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Are you ok? Don’t miss signs of depression

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By Denise Winn: Denise is a journalist, editor and author specialising in psychology – who has also practised as a human givens therapist since 2000. She tutors a 1-day training course ‘How to lift depression’ for Human Givens College. You may also be interested in the Human Givens online course: ‘How To Break The Cycle of Depression’.

Would you know if someone you care about has depression? Most people probably think that they would, but it isn’t necessarily as obvious as you might expect. Indeed, until some simple screening questionnaires were introduced for GPs to use, half of them were missing the diagnosis in patients that came to consult them.

Suppose, for instance, you have a friend who used to come to a class with you, perhaps sport or dancing or a fine art class. Then one week they don’t want to go. Perhaps they say they have strained a muscle or that they are working late more often. You believe them – why not? Time passes and maybe you call or you run into them in the street and ask if they are going to come back to class. No, they say, they have kind of lost interest, or the injury is still a problem, or they don’t seem to have time. You suggest a meal out one evening. Money is tight right now, they say, but they promise to keep in touch. And more time passes and you suddenly realise that you haven’t spoken for quite a while. Perhaps you feel hurt and think it must be something you said. Or perhaps they have depression.

Very many people will not say that they are depressed or may even deny it. They may manage a smile even though they are feeling deadened inside. But one important tell-tale sign is loss of interest in activities that someone used to enjoy. When people start to experience low mood (perhaps they have had a disappointment or a bereavement or have been made redundant or, for some other reason, start not to feel good about themselves or their lives), they gradually tend to withdraw from social activities. The more time they spend alone, however, the more time they have to dwell on whatever is worrying or upsetting them. The more they dwell, the more hopeless they may feel. They are very often filled with feelings or worthlessness and guilt (because depression gets everything out of proportion) and, unbeknownst to you, may have fleeting or not so fleeting thoughts of killing themselves. They find it hard to get to sleep or to stay asleep, feel exhausted in the mornings and lack motivation to get going with their day. They may comfort eat or avoid eating – both are common symptoms of depression particularly in women, whereas males are more likely to cut off their feelings through drinking or other substance abuse.

And they find it hard to think straight, so that even making unimportant decisions feels overwhelming. Perhaps you notice that they seem less sharp or more tearful. Or maybe you don’t get the chance to notice much at all. So the first alarm bells that should ring are when the person you care about stops engaging in and enjoying whatever used to give them pleasure. This is especially often the giveaway for adolescents in whom symptoms of depression can manifest as negativity, irritability, not feeling understood, behaving antisocially, etc, which may easily be mistaken for ‘normal’ adolescent behaviour.

Depression is a horrible, too often hidden, condition. But the good news is that, once recognised, there are simple, speedy straightforward ways to treat it that don’t require medication.

Writing Therapy

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All of us write — some more than others. We write our names on documents. We send texts messages to our loved ones. We send work-related emails to our colleagues. Some of us write professionally or as a hobby. What if writing could be therapeutic?

Much like art therapy, writing therapy can be used to allow clients to open up to themselves and to others. When a client puts pen to paper or types out thoughts, feelings and emotions, he or she may be able to better address issues that plague him or her. Thus, this will enable a client to know sources of issues and work toward solutions with a licensed mental health professional.

Mental health practitioners can use writing as a form in therapy in a variety of ways including journals, logs, questionnaires and so on. While writing about negative emotions can cause stress in clients, it can also help them get past traumatic experiences and improve mental and physical health. Practitioners focus on telling clients to write about their emotions, as was as more focused thoughts.

For example, if a client went through a very difficult breakup with her abusive ex-boyfriend, then writing could help her forgive herself. She is feeling guilty for certain behaviours during the course of their relationship. Writing about her feelings could help her confront them and better communicate them to someone who can help her. Another example could be that another client is struggling with the loss of his child. He seems to relive the seven stages of grief over and over. Writing in a journal could help him record his feelings, positive and negative, about the experience.

While writing therapy may not work for everyone, studies indicate that writing on a long-term basis helps clients figure out their behavioural patterns and what they can change or keep the same. Kathleen Adams, founder of the Centre for Journal Therapy in Colorado, uses the 79 Cent Therapy approach. She writes key details of her life and everyday happenings and stressors in cheap spiral notebooks. She says this about using writing as therapy: “For nearly 30 years, I’ve had the same therapist. I’ve called on my therapist at 3 a.m., on my wedding day, on a cold and lonely Christmas, on a Bora Bora beach, and in the dentist’s reception room. I can tell this therapist absolutely anything. My therapist listens silently to my most sinister darkness, my most bizarre fantasy, my most cherished dream. And I can scream, whimper, thrash, rage, exult, foam, celebrate. I can be funny, snide, introspective, accusatory, sarcastic, helpless, brilliant, sentimental, profound, caustic, inspirational, opinionated or vulgar. My therapist accepts all of this without comment, judgement, or reprisal.”

