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Credentials: What do All Those Letters Mean?

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Written by: Robert R. Cassman, LPCC-S

Navigating the field of therapy is difficult enough, especially when there are so many credentials. These letters that follow the names of therapists can be quite confusing. In this brief article, I will attempt to explain some of those letters.

MD: A “medical doctor” is someone who has gone to college, then medical school, and then to a residency to specialize in a particular type of medicine. An MD can prescribe medication for a variety of illnesses. A psychiatrist is an MD with specialized training in psychiatric medication.

LPCC: A “Licensed Professional Clinical Counselor” is a therapist who has obtained his or her master’s degree and has earned a license to practice professional therapy. To obtain this license, at least two years’ worth of professional experience and training is required. Someone with an LPCC is a professional counselor who views the mental health issues people struggle with on an individual level.

LMFT: A “Licensed Marriage and Family Therapist” is similar to the LPCC except the training is more focused on marriages and families and not so much the individual.

LCSW: A “Licensed Clinical Social Worker” has some similarities to the LPCC and the LMFT but some differences as well. The LCSW tends to view the issues a client struggles with from a perspective that looks at the society at large. LCSWs tend to advocate for social change and social justice. A LCSW can get a bad rap because many employees from social services and DCBS-type agencies have social work degrees. But not all LCSWs are out to take away your children! An LCSW is a professional therapist too.

PhD/PsyD: A “Doctor of Philosophy” (PhD) is usually a psychologist who has received a doctorate and focuses primarily on testing. If you child needs an ADHD test, or someone needs an IQ test more than likely a psychologist would do the test. A “PsyD” is a Doctor of Psychology and does mostly what a PhD-psychologist would do. Both of these tend to be professors in universities as well.

A therapist can be called a “doctor” if he or she has a doctorate degree in any field. This may be confusing as some will think of a “doctor” as only someone with a medical degree.  But a doctorate can be earned in many different fields.

Professional licensing boards require that therapists provide proof to the public that therapists are who they say they are. This leads to the credentials being placed on the walls of offices etc. Therapists also do this by listing their credentials after their names.  There are also credentialing organizations that give credentials to individuals who have obtained certain types of experiences and training. Above I have listed some of the basic credentials. There are many more. If you are unsure, simply ask the therapist. All therapists would be happy to explain all the letters after their name. Just ask.

Postpartum Depression

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Written by: Sam Rouse, LPCA

A new baby often brings joy and fulfillment to peoples lives.  Some mothers often have a baby after years of fertility issues and miscarriage.  Society expects mothers to be perfectly happy after all they have wished for comes true.  Many times this is not what happens. An estimated 15-30% of mothers experience what is called postpartum depression.

Most all mothers experience some form of the “baby blues.”  That does not necessarily mean that it is as serious as Postpartum Depression (PPD.)  These mood changes are often attributed to hormonal issues after the birth of a child. Sleep difficulty and adjustment to the new life with a baby can also contribute.  Mothers can start showing symptoms of PPD up to 12 months after the birth of the baby. The following are signs and symptoms of PPD:

  • Low mood
  • Irritability or “grumpiness”
  • Difficulty bonding with baby
  • Problems with eating or sleeping
  • Thoughts of hurting yourself or the baby

Postpartum depression is not the only issue that can affect mothers following delivery.  Mothers can also experience anxiety disorders, obsessive-compulsive disorders, even postpartum psychosis.  Any type of postpartum mental health issue is very serious and immediate attention is required. If you believe that you are having difficulty following the birth of your child seek medical attention from your OB or primary care physician immediately.

Medications can be used to help the symptoms as well as mental health counseling.  Most importantly, with any mental health condition, one important thing is the support system.  Surround yourself with the people who support you and educate them about the issue and ways they can help.

If you are having any thoughts of hurting yourself or your baby, seek attention immediately by calling 911 or going to your local emergency room.  Safety for you and your baby is the most important.

Some of the information here was from postpartum.net

Types of Parenting

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Written by: Robert R. Cassman, LPCC

While this article doesn’t attempt to provide an exhaustive list or description of parenting styles, we will discuss three of the major styles. None of the three parenting styles are pathological but there are differences and it will be clear which is the healthiest one.  

