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

Managing Seasonal Affective Disorder During the Pandemic

As we brace for the winter months when the days will grow shorter and become darker, the psychological effects of the lack of sun can go beyond “winter blues” to a form of depression known Seasonal Affect Disorder (SAD).  According to the National Institute of Mental Health, SAD is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. Depressive periods linked to the summer can occur but are much less common than winter episodes of SAD.  It is estimated that SAD effects five percent of the U.S. population each year. With the additional complications and stress of the COVID-19 pandemic, the effects of SAD may be more pervasive than usual this year.

Why is sunlight so important?  Exposure to sunlight is believed to increase a hormone in the brain called serotonin which is associated with boosting your mood and helping you to feel more focused and calmer. The darker lighting at night triggers the brain to make another hormone called melatonin which is responsible for helping you sleep. 

Symptoms of SAD are similar in nature to the symptoms of any other depression: feelings of sadness, difficulties getting out of bed, sleep problems, low energy, loss of interest in activities, difficulty concentrating and feelings of hopelessness or thoughts of death or suicide. In addition, SAD symptoms might include a craving for carbohydrates, overeating, turning to drugs, alcohol or tobacco to cope, self-isolation/distancing more than what is recommended.

To avoid or at least minimize SAD symptoms, it would be helpful to start now and establish good mental health habits rather than wait when the shorter and colder days are upon us. Here are some strategies to try:

If you cannot go outside, bring the sun indoors.

Light therapy can be a great way to fool your brain into making more of the chemicals that make you feel good — the same chemicals that you’re missing during a bout of seasonal depression. Search for lights that mimic natural light or light therapy boxes.

Healthy body and healthy mind.

Eat healthy, get plenty of exercise, meditate, engage in spiritual connectedness, and stimulate your intellectual curiosity by exploring new ideas.

Essential oils.

There are a variety of essential oils that are recommened to help relieve symptoms of SAD; such as, bergamot, lavender, sandalwood, sage, basil, chamomile, lemon, peppermint, jasmine, and orange.

Do what you enjoy.

Make time for your hobbies – music, cooking, playing an instrument, dancing, drawing or journaling.

Balanced life.

Make an effort to achieve balance between your personal and professional life and treat them as two different worlds.  This is especially important for anyone working from home because of COVID-19. Try and keep separate spaces for work/school and relaxation; remember to “log-off” after your usual work day and disconnect fully when transitioning to your personal time.

Get support.

If your symptoms are affecting your daily life and functioning, a licensed therapist can provide you with a variety of coping skills and support to improve your mental health well-being. JFCS is here for you. Call 609-987-8100 to schedule an appointment with one of our licensed professionals.

You can also be immediately connected with a counselor during our Phone Drop In Hours:

Monday, Wednesday, Friday 10 AM – 12 PM

Tuesday & Thursday 5 – 7 PM

Shirley Bellardo, LCSW, LCADC (Director of Clinical Services)

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 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

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

Disclaimer: This post speaks specifically to the experiences of heterosexual, partnered, cisgender women, although individuals in other groups may resonate to the feelings discussed herein.

Do you feel overwhelmed by the never-ending list, running like a news ticker-tape across your mind every moment of the day? Does it feel that at the end of the day you’re exhausted physically and mentally, and yet, also that you might have forgot something you were “supposed” to do?

This is mental labor, sometimes termed emotional labor, and is most often referring to the work women do in managing household tasks, child care, and their own jobs. According to one study, a “majority of women reported that they alone assumed responsibility for household routines involving organizing schedules for the family and maintaining order in the home.” (Ciciolla and Luthar, 2019).

There are the big “to-do” list items: planning the grocery lists, making (and remembering!) doctors’ appointments for you, the children, your partner, creating carpool plans and (socially distanced) playdates interspersed with the emptying – and refilling – of the dishwasher, breaking up sibling fights, feeding the pet, bedtime routines and daily minutia. Societal norms continue to influence the roles in heterosexual households. Women continue to feel accustomed to and taking on the majority, if not all, household and child caring jobs. It is no wonder you feel completely wiped out by the end of each day! The pandemic has only increased the amount of mental labor women do, as we now school our children and work from home, blurring pretty much every boundary that exists.

