1. Forgiveness Starts With You
This means that whether you think you’re to be blamed or not that you must start by forgiving yourself. Once you forgive your role in the situation, then you can better forgive the other person. This is also a way for you to take the time to evaluate what you could have done differently. Once you discover what could have been done differently don’t hold on to it. In your mind say, “I can’t change the past, but I will learn from my mistakes and never make the same ones habitually”.

2. Don’t Approach the Individual While Angry
To avoid bringing any more tension into the relationship take time away from the person and calm down. After you are calm and all of your thoughts are collected approach the individual who wronged you or who you wronged. This will lessen your chances of saying something that you might regret saying.

3. Don’t Point the Finger
When you finally sit down to talk through the issue, make sure that you explain your side without downing the other person. State facts and let them know how you felt, but do so in a way that will not make them hostile in any way. It is also important to point out your role in the drama. Let them know that you don’t blame them for everything that went wrong. *It is important that you don’t just tip-toe around the issues, go ahead and say what the real issues are. If you avoid this, forgiveness will become harder.

4. Keep in Mind Why You Care About that Individual
The fact that you’re seeking forgiveness in the relationship shows that you care about that person. Look back in the memory bank of your mind and recall what made them important to you. Make sure you verbally tell them why you want forgiveness between the two of you. Make them feel valuable because they more than likely are valuable to you.

Patience
The path to forgiveness looks different for everyone, so it is important to be patient with yourself and with the person that you are seeking forgiveness with. Everyone has their reasons for reacting to certain situations the way they do. Remember that and don’t grow weary if it seems like forgiveness is far off. If you are important to this person, they will forgive you; it may just take longer than you thought.

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Tips for Staying Healthy this Summer

Summer time is finally here and all you want to do is catch on sleep, eat, hang out with friends, get outside, and skip work. Well, for those of you who have plans on staying in shape physically and mentally this summer, here are some tips on how to do exactly that.

1. Read books

Reading is a great way to enjoy the time and also to keep your mind sharp. The key here is to read books that peaks your interest. Whether you’re into science fiction, adventure, historical or romance novels just find one that you actually want read.

Another great challenge would be to read a book about something or someone in your field of study. This book does not have to be a boring textbook. There are plenty of books that are interesting relating to topics such as: business, law, psychology, graphic design, broadcasting or whatever your field of study happens to be. Or, why not take an interest in something completely out of your comfort zone?

2. Develop a new skill or find a new hobby

Use the warm weather in the summer to learn something that you have always wanted to do. Perhaps you have always wanted to take up archery, fishing, masonry or even cooking. These are things that you actually have time to learn to do and do them well with all your new free time. Imagine how cool would it be to tell are your friends that this summer you learned how to fly a plane! That’s a bit extreme, but you get the picture.

Maybe you have the desire to learn a new skill or take up a new hobby, but you just have nothing in mind, the Internet is a great place to start looking. There are plenty of great ideas online and almost anything that you could think about is online. Plus, there are hundreds of YouTube videos out there just waiting to teach you something awesome, so start looking!

3. Hit the gym

If you’re anything like me, you loathe the gym and only go one or twice during the winter. My daily workouts during the semester include my morning pushups, walking around and taking the stairs whenever possible. The summer is usually my time to up my muscle mass.

You actually have time to go to the gym so go! There are no more lame excuses that are holding you back. Grab a friend or someone who will keep you keep you motivated and get back into shape. Take group class at your local gym if a friend is not available. There are plenty of programs that will have you in and out of the gym in an hour or less. In the words of Nike, “Just Do It”.

4. Find time to be outdoors

Whether you live in the country, suburbs or the city make sure that you plans some outside time. Being outdoors in the sun provides your body with lots of vitamin D and is just a good thing to do in general. Outside there is an abundance of fresh oxygen just waiting for you to enjoy.

You also have plenty of things to do outside that are free. Free is a good thing! Visit a local park, go on a run… Whatever you do just make sure you get outside and get active.

