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What happens in therapy? What should you know about starting therapy?

Let’s start with the first steps…getting connected with a JFCS therapist.

When you first call for a therapy appointment at JFCS, you will speak with our intake coordinator who will ask a few questions to gather some background information to pass along to the therapist with whom your case is assigned.

You will be asked for a general description of why you are coming to therapy – what is called the presenting problem. The reason the intake coordinator asks is to be sure that we are able to provide services for the problem you are dealing with. For example, if someone is experiencing a drug addiction, we would refer them to another provider as we do not provide substance abuse counseling.  The intake coordinator is bound by the same HIPPA laws regarding confidentiality and privacy of healthcare information as the therapist.

When one of our therapists is assigned to you, they will phone you and schedule an initial assessment session which will last for about one hour. This time is a ‘getting to know you’ session, where the therapist will complete what is called a Biopsychosocial Assessment, asking questions to better understand your background, current problems, symptoms, as well as strengths. Oftentimes, more than one session is needed to gather information to conduct a thorough assessment. We don’t want anyone to feel rushed while sharing their personal story of life experiences

At the initial assessment session, paperwork will also be reviewed, such as HIPPA forms, agency policies regarding attendance and other issues. Once the assessment is completed and it is determined that JFCS is the appropriate level of care for your presenting problem, the therapist and client will together develop a Treatment Plan which defines the problem and goals for treatment focus. It is important for both client and therapist to understand what is the ‘endpoint, or when will both know that therapy has been successful.

What does a typical therapy session look like?

Therapy can be held individually, as a couple, with a family unit, or in a group with a common treatment focus. Therapy is also available to anyone from childhood to elderly adults. Here at JFCS we can provide therapy services for children starting at age 5 and up to adults of any age.

Sessions are usually held every two weeks and last approximately 45-50 minutes. The length of treatment can vary depending on the complexity of issues which are the focus of treatment. The treatment goals and decisions for how often and how long to meet are collaboratively discussed by the client and therapist.

Currently, for the health and safety of all during the COVID-19 pandemic, all therapy sessions at JFCS are being conducted through video teletherapy on Zoom or by phone. Many other agencies and therapists throughout NJ are also providing services via video teletherapy.

There are both advantages and drawbacks to this mode of providing therapy. Some of the benefits of engaging in therapy remotely are: there’s no need to travel to an office – you receive services in the comfort of familiar surroundings; it’s an easy process – your therapist emails you a link which you click on at the time of your session to connect for a session. Our team at JFCS has found that clients, overall, have enjoyed the many advantages of video teletherapy.

What would be helpful to know about therapy? 

Roles: The relationship between the therapist and client is a professional relationship. This means that the relationship’s purpose is to benefit the client and that there are established boundaries or limits that are deemed appropriate according to the ethical standards set by the therapist’s profession, ex. social work code of ethics. This therapeutic relationship is different from your other relationships. The therapist is bound to keep confidential the information you share with them, with a few exceptions, ex. harming self or others. You can feel confident that what you talk about will stay with your therapist, this may not always be true of your conversations with friends and family.

Therapists reveal very little about themselves to clients, and if they do share something of a personal nature, it needs to be in the service or benefit of the client. The focus of the session is on you, the client; the therapist is there to assist with compassion and without judgment.

While it may seem like a nice idea to be able to continue a relationship outside of the therapy sessions, this is not possible. The therapeutic relationship is not a two-way relationship where both parties get to know each other. The role of the therapist is to help their client, never the other way around. Most therapists genuinely care about their clients and want to see them improve. Establishing healthy boundaries helps with this process.

Guidelines: At the initial session, most therapists will provide information to the client regarding the agency’s policies, such as the cancellation/no show policy, policy related to fees and insurance, how to best contact your therapist between sessions, etc. Discussing this information early on can help to clarify expectations and responsibilities for both client and therapist and help prevent any future misunderstandings. If you have any questions at any time, do not hesitate to bring them up to your therapist.

Expectations:  Along with a strong therapeutic relationship, there are several factors that can promote positive therapy outcomes.

  • Regular attendance to the sessions
  • Being willing to have the “difficult” conversations
  • Sharing honestly in session
  • Fully participating in therapy
  • Being open to feedback
  • Completing any tasks or written exercises outside of session

Feeling unsure about therapy?

