Who Should You Trust with Your Mental Health?

By DANIEL CHAMPER, LCPC - Intermountain Clinical Director

hen you have a headache, you can take ibuprofen to feel better regardless of the brand. This is because ibuprofen must follow a chemical manufacturing standard allowing it to be called ibuprofen. Unfortunately, psychotherapy (therapy) is not ibuprofen. While there are standards of care that accompany every psychotherapist (provider) licensed to provide care, the therapy they provided will ultimately be as unique as the provider themselves.

Because of this, it is important to understand the following three things: 1. What therapy is. 2. What questions to ask a new-to-you provider before making an appointment. 3. What the qualities of good therapy and of less-good therapy are. W

WHAT IS THERAPY? Psychotherapy (sometimes referred to as “talk therapy” or simply “therapy”), is a practice meant to assist children, youth, families, and adults as they address a broad variety of mental health concerns (such as depression and anxiety), emotional distress, co-occurring substance use, suicidal thoughts or ideation, trauma, and other life-impacting stress. The ultimate intention of therapy is to help someone cope with, alleviate, eliminate, or regain control of troublesome symptoms so they can ultimately experience increased emotional well-being and overall mental health.

THREE QUESTIONS TO ASK A NEW PROVIDER BEFORE YOU MAKE AN APPOINTMENT: 1. What is their area of expertise? Because there are thousands of mental health and relationship issues it is reasonable to expect your provider to specialize in one or more, but not all. It is good to make sure they have the skillset to address your concerns and age (some providers are age-specific – adults OR children).

2. How will they measure progress? It is reasonable to learn how a provider will track your progress throughout your sessions. If they have no answer to this question you might need to find someone who can.

The process to become a licensed provider takes a serious commitment. Licensed providers must earn a Bachelor’s Degree and Master’s Degree, obtain provisional licensure, complete work experience, pass state or professional examinations, obtain state licensure, and meet continuing education requirements. Providers must be licensed by the states in which they practice.

THREE EASILY IDENTIFIABLE QUALITIES OF GOOD (AND LESS-GOOD) THERAPY 1. Therapy is Not About Making a Friend While there are many opportunities in life to develop friendships and personal relationships, therapy should not provide one of them.

Good Therapy: + This provider should ensure your relationship stays professional (example: you will always feel like they are there operating in a professional capacity to address your needs). + They should maintain professional language (example: no profanity) and body posture (example: sitting upright and attentively listening). + They should work with you and guide you toward the mutually agreed upon outcome you hope to achieve from your sessions. + They should focus solely on you, your needs, and your time.

Less-Good Therapy: + This provider might be casual around you in language (example: swearing) and gestures (example: lying down) during your session. + They might ask you to hangout outside of your sessions. + They ask unrelated personal questions that are prying or voyeuristic. + They might not help you formulate or work toward the mutually agreed upon outcome you hope to achieve from your sessions. + They might multitask (example: look at, or use their phone or computer) during your session.

2. Evidence-based Practice is a Must Therapy lives and evolves just like all other medical practice, however, though it responds to new research and current information, any intervention used should be evidence-based (the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences).

Good Therapy: + This provider should offer individualized solutions based on tried and tested scientific research with proof of effective application. + They should be able to clearly explain the reasoning behind what they are proposing you try or what they are asking you to do. + If you are confused, they should work to explain what they are proposing or asking without inserting opinion. + They should be able to explain any suggested course of action they suggest through scientific research .

Less-Good Therapy: + This provider might use language such as “In my opinion…” or “If I had to guess…” + They might offer vague explanations which you may not understand. + If pressed for an explanation they may say things like “You will get it after a few more sessions…” or “This is really big stuff to try to understand right away…”

3. Personal Judgment Should Not Exist If you have arrived at the need to see a provider, chances are you have worked through a variety of thoughts and opinions to get there. Because of this, therapy should always be judgment-free.

Good Therapy: + Sessions with this provider should feel like an experience rather than a lecture. + This provider should offer acceptance, and ask questions to help them fully understand you without agreeing or disagreeing with what you tell them. + This provider should give understanding, undivided attention, empathy, acceptance, positive encouragement, and support.