Permissive parenting involves a parent who wants to be a friend of their child. The permissive parent constantly buys the cooperation of the child. In Walmart, this is the parent who has the out-of-control whiny child who only stops crying when promised something in return. Permissive parents are afraid to discipline the child. “I don’t want her to hate me” a permissive parent is likely to say when asked why discipline isn’t used. Permissive parents feel guilty when they do attempt discipline.  These children grow up to be demanding, permissive and excessive. They have poor relationships because they are spoiled and don’t know how to give toward someone else.

Authoritarian parenting may look like a “drill sergeant” to others. These parents show very little physical affection. This parent is orderly and structured. The children are, therefore, orderly and structured as well. In Walmart, this parent does not need to redirect his or her children. The children are quiet and control themselves. This parenting is colder and tends to be isolated. There is very little room for special circumstances. These children grow up to have distant relationships and have a difficult time interacting with others who are dissimilar.  They may also have a hard time standing up for themselves and tend to get taken advantage of in relationships.

Authoritative parenting is a good mixture of both. The authoritative parent gives a healthy dose of affection and a healthy dose of discipline to the child. This parent disciplines because the child is loved. These children tend to grow up to be healthy adults.

S.T.O.P

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Written by: Carl Puleo, LPCA

Imagine yourself standing in the middle of a river. But instead of water flowing around you, you are surrounded by flowing words, images, and emotions. This river represents the state of your mind. Sometimes the flow is nice and steady. Other times, the flow is choppy and difficult to handle as you are bombarded by waves of memories, upsetting emotions, and thoughts of worry. When your mind is in turmoil like a raging river, it is easy to feel as if your life is beyond your control. That is why I encourage my clients to STOP.

STOP is an acronym for Step away, Take a breath, Observe, and Proceed.

Step away

Continuing in the metaphor of a mental river, I encourage clients to imagine themselves stepping onto the shore. You do not have to wait for the river to be choppy and turbulent to do this exercise. In fact, I highly recommend practicing this when the mind is calm. Sometimes in order to step away mentally, one has to literally step away from a situation physically, such as going into another room or going for a walk. You can “step away” mentally too by thinking of something else or using your imagination. Whatever you need to do, the first step is to take a mental break, hitting the mental pause button, and stepping back away from your mind.

Take a breath

Breathing is important. I know that seems like an obvious statement. If you weren’t breathing you’d be dead, right? But breathing deeply, down into your belly is called diaphragmatic breathing. It goes like this: Breath deep and slowly through your nose. As you breathe you may have to pooch out your stomach in order for the air to go deep down into your lungs. Hold the breath for a few seconds and then slowly release it as if you were blowing on a pinwheel or blowing up a balloon. Do this two or three times as you mentally step away.  Doing this will cause your body to naturally experience relaxation.

Observe

Now that you have distanced yourself from the flow of thoughts and emotions, and have taken a breath or two, you and your body ought to be ready to consider the content in the flow of your mind. Observing is not the same as engaging with the thoughts and emotions. Observing is about becoming aware of them. You might discover that you have feelings of frustration that you were not aware of before, but because of your practice of stepping back you are no longer affected by it and can acknowledge its presence. It is sort of like the story of the person who complained about not being able to see the forest because they were surrounded by so many trees. If the person would have pulled back to another vantage point they would have been able to observe their surroundings from a distance. Continue to practice deep belly breathing as you observe while stepping away.

Proceed

After a few minutes of stepping away, breathing, and observing your flow of thoughts and feelings you will be able to return to whatever you were doing with a better sense of control and relaxation. If you find that you return once again to a turbulent state, you can always STOP again for a few more minutes until you are no longer carried away by the strong currents of thoughts and emotions. Doing the STOP practice once or twice a day will enable you to develop more self-awareness. With self-awareness comes self-control. With self-control comes more satisfaction which leads to a contented and happy life. If you are interested in learning more about STOP and other mindfulness coping skills to help you achieve a more contented and happy life see a counselor near you

Are You Depressed or Sad?

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Written by: Carl Puleo, LPCA

While there are some similarities, there are quite a bit of differences between depression and sadness. Let’s examine them.

