Articles & Trainings

Managing Your Private Practice: Writing Policies

In this blog series, “Managing Your Private Practice,” we look at how to successfully run your private practice as a mental health professional. We started the series with a dive into how to market your private practice. Now, let’s look at a critical yet sometimes overlooked element in owning a business: policy writing.

Written policy forms are an essential component for any successful business. Therapists have an additional responsibility when it comes to paperwork: you need to ensure your bases are covered when it comes to legal, ethical, and HIPAA compliance. Fortunately, Health Affiliates Maine is here to help clinicians when it comes to compliance and current regulations.

How to Write Effective Office Policies

How a counselor runs their private practice varies from person to person. Regardless of your office size or structure, there are several office policies we advise all practices to put in writing. While some behavioral health practitioners with staff develop internal policies specific to issues such as dress code and social media, we’ll focus on advice for external office policies here—the policies your clients will see and review. Here are some guidelines for how to write effective office policies.

Office Policies Reflect Your Practice’s Core Values

When you give clients forms to fill out, it’s not only important to ensure they are clearly written in simple, easy-to-understand language, it’s also essential to make sure the forms reflect your private practice’s core values. For example, if you value inclusion and diversity, you might want to create or modify an existing form or template to include options for preferred pronouns. Remember, while filling out paperwork such as an authorization to release information, intake, insurance, and informed consent forms, as well as signing office policies, your client is getting an impression of your business.

Get Feedback

Whether you consult a colleague, a mentor, or a trusted office assistant, getting feedback from others is invaluable. Outside perspectives allow others to see things you may be too “inside” your own practice to notice, and others may also have more experience around which areas of the practice need or could use written policies to make the office run more smoothly.

So, by all means, ask a friend or colleague to review the packet of forms you’ve created and get their impression. Ask:

  • Was there enough space to write your answers?
  • Is it easy to follow?
  • Are there areas of unnecessary repetition?
  • Did you find any typos?
  • How could this be simplified?
  • Which changes or additions would you make, if any?
  • Am I missing something obvious and important? (We all do this!)

While involving others in policy writing and reviewing takes more time, the final outcome of a collaborative process ultimately makes for smoother operations and happier clients. If that’s hard to add to your to-do list, consider reframing the time investment as optimizing your client’s care.

Strive for Clarity

Setting clear policies in writing is a bit like setting clear boundaries: it helps everyone know what to expect. Clear is kind.
Make it part of your therapy practice to include office policies in a new client’s paperwork and reshare annually or when policies change. Successful practitioners have standardized forms and make use of a secure, organized paper filing and recordkeeping system.

At the same time, don’t assume clients will read through all the forms. During your first session, discuss your office policies briefly. This helps ensure that expectations are clear and understood, and it contributes to building trust in the professional relationship you’re developing.

Which Office Policies Do I Need in Private Practice?

Which office policies you include in client packets are somewhat unique to the practice you run. In general, we advise therapists to develop written office policies around cancellations, fees, social media, and—important in Maine—weather. (Keep in mind office policies are separate from other paperwork you should require from clients, including intake, insurance or billing, authorization to release information, and informed consent forms.)

Cancellations and missed appointments: Life’s little mix-ups happen. But as a counselor in private practice, missed appointments can disrupt the treatment process and therefore adversely affect your income and business—particularly if they are a chronic, recurring issue. Craft a clear understanding with your clients in writing about what happens when you or they need to cancel, in addition to missed appointments.

Fees: Practitioners may accept all or some insurance, self-pay, and/or having slide scale fees. However you structure payment, be clear and upfront with clients about how (and when) you charge and collect fees in your practice. Include your fee structure with a written policy on payment and collections in every client package, regardless of whether they currently have insurance; and, of course, all practitioners should be up to date on the new GFE (Good Faith Estimate) law, which requires providers to give patients who either do not have or are not using insurance a written estimate for non-emergency procedures. (Find more information on GFE requirements here.)

Social media: Use of social media is prevalent in our country, so therapy practices in particular need policies on the use of Facebook, Instagram, TikTok, and the like. Set clear boundaries on how you or anyone in your practice orbit may communicate with prospective and current clients online, keeping in mind that some clients may have differing preferences around privacy. And, while we’re focusing this blog on external office policies, if you have an office assistant or other staff, we strongly encourage you to set an internal social-media policy for staff. And, finally, check with your licensing board and code of ethics to see what is required regarding confidentiality and social media use.

Weather: Maine knows snow days! Develop a written office policy on what happens in the event of inclement weather, letting clients know how you will get ahold of them or how they can check in with your office to see if it is open. Will you call them or text them? Should they check your practice’s website if the weather forecast looks questionable? While it may seem a small matter, this office policy will help eliminate confusion and smooth operations in the long term.

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Posted on by Author Rachael Severancein Categories Advice for Affiliates, Private PracticeTagged , ,

How Gender Norms Affect Men’s Mental Health

In honor of National Men’s Health Month in June, we’re taking a closer look at how traditional gender norms negatively affect men’s mental health in the United States and especially in Maine—a phenomenon that, as therapists, many of our readers will have observed firsthand.

In the article, we’ll cover how our culturally created and reinforced ideas of how a man “should” act impact the rates and reporting of mental health issues, including depression and eating disorders, and, relatedly, how certain, more-traditional models of masculinity can contribute to stigma around mental health, with damaging consequences to men’s willingness to access mental health services.

Depression Symptoms in Men Versus Women

Partly due to gender norms perpetuated in our culture, men and women can present symptoms of mental and physical illnesses differently. This can lead to health-related problems going undiagnosed, and that lack of diagnosis (or late diagnosis) can alter the course of a person’s life.

For example, men are more likely to report symptoms of fatigue, irritability and/or rage, risk-taking, and loss of interest in work or hobbies when they are suffering from depression, according to Mental Health America. Women, in turn, are more likely to report feelings of sadness or worthlessness. One way of framing the difference is that men’s reported symptoms tend to be expressed as outwardly directed feelings and behaviors, while women’s reported symptoms tend to be more inwardly directed.

How to Assess Depression in Men

How we measure depression clinically, of course, changes how we treat it—or even if we treat it at all.

Officially, more than 6 million men in the U.S. report suffering from depression each year, but we know that many more cases go undiagnosed. It follows that the questions we ask as mental health providers and the use of gender-inclusive diagnostic scales can have a profound impact, as a 2013 study in JAMA Psychiatry found.