Remember that running ticker tape? Mental labor is even more than managing the tasks at hand; it is constantly adding to the never-ending to-do list in one’s mind. It’s not just that while you’re trying to write this very blog-post, one child is asking you to watch his favorite show or another is asking you to look at his latest toy set-up, but more that while you type, you’re also thinking about when the playdate with your children’s “bubble” friends start and if you’ll have time to hit the pharmacy beforehand.

So as you try to balance all of this, your husband comes to ask “What can I do to help?” And internally your ideal response is “Why not just step in without asking permission?!” Yet, he is not entirely to blame, and neither are you. Our internalization of societal norms means you have become so accustomed to delegating tasks to your husband that you and he have become entrenched in the role of managers and employee. He does not recognize that he can in fact just do without direction. Not only does this leave you mentally spent, but also reinforces the lesson for children that it is women’s job to manage it all.

The expression “a woman’s work is never done” comes from a rhyming couplet that dates from the time of the American Revolution: “Man may work from sun to sun/but a woman’s work is never done.” Unfortunately, despite decades of advances in women’s rights and in the workforce, our home lives still reflect this old saying. Bringing this sentiment into this century, an excerpt from an essay by Kelly Gonsalves of MBG Relationships, may resonate with many:

“Even when husbands do unpaid work (like housework and child care), they still depend on wives to tell them what to do and when. So let’s say a husband is going to grocery shop for the family. The wife will be the one who looks at their fridge, their pantry, thinks about what they are missing, what they will need in the next week or so, and makes a list. The husband goes and shops, often even calling the wife if he can’t find an item to get her to guide him.” (Gonsalves, June 22, 2020).

So…where does that leave us? First and foremost, this not intended to place any or all blame solely on men. Rather, this illustrates that in a majority of households, with a man and woman, the emotional, mental and physical domestic load is not shared equitably. You did not need to read this post to know you feel this imbalance in responsibilities and mental fatigue, but now you are able to identify it by name. Naming a challenge can be a step towards confronting the causes.

If the message resonates and spurs you to action, what can that action be? How do you dismantle societal gender norms that are millennia in the making? That is well beyond my personal and professional expertise, but I can share simple tips that have worked for me…

• Remember to delegate! The more your spouse and/or children are given the autonomy to complete their day to day chores, the more (physical and mental) muscle memory is built up.
• Be open to mindfulness practices. I know, great, one more thing on your list! Or worse yet, how exactly does one find time to meditate or fully commit to it when mentally juggling a variety of to-do’s? By no means am I discouraging mindfulness; it’s an effective method of stress management, however, do not be hard on yourself if you cannot find the time.
• Journaling is often an encouraged mindfulness practice. It can be anything from a mental dump of your day or your current thoughts, to a gratitude journal. If you want to make it focused toward the household/labor debate, consider writing down every task you did in the day to contribute towards the household. Share this with your partner; a visual can give deeper perspective into just how much of an imbalance is present. Take that opportunity to start a conversation about the mental fatigue you feel and how your partner can help. I have also found that journaling my thoughts for the day – whether it is related to a mental fatigue or other day to day experiences – it grounds me and I am able to release any mental tension and move forward.
• If you are feeling this mental fatigue take a toll on you personally and affect your relationship, start a conversation with your partner.

Looking for further support? Join me at a weekly Pandemic Parenting Group. Held Wednesdays at 12 PM, the virtual group is a space for parents to share their experiences, find support, understanding and insights! Register for our upcoming session.

Claire Brown, LCSW

Works Cited:

Ciciolla, L., Luthar, S.S. Invisible Household Labor and Ramifications for Adjustment: Mothers as Captains of Households. Sex Roles 81, 467–486 (2019).

Daminger, Allison. The Cognitive Dimension of Household Labor. American Sociological Review (July 2019)

Gonslaves, Kelly. What Is The Mental Load? The Invisible Labor Falling On Women’s Shoulders. MindBodyGreen Relationships. June 22, 2020.