Archive of ‘Counseling’ category

Gridlock vs. Perpetual Problems in Couples

Did you know that 69% of problems are perpetual problems? What does that mean? According to a study by Gottman and Gottman, 69% of couples’ problems have no resolution and 31% of their problems are resolvable. Looking at your own relationship, do you find yourself arguing over the same issue over and over? With zero headway being made?  Just more hurt feelings and anger which can lead to a painful impasse. Gridlock. 

The goal is to move from gridlock to dialogue.

Problems that Lead to Gridlock

In counseling, the goal is to manage conflict rather than solving the problem because the majority of the time there is no solution. Even in the healthiest relationships, most conflicts are not resolved. The problems remain perpetual and couples learn how to live with them or become gridlocked. Another obstacle is simply a mismatch of conflict styles. One partner may be an avoider and the other a pursuer. We all know what this looks like.

Wife: “So you’re just going to let our son go to baseball practice after he failed English?” 

Husband” “Yes”

Wife: “So he gets a privilege? A reward? And You’re the hero again?”

Husband: “ He needs an outlet.” as the husband walks away to the bedroom.

Wife: “ If baseball was so important to him he would pass his classes….” as she follows her husband and continues, “We go through this every grading period since he was 10 years old…….

Husband: “I am not having this conversation again” and closes the door 

We can see where this is going. There is clearly a mismatch in conflict styles. There is clearly a long standing disagreement regarding grades and extracurricular activities. Couples can become entrenched in their respective positions. Refusing to engage in give and take. When in gridlock,  it is important to explore each other’s values in a position. 

“Why won’t he/she budge on ___?” 

And they may be surprised by the answer. There are reasons why certain values are important to us. And they often differ from our partner’s values. And that is ok. But have we explored why our partner finds certain values important? Can we put on their lens for a minute? Can we try and understand why they will not budge? And then can we compromise? Compromise does not always feel good. It can feel as though we are not winning or not being heard.

How to Unlock Gridlock

One of the hardest things to do is to come to some sort of acceptance of the problem. This can change the level of frustration. Without making some sort of peace with the problem, it can lead to emotional disengagement. The problem will remain gridlocked and couples will continue to hurt and vilify one another. 

The goal is not to solve the perpetual problem but to lay the groundwork for dialogue. Honor each other’s values. Turn the focus to exploration and understanding one another. Use your friendship to uncover emotions and underlying meanings regarding the perpetual problem. Compromise. We do not have to agree on the solution because there is not one. In most conflicts there is a conversation that should have been had. Using these strategies can avoid painful exchanges and icy silence. Wouldn’t it be nice for the couple in this scenario to be prepared for the next grading period? 

Written By: Jenny Cantu, LPC

Are My Therapist’s Notes Really Confidential?

The success of therapy is often predicated on the trust in confidentiality. When you show up to your first session, odds are that your therapist has explained to you three situations in which they may have to breach confidentiality, and may do so without your consent. Briefly, they are: 

  1. If the therapist suspects abuse or neglect of a child, disabled person, or elderly person.
  2. If the therapist hears of imminent danger occurring to the client or someone else; and
  3. If a judge subpoenas the therapist or their notes.

Ethically, a client must be aware of these three exceptions in order for them to give their “informed consent.” What if I told you that those aren’t the only situations where your Private Health Information (PHI) MAY be disclosed to a third party? 

Certainly, a therapist may share information with outside parties if they have a written, signed agreement with the client. 

But a therapist may also share information in other situations without written consent. Specifically: 

  1. To a public health authority acting as authorized by law in response to a bioterrorism threat or public health emergency.
  2. In the following situations, the disclosure must be limited to: name and address, date and place of birth, social security number, ABO blood type and rh factor, type of injury, date and time of treatment, date and time of death, and a description of distinguishing physical characteristics. 
    • For purposes of identifying or locating a suspect, fugitive, material witness or missing person
    • About a suspected perpetrator of a crime when victim is a member of the therapist’s workforce (i.e. when a client commits a crime against a therapist)
    • To identify or apprehend an individual who has admitted participation in a violent crime (Source: U.S. Department of Health & Human Services)

There are a few other very specific instances (namely when crimes have been committed), where a therapist MAY share information, but it starts to get a bit in the weeds, and the limits on what information can be shared becomes narrowed. 

What is important to stress, is that in the above situations (1 and 2), a therapist is not REQUIRED to share PHI, but MAY disclose this information.  

Additionally, as counselors, we have an ethical duty to ”protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification.” (Source: LPC Code of Ethics)

If you have ANY concerns about how your PHI may be used or disclosed, please speak with your therapist. 

Written By: Mike Rothschild (he/him), M.A., LPC-Associate, NCC, supervised by Michelle Hawn, LPC-S

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.

References

Center, Counseling. “Benefits of Animal Assisted Therapy.” Advanced Counseling Services, LifeStance Health, 17 Jan. 2018, https://advancedcounseling.info/benefits-of-animal-assisted-therapy/. 

Cherry, Kendra. “What Is Expressive Arts Therapy?” Verywell Mind, Verywell Mind, 19 Aug. 2021, https://www.verywellmind.com/expressive-arts-therapy-definition-types-techniques-and-efficacy-5197564. 

Fishman, Andrew. “Why I Play Video Games with My Therapy Clients.” Psychology Today, Sussex Publishers, 7 Mar. 2022, https://www.psychologytoday.com/us/blog/video-game-health/202203/why-i-play-video-games-my-therapy-clients. 

“What Is AAT?” TheraPet Animal Assisted Therapy, TheraPet, https://therapet.org/about/what-is-animal-assisted-therapy/. 

Written By: Lindsay Thompson, LPC-Associate, Supervised by Liz Lawrence, MA, LPC-Supervisor

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