When a gender-inclusive scale is used, 30.6 percent of American males are found to have experienced a period of depression in their lifetimes, with no significant difference between sexes in rates of lifetime depression. However, when traditional depression scales are used, depression is found to be more common in women than in men.

It’s worth noting here that the State of Maine reports rates of diagnosed depression as higher in females, at 25.9%, than in males, at 16%. Because the State of Maine does not use a gender-inclusive scale when measuring depression, it is likely that many men who suffer from depression are not being counted, and we may be missing a large segment of the adult population in our diagnoses and treatments.

Men and Suicide Rates in Maine and the U.S.

The suicide rate among men in the United States is an unacceptable four times higher than it is for women, according to the Centers for Disease Control and Prevention, and it has been on the rise since 2000. Suicide deaths follow a similar trend in Maine, with significantly higher rates among men (24.3 per 100,000) than females (7.9 per 100,000). The suicide rate in our state is higher than the national rate (15.9 per 100,000, compared to 13.5), according to the 2019 Maine Shared Community Health Needs Assessment Report.

Given how far fewer men are diagnosed with depression when traditional depression scales are used, it is worth considering whether the suicide rate could be lowered simply by universally employing gender-inclusive depression scales in our field, thereby treating the depression before it can potentially manifest into suicidal ideation or suicide.

Masculinity and Access to Mental Health

One thing is clear, when we consider the underdiagnosed, under-cared-for rates of depression and national suicide rates for men in America: we need to improve accessibility to our services.

According to the National Health Interview Survey, only one in four men with depression has spoken to a mental health professional. This sobering statistic is likely due to influential social norms of masculinity, among which are the hyperinflation of emotional control and self-reliance, as measured in the widely used Conformity to Masculine Norms Inventory developed by James R. Mahalik and colleagues.

The net result of these influential social norms of masculinity is American men who are reluctant to talk and who downplay their symptoms when experiencing mental health issues, including depression, substance use, and stressful life events. Moreover, male minorities are even less likely than White men to seek assistance for mental health. The more we can reduce all barriers to mental health treatment across our field—and that includes stigma—the more we can be of service.

How Cultural Norms Affect Men with Eating Disorders

As we see with depression, men with eating disorders, such as muscle dysmorphia, are less likely to seek professional help than women, and once again gender expectations are the likely culprit. Men currently make up approximately 30 percent of eating disorder diagnoses, which is actually an uptick from previous years’ statistics, according to social psychologist Jaclyn A. Siegel, PhD. “Self-reliance is one characteristic of traditional masculinity,” Dr. Siegel said in a recent interview. “Because of this, men are less likely to seek help for medical and psychological conditions. … I suspect that every statistic we have about men with eating disorders is an underrepresentation of the actual number, because it’s not stereotypically masculine to admit to having these conditions, and it’s definitely not stereotypically masculine to go to a doctor or a specialist and get a diagnosis.”

Dr. Siegel goes on to note that men in the LGBTQ+ community are at an elevated risk for eating disorders, and that more research is needed on Black men’s experiences with body image, eating disorders, and other mental health issues.

Conclusion

When we have evidence of men feeling limited in their willingness and ability to access mental health treatment for issues like depression and eating disorders due to social stigma and traditional models of masculinity, it is time to reconsider how those models are serving us as a culture. What might the mental health of our nation’s men look like if we were to adopt more flexible gender norms that allowed for personal expression and authenticity?

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Posted on by Author Rachael Severancein Categories Understanding Mental IllnessTagged ,

Managing Your Private Practice: Marketing

In this new series, “Managing Your Private Practice,” we’ll look at various things you can do to keep your private mental health practice thriving. Topics will include marketing and business skills, finances and taxes, writing policies, and liability and insurance issues. We’ll also explore more therapist-specific interests, such as how to balance the clinical and business aspects of being in private practice.

To start, let’s look at an essential part of attracting clients: how to market your private practice.

But before we get to a numbered list of specific marketing tactics, let’s look at the underlying idea that should guide your marketing strategy:

Marketing is all about relationships.

To market your practice effectively, you need to develop and follow a strategy to build relationships and make yourself known with potential patients, in the community, and among reliable referral sources.

If you’re new to private practice, you may find yourself spending more time establishing your referral network and getting your name out there; and if you’ve been in private practice for a while, you already know that these are areas that needs ongoing attention. Considering the effort you’ve put in to build your practice, it’s worth reassessing your marketing strategy every few months to determine if it’s still working for you, and, if it isn’t, tweaking and revising your strategy to ensure that it’s generating the clients and business you envision.

Okay—on to the numbered list!

How to Market Your Therapy Practice

To achieve your business goals, you must present yourself consistently—across all marketing channels and in-person events—as a skilled and accessible mental health professional while also communicating in a way that is authentic to your beliefs, your values, and your therapeutic approach. By developing and understanding what drives your practice, you can keep your marketing in line with your values and avoid sounding disingenuous.

1. Set core values. Core values are your fundamental beliefs, and it can be extremely helpful to formalize them in writing. Your core values are what guide decisions and behaviors, and when captured in a formal document, they can help you understand how to navigate your business accordingly. Is there a set of values that is especially meaningful to you?

Take some time to brainstorm a list of three to five core values that light a spark in you. Think about words like service, collaboration, growth, understanding, resilience, care, and what they mean to you and your practice. Once you get a handle on your core values, use them as a jumping-off point to compose a mission statement for your practice. You don’t necessarily need to post your mission statement or core values externally, but they can serve as a guide for how you do business and how you wish to be perceived by your clients and in your community.   

2. Create a digital presence. Many people find a therapist by searching online. They tend to compare mental health providers listed on their insurance company’s approved providers list with word-of-mouth recommendations, online references, and therapists’ websites and profiles on reliable databases, such as Psychology Today, goodtherapy.org, and our own Health Affiliates Maine list.

To maximize your approachability and searchability, curate your digital presence with care, and be sure your profile can be found in multiple online locations. That’s worth repeating: Post your profile in as many locations as possible! Some examples: create a simple website; consider writing a blog, vlog, or podcast; create (and maintain!) a practice profile on social media; and list yourself on professional databases. Learn more about all of these marketing options in our blog here.