Less-Good Therapy: + This provider might use judgmental phrases in the vein of “that’s crazy…” or “I wouldn’t have done that…” + They might offer advice. + They might make assumptions without seeking clarification. + They might be condescending, or dismissive. Though these tools are just the start of understanding the difference between good therapy and less-good therapy, they should help you begin to make better decisions around who to trust with your mental health. ■

By DANIEL CHAMPER, LCPC - Intermountain Clinical Director no reason TO LOSE SLEEP

eadened eyes stare. Pasty skin shimmers. Colorless tongues drool. Listless arms dangle. Guttural sounds emit. Rancid odors waft. Zombies? Not likely.

There are many more believable explanations for all of these ghastly signs. Would you care to guess along with me? Teenagers? Parents of newborns? New night shift employees? Single parents working three jobs? If you have ever been in any of these situations then you most likely can (somewhat) humorously conjure up memories in which you resembled the description listed above. But what do all of these life situations have in common? The common link for all of the aforementioned circumstances and descriptions is sleep deprivation.

Sleep deprivation is commonly defined as the condition of not achieving adequate restful sleep. Symptoms of sleep deprivation are many. The list includes irritability, impaired judgment, slower reaction times, increased depression, inability to focus, weakened immune system, and on and on. We live in a culture of constant technological stimulation and are constantly confronted with the idea that success has a direct positive correlation with personal drive and industry. We text, type, and tweet. We crush candies and binge watch 80’s sitcoms late into the night. We allow work to follow us into the once sacred space of our living rooms and kitchens. Teenagers and adolescents, who formerly found relief from the pressure of social engagement in their bedrooms, have found these sanctuaries invaded by technological socialization throughout the evening and into the wee hours of the morning. This trend is often compounded by mounting pressure to perform and excel in the academic, vocational, and extracurricular arenas. In short, we live in a society custom built for restricted sleep habits.

The topic of sleep is vast, and science is still attempting to learn all it can about an immensely complex subject. As a result, we D

Teenagers and adolescents, who formerly found relief from the pressure of social engagement in their bedrooms, have found these sanctuaries invaded by technological socialization throughout the evening and into the wee hours of the morning.

continue to learn more and more about the positive and negative effects that sleep has on our waking lives. According to a recent study completed by Alexandra Agostini, from the Centre for Sleep Research at the University of South Australia, sleep deprivation has a snowballing nature. She also found that for teenagers and adolescents, this “sleep debt” cannot be fully paid by sleeping in on the weekends. And, we all know that many teenagers and adolescents rarely receive the 9 to 10 hours of nightly sleep that is widely recommended throughout the health community.

Another concept related to sleep that has emerged alongside the increased use of technology is the idea of sleep hygiene. Sleep hygiene refers to the quality of sleep that one receives. This quality can be negatively affected by stimulation close to bed time. Sleep hygiene can decline as a result of many different activities. Increased aerobic activity, technological and lightrelated stimulation, increased anxiety and constant thoughts all contribute to poor sleep quality. Basically, anything that rouses physiological or psychological activation within 30 to 45 minutes of sleep can have an adverse effect on the quality of sleep that one receives. And so it appears that we are about to head into the murky waters of the age old debate over quality versus quantity. Wrong. When it comes to sleep, both quality and quantity are equally important.

Much of this is not news. The zombielike creatures that shuffle into our mirrors, kitchens, and classrooms each morning make us painfully aware of the lack of sleep that our society receives. Energy drinks and coffee mugs the size of a flower pot are simply symptom reducers that make it possible to function at a fraction of our potential. Change must be intentional and supported. We cannot simply will ourselves and our children to better sleep habits and routines. So where do we start?

First, we must evaluate the extent of the problem. Track the number of (quality) hours of sleep you or your child receives each day for a period of at least a month. Then, set a goal. You will never increase the quality of your rest if your goal is simply “better.” Be specific with your goal (including a time or date for achievement). Be sure to set this expectation with your child in a clear and collaborative manner. Next, identify all factors that negatively affect the quality and / or quantity of sleep that is received. Remember to consider activity level, technology use, social pressures, and anxious or racing thoughts that you or your child may experience within an hour of your target bed time. Finally, get to work (AKA rest). If these steps are followed yet positive results are not experienced, seek medical attention for yourself or your child as there are many sleep disorders that can be treated by your primary care provider.

Zombies have taken over television, movies, and video games. With a little bit of knowledge and effort in the area of sleep management, we can keep them from taking over our homes, schools, and places of employment. ■