Archive of ‘Anxiety’ category

How Your Favorite Hobby Can Be A Part of Your Therapy

Imagine you’re a new client, coming in for talk therapy with a counselor. You arrive at the office, seat yourself and wait for your therapist to call you in. Once you are in the room, your counselor greets you warmly, introduces themselves and begins the session. It begins as you expect, with a lot of talking. However, near the end of the session, the therapist pulls out a large canvas notebook and colored pencils. You’re intrigued, but taken off-guard. Are they going to draw me? Ask me to draw them? However, your therapist smiles, hands you the materials, and asks you to draw your feelings about the session that day. You’re unsure how to take this, but as you begin to draw, your mind feels calmer and it quiets the anxiety you felt throughout the session. It is as if getting it onto the paper has freed it from bouncing around your agitated mind. Once you are done, your new therapist takes the time to discuss the drawing with you and you realize that you are able to make connections and think about the session in a new way after drawing it out. At the end of the session, you thank your new therapist and head out of the office, feeling surprised, but excited to continue trying this unexpected part of therapy.

Expressive Arts in Therapy

Expressive arts is a form of therapy in which artistic expression is used to process emotions or express ideas that are sometimes difficult to present verbally. Many different art forms can be used, including dance, writing, sculpting, drawing, creating a collage, coloring, music, and drama. Many people already do one or many of these as hobbies in their daily life. This form of therapeutic technique is probably the most well-known and most used of those that I am presenting in this article. 

So what sorts of issues can expressive arts help address? An article by VeryWellMind lists these as the possible concerns and conditions it can help with: anxiety, ADHD, grief, depression, eating disorders, emotional and interpersonal issues, self-esteem, PTSD, and, of course, stress. These issues are common and this shows that almost everyone who enters into therapy could benefit somehow from expressive art usage in therapy.

Video Games in Therapy

Okay, this sounds strange, I know. I admit that even I did not think of video games as being a therapeutic tool until recently. However, there are already therapists who use video games in sessions. Andrew Fishman, LCSW, reports using video games as a therapeutic tool to facilitate conversation, teach children emotion regulation, build a relationship with a client, and even teach and practice skills. Some of you may be able to think of some games that have therapeutic themes. Spiritfarer is one that came immediately to my mind as a wonderful game centered around processing grief. Others include Animal Crossing New Horizons (self-care anyone?), It Takes Two (this game is basically centered around couples therapy), Pico Park (cooperation in a group has never been so important), and Pokemon (helpful to teach patience and consequences to children). Ultimately, video game usage in therapy is not so unusual or unattainable. Games such as Uno or checkers have been used in therapy for quite some time, especially with adolescents and children. 

So what are the possible ways in which your therapist could use video games in therapy? Honestly, a therapist may simply play Mario Kart with you as a way to have something to do as you are talking. Something about speeding down a track and throwing shells at each other can make people more likely to discuss difficult topics. Another usage may be connection and learning more about you. After all, your Animal Crossing island or Stardew Valley farm can say a lot about your personality. Discussing who you choose to romance in a game or who is your favorite villager is another way for your therapist to gain insights into what you’re coming into therapy for. Lastly, some games allow your therapist to teach and role-play or practice skills. Andrew Fishman states that he uses games such as Call of Duty in order to model and teach emotion regulation skills to children. Therefore, if playing video games is one of your favorite hobbies, perhaps you may ask your therapist about integrating a game into your therapeutic experience.

Animal-Assisted Therapy

Animal-assisted therapy is when animals are used in therapy sessions to enhance or supplement the therapeutic experience. Many different kinds of animals can be used as therapy animals. For example, as a client in animal-assisted therapy, I worked with a tortoise. An article by TheraPet reveals that other animals that can be used are dogs, cats, horses, rabbits, guinea pigs, pigs, and even llamas. Dogs are the most commonly used animal in animal-assisted therapy because of their prevalence as a pet and their ease of training. 