If you are hesitant about meeting with a therapist, let me share this:  Do you think it would be realistic – or a good idea, for a person to go through their entire life, and never see a medical doctor for physical problems? Probably not.

Throughout our life we are bombarded with many outside toxins, viruses, germs, and we also have body parts and systems that wear out or get injured. To alleviate these various illnesses and problems we may need professional help, medical help, to deal effectively with the problem.

It is the same with our mental health. Is it realistic to think that we can go throughout our entire life without needing some professional help for our mental health related problems? Our mental health is just as important as our physical health.

When you are in need of therapy remember that JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed therapists.

Teri Cheresnick, LCSW, LCADC

Why do people go to therapy? How can therapy help?

There are many reasons why someone may go to therapy, but a few of the reasons are:

  • You’re having difficulty managing your emotions. While everyone feels upset, sad, or angry at some time in their life, it’s important to pay attention to how often or how intensely you feel these emotions. For example, if you feel continually sad, hopeless, or disengaged in your daily life for at least two weeks or longer, it may be a sign of clinical depression which is different from an occasional depressed mood.
  • You notice a decrease in your level of effectiveness in your role at work, home, or school.
  • You are experiencing noticeable changes in your sleeping pattern – sleeping too much or too little or changes in appetite – either overeating or not eating enough.
  • You are having difficulty in your interpersonal relationships.
  • You’ve experienced trauma, whether it’s sexual abuse, domestic violence or another trauma that you haven’t recovered from.
  • You no longer find pleasure in activities you once enjoyed. When you struggle with a psychological issue, feelings of disconnectedness can cause a person to have a loss of interest in hobbies, socializing and other activities.
  • You are experiencing grief. Grief can be a response to many losses, not just the death of someone we care about. We can grieve the loss of a relationship, the loss of a job – and sometimes we need help to process these painful feelings.
  • You use an unhealthy substance or activity to cope with stress. At times when we are feeling overwhelmed we look for relief by using something to numb our emotions – and that can be alcohol, drugs, or sex.

How can therapy be beneficial?

Therapy is more than just talking things over with someone and getting things off your chest. While talking to a friend or loved one can be helpful, sometimes more than just a sympathetic ear is needed.  Some ways that therapy can be beneficial are:

  • Therapy can help a person learn to identify and change behaviors or thoughts that are adversely affecting their life.
  • Therapy can assist with developing more healthy, effective ways to cope with and solve various stressors and problems. And therapy can assist you in having more meaningful relationships.
  • If someone has a diagnosable mental health disorder such as depression or an anxiety disorder, therapy can also help the individual to understand the illness, eliminate or decrease the symptoms, and improve their daily life interactions.

According to Dr. Ramani Durvasula, a clinical psychologist, therapy “is an honest, objective and confidential space that allows a person to explore uncomfortable feelings, understand its root causes, place it in a context and learn coping skills to overcome those feelings.”  Additionally, “it’s a trusting space where you can be vulnerable and explore deeper issues that require the assistance of a trained professional, such as trauma or high-risk behaviors”.

If you or someone you know may benefit from therapy, JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed therapists.

Teri Cheresnick, LCSW, LCADC

Who provides therapy? How to find the right therapist for you?

Who can provide therapy?

When you are looking for a therapist, and new to therapy, it can be hard to understand the different titles, licenses and credentials of professionals in the field. Let’s explore who can provide therapy…

In New Jersey, therapy can be provided by several licensed mental health professionals such as a psychiatrist, psychologist, counselor, social worker, or psychiatric nurse.

A psychiatrist is a medical doctor who specializes in diagnosing and treating mental illness and is licensed to write prescriptions. Many mental disorders, such as depression, anxiety, and schizophrenia, are treated with medications along with ‘talk’ therapy. The psychiatrist will conduct an initial psychiatric evaluation to determine if medication would be beneficial for an individual. Sometimes it is a combination of medication and therapy that is needed to best treat the mental health condition. Many mental health disorders, such as depression, can have a biological basis and being prescribed a medication may be part of your treatment plan. If medication is prescribed, the psychiatrist will meet periodically with the client for brief medication management sessions and the client will usually receive ‘talk’ therapy on a more frequent basis, perhaps bi-weekly, with another licensed mental health professional such as a psychologist,  LPC/LMFT or LCSW. The letters after a person’s name indicate their credentials.