5. Eat Right

Take advantage of those free homemade meals this summer. Homemade meals are normally more healthy and they’re my favorite word, FREE. Or join a BBQ at one of the major holidays this year. Take advantage of the warm weather and the mass grilling taking place all around you..

Avoid overindulging and catch up on the vegetables that you neglected so much.

Got any more ideas? Add them in the comments below!

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Clinical Psychologist Meg Jay was featured on TED talks this past week for her talk on twentysomthings.

According to Meg, there are 50 million twentysomethings in the United States right now. That’s about 15 percent of the population, or 100 percent if you consider that no one’s getting through adulthood without going through their 20s first.

Meg specializes in twentysomethings because she believe that every single 50 million twentysomethings deserves to know what psychologists, sociologists, neurologists and fertility specialists already know: that claiming your 20s is one of the simplest, yet most transformative, things you can do for work, for love, for your happiness, maybe even for the world.

To view the entire Ted Talk:

“This is not my opinion. These are the facts. We know that 80 percent of life’s most defining moments take place by age 35. That means that eight out of 10 of the decisions and experiences and “Aha!” moments that make your life what it is will have happened by your mid-30s. People who are over 40, don’t panic. This crowd is going to be fine, I think. We know that the first 10 years of a career has an exponential impact on how much money you’re going to earn. We know that more than half of Americans are married or are living with or dating their future partner by 30. We know that the brain caps off its second and last growth spurt in your 20s as it rewires itself for adulthood, which means that whatever it is you want to change about yourself, now is the time to change it. We know that personality changes more during your 20s than at any other time in life, and we know that female fertility peaks at age 28, and things get tricky after age 35. So your 20s are the time to educate yourself about your body and your options.”

“Twentysomethings are like airplanes just leaving LAX, bound for somewhere west. Right after takeoff, a slight change in course is the difference between landing in Alaska or Fiji. Likewise, at 21 or 25 or even 29, one good conversation, one good break, one good TED Talk, can have an enormous effect across years and even generations to come. So here’s an idea worth spreading to every twentysomething you know…Thirty is not the new 20, so claim your adulthood, get some identity capital, use your weak ties, pick your family. Don’t be defined by what you didn’t know or didn’t do. You’re deciding your life right now.

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2. Set up a 401(k)
If you are young, look into a 401(k). It really isn’t that scary! Also, when you are younger, go ahead an max out your available contributions (with your employer matching them).

3. Record what you Spend
Documenting what you spend used to be difficult. You’d pull money out at the ATM, and then a week later it was gone. Now that we use our debit/credit cards on every purchase (even the $.99 ice cream cone), your bank will have a monthly statement of your purchases. According to VISA (and this was in 2007), men can lose over 3k a year in nominal purchases. Make sure you tally up your money. Small spending turns into big spending. At then end of a few months, add up the purchases you may not have needed. You’d be surprised what you could save.

4. Start to Get out of Debt
Getting out of debt is difficult, and our goal should not be to starve ourselves out of debt. We should make small, doable goals to get out of debt. For starters, just make sure that you are making the monthly minimums on your cards, avoid paying last fees, and try to pay the interest off. Repeat. Repeat. And Repeat. The debt will start to go away.

5. Finally, Get a Good Tax Rep
If you have had a major life change – getting out of college and doing your taxes for the first time, just got married, had a baby, had another baby, had yet another baby, a great financial planner can save you thousands – and the best part – financial planners normally do not cost too much because, well, they are financially minded.

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Professionals use telephone counseling—a lot. 

Similarly, a survey of psychiatrists found that 45% use the telephone as an adjunct to face-to-face (FTF) sessions, and 19% use it as their primary medium for providing treatment. Also, research has found that for some medical practices up to 70% of problems are handled solely by telephone. In my own research study (published in the Journal of Mental Health Counseling) of 841 mental health professionals, 73% reported using telephone counseling.

Such data irrefutably shows that the use of the telephone in the delivery of mental health services is nearly universal, and this doesn’t even include para-counseling services, such as those provided through radio or television call-in programs.