In crafting your marketing content, it can be inspiring to look around and find examples you enjoy from among your peers. When you sit down to write your own content, choose your words carefully. Use your core values to inform your online voice and messaging. Consider carefully who your prospective clients are and what might resonate with them. Ask yourself, “What unique benefits do I bring my clients?” and “Would I want to engage with this therapist if I read this?”

3. Speak and teach. Libraries, adult education programs, businesses, and local community centers are wonderful venues for you to speak and teach on the topics you are most passionate about. These classes, lectures, and workshops can help get your name out into the community as an expert—and could connect you with individuals who might need your counseling services, either now or in the future.

4. Print business cards. While it may be tempting to skip this step in our increasingly digital world, this inexpensive, simple paper artifact makes it easy for potential clients to retrieve your name and contact you.

5. Learn from others. Networking with professionals from other therapy practices is a wonderful way to compare notes and share insights and information with your peers. (It’s also a great stress reliever!) Learn what’s working—and what isn’t—across practices that are similar to yours. And just as you can learn from your colleagues, they can learn from your experiences as you develop your private practice—the ultimate collegial win-win!

HAM Affiliates frequently remark that the group trainings and monthly supervision sessions are among the most-valued benefits of going into private practice with Health Affiliates Maine. Collaboration builds support for everyone involved.

 

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Posted on by Author Rachael Severancein Categories Advice for AffiliatesTagged , ,

Coming Out of the Pandemic: From Surviving to Thriving, Part 2

On the COVID-19 pandemic’s third anniversary, we’re pausing to honor the 6.6 million lives lost, reflect on the profound experience this disease has had on us as survivors, and look for meaningful paths forward. In the first of this two-part series on moving from a state of survival to conditions for thriving, we looked at how American lives have collectively changed over the course of this ongoing public health crisis. In this article, we turn our attention to what happens when we pause and reflect on the lives we lead.

COVID-19: Reflection Mode

Because of the massive disruption COVID-19 had on billions of lives, a disruption that caused significant changes in our everyday behaviors, over time we slowly moved from survival mode [link survival mode to March blog post] toward lockdown reflection. And what we seemed to notice during this time was our mental health is paramount.

Such a big disruption naturally makes people ponder big questions. To pause. To notice. And while on a societal level, we seemed to be waking up to inequalities within our operating systems, racial and otherwise, on a personal level it looked like a series of ambiguous, philosophical questions. Presented with so many deaths in a short time span, we asked ourselves: How do we live a life of meaning?

How COVID-19 Changed Our Ideas about Work

There is, of course, no single answer to how to live a meaningful life. It was clearly on many people’s minds, though. The question quietly rang behind social shifts we saw in the second and third years of the COVID pandemic. The Great Resignation, aka the Big Quit, the Great Rethink, or the Great Reshuffle, saw people leaving the workplace in droves: leaving for safety concerns, because of burnout, inadequate support from companies, and the need for childcare (which is closely tied to the issue of unpaid care work), or people who discovered they wanted autonomy or meaning in their work, or more money as the labor market tightened. Resignation rates remain high. “People are now looking at work and the role they want it to play in their lives in a different way, and switching to jobs that better align with their new values,” writes Kate Morgan for the BBC.

Like the Black Lives Matter movement, the Great Resignation may have gotten its spark from the pandemic, but the embers had been building long before COVID came to be. Quit rates have been steadily increasing over the past decade. Wages have stagnated for decades, and minimum wage has not been keeping up with rate of inflation. There is an American culture of presenteeism and widespread burnout in the workplace. The pandemic wasn’t the cause, per se—but it may have been the collective taking in of breath and deciding factor for workers to act on their mounting dissatisfaction. Many of us are looking for ways to restore wellbeing, and our professional lives are a natural place to ponder.

Just as pausing to engage in deep breathing, meditation, and other coping strategies helps our mental health, the collective pause caused by COVID-19 has helped create a shift in priorities. It allowed us time to reevaluate society. What’s working? What isn’t? What can I do about it? How am I spending my time, which is ultimately my life? Rethinking the workplace—where, how, and why we work—is part and parcel of that process. After all, one-third of the average American’s life is spent at work. Some may prefer to work remotely, work less, go into private practice, switch jobs, or any number of configurations that align more closely with their idea of meaning and success.

One method to considering how you spend your time is viewing time management not through the lens of productivity but that of mortality. Rather than cramming in as many work products as you can into every hour, attempting perfection, or delaying creative work because of busy culture, scale grander. As Oliver Burkeman writes in the book 4,000 Weeks: Time Management for Mortals, we suffer when we engage in “causal catastrophe,” or treating every moment as a means to some future end. He, like many others, stresses the importance of enjoying the now and connecting with others.

How COVID-19 Revived Self-Care

The pandemic lockdown was a poignant reminder that loneliness hurts our health. Being isolated can have serious consequences on our minds and bodies. We are, after all, social animals. Presented with a widespread public health problem, we reconsidered what it means to be happy and live a fulfilling and purposeful life. In addition to shifts in the way we work, we are starting to see a revived focus on mental wellness and self-care as a result of those inquiries.

With COVID’s stark reminder that life is short, Americans are slowly unraveling the myths of the busyness badge and that taking time to take care for oneself is frivolous. Self-care is not self-indulgence. As therapists, we know it’s a vital part of coping with stress and restoring mental wellbeing.

In addition to more importance placed upon mental health and wellness, another silver lining from the pandemic for mental and behavioral health services may be that access to care has increased as a result of telehealth. It’s become much more commonplace to remotely visit a therapist or substance use counselor, which has important implications for how we can provide support to rural patients across the large state of Maine. Telehealth has removed geographical barriers to mental health services that some have unfortunately experienced in the past. And the more normalized work-from-home office has helped some people find the flexibility in their work schedules to attend therapy appointments.

COVID-19: Imagination Mode

The calls for “back to normal” we heard mid-pandemic were largely calls coming from those who profited by what normal was pre-pandemic. It’s imperative that we continue to question and reflect on our values and imagine and shape our collective future accordingly. What can you picture? How can you align your life to your values? How can we reimagine and rebuild society so that it values equality, justice, and collaboration, or any number of core values that resonate with us? What does it look like to become a nation where, as Jean Accius of AARP puts it, “race and other social demographic factors do not determine your ability to live a longer, healthier and more productive life”?

