types of harassment. This can limit the actions legal authorities can take.

Attempting to report online harassment can be frustrating when bullying and threats aren’t taken seriously. These are real concerns, and they should be treated as such, especially if they’re having a negative impact on your health.

Many states do have laws about cyberbullying and online harassment, so it’s still a good idea to report harassment. While it may be discouraging if authorities don’t respond and the harassment continues, violent threats in particular should always be reported.

If you’re experiencing online harassment, consider taking these steps:

Reach out to the site or platform administrator. Larger sites such as Facebook and Twitter often have built-in mechanisms for reporting harassment. For smaller sites, you may need to reach out directly to the website’s administrator. These options can help get the person blocked and prevent them from contacting you again. Save the messages or emails you send and any replies you get from the administrator.
Avoid contacting the person who’s bothering you. Don’t interact with or engage with them in any way. If you know the person, you could ask a parent, friend, or someone you trust to reach out to the person and ask them to stop messaging you. This could help in some situations, but in others it may be best to let law enforcement handle the situation.
Report the person to law enforcement. The officer you speak to may be able to give you more guidance on how to proceed. Continue reporting any further incidents.
If you believe the person harassing you is breaking the law, you may wish to involve a lawyer.
Seek social and professional support. This can help decrease the negative impact of online harassment.

COPING WITH ONLINE HARASSMENT
Research indicates many people who experience online harassment get little support from law enforcement professionals or community organizations, such as their schools or universities. Lacking support can greatly increase the chances that online harassment will have long-term mental health consequences.

You may feel inclined to avoid the internet after experiencing harassment. Doing so could help reduce distress and may help you cope with the experience. But avoiding social media could also make it more difficult to talk to friends and family, which can lead to isolation. If you choose to stop using the internet for a time, let your friends and family know what’s going on and work out a plan to stay in touch so you don’t become isolated.

It’s often difficult to share distressing experiences such as harassment or online abuse. But friends and family can offer support and advice, so talking to them may help more than keeping the situation to yourself.

Practicing good self-care can also help you cope. Making time to take care of yourself is always a good idea, but self-care becomes even more important when you’re in distress. If you feel anxious, overwhelmed, or angry, try:

Taking a walk
Journaling about what you’re feeling
Joining an online harassment support group
Getting a massage
Practicing relaxation techniques
Another part of self-care is taking care of your emotional health. You may find it easier to deal with online harassment when working with a therapist. They can offer compassion, support, and understanding in a safe space. It’s also possible they’ll have suggestions on how to deal with harassment. At the very least, they’ll be able to listen and help you develop strategies to cope with your distress.

If you have suffered online harassment, contact me to make a counseling appointment at my Portland office.

Courtesy of Good Therapy.

Mental Health Awareness : How Can Therapists Participate?

Life With Mental Health, Counseling Help & Fighting Stigma in Portland

Webster defines mental health as “The condition of being sound mentally and emotionally that is characterized by the absence of mental illness and by adequate adjustment, especially as reflected in feeling comfortable about oneself, positive feelings about others, and the ability to meet demands of daily life.” Additionally, according to The World Health Organization, mental health includes “Subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential.”

In these definitions, the message is largely about stress, which directly impacts how we feel about ourselves and the world around us. Stress can refer to big traumas or even small traumas that disrupt our daily activity and ability to function. It creates a lens, or filter, for how we deal and cope with various situations.

THE IMPORTANCE OF ADDRESSING MENTAL HEALTH
Mental Health Help PortlandOften, our coping mechanisms become skewed, and we find ourselves even more overwhelmed, with a warped sense of self as a result. People can slip into a mindset of being inadequate, bad, or invisible. How often do we allow these mindsets to linger and settle in our psyche? What is the normal response to talking about and managing our stress? “Just deal with it;” “I don’t have time to think about that stuff;“ or “I have to keep moving”: Society, media, and even our families may tell us how we should be and what we should be doing. But we may rarely be instructed in the intricate steps for achieving these goals.

We are told to achieve, to obtain; but if we do not care for ourselves, how do we maintain motivation or momentum to do so?

HOW PROFESSIONALS CAN HELP
During Mental Health Awareness Month, it is our duty as professionals to get the word out about how self-care, which leads to self-actualization (the top tier in Maslow’s hierarchy of needs to be healthy and happy) is a priority, and it is necessary!