Some benefits of participating in animal-assisted therapy include a reduction in blood pressure, lowered stress and anxiety levels, enhanced self-esteem, increased emotional awareness and regulation, reduced aggression and loneliness, improved immune system, increased trust and trustworthiness, reduction of depression, and a stimulation of positive communication (Benefits of Animal Assisted Therapy). If walking your dog or playing with your pet is one of your favorite hobbies, animal-assisted therapy could be a good fit for your therapeutic needs!

There you have it. Which of these hobbies would you be interested in adding to your therapeutic experience? Think it over, and maybe the next time you’re searching for a new therapist, you’ll be looking for one who includes your hobby in their work.


Center, Counseling. “Benefits of Animal Assisted Therapy.” Advanced Counseling Services, LifeStance Health, 17 Jan. 2018,

Cherry, Kendra. “What Is Expressive Arts Therapy?” Verywell Mind, Verywell Mind, 19 Aug. 2021,

Fishman, Andrew. “Why I Play Video Games with My Therapy Clients.” Psychology Today, Sussex Publishers, 7 Mar. 2022,

“What Is AAT?” TheraPet Animal Assisted Therapy, TheraPet,

Walk and Talk Therapy: Is it Right for Me?

Walk and Talk Therapy is an approach to traditional talk therapy where the therapist and client take their session outdoors and walk together while discussing the client’s issues. This type of therapy is becoming increasingly popular and provides similar benefits to those found in mindfulness, physical activity, ecotherapy, and more traditional psychotherapy.  

Benefits of Walk and Talk Therapy:

Some of the benefits include:

  • Reduced Stress and Anxiety: Walking is a proven stress reliever and can help reduce feelings of anxiety. Exercise releases endorphins, which are natural mood boosters that help to alleviate stress and anxiety. When you combine walking with talking about your feelings, you get a powerful combination that can significantly reduce your stress and anxiety levels.
  • Moving Forward: Taking a walk with your therapist can help shift the focus towards moving forward; this added movement and momentum can help in getting unstuck. Walking can also provide a natural rhythm to the conversation, making it easier to stay on topic and keep the conversation flowing.
  • Bilateral Stimulation: Bilateral stimulation is any method of stimulating the body and brain in a rhythmic right-left pattern. It is often used in therapeutic settings (such as in EMDR therapy) to help reduce the symptoms of trauma, anxiety, and other mental health conditions. Bilateral stimulation can help regulate the brain’s response to stress and trauma, promote a sense of relaxation and well-being, and allow for the processing of emotions and memories previously stuck in the nervous system. Walking is a simple form of bilateral stimulation, stimulating and balancing the right and left brain. (EMDR founder Francine Shapiro was taking a walk in the park when she first realized the potential benefits bilateral stimulation could have on the nervous system.)
  • Supplemental Health Benefits: Walking is a low-impact exercise that is beneficial for both physical and mental health. When you participate in Walk and Talk Therapy, you get the added benefit of exercising while working on your mental health.
  • Healing through Nature: Spending time in nature is linked with many physical and mental health benefits, including decreased depression, decreased stress and anxiety, improved ADHD symptoms, increased focus, improved sleep, and improved overall well-being. (For more research, see’s Benefits of Nature page.)

Risks of Walk and Talk Therapy

Like any form of therapy, Walk and Talk Therapy carries some risks. Here are a few things to consider:

  • Safety Concerns: Being outdoors has inherent safety risks, such as from a sunburn, bug bites, or other injury. If you’re walking in a park or other public space, be aware of potential hazards such as uneven terrain, traffic, or other people.
  • Weather Conditions: Walk and Talk Therapy sessions are subject to the weather. If it is too hot, too cold, or too wet, it may be uncomfortable or even unsafe to continue the session. Consider having a backup plan (such as telehealth) and be ready to communicate with your therapist concerning any last minute changes.
  • Distractions: Walking in a public space can be distracting, with other people, animals, or vehicles around. These distractions can make it difficult to focus on the therapy session and may reduce its effectiveness.
  • Confidentiality Concerns: Walking in a public space may make it more difficult to maintain confidentiality. While therapists will continue to take measures to protect their clients’ privacy, it’s important to be aware that you might encounter someone you know on the trail, or a stranger could overhear part of your conversation.