We’ve had COVID-19 survival and reflection modes. Let’s enter a COVID-19 imagination mode. Let’s ask ourselves: What future do we want to create?

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Posted on by Author Rachael Severancein Categories NewsTagged ,

Coming Out of the Pandemic: From Surviving to Thriving, Part 1

As we approach the third anniversary of the COVID-19 pandemic and are hopefully transitioning to an endemic phase, we’re pausing to honor the 6.6 million lives lost, reflect on the profound experience this disease has had on us as survivors, and look for meaningful paths forward. In this article, part one of a two-part series on moving from a state of survival to conditions for thriving, we look at how American lives have collectively changed over the course of an ongoing public health crisis.

COVID-19: Surviving Survival Mode

In the beginning of the COVID pandemic, Americans went into survival mode. Many sheltered in place if they could; many experienced personal tragedies, from the deaths and prolonged illnesses of friends and family. We changed our behavior with social distancing; some of us shifted to unemployment or remote work; we developed coping strategies for the extreme stress, anxiety, and depression we were experiencing.

The trauma of COVID-19 caused such stress that our brains functioned in a different manner. Our prefrontal cortex, where executive functioning skills come from, turned the reins over to our survival brain. For adults, being in survival mode might look like:

  • A lack of focus.
  • Changes in memory. Your days may blend together, or you might not remember what happened earlier.
  • Low energy and fatigue. This includes your body and your mind.
  • Insomnia.
  • Emotionally reactive and/or withdrawn.
  • Forgetting basic needs.
  • More impulsive. Many Americans ate and drank more, for example.

For those who were able to develop healthy responses to the ongoing stress, they started to exercise and physically move, such as getting out of the house for a daily walk; to reach out and connect with others, perhaps through Zoom; and to practice self-care, including getting quality sleep, developing a new pandemic routine, making time for a new hobby like baking bread, or seeking out moments of joy and laughter. In other words, they developed a resilience toolkit. These Americans were able to slowly exit survival mode, or at least manage the chronic stress well. For many, though, stress management was not quite that simple—and chronic stress was not necessarily a new experience.

COVID-19: Stuck in Survival Mode

When you’re stuck in survival mode and experiencing chronic stress—because, say, you’re a frontline worker in constant danger of contracting COVID-19 who can’t work remotely or afford to look for another job or take time off—it affects your productivity, relationships, and health. You’re more likely to have serious diseases, such as heart disease, obesity, and Type II diabetes; have an addiction, such as with alcohol, nicotine, and/or prescription drugs, as well as the internet, food, or gambling; and have mood and anxiety disorders. Whether it’s from the pandemic or it’s more related to poverty, discrimination, or a combination, overexposure to cortisol—the “stress hormone”—disrupts almost all of the human body’s processes.

COVID upended everyone’s lives. But it most significantly impacted BIPOC communities. Blacks, Latinos, and other people of color have suffered higher rates of COVID-19 infection and morbidity. They are more likely to be essential workers, and they were more likely to be unemployed as a result of the pandemic—especially Black and Latinx women.

Furthermore, and important to our work in mental health, Black, Indigenous, and people of color are less likely to have access to and seek out mental health services, and they are less likely to receive needed care. When they do receive mental health services, they are more likely to receive low-quality care and end care prematurely. The vast majority of mental health treatment providers in the United States are white, and some research shows that provider bias and stereotyping are factors affecting health disparities. It is imperative that in our field especially we increase cultural competency trainings, diversify workforces, and reduce stigma of mental illness.

All told, COVID-19 helped expose huge disparities in health, wealth, and healthcare access for Americans of color as compared to white Americans. With such a wide discrepancy between how some Americans were affected by COVID-19 compared to others, Americans were confronted with the stark differences in their lives due to privilege. This led to public outrage and was partly why—in addition to police brutality, growing economic and political divides, and building momentum toward racial consciousness, among other factors—Black Lives Matter protests drew record-breaking crowds. An estimated 26 million people took to the streets in the United States in the summer of 2020 to draw attention to and decry systemic injustice.

COVID-19: Moving toward Reflection

With a more-widespread understanding and management of chronic stress, proclamations in support of racial justice, and a gradual acclimation to life during the COVID-19 pandemic, more people began to move from survival mode toward a mode of reflection. We considered essential questions about our lives aroused by the pandemic. Presented with so many deaths in a short time span, we asked ourselves: How do we live a life of meaning? We’ll look at this question in depth in part two of “Coming Out of the Pandemic: From Surviving to Thriving.”

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Posted on by Author Rachael Severancein Categories News

More Effective Time Management

For independently licensed mental health professionals who own their practices, time management is an essential skill. You are juggling your caseload, your schedule, attentive care to your clients, and running your own business. Not to mention personal and family responsibilities – your plate is full.

To avoid overwhelm and the feeling that you just can’t get everything done, consider trying a few things to help with overall time management. Remember back in December when we talked about the issues with multi-tasking? Well, we’re revisiting the topic in order to help you strengthen your own time management talents.

Focusing on a single task at a time is a more effective time management skill because multitasking is distracting, slows you down, impairs executive function, and makes you make more mistakes. Some studies estimate that when you attempt to multitask, you actually end up taking 40 percent longer to finish the project than you would have taken if you’d given it your complete attention.

What to manage your time more effectively? Try to avoid:

  • Bouncing from one device to another; it’s just as distracting as bouncing from one task to another. Avoid spending time on multiple devices at once (aka media multitasking).
  • Constantly checking your phone or email.
  • Interrupting others who are in focused activities.

Instead, try this:

  • Self-regulate to purposefully avoid multitasking.
  • Time blocking – a powerful way to maintain control over your schedule by blocking off time on your calendar each day for specific tasks
  • Turn off electronic devices.
  • When interrupted, finish what you started first, if you can.
  • Silence online notifications. These are mini distractions!
  • Engage in single-tasking as much as possible.
  • Say no sometimes – it’s okay; we all take on too much at times.
  • Give others your full attention.
  • Model the behavior you wish to see.
  • Encourage and make time for mindfulness and mental wellness.
  • “Chunk” (single-task) your time, setting aside 25 minutes to two hours for each activity.

Is all Multitasking Bad for You?