There are several ways online counseling is provided. These methods include (1) email counseling, (2) text-chat counseling, and (3) videoconference counseling. 

Computer Mediated Communication
Computer mediated communication (CMC) is a fancy way of saying “talking to someone through a computer,” and without it online counseling—the online part, anyway—would be limited to an online version of bibliotherapy. That is, without CMC, a person suffering from depression could find a website and read about depression, or watch a video on depression recovery, but back and forth dialogue between client and counselor would not be possible. Therefore, having at least a basic understanding of CMC will help us immensely as we begin to discuss online counseling.

CMC is commonplace for persons with Internet access, especially younger Internet users who use CMC to be part of online communities, and to connect emotionally with others. There are two basic types of CMC, asynchronous communication and synchronous communication.

Asynchronous Communication

Asynchronous communication is a conversation that is not in ‘real-time’. This means there is a significant time-delay between the period when one person makes a statement, and when another person responds. This is nothing new. Mailing letters back and forth with a friend is an example of asynchronous communication. A friend of mine participates in asynchronous communication when she uses a camcorder to record video-messages from her and her daughter, and then emails the file to her husband, who is overseas. On the Internet, asynchronous communication is very common and takes the form of email, discussion board forums, and bulletin boards.

Synchronous Communication

Synchronous communication is a conversation in ‘real-time’. This means that two or more persons receive and immediately respond to each other’s dialogue. We are all experienced with synchronous communication—every in-person conversation we have ever had has been synchronous, as has every telephone conversation. Videoconference would also be an example of synchronous communication, as would text-chat.

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Anxious/ambivalent attachment style: The attachment style defined by a child who displays extreme caution in the presence of a stranger. The child’s ability to explore the environment is greatly diminished when the primary caregiver is absent. When the caregiver does return the child remains close, but becomes noticeably angry and hard to soothe or comfort (Newman & Newman, 1999).

Avoidant attachment style: The attachment style defined by a child who avoids interaction with his/her primary caregiver after separation. A child displaying this style of attachment is also likely to ignore the caregiver. Children of this attachment style typically show less distress in the caregiver’s absence (Newman & Newman, 1999).

Anxious-avoidant attachment is characterized by infants who, after the mother has returned from separation, shun their mother’s efforts to interact and escape contact. They ultimately are more comfortable being alone than infants with other attachment styles. These infants are more likely to cry at home and have a harder time being consoled when their mother does return. Extreme caution is exhibited by infants of an anxious-resistant attachment style when a stranger is present. Their exploration of the environment is remarkably disturbed when the mother leaves the room. When she returns however, the infant seems to struggle with ambivalent feelings of anger toward the mother and the eagerness to be comforted by her.

Secure attachment style: The attachment style defined by a child who is not fearful of exploring his/her environment when the primary caregiver is absent. When the primary caregiver returns, the child will actively return and seek communication. If the child was distressed in the absence, the caregiver’s return decreases the stress of the child and permits the child to actively explore the environment once again (Newman & Newman, 1999).

Infants who develop a secure attachment are also less likely to cry than others their same age. They are more likely to obey and respond more positively to their mother’s request and they also welcome their mothers more assertively after normal separations. It is evident that securely attached infants expect their caregiver to not only be approachable, but to also acknowledge them. Infants who develop a secure attachment are able to both interact with strangers while their mother is present and enthusiastically investigate their surroundings. When the mother returns after the separation, the infants are quick to seek their attention and comfort.

Research provided by:

Joshua Straub, Ph.D. is a speaker, author, counselor and professor. He specializes in attachment and relationship research, the Millennial generation, crisis and trauma, marriage and family, and spiritual formation.

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I was hoping I could pick your brain a bit regarding hiring a few part time folks at my practice. My thinking originally was to give a set percentage for each session that the licensed counselor performs but now for ease of payment I was thinking a flat hourly rate per session. Another agency in the state pays $30.00 per session regardless of the type. I personally never made more than $23 an hour working for someone else, but it was a fulltime job and offered benefits. I was considering $30 per regular session and $40 per group. In the future when we could afford it, we would then start hiring fulltime with benefits.