Is Walk and Talk Therapy the right form of therapy for me?

Here are some reasons why Walk and Talk Therapy might be right for you:

  • You enjoy being outdoors and find it safe, calming, and relaxing.
  • You’re tired of traditional talk therapy sessions that take place in an office or clinic, and want to try something different.
  • You’re feeling stuck and are curious to try a more active and dynamic approach, as compared to more traditional talk therapy sessions.
  • You need a change in routine. You’re hoping to get in more steps, spend more time in nature, and reap the benefits of regular exercise and time spent outdoors.

As with any form of therapy, Walk and Talk Therapy has its own unique risks and benefits. With proper planning and precautions, many of these risks can be minimized. If you’re curious to learn more, talk to a licensed therapist or counselor to discuss whether Walk and Talk Therapy is a good fit for your specific needs and circumstances, and to address any concerns you may have.

Written By: Jim Rowell, LCSW
Currently offering Walk and Talk Therapy in Northwest Hills, Westlake, and East Austin.

This Pathology is Not All Yours… And Why Therapy Must Consider The Cultural Milieu

Psychotherapeutic training generally includes something called Universality as a healing technique. It stems from Irvin Yalom’s germinal Therapeutic Factors for facilitating group therapy. It basically means that when humans get to hear and witness another human facing something similar to their own experience, this communality engenders a sense of validation and fosters healing. Universality, with its relational delivery, inherently addresses the isolation any human can feel amidst a problem that had felt singular.

Normalizing Responses to Societal Issues

As a trauma-informed and relational therapist who specializes in climate change grief and disaster trauma; this is of interest to me for several reasons. A dominant one is that grief and anxiety created by several ongoing collective traumas are hard to separate from their myriad effects on a single person’s psyche, which at times is simply responding to these threats, pressures, and perils. Living within a colonial, imperialistic, and capitalistic society under threat of both climate change and continual pandemic pressures is not a cakewalk. Even that sentence stresses me out! The waters we swim in matter. Our collective ills contaminate human psyches and can show up as pain, depression, anxiety, panic, and the like. Our collective diseases become individuals’ problems.

And yet, as universality would have it, a clinician understanding these ills—as best they can from the purview of the client—is paramount to good treatment. Coping strategies alone are not sufficient, normalizing the client’s response to the collective deficiencies is part of alleviation of these pressures. Normalizing in this way may look like: “yeah, this is not, or should not be, normal.” This is a bit of disclosure from the therapist– a human to a human, both part of the same culture admitting where things stand.

I don’t think I am going out on a limb to note that our culture is currently struggling. As I write this, in Texas, transgender citizens’ rights are on the line. Gender-affirming care is slated to become criminalized, at times targeting trans children’s parents with threats of abuse. Recently, trans adults were added to the list with SB1029, which targets insurance companies and providers. Abortion is banned, though it is a medical intervention that can be lifesaving. To make matters worse, bounty laws that enforce this are creating an environment that is truculent and dangerously paternalistic. Books are being banned, and educators censored. A new Don’t-Say-Gay-esque bill was proposed just last week, modeled after Florida’s, which threatens an outright book ban around anything mentioning LGBTQ+, as well as censoring classroom discussions around the same. And the effects and human impacts of a climate changed are palpable and ever-increasing–in our area, we are recenrtly off the heels of another freeze. All of this on top of year three of the pandemic and its longstanding disruptions on learning, isolation, mental health, and physical health.

When Diagnostics Are Not Enough

And listen, I am not against diagnosing one’s mental health issues. Diagnostics as a part of comprehensive therapeutic treatment can be incredibly beneficial. They can certainly aid in devising and guiding successful treatment within the therapeutic consulting room. For the client who has been struggling with symptoms; a diagnosis can provide relief, an explanation, and a framework to describe their internal state or external behavior to themselves, family, classmates, work colleagues, and friends. Diagnostics on the whole can open up lines of communication within a treatment team, creating access to intervention avenues at the school level, or equally, funnel information to a psychiatrist who can better medicate. A correct diagnosis can create ease within a family system to remove the label of Identified Patient (IP) from a child’s role and help the system see their child or sibling from a more educated and supportive perspective. 