We can do this by highlighting various concerns that arise when mental health is not addressed. We can use social media as a vehicle and platform to promote ways in which people can implement positive coping skills and learn how to identify when they may need to implement them.

Social media can also be used to advertise when and where support groups may occur or agencies that may be able to support a person who might need help addressing their mental health.

Taking care of ourselves allows us to understand our roles within our families, communities, and more importantly, within the community of the Self. How do we get the word out that it is okay to acknowledge, accept, and make agreements with Self and others to work on improving our state of existence? Mental Health Awareness Month is one way! It is about just that: making it acceptable to breathe. Making it acceptable to stop and address all those stressors that impact our self-worth and allow us to doubt our abilities.

Where do people go to “breathe” or catch a break from reality? Churches and other religious or community centers are a few places! Professionals could speak at local community centers through holding a seminar once a week or handing out pamphlets. They might even place a flyer on community bulletin boards to bring attention and awareness to mental health.

Barber shops and hair salons can serve the community in the same way. Many people come to these spaces to gain insight and gain acceptance. They may often engage in banter that promotes thought and facilitates change. People in these places could be more likely to pick up a pamphlet that’s left around.

FIGHTING MENTAL HEALTH STIGMA
If we do not address our mental health, it can decline into mental illness. Most people do not understand or know the difference between mental health and mental illness. Part of what we can do as professionals is educate the public on these differences and how one can be related to the other. During this month, we can highlight the difference!

We can speak to people about how to address both mental health and mental illness. As people may often try to avoid these topics, in such a forum as Mental Health Awareness Month, they can gain information without “outing” themselves.

As identified previously, if people do not address their mental health or stress, the symptoms can become harder to control, hide, or contain. They may slip out in ways that can be embarrassing, harmful to self and others, and detrimental to employment, relationships, and even physical health. These are the pitfalls of allowing stress to grow without being managed or supported.

No matter what stage of change (pre-contemplation, contemplation, preparation, action, maintenance, relapse) you may be in, having better understanding can help! The more we put the word out there and dispel the stigma associated with mental health, the better we can aid people in propelling themselves into possibly and the next phase of change.

Mental health is still, in some communities, seen as an excuse or as not real. Other times, it is misunderstood or not even acknowledged. Our job, not just in the month of May, but every day, is to increase the general understanding of how mental health is a real thing that people struggle to cope with and gain control of.

If mental health is a concern for you, set up a counseling appointment at my Portland office.

Courtesy of Good Therapy.

Stressful School Year? Use Summer to Help Your Student Manage Anxiety

Summer Therapy Can Help Students Manage Anxiety

Portland summers can be a time to treat a student's anxiety.If your child or adolescent struggled with anxiety during the school year, now is an opportune time to address it. Take advantage of the summer break to give them the skills they need to manage stress, feel confident, regulate their emotional responses, maintain strong friendships, and—most importantly—feel better about themselves.

Not sure if your student has anxiety? Here are some common signs:

  • Excessive worry about a variety of issues, such as grades, appearance, peers, family matters, performance in sports/activities, homework, and tests
  • Physical symptoms such as upset stomach, vomiting, and headaches
  • Trouble falling or staying asleep
  • Changes in eating behavior
  • Inability to relax even when they recognize their fears are out of proportion or unreasonable
  • Treating themselves harshly and/or expecting perfection
  • Fear and avoidance of social situations
  • Disconnecting from friend groups
  • Mood swings and/or increase in irritability
  • Obsessive thoughts and/or compulsive behaviors

Trying to resolve these issues during the school year, when symptoms may be at their peak, can be challenging. Homework and tests are a constant, then add on any extracurricular commitments. There may be few opportunities for your student to decompress and learn from the last anxiety-producing experience before they happen upon the next one. Summer provides a (hopefully) more relaxed schedule to reflect on what creates anxious feelings and to practice and adopt effective ways of coping.