What are your thoughts? Any information would be greatly appreciated as this in NOT my area of expertise at all (I design programs and practices but have not been involved with HR related stuff).

I see you are burning up the pages of CT. Glad to have a guaranteed good read!

Take care and thanks again for the offer of help and guidance! (the offices should be sheet rocked in the next week or two!)

John

Hi John,
Of course I’d be happy to help.

There are really no “right” answers as it comes to this sort of thing.

Counselors do tend to prefer a flat rate over a % split, because they don’t need to worry about money coming in from clients or insurance companies. That being said, it seems that most small practices pay their licensed clinicians on a split. For independent contractors, a typical split is often 60%/40%, in the licensed clinician’s favor. Some practices pay more, and some pay less.

And some–like Thriveworks–pay their clinicians as employees (not independent contractors) and absorb a 7.65% payroll tax in addition to compensation fess paid. And offer benefits. Ouch.

Perhaps, instead of looking at what you pay per appointment, it would be best to look at whether someone could make a good living working with you. That’s going to keep your practice competitive, and help you to retain a good team. Losing a clinician is REALLY HARD on a practice, so you want to make sure that your clinicians are not going to depart to pursue better compensation elsewhere.

I have encountered too many practices that lose their best clinicians every couple years or so because they pay under market rate. These practices can recruit new clinicians, but most of them–at some point–decide to leave. This can hinder a practice’s growth and long term success. That said, I see just as many practices pay their clinicians too much (typically over 60% as employees, or over 65% as contractors). These practices never seem to have any money to grow the practice, because too much of their revenues are tied up in staff compensation.

I hope this helps John!!

–Anthony
 

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“If it takes a village to raise a child”, a village (community) can help individuals when they are in the middle of divorce, struggling with addiction, working through relationship problems, or even struggling with depression.

If you have a question that you have been dying to ask, feel free to ask it on our community counseling forum. Or, if you have the ability to answer questions, feel free to respond to the community.

The basic ground rules for discussions on Thriveworks are simple: be polite. Our fellow community members will treat guests in these forums with courtesy and respect. The forum is a place for counselors and members alike to ask questions and receive help…

To start asking or answering, visit the community forums today.

Some of the forums already started:

• How to deal with depression?
• How do you overcome addiction?
• How have you forgiven someone that hurt you?
• When do you ask for financial management help?
• For Counselors: What are the best insurance panels to be on?
• For Counselors: Education is Expensive: Is it worth obtaining a Doctorate or a Ph. D degree in Marriage and Family Therapy?

Come Join Us!

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What am I meant to learn from this plateau? What do I need to overcome to move to the next level?

As if preparing for battle, I carefully unfold and spread out 1 pair of tight black Capri pants, 1 chest squishing sports bra, my favorite purple dry-wick t-shirt, 1 pair of special support socks, 1 beloved pink/gray iPod sports band with hot pink headphones, 1 pair of slightly scuffed running shoes, and 1 cold bottle of water, on my bedspread. I step back to face down my running gear, fists on my hips, and assess my motivation for running today.

The back of my right knee has a dull throbbing pain, my left quad is as tight as a guitar string, and on the edge of my right scapula (in the most impossible place to stretch) I have a pea sized, sharp shooting spot of pain. My gremlin says, “What’s the point? You’ve been at the same pace and same training pattern for 4 weeks now. You’re not even getting any better.”

My mind tells the gremlin to “shut up” but even my heart recognizes the lack of conviction in my words. I’ve been training for a 5k…for the last 4 months…and yes, I’m still at the very beginning of the running intervals (2 minutes running then 2 minutes walking). I love the idea of running, but am less than thrilled with the reality of it. This is my plateau and the gremlin seems to be winning.