Sadness is an emotion. It is common among most humans (and allegedly other animals as well). Unless you have a brain dysfunction you most likely have experienced sadness at one point in your life. Welcome to being human! Some other words that might describe sadness are grief, heartache, down, the blues, and tearful to name a few.

Just about anything can cause someone to feel sad. Losing a relative to death, not getting a job you really wanted, breaking up with a boy or girlfriend, or maybe missing a friend who has moved away are examples of situations that may cause you to experience sadness.

Whereas sadness is an emotion, depression, on the other hand, is a condition. It is a mental illness.

According to the Center for Disease Control, nearly 26 million people in America reported being depressed from 2009 to 2012 (CDC.gov). “Nearly 90% of persons with severe depressive symptoms reported difficulty with work, home, or social activities related to their symptoms” (CDC.gov). According to a survey by the Foundation for a Healthy Kentucky, almost 50% of people who were asked stated they knew someone who had a problem with depression.

Depression is not just a mood disorder. It is an EVERYTHING disorder. Depression affects your emotions, thoughts, physical health and behavior.

Emotions

Although sadness may be experienced when one is in a depressive state, most often people report feelings of emptiness, worthlessness, hollowness, and hopelessness.

Thoughts

Depression affects the way you perceive the world. Usually, depressed people have a negative outlook on themselves, others, and life in general, and find it difficult to shake those thoughts. They have consistent negative self-talk and irrational beliefs.

Physical Health

Depressed people tend to either sleep too much or not be able to sleep well at all. Depression tends to lead to a decrease in a person’s immune system so they become more vulnerable to colds and illnesses.

Behavior

With all of the negative emotions, thoughts, and health issues, most depressed people find it difficult to get self-motivated and will isolate themselves from others. They will not take care of their hygiene and will jeopardize their jobs, family, and social life.

Sadness will eventually pass but depression tends to hang on for longer periods of time. Also, be aware that sadness can develop into a depression. If you have experienced sadness for longer than you think is normal, or if you can relate to the symptoms described above, seek help. Untreated depression can lead to suicidal thoughts. Don’t hesitate to seek a professional for help if you or others believe you may be depressed.

How do I Talk to My Child about Suicidal Thoughts?

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Written by: Nick Bloodworth, LMFT

Suicide attempts and successful suicides are on the rise and has been steadily increasing over the past few years. People are afraid of talking about suicide out of fear that it may increase the chance that someone commits or attempts suicide. In this article, I want to help encourage the reader to understand the importance of having this conversation as well as identifying common fears people have for avoiding this conversation.

When it comes to asking someone if they are okay, fear often times gets in the way. We fear what response we might get, we fear our inexperience on the topic of suicide and we fear to appear to be nosey. However, the concern for beginning these conversations clouds the relief that people feel after they hear that question, ‘are you okay?’ The question for us as parents, teachers, professionals and everyone else is, “how do we challenge our fears to ensure we are asking the question in a supportive and encouraging manner?” First, we have to discuss our fears that often keep us from having the conversation.

  • “I don’t know what to say.” You don’t need to offer advice or solutions, being there for support by listening gives the person hope and it validates the emotions that the individual is feeling.
  • “I don’t want to make it worse.” People have this myth that talking about suicide makes it worse, but that is not the case and this myth keeps people from reaching out. You can’t make matters worse by sharing that burden and adding another person of support can only be a positive thing. After sharing, most people feel better and feel as if the weight on their shoulders is lighter.
  • “I’m worried about offending them.” If given a negative response or an angry response, this is often the sign of a defense mechanism. It is possible for them to respond out of anger when asked. This is a great opportunity to share your concern with them. You don’t want to take the angry response and use it as an excuse to step back and avoid the conversation. You might say, “I did not mean to upset you, I was simply concerned and wanted to see that everything is going okay.”
  • “I’m not an expert.” No one needs to be an expert to ask the question, “Are you okay?” Caring about someone is enough reason to ask because while you may not be an expert, you are someone that the person values. You can always seek professional help after having the conversation for further assistance.
  • “It’s none of my business”. If you are concerned about someone, that’s all the permission you need to ask the question. Even if they don’t answer or are not honest at that moment, you open the opportunity to have the discussion in the future. The wellbeing of the people around us is always our business

We all have fears or excuses that can be used to avoid having the conversation with someone we care about. We simply need to remember that a conversation could change a life. This conversation could be the simple gesture that shows compassion and support that could have a positive effect on someone that is going through troubling times.