Cognitive behavioral therapy (CBT) is one form of treatment that has been found to be effective for anxiety (Otte, 2011). With the guidance of a trained counselor, CBT brings to the forefront the thoughts a person is having, the emotions that accompany those thoughts, and the behavior that results. Modification of just one of these variables can help improve the other two. Students can learn more effective ways to cope by examining faulty or irrational thoughts. For example, a young person with test anxiety may have a negative internal message that reminds them that they have no hope or confidence they can pass their tests. This negativity can spill over into areas such as homework, extracurricular activities, and friendships, leading to a prevailing sense of powerlessness, hopelessness, and failure. The resulting behavior can include the symptoms listed above.

Taking time to challenge a student’s way of thinking and replace negative narratives with more reasonable and accurate self-statements can help them feel more capable and empowered. Confidence helps build a sense of control and possibility, and in turn leads to adopting healthy behaviors in the face of all the ups and downs that come along.

It’s important to educate your student about anxiety so they understand everyone experiences it in varying degrees, thanks to the fight-or-flight response. The human brain is hardwired to assess for dangers and react to threats in the environment, an evolutionary survival mechanism (Schab, 2008). Helping your student understand that the fight-or-flight response is there for a good reason assures them that (1) they aren’t flawed and (2) opens the door to learning ways to turn the dial down so they aren’t constantly on high alert. Chronic anxiety builds up stress hormones that can, over time, cause emotional and physical problems.

According to the American Psychological Association’s “Stress in America” survey conducted in 2013, “Teens report that their stress level during the school year far exceeds what they believe to be healthy (5.8 versus 3.9 on a 10-point scale) and tops adults’ average reported stress levels (5.1).” This summer, take the time to help your student better understand the anxiety that comes with all that stress, and partner with a therapist to develop strategies for building the confidence they need to manage it in the next school year. Make an appointment at my Portland area office or contact me for more info on anxiety therapy.

References:

American Psychological Association survey shows teen stress rivals that of adults. (2014, February 11). Retrieved from http://www.apa.org/news/press/releases/2014/02/teen-stress.aspx
Otte, C. (2011). Cognitive behavioral therapy in anxiety disorders: Current state of the evidence. Dialogues in Clinical Neuroscience, 13(4), 413–421.
Schab, L. (2008). The anxiety workbook for teens. Oakland, CA: New Harbinger Publications, Inc.

Courtesy of Good Therapy.

Factors That Affect University Student Mental Health

Are You A Portland State University Student in Need of Counseling?

Mental health factors affecting Portland State University students.The study did not identify a specific causal link between certain graduate school experiences and mental health concerns. Yet it did identify some common challenges students face. Fifty-six percent of students with anxiety said they did not have a good work-life balance. Among students with depression, 55% said the same.

Half of students with anxiety or depression reported a lack of guidance. They said their advisor or principal investigator did not offer “real” mentorship. The study adds that many universities don’t offer career development programs.

The study’s authors caution that their research may overestimate the prevalence of mental health concerns among graduate students. People experiencing mental health concerns might have been more inclined to respond to the survey.

Even so, other research supports the notion that graduate and professional school students face high rates of mental health concerns. A 2016 study found high rates of depression among medical school students. In that survey, 27% of respondents reported clinically significant depression symptoms. Eleven percent reported suicidal thoughts. If you are a University student and are looking for counseling in the Portland area, contact me to make an appointment.

References:

Depression, anxiety high in graduate students, survey shows. (2018, March 6). UT Health Newsroom. Retrieved from https://news.uthscsa.edu/depression-anxiety-high-graduate-students-survey-shows

Graduate students need more mental health support, new study highlights. (2018, March 6). Science. Retrieved from http://www.sciencemag.org/careers/2018/03/graduate-students-need-more-mental-health-support-new-study-highlights

Courtesy of Good Therapy.

10 Good Reasons to Seek Relationship Coaching

You Don’t Need a Crisis for Relationship Coaching

One of the main reasons people seek therapy is for help with intimate and close relationships. And while couples counseling tends to be viewed as something for only relationships in crisis, there are many reasons people in relationships might pursue it. Some are small, some larger, but all are important and deserve to be explored and worked on.

Here are 10 good reasons to look into relationship counseling:

  1. COMMUNICATION ISSUES

Communication is the foundation of all relationships. Communication comes in many forms, both in person and over the phone, text, or social media. Therapy teaches couples how to communicate with each other in a positive manner that works. The type of communication a person grows up around tends to strongly affect how they communicate in their adult relationships. Counseling can help couples make a conscious choice of communication style and not just fall back on what they know from their history.