What am I meant to learn from this plateau? What do I need to overcome to move to the next level? And even if I can master control of my gremlin, overcome the negative thoughts, and believe in my abilities, do I still have the motivation to persevere?

There are many plateaus that we encounter in life; trying to lose weight (been there), on our career path (yep that one too), exercising (running – the bane of my existence at the moment), relationships that stagnate (overcame that one), and feeling “stuck” in the counseling process.

Once a client myself (all good therapist must know what the couch feels like), I hit that plateau…it was like running on the treadmill…working hard and getting nowhere fast. Frustrated, defeated, and close to giving up, my therapist introduced a different technique that helped me to get on a new path, with a nice change of scenery.

My therapeutic perspective is a strategic combination of biopsychosocial theory, energy psychology, and attachment theory with a hint of traditional psychodynamic perspective. This allows me the freedom to pull different “techniques” from my toolbox, when I need to help a client get “unstuck”. Every school of thought proposes a different approach to plateaus. What is your theoretical and practical perspective?

What tools are most appropriate in your practice to tackle these plateaus? If you are struggling with these questions, seek out guidance from your consultant or mentor. If your tools are scarce, search for workshop or training opportunities (provided by reputable and well qualified instructors) which will fill your toolbox.

Training for my 5k takes practice, determination, patience, and pursuit of a goal more important than listening to my gremlin. Providing therapy takes the same level of perseverance, and as the expert, it is your responsibility to assist your clients in overcoming the plateau. When I’m running (yes, I grudgingly put my running gear on and do it despite my gremlin), I keep in mind there are 3 types of people who see me on a run; runners – who think “that is hard stuff, glad I finished my run”, non-runner spectators – who think “that looks really hard, glad I’m not out there”, and those running on the same path – who think “this is really hard, let’s go get it!”

What kind of therapist are you – spectator or runner?

Lauren Somers holds a LPCC in the State of California, a Doctorate in Counseling Psychology, certification in EFT (energy psychology), and over 19 years of experience in delivering counseling to adolescents and adults in individual and group settings. She hosts a private practice in the beautiful San Francisco Bay Area where she endeavors to understand her client’s story and weaves the traditional therapeutic modalities with a bit of shamanic healing, energy psychology, and mindfulness to bring about growth and healing.

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5 Reasons Why Counseling Needs a Franchise
(And Why Counselors are Ready for it!)

In a previous article, I discussed 3 reasons why, despite the proliferation of healthcare franchises, a successful counseling franchise hasn’t existed. In this column, we’re going to investigate the issue from the opposite perspective—why a counseling franchise could work, and how a franchise could benefit both clients and the counseling industry as a whole.

1) Training, Guidance, and Support
When counselors go into private practice, the day they open their doors is often their first experience owning and running a business. In fact, some clinicians don’t realize they have a business at all; I’ve heard some counselors say, “I don’t think I have a business…I have a practice!”

Counselors love the work of counseling, and they often venture into private practice because they want to be their own boss, deliver excellent care, and find success working in their profession at a level above what other settings have offered. To this end, a franchise could be an asset to counselors. A ‘franchisee’ (one who purchases a franchise) is not an employee—he or she is a bona fide owner of his or her own company. At the same time, a franchisee receives valuable training, guidance, and support from the franchising company (the ‘franchisor’).

2) A “Turnkey” Business
While every counselor is unique and brings his or her own style to the counseling process, there are many parts of running a counseling business that are the same from one well-run practice to another: the phone needs to be answered, the appointments need to be scheduled, the bills need to be paid, etc. A franchise could help counselors because franchisees wouldn’t need to “reinvent the wheel” or participate in costly and time consuming “trial and error” figuring out what works, and what doesn’t. Franchises are designed to be “turnkey businesses,” which means that they include everything one needs to start running the business on day one—including a proven business model.

In addition, a counseling franchise could provide additional value to franchisees if it connected franchisees with operational services such as medical credentialing, medical billing, reception, scheduling, recruiting, Electronic Health Records, and other services. The more a franchise can take administrative burdens off the shoulders of counselor-franchisees, the more those franchisees could focus on building clinical teams, and their first passion—helping clients.