So- we can diagnose the person inside of the room however, we must also pay mind to the collective upheavals, distresses, and systemic issues that contextualize this individual. The medical equivalent might be something like this: we have a town next to a factory that is seeping toxic waste into the town’s water supply–a large and suspicious portion of the town comes down with a respiratory disease. Diagnostics alone would create a closed loop within the local medical system, with continuous siloed individual diagnoses reporting the disease created by this substance. AND/OR; the water supply could be addressed, and toxin mitigated. This is made more complex when we consider mental health as things tend to be created by many factors– and it can be tricky to suss out the causes, and the collective fixes. But complexifying our solutions, and as collectively as possible, is exactly the medicine called for in this era.

Psychologist James Hillman said (and of note, before the internet took hold):

“Of course I am in mourning for the land and water and my fellow beings. If this were not felt, I would be so defended and so in denial, so anesthetized, I would be insane. Yet this condition of mourning and grieving going on in my soul, this level of continuous sadness is a reflection of what is going on in the world and becomes internalized and called “depression”, a state altogether in me ─ my serotonin levels, my personal history, my problem…”

(Hillman, 1996)

Trauma-Informed Care as a Path Toward Healing

I know I am outting my politics, but alas—my last two blogs have been about porn and fairy tales so that cat is already out of the bag. Let’s take the example of gun violence. I see teens and work often with parents with young children. Both demographics are widely impacted by the nations’ lack of legislation on guns and are moreover the compensatorily-devised adaptation techniques that infiltrate our learning institutions instead of real action. If a teen client comes in saying; “I have had [X many] years of Active Shooter Drills at school and I am experiencing nightmares.” Yes, we can work to shift the nightmares, ameliorate the residual fear and treat the existence of such symptoms. But resounding data is against these drills and particular practices within. Why would I simply normalize them? 

A study quoted by Everytown bleakly reports:

“Active shooter drills in schools are associated with increases in depression (39%), stress and anxiety (42%), and physiological health problems (23%) overall, including children from as young as five years old up to high schoolers, their parents, and teachers. Concerns over death increased by 22 percent, with words like blood, pain, clinics, and pills becoming a consistent feature of social media posts in school communities in the 90 days after a school drill.”

Similarly, if a parent comes in citing concern their little one is going to be soon introduced to this practice at their new school, it would be wholly inauthentic of me to ignore not just the upset this future event is inciting but to not also see this concern within the structure of the collective climate. 

I speak here from a position of activism, allyship, and a desire to move forward as clinicians with eyes open, and as collectively aware as possible. No matter the source, symptoms and their manifestations are treatable. Therapy can provide meaning-making, the healing relationships can be sturdy-ing, and its structure and techniques can actively reify the resilience, connectivity, and vibrancy of the Self. If you love data, therapy has been shown in many forms to change the brain’s structure, namely in the frontal and temporal cortex, which enables more integration, processing capacity, and regulation of neural symptoms. When under the care of a trauma-focused and trained practitioner; trauma can be reprocessed to repair mental injuries from not only the initial trauma(s) but also any newer experiences that have been neuropsychologically linked up with the traumatic experience. EMDR, for example, uses bilateral stimulation as an adaptive information processing technique to reprocess and restore improperly stored, fragmented memories that can otherwise create interruptive and discontented states. The de-fragmentation and integration it engenders can be deeply impactful.

Therapy is helpful, and it is more helpful when it considers itself as a tool within a structure, that keeps in mind the structure’s influence on the clients it is aiming to help. I would be doing a disservice to clients to ignore the wider lens, and I hope that in and of itself is a helping technique. 



I am not telling you to do or not do anything, but here is a list of books that have been banned in Texas.

Other clinicians

Dr. Jennifer Mullan’s Decolonizing Therapy model provides trainings for Politicizing your Practice

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