  1. PREMARITAL COUNSELING

10 reasons for relationship coaching Portland.

There are many issues couples face before they tie the knot. Premarital counseling is a place to discuss many things. One example is finances. Will bank accounts be shared? What about making decisions about what to purchase? Another consideration is household duties. Are children part of the picture? What role(s) will in-laws play in your life? Couples counseling can be a safe place to start the conversations that need to be addressed.

  1. SEXUAL ISSUES

Sex can be something that heals and brings a couple together, or it can be a battleground fraught with anxiety, embarrassment, anger, and hurt. Counselors encounter sexual issues frequently and can help.

  1. INFIDELITY AND UNFAITHFULNESS

Infidelity within a relationship can be the most hurtful and damaging thing a couple ever goes through, but it does not mean the relationship has to be over. Couples counseling provides a healing space to begin the journey toward resolution. It can help find practical and meaningful ways to navigate the treacherous waters of unfaithfulness.

  1. ASSISTANCE MANAGING OTHER RELATIONSHIPS

Couples have relationships with people outside of their relationship together. Friends, extended family, children, coworkers, and supervisors/bosses/professors are just a few. These relationships can be either healthy or unhealthy. Some things that can be discussed are boundaries with members of the opposite sex or same sex, communication with exes, and together and alone time.

  1. NONTRADITIONAL RELATIONSHIPS

Nontraditional intimate relationships, such as polyamory, open relationships, and swinging, can have problems and struggles—some of which are specific to their lifestyle and identity, some that all couples deal with. It can be intimidating to seek relationship therapy for fear of not being valued or understood because of the type of intimate relationship one is in. Many relationship counselors are comfortable and have the background and understanding to work with people in nontraditional relationships and can provide an open and safe place to work on the struggles a couple is having.

  1. BLENDED FAMILIES

When one or both partners have children from another relationship, blending has its own specific struggles and difficulties. Parenting differences, the role of the other parent, and the new identity of the family all need to be explored.

  1. THE END OF A RELATIONSHIP

When a relationship has ended, whether by mutual agreement or otherwise, managing life can be difficult. Often, individuals need to express anger, sadness, and grief. There may be practical issues to sort out as well, such as housing and children. Agreeing how and when to communicate is another example of a matter to be discussed in couples counseling.

  1. DIGITAL-AGE ISSUES

Facebook. Twitter. Texting. Sexting. Instagram. YouTube. Snapchat. These are just a few ways technology can infiltrate and affect relationships. Communicating via social media has its own pros and cons. Couples often have conflict regarding who to “friend,” what to “like,” and who to text, block, or chat. Communicating that is not done face-to-face or even on the phone is hard. No matter how many emojis are used, words can be misconstrued and misread. Tone of voice and body language are important to understanding what is being conveyed. Relationship counseling can help couples work through problems technology has caused, and create boundaries with each other to help restore trust when social media have hurt the relationship.

  1. TRUST ISSUES

After trust is broken, relationships can be harmed or even destroyed. Part of having a solid and healthy relationship is to be able to trust one another. Learning to trust again is a slow and hard process, and it can be painful and frustrating when it doesn’t happen quickly. Counseling can educate and assist couples with understanding the process of regaining trust, and provide tools and direction to help.

All relationships are difficult in some form or another. There will be disagreement, conflict, and hurt even in the best of times. Relationship counseling can help individuals and couples grow and heal. Like all types of therapy, the lessons learned and behaviors changed will continue to serve each person for much longer than the therapy itself.

It takes work to have a solid and positive relationship. Couples counseling is worth considering for any couple and can promote mutually beneficial change for years to come. Make an appointment at my Portland area office for more info on relationship coaching.

Courtesy of Good Therapy.

University Graduate Students Counseling Help

Are You a Graduate Student? Feeling Stressed? Counseling Can Help!

With greater access to treatment, more people find they can take on the monumental venture of earning a degree. Yet once they are in school, their risk of mental health problems increases. Graduate students in particular may struggle to manage school, finances, and self-care. The combined stress can be devastating to mental well-being.