There is also an APRN designation which is a licensed advanced practice registered nurse. This individual is a registered nurse who has training in mental health services and can prescribe medications along with providing treatment for mental health disorders.

The following licensed mental health professionals are all qualified to evaluate and treat emotional difficulties and mental health disorders, but cannot prescribe medications:

  • A psychologist holds a doctoral degree (PhD, PsyD, or EdD) in psychology which is the study of mind and behavior.
  • An LPC is a licensed professional counselor and an LAMFT is a licensed marriage and family therapist. Both have a master’s degree (MA) in counseling.
  • LSW is a Licensed Social Worker: has a Master of Social Work (MSW) degree.  An LSW may provide clinical social work services when supervised by an LCSW.
  • LCSW is a Licensed Clinical Social Worker: has a Master of Social Work (MSW) degree. While both LSW and LCSW have written licensing exam requirements, the LCSW has also completed additional clinical experience to obtain the LCSW license.

Letters in addition to the above may indicate additional certifications or training. For example, LCADC is a licensed clinical alcohol and drug counselor.

Do not hesitate to ask your therapist what the letters after their name means. You are paying for their services and have a right to know the credentials of the person providing your care. They won’t be insulted if you ask.

How can I find the right therapist for me?

First, identify what’s most important to you in a therapist.  Do you prefer working with a woman or man? Do you prefer someone who uses an eclectic approach or is DBT preferred?  Is someone whose client focus is LGBTQ important to you?

Once you’ve thought about what’s important…

  • Ask your friends and family – people you trust, for their recommendations.
  • Call your health insurance company for a list of in-network providers or go to their website to look.
  • Go online to Psychology Today and utilize their free therapist search tool that helps you choose a local therapist using various search criteria.
  • Ask your primary care physician for a recommendation. Many therapists have their own website where you can learn more about them – their training, therapy style, specialties, etc. Give them a call to ask any questions you may still have after viewing their website.
  • Search online for “Therapist Near Me” or “Therapist in Mercer County” to find local listings

For those times when you may need some additional assistance in dealing with life’s challenges, JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed professionals. The JFCS clinical team includes licensed clinical social workers, licenses social workers and a licensed family & marriage therapist.

Teri Cheresnick, LCSW, LCADC

What is Therapy? Understanding Types of Therapy for Mental Health Care

Perhaps you’ve never met with a therapist before and are unfamiliar with psychotherapy – or maybe you have participated in therapy and still have some questions about it. Let’s dive into what therapy is all about…

What Is Therapy?

Psychotherapy, also known as “talk therapy” or just “therapy,” is a form of treatment designed to help people with emotional difficulties and mental health problems. Psychological problems are treated through communication which is grounded in dialogue and relationship factors between a client and their therapist. The trusting relationship between an individual and their therapist is essential to working together effectively and benefiting from therapy. Therapy provides a supportive environment that allows a therapeutic relationship to develop where you can talk openly with someone who is understanding, objective, and nonjudgmental. The purpose of therapy is to help the individual increase a sense of well-being and eliminate or control distressing symptoms so they can function better in their life. 

Some of the problems that can be helped by therapy are life problems: coping with losses such as a death, divorce or loss of a job; adjusting to life transitions such as the ‘empty nest’ when children leave home; dealing with a serious physical health problem;  recovery from abuse; to resolve conflicts with your partner – and specific mental health disorders, such as depression, PTSD, anxiety, or bipolar disorder, to name a few.

Therapists can engage in various approaches or types of therapeutic treatment. The type of therapy may depend on the presenting problem of the client as well as the therapist’s preference and training. There are many types of psychotherapeutic treatment. For example, cognitive behavioral therapy (CBT) helps people identify and change thinking and behavior patterns that are problematic and replace them with more accurate thoughts and functional behaviors.

Dialectical behavior therapy (DBT) is a specific type of CBT that helps regulate emotions by teaching new skills to help people take personal responsibility to change unhealthy or disruptive behavior.