Writing is an inexpensive way to unleash your thoughts. Even writing for 15 minutes per day can help clients sort out their thoughts and emotions. Talk with your mental health practitioner or someone online at BetterHelp to sort through your thoughts and emotions and see if writing therapy is a right fit for you.

Solution Focused Brief Therapy

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SFBT is an energetic, innovative, proven therapeutic intervention that significantly appeals to clients because it approaches problems from the perspective of The Solution and not exclusively revamping the painful past. It is positive and goal oriented importantly led by the client who determines the objectives, the timeframe and the outcome.

Contrary to popular belief Brief Therapy is not new. The term Solution Focused Brief Therapy is attributed to the American Steve De Shazer, which he and his colleagues started to use in the early 1970’s. However, the renowned Milton Erickson and other great therapists such as Albert Ellis often saw clients for just a handful of sessions. Ellis actually was famous for very brief sessions sometimes only 15 to 20 minutes in length! The initial concepts of Brief Therapy were being discussed, researched and applied as early as the 1930’s. Wally Gingerich, a social worker and researcher, may have defined it best when he said:

“Solution Focused Brief Therapy is a short-term goal-focused therapeutic approach which helps clients change by constructing solutions rather than dwelling on problems. Elements of the desired solution often are already present in the client’s life, and become the basis for ongoing change. The therapist intervenes only to the extent necessary, with treatment usually lasting for less than six sessions.” (source)

There are a number of significant and essential assumptions about SFBT that makes it such an effective and successful therapeutic method. Often times the client is so enmeshed in their problem that they don’t see or recognise their strengths and resources. SFBT can very simply and quickly elucidate these resources, resulting in empowerment for the client and a clearer sense of direction. Clarity is vital, clients can have their perspective distorted or blurred by being overly emotional and stressed by their dilemma. Getting the client to identify salient, realistic, achievable, specific and measurable goals and objectives is essential and a driving force behind the client taking responsibility and affirmative action. Once they are solution-focused their energy is positive and confident and the desired changes compound and multiply.

The use of language is critical and decisive in SFBT. SFBT therapists are trained to use progressive enlightened language with a constructive and assured orientation. This helps the client to normalise their issue and put it in the correct perspective. Various other relevant techniques in this therapy such as Scaling (“on a scale of 1 to 10 if 1 is the worst you have felt and 10 the identified best place to be, where are you now on that scale?”) helps the client recognise their resources, hidden strengths and to recall how they used these skills in other problematic areas in their life in the past.

Trainerpathways are holding an introduction to SFBT on Friday 24th February in London. Find out more and sign up here.

Guest Post: E-Cigarettes are not the Solution

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Don’t believe the hype, e-cigarettes and vaping devices are not going to help you quit smoking says a new study. Let’s start with the promise first. The idea of e-cigarettes and vaping devices was two-fold. Firstly, they would reduce the amount of toxins and carcinogens inhaled by the user by such an amount to make them almost negative in harmfulness.

Secondly, there was a simple theory of how these devices could be utilised as quitting aids, much in the same way as nicotine patches. This is possible because users can adjust the nicotine dose of each cartridge so they can slowly reduce the amount they inhale. That being said, being able to do this requires a huge amount of will power. Furthermore, evidence is starting to pile up to bust both ‘facts.’

The Reality of E-Cigarettes and Vaping

Let’s take the first point – health. Studies into the long term effects of any kind of medication or substance takes decades and the technology is too new to understand these effects fully – though predictions can be made. However, scientists are able to look at the substances inhaled and exhaled. So far, test results show that while toxic materials are vastly reduced, they are still present. Not only that, but as e-cigarettes and vaping is often allowed in areas traditional cigarettes are not, and that there is no filter, the risks of passive smokers are increased.

A controversial study quoted in Medical News Today says that cancer patients trying to quit are far more nicotine dependent if they use e-cigarettes than those who don’t use them. This report has been criticised, however, for its poor methodology, having been accused of not counting unfavourable data and for a high dropout rate of participants.

The report’s assertion that nicotine reducing tech fails to help users quit the habit within 6 to 12 months is backed up by other studies, and studies into nicotine patches. Furthermore, surveys of American youths has shown that an additional 250,000 teenagers have become nicotine addicted through the appeal and flavors of e-cigarettes and vaping. Other reports suggest a high return to nicotine addiction from former smokers who believe these devices to be harmless.