The Four C’s of Counseling

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Written by: Carl Puleo, LPCA

What is counseling? Why do people choose to go to counseling? How do people know if counseling is right for them?

People choose to go to counseling for many reasons and in this article, I would like to explore what I believe people need to consider before going into counseling. I call this the four C’s of Counseling: Change, Commitment, Challenge, and Courage.

Change

First, counseling is about Change. People who choose to go to counseling do so because they either have problems in their life that they wish they did not have. Or, they lack something in their lives that they wish they did have. And, oftentimes both of these conditions exist. Most people want to be happy and content with life and when it is difficult to be happy due to depression, anxiety, or stress, people will seek help to change because change is the reason people seek counseling.

Commitment

Second, counseling is about Commitment. I often tell my clients that counseling is a marathon, not a sprint. Change does not occur overnight. There is no light switch that can be flipped nor any magic wand that can be waved that will produce change. It takes a commitment to stick with the process. Many times people become frustrated because they expect counselors to change them or the process of change moves slower than they expected, and they quit going to counseling. If you want a change in your life and are considering going to counseling you will need to be prepared for the long haul.

Challenge

Third, counseling is about being Challenged. As a client, you will have to work. You will have to work on adopting new ways of thinking, feeling, and behaving. You may have to move outside of your comfort zones. You may even have to experience mental pain before you can experience healing. Again, this is a process that you will have to stick with. Counselors are there to help you become the best person you can be, and sometimes that means dealing with, facing, and challenging old habits, buried emotional wounds, and taking an honest look at yourself. This can be very challenging, but it is the only way to achieve true change in your life.

Courage

Forth, counseling is not for those who are weak. That is why the fourth C is Courage. There is a false belief that if someone goes to counseling it indicates they are weak and unable to cut it in life. This is so far from the truth. If you go to counseling you are one of the bravest people out there. It takes guts to trust another person to share your innermost thoughts and feelings. It takes intense bravery to face one’s inner demons and overcome serious problems.

If you are considering counseling then be aware that in order to Change your life you will need to Courageously be prepared to Commit to being Challenged.  Understand this: counseling works! But it only works for those who understand the Four C’s. Now that you know, are you ready to go to counseling?

 

What are Case Managers?

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Written by: Christy Johns, TCM

Case managers work to bridge the gap to needed services and resources in the community. They do not provide a service but assist and link clients to resources and services needed to meet the client’s mental health needs, achieve recovery, overcome barriers to treatment and live independently in the community. Case management is a means for achieving client wellness through communication, education and service identification with appropriate referrals. It is a time-limited process with the goal of self-sufficiency.

Case managers work in such a way as to encourage clients to navigate and access resources independently in order to build confidence and prevent enabling the client. Case managers work closely with clients age 2-64 who are actively involved in their care.  Case managers empower individuals to decide what they want for their lives and those decisions then form the basis for the development of plans and implementation. The case manager and client create a service plan based on functioning, strengths, and needs, and meet two times monthly in the home or community to monitor the success of utilization of resources.  Case managers coordinate services with other providers to help clients achieve personalized goals. Case managers ensure the changing needs of clients are addressed on a continual basis and appropriate resources are provided as well as all members of the treatment team and involved community partners are made aware.

Case management services include: identifying barriers to treatment, identifying support systems, referrals to needed medical, psychiatric, dental, vision, vocational, educational, social and benefits services. Coordination and ongoing monitoring of services, crisis planning, assistance with finding and maintaining housing, linking to rehab facilities and advocating in the school system.

Case managers work with a person-centered approach allowing us to see the person first and what matters to them, not what is the matter with them. Case managers ask what is important to clients as well as for them while respecting individuality, rights, and dignity and encouraging independence which allows clients to make choices and maintain privacy. Case managers attempt to “wrap” a comprehensive array of individualized services and support networks around the client rather than force them to participate in a pre-determined and inflexible treatment plan.