Psychodynamic therapy is based on the idea that our current behavior and mental state is influenced by our past childhood experiences and thoughts or feelings that are outside the person’s awareness. Working with the therapist, a person begins to increase self-awareness and change old ways of behaving to more fully take charge of their life.

Oftentimes the therapist will use an eclectic approach, incorporating a range of proven methods from a variety of disciplines to best help the client. This approach customizes the therapeutic process for each client.

For those times when you may need some additional assistance in dealing with life’s challenges, JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed therapists.

Teri Cheresnick, LCSW, LCADC

Five (More) Strategies to Building Emotional Resilience

In my most recent blog, I presented five research-based strategies that can help us to develop and strengthen our emotional resilience – our ability to ‘bounce back’ from stressors. In this post, we explore an additional five research-based strategies that can help us increase our emotional resilience:

Have Social Support:

All of us need to feel that we are not alone. Social connectedness to others releases oxytocin which calms the mind and reduces stress. Reaching out to others is not a sign of weakness, but instead an acknowledgement of knowing your own limitations and that you value human connection. In times of difficulty, reach out to others and ask for help. Reaching out to others and asking for their help is often a gift you give to them. Think back to how you may have felt when you helped a friend. We feel useful, and resilience builds for both the giver and receiver.

Be a Lifelong Learner:

Learning is not just for the young, it is also for the “young at heart.” By constantly growing your mind and adapting to new information about the world, you remain mentally sharp. Ask yourself, “Am I stuck in my ways?” Be open to new ideas, meeting new people, exploring new interests, learning new skills. Learning does not have to always be a major accomplishment, such as learning a foreign language, but can be as simple as trying a new recipe.

Change the Narrative:

When something bad happens to us, it is common for people to ruminate about the experience, the decision, replaying it over and over again in our mind and re-experiencing the pain.

Instead of replaying a choice or event, explore new insights that resulted from the challenge, rather than simply ruminate. One way to ‘change the narrative’ can be expressive writing. For several days, write freely for 20 minutes about one situation that is bothering you – no agenda, no questions to answers – simply write about the thoughts and feelings you have about the situation. When we focus and give our thoughts structure and attention, we can gain new perspectives. We process the event which can help give us a sense of control.

Focus on Self-Care:

We will have a hard time being emotionally resilient if we are physically exhausted or poorly nourished. Take care of yourself – schedule an annual check-up, eat (mostly) healthy foods, get moving with exercise, limit caffeine, and spend some time resting or relaxing. Turn to online options such as Youtube, to find short, guided relaxation videos; a 10-20 minute relaxation video can be like mini-vacation.

Control your Destiny:

While we cannot control what happens in the world or what other people do, we have control over how we respond and think about a situation. It is not the situation that causes the stress or anxiety, rather, our reaction to the situation.

Have you ever noticed people in their cars stuck in traffic? You can have one person calmly listening to the music on the radio, waiting patiently, while another driver is fuming, pounding the steering wheel beeping his horn. Same situation, two totally different reactions.

One way we can help ourselves is to say “I have a choice how I’ll respond” every time we face a challenge or difficulty.

When you feel overwhelmed by stress, try one of these strategies, or one of those previously discussed. Each small step you take can help to build your emotional resilience.

For those times when you may need some additional assistance in dealing with life’s challenges, JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed therapists.

This is the last of three blogs covering Emotional Resilience. View the previous entry here. You can also view Teri’s webinar on this topic by clicking here.

Teri Cheresnick, LCSW, LCADC

Five Strategies to Building Emotional Resilience

In last week’s blog post, I discussed emotional resilience as our ability to bounce back and adapt to life’s stressors. In this post, I will explore five research-based strategies that can help to develop and improve emotional resilience.

Be an Optimist

This does not mean the “rose colored glasses,” but a realistic optimist. Someone who looks at any negative experiences around them and sees what is relevant to the problems they are facing. The realistic optimist disengages from the problems outside of their control and turns attention to problems they believe they can address. Acknowledge the problem, but then see what, if anything, about the problem directly impacts you and that you can work on. Be realistic about the world, and confident in your abilities that you can make positive changes to problems within your control.

Find a sense of purpose and meaning in your life:

Resilient people have a mission and purpose in life that gives meaning to the things that they do. When tough times roll in, they feel a greater purpose is behind them, propelling them forward. That purpose can be that “I go to work to provide for my family” or “my role is to care for my loved one.”