Therapy is More Effective than E-Cigarettes

To be successful at quitting, users need to have will power. While a few can quit on their own, many need some kind of additional support. It is clear that these devices have commercial appeal and draw in people who think they are less harmful. However, professional counselling is by far the more effective method. Whether this is counselling sessions, group therapy, or even hypnotherapy, studies suggest they present the positive and healthier options for getting nicotine free.

Note: this article has been submitted independently to the UK Therapy Hub. It is not an endorsement or recommendation of the product. Please visit the websites above for further information.

Getting a website for your private practice

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Creating and maintaining a successful website can be a nightmare for the non tech-savvy. Here are our Top 10 Tips to keep you on the right track.

  1. Accept that you need a website. Nowadays, a quick online search is the first port of call for people looking for therapists. So in order to get more clients, you need to have an attractive online presence.
  2. Have a clear objective. What do you want your website to achieve? It is important that you know the answer to this question to help you or the design company to build it. For example, do you want clients to contact you via email, contact form or phone? How many extra clients do you want as a result? What is a priority? What is not? Having clear goals will improve your website’s SEO.
  3. Choose a domain name. Make sure it is relevant, short and easy to remember, and then check it is available to buy with search tools such as Domain Check.
  4. Choose an established hosting provider. Hosting providers rent server space for your website, with a pricing plan that depends on your content requirements, such as pictures and videos, and emails. Choose one who will answer your queries before asking for your money.
  5. Create your website. Depending on how much creative control you want to have, you can choose anything from a DIY website builder with templates, to a fully bespoke designed website. An important thing to consider here is the level of long term support you require. To help you decide which option is best for you, here are some reviews from the Private Practice Hub.
  6. Make sure your website looks professional. There is a reason why some DIY website builders are so cheap. These packages will often make your website look amateurish, and turn off potential clients as a result. To avoid this pitfall, think about how much you are willing to invest in your website and keep the design clear and clean.
  7. Use the right words. Your website needs to be able to attract and hold your visitors’ attention within 5 seconds. The right copywriting will help you do this. Good copy will consider the aim of your website, your target audience, and the benefits of therapy. It will also take a conversational style and appear in short, digestible chunks.
  8. Have a call to action on every page. In other words, prompt your visitors to take action and ‘give me a call on…to find out more’. To make this successful, make sure you provide your contact details on each page too.
  9. Consider social media integration. Like it or not, integrating social media on your website will pull in a wider audience and improve SEO. Most providers will integrate with the standard social networks (Facebook, Twitter, Google+, LinkedIn), but do consider other platforms. For example, is an integrated blog important to you?
  10. Beat the competition. A recent survey found that 20% of therapist respondents do not have a website. It also discovered that 25 % felt their websites didn’t do the job they wanted; 67% didn’t know how many visitors they received; and 30% hadn’t updated their sites for 4 months or more. If you want to get ahead of the crowd, a good website is essential.

Online directories for therapists

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More often than not, marketing is a necessary but frightening concept for those who do not specialise in it. For therapists in private practice, it is crucial to be able to create a strong online presence whilst still dedicating time to the therapy side of your work. This can be a tricky balance to strike.

Nowadays, most potential clients look for therapy by searching online, so if you register your practice in an online directory, you will be contacted by more people than if you use business cards or newspaper ads alone. Plus, once you have signed up, you will save a significant amount of time on marketing and be able to focus on other aspects of your practice.

Registering with general online directories (such as Yell or Freeindex) can be helpful, but many successful therapists in private practice will tell you that therapy specific directories work more to their advantage, in terms of the number of clients that are referred through them.

This is due to the fact that industry-specific online directories have the power to increase your visibility to potential clients through their increased Search Engine Optimization (SEO). In effect, this means that your practice will appear higher up in their Google search results, leading to more prospective clients and increased referrals.

It is also beneficial to register with an online directory that is specific to therapy because it will enhance your reputation by association. If people feel that they can trust your practice, they will be more inclined to contact you.

On the Private Practice Hub website there is a comprehensive list of online directories specifically for therapists, which can be downloaded by becoming a member, free of charge. This includes UK Therapy Hub, an online directory for therapists which lets you have total control of your profile. UK Therapy Hub gives you the space to tell potential clients about your experience and what you can offer them. This will help you to build a connection with potential clients and encourage them to contact you.

Using an online directory like this can make marketing your practice so much simpler, cheaper and more effective – it doesn’t seem like such a frightening prospect after all!

What is Eye Movement Desensitization and Reprocessing (EMDR)?

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It may sound intimidating, but Eye Movement Desensitization and Reprocessing (EMDR) is actually a very straightforward yet powerful therapy.