While the research is pretty clear that multitasking isn’t healthy for you, there is some nuance in the study results. Not all tasks require our complete concentration and focus. We can, for example, fairly effectively sing and take a shower at the same time.

The human mind is “evolutionarily scripted for monotasking,” writes psychologist Jeff Comer, Psy.D. As tasks increase in complexity (and thus need more of our cognitive skills available), our ability to be efficient decreases when we multitask. So next time you are inclined to “get more done” and, say, text and write a paper, or finish up that email while you’re listening to a Zoom call? Think again. There is a real cost to your productivity and performance.

A Healthier Approach to Time Management

To complete a task, we must set a goal, identify the information we need to achieve it, and disregard irrelevant distractions. When we invite irrelevant distractions by attempting to focus on more than one task at once, we take away from our ability to complete the tasks. Over time, this behavior leads to more distraction. Research is ongoing to determine the long-term effects of multitasking on our brain function. For now, we know that studies show there are short-term negative consequences. To combat the erosion of concentration and focus that multitasking can produce, we can develop stronger mindfulness habits and engage in single-tasking.

Perhaps it’s worth pulling back and considering why we invest in time management techniques in the first place. As Anne Helen Petersen recently asked in her article, “The Diminishing Returns of Calendar Culture,” what would happen if we decouple time management and optimization from our ideas of “success” altogether?

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Posted on by Author Rachael Severancein Categories Advice for Affiliates, Tips for Healthy LivingTagged ,

Resolutions, Goals, and Setting Yourself up for Success

As Americans, we like to think of ourselves as rugged individualists, self-sufficient and driven to succeed. So, it’s no surprise that when it comes to our New Year’s resolutions or other big goals, we rely on our willpower and sheer determination to change our habits. After all, we can do it! But nearly 80% of New Year’s resolutions fail within a month. It may be wise to consider how humans can effectively implement personal change and use an alternative approach to make your goals—and ultimately your life—successful.

Who to Blame When Goals Fail

We tend to blame our lack of willpower for failed New Year’s resolutions, and equate this with a countrywide decline in self-control. Science does not back up our propensity to insist that we and our peers follow the age-old, all-American advice to “pull yourself up by your bootstraps,” though. In fact, it’s nearly the opposite.

It’s true that there is some work you can do by yourself to make change impactful and lasting. A deep understanding of how and why you operate the way you do is beneficial in many areas of life, not least of which for behaviors you’d like to change. When you truly grasp your mindset and core values, as well as what’s holding you back and limiting you, you will be more effective at changing your habits. An action you want to achieve that speaks to your core values, life purpose, and sense of meaning is an action you are more likely to take. And when you make it a SMART goal, you are more likely to succeed with that action.

That said, big personal change and goal achievement doesn’t happen in a vacuum. You need to make a sustained effort to change your habits over the long term, and one of the more effective ways to get there is by shaping your external environment—not focusing on your internal “lack” of self-control or otherwise blaming yourself for missteps or failures.

How to Make Goals Successful: Our Environment

We need to face facts. We will always have temptations thwarting our best intentions: the free candy when you’re trying to reduce added sugars in your diet, the compelling clickbait article when you’re trying to lower how much time you spend in front of a screen. There will always be obstacles in our way to a better life; we can’t control these. We can, however, exert some influence on our social and physical surroundings. Research shows that rather than rely solely on willpower to achieve our resolutions, we need to shape our environment to make self-control and accountability simple, easy, and convenient. Think of it as preparing the groundwork to then be lazy!

You have likely heard of the term “accountability partner” in reference to goal setting—and with good reason. When you shape your environment to achieve lasting change, put help via outside accountability high on your to-do list. This may come in the form of a formal or informal support group, online or in-person, who are making similar changes themselves, or it could be an individual accountability partner: a coach, a mental health practitioner, or someone else who is committed to helping you make the change you wish to see. Whichever it is, check in regularly.

That may sound like more work, and it is, but it substantially increases your chances of being successful with your stretch goals. We are, after all, social animals. Keep in mind that by adopting a support network, it may mean more internal work, too, in that you may need to not only hear constructive criticism, but embrace it. By welcoming external feedback, you can discover what went wrong and find ways to fix it, thereby improving yourself and moving ever closer to your big goals.

In addition to finding others to support us, another method to creating a fertile field for change is to design our physical environment. When we optimize our environment, we make self-control easier. If your goal is, for example, to spend less time with your smartphone, you could change your physical surroundings by putting your cell phone in a hard-to-reach place or disabling apps that might be tempting. The farther away and the more effort you have to make to indulge a temptation, the better. Make the good choice the easy choice by default.

Willpower is a limited resource, just like attention. Don’t make it do all the work to change—shape your support network and design your surroundings so you are set up for success.

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Posted on by Author Rachael Severancein Categories Tips for Healthy LivingTagged ,

How to Tackle Your To-Do List and Maintain Your Well-Being

With the winter holidays upon us, we may feel the additional pressure to go, go, go: making holiday cookies, selecting gifts, getting twinkly lights up, seeing family and friends—all on top of our everyday lives, a mile-long to-do list, and what may feel like perpetual busyness. While your natural inclination may be to multitask and make it all happen, a smile plastered on your face all the way to the finish line, let’s pause for a moment and consider: is multitasking a healthy way to live?

What Is Multitasking?

Before we look at whether multitasking is a healthy habit, we need to define what multitasking is. Multitasking is, essentially, the performance of more than one task simultaneously. We all know what that looks like: wrapping up an email while we talk on the phone, responding to an instant message while we’re on a Zoom conference call.

A 2017 study published in Applied Ergonomics delves further in and differentiates between three types of multitasking:

Concurrent multitasking is when you conduct two or more tasks at the same time.

Interleaved multitasking, or task switching, is when you switch between two or more tasks as they develop.

Combined multitasking is a combination of the two types above; it is when you execute two or more tasks concurrently while switching between tasks as they develop.

In general, when folks refer to multitasking, they are referring to combined multitasking.

Is Multitasking Bad for You?

With job descriptions routinely advertising for employees who can juggle multiple tasks and lives that seem to get busier and busier, multitasking can seem like a knee-jerk response to getting more done in a day. It’s worthwhile, however, to pause and look at the research done on time management techniques and consider whether multitasking is a healthy or unhealthy practice to partake in.