We can also start to develop our purpose in a small way. Over the next week, identify your focus. Take the time to acknowledge how you want to spend your time and energy. It could be as simple as “I’m going to call my friend because he’s been feeling down” or “I’m going to donate to a charity I believe in.”

When we have a purpose it nourishes us.

Face your fears:

When we avoid something we are afraid of, the fear inside us grows. When you face your fears, the intensity of the fear lessens. We cannot just talk ourselves out of the fear, but we have to address the fear one step at a time.

As an example, if we have a fear of speaking in public it can be helpful to begin addressing this fear by starting a conversation with a neighbor, then working up to giving a toast at a dinner party, each time taking a bigger step towards your goal. During this ‘exposure therapy’ we start to change the negative associations we have to situations or objects, being able to believe “that wasn’t so bad. I can do that.”

Be adaptable and flexible:

Resilience is figuring out a new way to behave when your old ways of behaving are not working or are not accessible any more. We have the power within us to make new choices, to try new ways of reacting. Resilient people use a number of ways to deal with stressful situations. They are not stuck on using one way of coping. Instead they shift from one coping strategy to another as needed. Imagine having a variety of tools in your toolbox to fix a problem.

Practice spirituality:

In general, we might say that spirituality includes a sense of connection to something bigger than ourselves, involving a search for meaning in life or simply a deep sense of aliveness and interconnectedness. Some people experience their spiritual life through a church, temple, mosque, or synagogue affiliation. Organized religion can provide structure, community, and meaning or identity. However, there are many ways that we can practice spirituality. Maybe through prayer or personal conversations with a higher power. Nature or art also provide for an expression of our spirituality.

Next week, I will share five more research-based strategies that you can use to help develop and improve your emotional resilience. However, for those times when you may need some additional assistance in dealing with life’s challenges, JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed therapists.

This is the second of three blogs covering Emotional Resilience. See the next entry here. You can also view Teri’s webinar on this topic by clicking here.

Teri Cheresnick, LCSW, LCADC

Stress & Anxiety: Understanding Your Reaction to and Recovery from Stressors

Are you an Oak or a Willow?
We think of the oak tree as a symbol of strength and resilience, the tall and mighty oak! But consider what happens to many an oak tree when fierce storms come through. They topple, their branches get broken, they get uprooted.

But what about the willow tree? Their branches will never easily break no matter how strong the winds are; this tree is a survivor. Adaptable. Flexible.

“The oak fought the wind and was broken, the willow bent when it must and survived.” ― Robert Jordan

When stressors, the ‘storms’ of life, come blowing in, how do you react? Which ‘tree’ are you? And more importantly, how can we develop more of the willow’s ‘flexibility’? Stress is defined as the body’s reaction – and that can be physical, mental, or emotional reaction – to any change that requires an adjustment or response. So something happens in our environment which causes us to react., for example, we lose our job, we feel uncomfortable wearing a mask to go out, we’re dealing with a financial problem. Sometimes it is easy to ‘roll with the punches’ and deal with the stressors; and, then other times, not so much.

Our ability to adapt to, respond to, and recover from stressful events in our life is our emotional resilience. The word resilience comes from the Latin word for ‘resilio’ which means ‘to bounce back or rebound’. We are being emotionally resilient when we exhibit traits like resourcefulness, flexibility, or perseverance. We have little control over many of the unexpected life events that come our way, a sudden illness, death of a loved one, a car accident, a business failure; however we can develop skills, the emotional resilience, to weather the storms.

Ways to Build Emotional Resilience:
1. Be an optimist
2. Find a sense of purpose and meaning in your life
3. Face your fears
4. Be adaptable and flexible
5. Practice spirituality
6. Have social support
7. Be a lifelong learner
8. Change the narrative
9. Focus on self-care
10.Control your destiny

Over two additional blog postings, I will further discuss these ten research-based strategies that can help us to develop and improve our emotional resilience. For those times when you may need some additional assistance in dealing with life’s challenges, JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed therapists.

This is the first of three blogs covering Emotional Resilience. You can also view Teri’s webinar on this topic by clicking here.

Teri Cheresnick, LCSW, LCADC