EMDR can be extremely effective if you’ve had a traumatic experience, especially if you find it difficult to talk about past events. It’s also used to treat people with anxiety, phobias or depression.

In essence, EMDR helps the brain to reprocess distressing memories or flashbacks so that their intensity is reduced.

It’s all about how the human brain deals with thoughts and feelings associated with traumatic or difficult experiences. Feelings such as panic, guilt or anger can often be difficult to process. As a result, small associations or reminders of an event may trigger those feelings.

Sufferers can feel like they can’t control their thoughts or emotions, and that the smallest things can trigger flashbacks and feelings of distress. This often leads to sufferers avoiding work, other people, relationships, and so on.

How does EMDR work?

A key element is the use of guided eye movements. When you move your eyes, you stimulate the right and left hemispheres of the brain, which relate to your emotional and rational sides. Guided eye movements when thinking about difficult experiences can help your brain to process those experiences more effectively.

During EMDR, you will be asked to follow hand movements with your eyes – often side-to-side. At the same time, your therapist will carefully help you to think about your trauma or feelings of distress, and will direct you to replace those feelings with more positive ones.

Is EMDR a serious form of therapy?

If you’re concerned that EMDR is just a ‘fad’, don’t worry. Although it’s relatively new, EMDR is an evidence based practice, meaning that research has been carried out into its effectiveness. You can also read about this therapy on the NHS website.

If you are considering EMDR therapy, ask your therapist if they have undergone EMDR training and are accredited with EMDR Europe.

This article was written by Connect Psychotherapy Practice in Bristol and Bath.

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What is Cognitive Behavioural Therapy?

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Cognitive Behavioural Therapy (CBT) is one of the most powerful treatments for anxiety, trauma and depression.

It focuses on the here and now – helping you to change the way you think and act in any situation.

So, for example, if you’re extremely shy, CBT will give you tools to overcome your feelings of anxiety and face whatever you are dreading – be it going to a party, attending a job interview or interacting with others without fear.

Or, if you suffer from depression, CBT will help you to identify and overcome the negative thoughts that are affecting the way you feel and behave. You’ll be given practical tools that will change your mindset for the better.

Cognitive Behavioural Therapy is an effective treatment for any problem that affects the way you feel and the way you behave, including post traumatic stress disorder, OCD, eating disorders and phobias.

Some therapies may claim to completely remove problems such as depression and anxiety. CBT is different, taking a much more realistic and practical view. CBT helps you to break down your problems into small parts, making them easier to deal with. In essence, Cognitive Behavourial Therapy helps you to take control of your life.

How much CBT therapy do I need?

Every person is different, but generally, CBT tends to achieve relatively fast and long lasting results. You’re likely to see improvements in the way you are feeling within around six to twelve weeks.

This article was written by Connect Psychotherapy Practice in Bristol and Bath.

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Your therapy business: keeping in touch with clients

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If you don’t keep in touch with your existing clients, you’re missing a trick.

Here’s why it’s such an important part of marketing your therapy business:

repeat business is worth just as much, if not more, than new business
it’s three times more cost effective than marketing to new clients
loyal clients will give you referrals and glowing reviews

It’s easy to keep in touch with clients. There is plenty of CRM software available (customer relationship management) that will help you. In its simplest form, CRM software can include a database, an email system, or both. It can offer a whole host of insights about your clients, too.

Don’t be afraid of hassling or bothering your existing clients. If you do it correctly, you won’t drive them away – instead, you’ll build a more genuine and long lasting relationship.

For some practical advice about keeping in touch with your therapy clients, you can read this article by marketing expert Massimo Gaetani from Salus Wellness, a complementary health centre in Cambridge.

Massimo′s advice is particularly suitable for leisure complementary therapy businesses such as massage, but more remedial therapies such as psychological or pain reduction businesses will still find much of interest.

Your therapy business: are your marketing efforts really working?

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How do you promote your therapy business? What things do you do to get more clients?

Perhaps you try a flyer drop, or put up leaflets in local stores. Perhaps you have tried an email campaign, or an advert in your local newspaper.

Whether you give up after one attempt, or keep going with a particular strategy, it’s vital that you understand whether or not it’s really working.

One of the best ways to do this is compare the cost and time involved against the results. Don’t just measure results according to number of clients received (and the value of their business).

Results can include an increased number of visits to your website, or more enquiries.

One example of results measurement can be found in this article by marketing expert Massimo Gaetani from Salus Wellness, a complementary health centre in Cambridge.

You’ll also find plenty of articles about marketing your therapy business in the marketing section on the Private Practice Hub.