People who multitask are less efficient than those who focus on one project at a time, according to a study in the Journal of Experimental Psychology. In fact, Stanford University studies show that productivity can be reduced by as much as 40% when we multitask. With substandard results in our performance, why do we persist in our attempts to multitask, and continue to believe it’s an efficient, productive way to work when, in fact, it’s not?

When you multitask, it seems like you’re accomplishing many things at the same time. But rather than getting more done, what you are really doing is quickly shifting your attention and focus from one thing to the next. It’s this switching, or interleaved multitasking, that slows you down and stresses you out.

How Does Task Switching Affect Me?

Multitasking is managed by your brain’s executive functions, which determine how, when, and in what order tasks are done. There are two stages to the executive control process: goal shifting (deciding to do one thing instead of another) and rule activation (changing from one task’s rules to the rules for a new task). When you multitask, you incur what psychologists call “task switch costs,” or the negative effects resulting from switching among tasks.

Research has shown that when we grow accustomed to frequent interruptions, we develop a short attention span and even begin to self-interrupt, which leads to a longer-term problem, as it extends the amount of time needed to finish tasks.

What Happens When I Multitask?

People tend to overestimate their ability to multitask, and those who multitask the most demonstrate more impulsivity, less executive control, are more easily distracted, and tend to downplay the negative effects of their behavior.

Intense multitasking can induce a stress response, according to Dr. David Meyer, a psychology professor and codirector of the Brain, Cognition, and Action Laboratory at the University of Michigan. This further degrades cognitive processing, says Dr. Jeff Comer.

Multitasking results in:

  • Diminished ability to concentrate
  • Decreased ability to pay attention to details
  • Lower competency in organization skills
  • Being perceived as disrespectful
  • Delayed task-completion
  • Increase in stress
  • Increased impulsiveness
  • Lower recall
  • More frequent memory lapses
  • More frequent accidents and errors
  • May worsen work and/or school performance
  • Burnout

The Importance of Breaks

Guess what? Multitasking makes us very tired. By quickly switching between activities, even minor ones, we use up our precious supplies of oxygenated glucose in our brains—the very same fuel we need to focus on a task! To compensate, many folks reach for more coffee (caffeine), more food—in other words, more energy. Instead, Dr. Daniel Levitin, professor of behavioral neuroscience at McGill University, speaks to the benefit of regular breaks. When we take 15-minute breaks every couple of hours and allow our minds to truly wander, we’re more productive. Your brain is, after all, a muscle, and it needs time to rest and recover after it’s worked out.

One way to think about multitasking is purposefully giving ourselves distractions in the form of other tasks. But switching tasks is stressful, and on average it takes us twenty-three minutes to return to our work when we’re interrupted, according to Dr. Gloria Mark at the University of California, Irvine. To avoid that switch-induced delay caused by multitasking, she advises “chunking” your time. Also known as time blocking, monotasking, or single-tasking, this method of scheduling your day can give you a sense of control over your time and make you more productive.

What Is Single-Tasking?

Single-tasking is the opposite of multitasking. With single-tasking, you balance competing tasks. When you become a single-tasker, you are filtering tasks, determining priorities, setting goals, and completing the many items on your to-do list. You maximize your productivity by setting aside specific times for completing your most important work. You can do this by focusing on creating a prioritized to-do list and then time blocking.

Single-tasking (aka time blocking) is a time management technique that is as simple as it sounds: block off a period of time to complete a particular task. By setting aside specific times to respond to emails, return calls, and focus on important projects throughout your day, you can improve your focus and deter any tendency you might have to procrastinate. Best yet, at the end of the day, you’ll feel like you accomplished something—because you likely did!

As we move through the hectic holiday season, consider taking a break from multitasking and purposefully engage in a time management technique that will reduce stress, improve your focus, and help you happily, healthfully conquer your never-ending to-dos.

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Posted on by Author Rachael Severancein Categories Tips for Healthy LivingTagged

Trauma-Specific Self-Care: Part 2

We know that self-care is important for everyone. But how do you practice self-compassion and personal wellness when you have been through trauma or are trying to help someone through a traumatic life event? In the first part of a two-part series on trauma-specific self-care, we looked at how your body responds to stress and trauma and what individuals can do to begin healing. Now, in part two, we’ll explore how mental health professionals can take care of themselves while they take care of their clients.

How Does Treating Clients with Traumatic Experiences Affect Me?

The reality is that treating clients who have experienced trauma can have impact. This “inevitable secondary stress,” as Trauma expert and Simmons College Graduate School of Social Work professor Julia Colpitts, MSW, calls it, is natural. We evolved to connect with our pack to survive. When we see or hear other people’s trauma, the areas in our brain that are activated are the same ones that would be activated if it was primary trauma—our own trauma. Mirror neurons are engaged in the trauma’s retelling, and our bodies respond to the story and mimic the survivor’s physiological response. Trauma is, in a sense, contagious. So, what can we do about it?

What Is Secondary Stress?

“Vicarious or secondary stress is empathy in action,” Colpitts states, and it is unavoidable. We are social animals, and we respond naturally to others. The impact ranges from mild to clinically symptomatic, but all responses on the continuum can have a long-term effect. We can get stuck in arousal mode from the continuous retelling of traumatic life events if we don’t actively manage our secondary stress and its impact on us as therapists and mental health providers. It doesn’t have to lead to professional burnout; viewed and managed differently, it can even become an invitation to grow personally and professionally.

Secondary traumatic stress often causes muted arousal responses, either hyper (flood of anxiety, fear, and anger) or hypo (distancing from emotion). Over time, cognitive distortions can develop, altering one’s focus, the content of their thoughts, and even their worldview. Unacknowledged vicarious stress also has a negativity bias, which can obscure our compassion satisfaction and real accomplishments. For therapists who hear traumatic stories that resonate with their own prior life trauma, the arousal response can deepen—and our professional dissociation and burnout, historical and/or cultural trauma, and traumatized organizations can serve to further deepen that response.

Some mental health professionals, like others in the population, cope with secondary stress and trauma by employing short-term relief strategies to manage their state of arousal, such as food and alcohol issues, inactivity or “mindless” (dissociative) activities, and overwork. These primitive defense mechanisms may appear to help for a few hours, but ultimately they all have long-term negative consequences.