3) Brand Trust & Industry Standards
Starbucks re-invented the coffee industry in America. Pre Starbucks (i.e., before 1971), most Americans were drinking what Howard Schultz* describes as “swill”—coffee made from low grade Robusta coffee beans, instead of higher quality Arabica coffee beans. Many Americans settled for an inferior brew because they didn’t have high quality options, and they didn’t know what they were missing. While small coffeehouses love to pick on Starbucks for being too corporate, Starbucks set the bar in the industry.

Today, few coffeehouses will succeed by providing a low quality Robusta bean product. However, coffeehouses that offer a high-quality alternative to Starbucks coffee may do exceedingly well. Shultz explains, “Clearly there’s room for many different styles of coffee stores or coffeehouses…[customers] decide which coffeehouse to visit. They may vary their choice of establishments, depending on their need or mood. In the end all of us benefit.”

While many practices provide excellent care and service, a few bad apples can spoil the bunch, and this has led to a caricature, portrayed in movies and the media, of the ‘ditsy therapist.’ Some people who receive poor clinical care don’t know that they’ve stumbled upon a sub par practice. Because there’s no known standard, they think counseling is a sub par profession. A counseling brand could give clients a benchmark of service and care to expect; and the industry standard could serve to help improve the reputation of the counseling field as a whole. This is happening right now in the massage therapy field, with the proliferation of Massage Envy centers. The Massage Envy franchise is improving the reputation of massage, and even independent massage practices will benefit. Like massage therapy, and even coffee, counseling needs a brand to set the standard.

4) Community & The Family Effect
An irony of having a counseling practice is that even when counselors are in session with clients all day, counseling can still be a very lonely job. A counseling franchise could offer community to private practice owners—as well as peer supervision and support. Such a community could be unusually strong because, since every franchisee has a protected trade area (as is customary with franchises), no franchisee would be in competition with another. In fact, the exact opposite would exist! The success of any franchisee would benefit the system as a whole. Hence, each franchisee would have a vested interested in other franchisees’ successes, and therefore be incentivized to share openly their insights and learnings with the community at large.

5) Bargaining and Purchasing Power
While small mental health practices can struggle to make ends meet, being part of a larger system could lead to increased bargaining power in areas such as marketing, technology, recruitment, and perhaps even the ability to negotiate higher rates with insurance companies.

In addition, it’s reasonable to expect that a franchise would be better equipped than a traditional private practice to purchase or develop valuable resources and technologies. For instance, developing an EHR program, creating validated psychological tests, or even commissioning an iPhone or Android App might be outside the resources of a solo practice, but for a franchise—a community of practices—such endeavors could be just another day’s small investment in the pursuit to continually expand and improve service offerings.

Red Herrings
When I first began considering whether a counseling franchise was a viable idea for our industry, I consulted with a number of professionals in the field. While many saw the value a franchise could bring, there were also concerns and “what ifs” such as:

• What if the franchise didn’t focus on quality clinical care?
• What if the standardization of practices took the “soul” out of therapy?
• What is the franchise interfered in the client-counselor therapeutic relationship?

It became clear that professionals who expressed concern weren’t worried about a Ritz Carlton- (who uses the motto “We are Ladies and Gentlemen Serving Ladies and Gentlemen”) or even a Starbucks-caliber brand joining the field, they worried about a Taco Bell or McDonalds harming the field by focusing on quantity over quality.

It was clear that if a franchised brand were to exist, that brand would need to be dedicated to excellent clinical care, clinician creativity, customer service, and the essence and power of counseling relationships.

While some worry about what will happen to the field if there is a recognizable brand, I tend to worry about what’s going to happen to the field if there’s not a recognizable brand. But no matter which worry you have, one thing is clear: the time to discuss the need for a recognizable counseling brand is now.

*Howard Schultz is Founder and CEO of Starbucks

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