Counseling can help graduate Portland State University students.The American Psychological Association says the need for mental health care on campuses is increasing. A 2015-2016 report from the Center for Collegiate Mental Health surveyed college counseling centers across America. The report showed an increase in student hospitalization, medication use, and suicide. More than 55% of the centers saw increases in salary budgets to meet demands for care. But some clinics still face challenges in meeting students’ needs. They may have limited hours of service or high costs of care.

Meanwhile, almost a third of PhD candidates may be at risk for mental health concerns. Around 34% of graduate students may already experience moderate to severe depression.

Researchers continue to study the specific differences between undergraduate and graduate students’ health. Further surveys may determine how to improve psychological care for each population. The goal is to promote mental well-being in colleges and universities.

RISK FACTORS FOR MENTAL HEALTH CONCERNS IN GRAD SCHOOL

Some populations are more at risk of developing mental health concerns. As the population of graduate students grows more diverse, so do mental health needs. Minority and international students may need help with multicultural issues. LGBTQ+ students can also face discrimination.

These populations can benefit from seeking mental health treatment on campus. Yet not all students may feel represented at their school’s counseling center. Around 71% of counseling center staff members are white. The number of openly LGBTQ+ counselors is limited. Counseling centers could better serve minority students by hiring more diverse staff.

Another risk factor is academic performance. Students who feel they are behind in their classes are more likely to report stress and anxiety. The Graduate Assembly of University of California, Berkeley rates academic performance as one of the top three predictors of depression in graduate students.

Yet catching up may be easier said than done. Many graduate students have responsibilities outside school such as childcare or employment. In a 2014 survey, graduate students cited job outlook, financial stress, loneliness, and alienation from mentors as contributing factors to depression and negative well-being.

Graduate students can help improve mental health outcomes by learning what signs to watch for. Any of the following symptoms may indicate a larger mental health concern:

  • Irritability
  • Sleeplessness
  • Panic attacks
  • A dependence on drugs or alcohol
  • Inability to complete daily tasks
  • Feelings of worthlessness
  • Suicidal thoughts

HOW GRAD STUDENTS CAN USE COUNSELING CENTERS

Psychological care addresses diagnoses that affect students as well as the general population. For example, cognitive behavioral therapy can help individuals cope with anger or anxiety. Acceptance and commitment therapy can help busy students focus on their priorities.

Counseling centers can also introduce students to alternative treatments to complement traditional therapies. Some therapists might assign internet-based worksheets to help reprogram harmful thoughts. Others may direct students to mindfulness practices like yoga.

Treatment can be especially helpful for students whose diagnoses impact learning. When a survey asked students if campus counseling services helped with their academic performance, over 70% answered positively. These results suggest counseling can help both mental health concerns and academic issues.

PREVENTING MENTAL HEALTH ISSUES DURING GRAD SCHOOL

Self-care practices like sleep and exercise can promote more positive mental health outcomes. Students who limit their schedules and have a social life have less risk for burnout. Experts encourage students to find a therapist before their symptoms become overwhelming.

There are several ways graduate schools can reduce students’ risks of mental health concerns. Schools can accommodate students’ schedules, aid their career preparations, and improve campus mental health care. Schools can also help by educating students about time management and self-care. Close mentorship is also linked to improved mental health and academic outcomes. Academic advisors are particularly helpful for international students.

Graduate students are a population with unique mental health needs. If schools improve their campus mental health care, they can not only lower the rate of mental health concerns, but also promote academic success. Mental health care on campus can improve all aspects of graduate student life.

LIFELINES AND FURTHER RESOURCES

Jed Foundation is an advocacy group for teen and young adult mental health. Students can find information about their legal rights related to mental health.

The National Grad Crisis Line provides suicide prevention services specifically for graduate students. Individuals can reach the hotline by calling 1-877-GRAD-HLP (1-877-472-3457). People studying abroad can access the hotline through a Skype number.

ULifeline.org is a service of the Jed Foundation. It offers self-assessment tools to evaluate mental wellness and suitability for counseling. There are also resources for those who need immediate help.

American Psychological Association has an online section of articles especially for graduate students. Helpful pages include self-care tips and advice for seeking mentorship.

If you’re a graduate student or student of Portland State University, I can help with local counseling. Make an appointment today for more information.

Courtesy of Good Therapy.