Unhealthy coping behaviors such as substance use may have the same effect as ignoring the secondary stress altogether: illness, including serious chronic conditions such as heart disease. Women who are social workers, for instance, are 36% more likely to have heart problems than women in other professions (American Heart Association scientific session, November 2019). And “community and social services” is number one of the top ten professions correlated to cardiac arrest (gender-neutral) (CDC Morbidity and Mortality Weekly Report, 2016). It is therefore crucial that we develop positive coping methods for secondary traumatic stress.

A therapist’s self-care involves acknowledging the continuous stress you are under and allowing yourself a release. We need to proactively prepare for secondhand stress and its impact on us through daily doses of calm interspersed through our days.

Which Tools Should Therapists Use for Secondary Stress?

How do we turn off the arousal response? We activate the care system.

“Self-care is not just what we do after work. Self-care is how we do the work itself.” –Julia Colpitts, MSW

 

First of all, guard against the tendency to overcommit, to overwork in an effort to soothe. Like the proverbial oxygen mask on an airplane, you are ill equipped to help others if you’re not functioning well yourself.

Then, create a resilience menu. Choose from an array of simple, self-care actions to calm the body and calm the mind—a personal relaxation practice that can radically reframe how you go about your day. As though you are selecting a dish from a restaurant menu, choose the one(s) that sound best to you that day, at that time. And just as we are advised to “eat the rainbow” when it comes to dietary health, your resiliency menu or toolkit works best when you layer soothing actions across the spectrum, and use self-care well not just when there’s a personal crisis, but proactively and intentionally, every day. Some examples of what relaxing options might be on your resiliency menu [link “resiliency menu” to October blog] include:

  • Breathwork, such as box breathing
  • Being kind to yourself—kick out the inner critic
  • Muscle tension release using progressive relaxation techniques
  • Guided meditation, such as those offered by Kristen Neff
  • Sensory stimulation (e.g., aromatherapy, calming visuals, nature sounds, savory tastes, touch, water, sexual activity, massage, Reiki bodywork, and grounding strategies)
  • Acupressure and acupuncture
  • Yoga, tai chi, and other mind-body centering work
  • Conjuring up images of love and connection
  • Self-compassionate meditation and activities, such as bilateral stimulation like the butterfly hug, and affirmations
  • Interacting with animals, including equine-facilitated therapy
  • Mindfulness and related physical practices, such as walking meditation and forest bathing
  • Body scans
  • Expressing gratitude and love

Your resiliency tools not only help to heal the impact of secondary traumatic stress by releasing stored arousal responses and reestablishing a peaceful baseline, they also help strengthen your capacity for joy and presence and prepare you for future sources of stress.

How Can I Support Other Mental Health Professionals’ Well-being?

To journey to wellness together, we need to support positive attachments to ourselves, to others, and to community coregulation. As mental health providers, we can:

  • Talk openly about secondary trauma and its impact.
  • Add moments to meetings that emphasize compassion satisfaction.
  • Practice personal relaxation techniques openly, as appropriate, to model calm.
  • Notice and address when organizations are traumatized.
  • Support setting realistic workloads.

Thank you to Julia Colpitts, MSW, for sharing her keynote presentation and ideas on this subject.

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Posted on by Author Rachael Severancein Categories Tips for Healthy Living, Understanding Mental Illness, WellnessTagged ,

Frederic G. Reamer

Ethics and Risk Management Challenges in Behavioral Health

This webinar will provide participants with an overview and in-depth examination of compelling ethical challenges in behavioral health.

Thu, November 10, 2022
Wed, November 30, 2022
8:30 AM – 4:00 PM EST

Refund Policy

No Refunds

About this event

About the Training:

This webinar will provide participants with an overview and in-depth examination of compelling ethical challenges in behavioral health. Dr. Frederic Reamer will explore complex and challenging ethical issues and practical strategies designed to protect clients and practitioners. The webinar will include a series of challenging cases and discuss practical steps professionals can take to manage ethical issues skillfully. Key topics will include boundary issues, dual relationships, conflicts of interest, confidentiality, privileged communication, informed consent, clients’ rights, delivery of services remotely, termination of services, and impaired professionals, among others. Dr. Reamer will discuss relevant ethical standards; national practice standards; and statutes, regulations, and case law. The webinar will focus especially on complex documentation issues. The presenter will make extensive use of case material and provide ample opportunity for audience participation.

This training is worth six (6) contact hours.

By the end of this workshop, participants will be able to:

  • Identify challenging ethical issues and dilemmas in behavioral health
  • Apply practical ethical decision-making frameworks and protocols
  • Identify ethical issues that pose malpractice and liability risks
  • Design strategies to protect clients and practitioners

Agenda for the Day:

  • Difficult ethics cases in behavioral health: The anatomy of ethical dilemmas (8:30-9:30 a.m.)
  • Compelling ethical challenges: boundary issues, dual relationships, conflicts of interest, confidentiality, privileged communication, informed consent, clients’ rights, delivery of remote services, termination of services, and impaired professionals (9:30-10:15 a.m.)
  • Break: 10:15-10:30 a.m.
  • Compelling ethical challenges in behavioral health (continued) (10:30 a.m. to noon)
  • Lunch (Noon to 1:00 p.m.)
  • Risk-management strategies to protect clients and prevent ethics complaints and litigation (1:00-2:30 p.m.)
  • Break: 2:30-2:45 p.m.
  • Ethical decision-making strategies (decision-making protocols; codes of ethics; ethics literature; ethics committees; practice standards; relevant regulations, statutes, and case law) (2:45-3:40 p.m.)
  • Questions/answers (3:40-4:00 p.m.)

***This training has been approved for LADCs and CADCs by the Maine Board of Drug and Alcohol Counselors.***

About the presenter:

Frederic G. Reamer is Professor in the graduate program of the School of Social Work, Rhode Island College, where he has been on the faculty since 1983. His research and teaching have addressed a wide range of human service issues, including mental health, health care, criminal justice, public welfare, and professional ethics. Dr. Reamer received his Ph.D. from the University of Chicago (1978) and has served as a social worker in correctional and mental health settings. He has also taught at the University of Chicago, School of Social Service Administration (1978-1981), and the University of Missouri-Columbia, School of Social Work (1981-1983).

Dr. Reamer has served as Director of the National Juvenile Justice Assessment Center of the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention (1979-1981); as Senior Policy Advisor to the Governor of Rhode Island (1987-1990); and as a Commissioner of the Rhode Island Housing and Mortgage Finance Corporation, the state housing finance agency (1987-1995). Dr. Reamer served on the State of Rhode Island Parole Board from 1992 to 2016. He also served as Editor-in-Chief of the Journal of Social Work Education (1990-1994). He serves as Associate Editor of the National Association of Social Workers Encyclopedia of Social Work (Oxford University Press and National Association of Social Workers). Since 2012, Dr. Reamer has served as the ethics instructor in the Providence (RI) Police Department Training Academy.

Dr. Reamer has conducted extensive research on professional ethics. He has been involved in national research projects sponsored by The Hastings Center, the Carnegie Corporation, the Haas Foundation, and the Scattergood Program for the Applied Ethics of Behavioral Healthcare at the Center for Bioethics, University of Pennsylvania. He has published 24 books and 175 journal articles, book chapters, and encyclopedia articles. His books include:

  • Moral Distress and Injury in Human Services: Cases, Causes, and Strategies for Prevention (NASW Press)
  • On the Parole Board: Reflections on Crime, Punishment, Redemption, and Justice (Columbia University Press)
  • Ethics and Risk Management in Online and Distance Behavioral Health (Cognella Academic Publishing)
  • Ethics and Risk Management in Online and Distance Social Work (Cognella Academic Publishing)
  • Risk Management in Social Work: Preventing Professional Malpractice, Liability, and Disciplinary Action (Columbia University Press)
  • Boundary Issues and Dual Relationships in the Human Services (Columbia University Press)
  • Heinous Crime: Cases, Causes, and Consequences (Columbia University Press)
  • The Social Work Ethics Casebook: Cases and Commentary (NASW Press)
  • A Guide to Essential Human Services (NASW Press)
  • Criminal Lessons: Case Studies and Commentary on Crime and Justice (Columbia University Press)
  • Social Work Values and Ethics (Columbia University Press)
  • Tangled Relationships: Managing Boundary Issues in the Human Services (Columbia University Press)
  • Ethical Standards in Social Work: A Review of the NASW Code of Ethics (NASW Press)
  • The Social Work Ethics Audit: A Risk Management Tool (NASW Press)
  • Ethics Education in Social Work (Council on Social Work Education)
  • The Foundations of Social Work Knowledge (Columbia University Press; editor and contributor)
  • Social Work Malpractice and Liability (Columbia University Press)
  • Social Work Research and Evaluation Skills (Columbia University Press)
  • The Philosophical Foundations of Social Work (Columbia University Press)
  • AIDS and Ethics (Columbia University Press; editor and contributor)
  • Ethical Dilemmas in Social Service (Columbia University Press)
  • Rehabilitating Juvenile Justice (Columbia University Press; co-author, Charles H. Shireman)
  • The Teaching of Social Work Ethics (The Hastings Center; co-author, Marcia Abramson).
  • Finding Help for Struggling Teens: A Guide for Parents and the Professionals Who Work with Them (NASW Press; co-author, Deborah H. Siegel)
  • Teens in Crisis: How the Industry Serving Struggling Teens Helps and Hurts Our Kids (Columbia University Press; co-author, Deborah H. Siegel)

Dr. Reamer is also the author of chapters on professional ethics in the Encyclopedia of Social Work, Encyclopedia of Bioethics, Encyclopedia of Global Ethics, Encyclopedia of Applied Ethics, Encyclopedia of Lifespan Human Development, Encyclopedia of Higher Education, and Encyclopedia of Primary Prevention and Health Promotion. He has been an essayist on National Public Radio’s Morning Edition (“This I Believe” series), a commentator on National Public Radio’s All Things Considered, and a guest on various radio and television broadcasts. From 2007 to 2021 Dr. Reamer served as host and producer of the National Public Radio series This I Believe—New England, broadcast weekly. He is featured in the podcast series Trapped in Treatment produced by Paris Hilton, Warner Brothers, and iHeart Media; Yahoo News national series Unfiltered; and as a commentator in the video documentaries America’s Serial Killers: Portraits in Evil and Rampage: Killing without Reason. He is also a featured expert on the PBS (Public Broadcasting Service) series This Emotional Life.

Dr. Reamer has lectured extensively nationally and internationally (including India, China, Singapore, South Korea, Japan, Taiwan, Sweden, Germany, Italy, Portugal, Djibouti, Bahrain, Indonesia, Diego Garcia, Spain, Romania, Poland, Greece, and Canada) on the subjects of professional ethics and professional malpractice and liability. He has served as an adjunct professor and visiting scholar at the University of Pennsylvania, Tulane University, Simmons University, Smith College, University of Oklahoma, and Augsburg University. Dr. Reamer chaired the national task force that wrote the National Association of Social Workers Code of Ethics and served on the code revision task force. He chaired the international commission sponsored by the Association of Social Work Boards to develop Model Regulatory Standards for Technology and Social Work Practice. Dr. Reamer also chaired the national task force sponsored jointly by the National Association of Social Workers, Association of Social Work Boards, Council on Social Work Education, and Clinical Social Work Association to develop Technology Standards in Social Work Practice. He has served as an expert witness and consultant in 130 court and licensing board cases addressing professional ethics.

Dr. Reamer received the “Distinguished Contributions to Social Work Education” award from the Council on Social Work Education (1995); Presidential Award from the National Association of Social Workers (1997); Richard Lodge Prize from Adelphi University for “outstanding contributions to the development of social work theory” (2005); Edith Abbott Award from the University of Chicago for “distinguished service to society and outstanding contributions at the local, national or international levels” (2005); Neil J. Houston, Jr. Memorial Award for “dedicated service and citizen contribution toward the criminal justice profession and the public interest” (2009); International Rhoda G. Sarnat Award from the National Association of Social Workers for significantly advancing “the public image of social work” (2012); Excellence in Ethics Award from the National Association of Social Workers (2015); and inaugural Contributor Award from the Association of Social Work Boards (2019). In 2016 Dr. Reamer was named a Social Work Pioneer by the National Association of Social Workers for his “commitment and dedication to the social work profession and to the improvement of social and human conditions at the local, state, national, and international levels.”

Register here for the Tuesday, November 10 session!
Register here for the Wednesday, November 30 session!

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Posted on by Author Randy Runnelsin Categories Events

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