What’s Family therapy really like? Guest post by Christine H

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(image: Christine H)

Therapy is growing more and more accepted as a mainstream practice, rather than a scary, stigmatised ordeal. After all, it’s important to take care of mental health, and sometimes, we could all use a little extra help.

However, when it comes to any kind of therapy, it can still be scary. We don’t know what to expect, and we worry that we’ll be forced into something that makes us too uncomfortable. This can especially true in the case of family therapy. Often, family therapy is utilised when one or more family member confronts a serious mental health challenge (such as, for example, bipolar disorder, addiction, or major behavioural issues) that affects the rest of the family.

So, in order to dispel some of the misunderstandings surrounding family therapy, and to perhaps help people become more comfortable with it, here are some important things to know:

 

There May Be a Mix of Alone and Together Time

Contrary to popular belief, family therapy isn’t just going to be your family talking in a circle with a therapist the whole session. Well, maybe sometimes it will be. But other times, “family therapy” refers to a lot of different compilations of relationships within your family. Parents may talk with the counsellor separately, and then a child who has been the primary subject of therapy will talk with the therapist, and then perhaps the counselor will enable a conversation between the child and parents in order to share information that needs to be shared.

Additionally, family therapy is most effective when all family members are utilising therapeutic tools to get what they can out of the experience. For example, often in the case of addiction, support groups are available for both the person struggling with addiction, and for the family members who are affected by it. In these separate group therapies (which you can learn more about here) family members can gain new perspectives which will empower them to return to family therapy with the information they need to make it a productive venture.

 

Information that You Want Confidential Can Be Confidential

During all the mix-match of family therapy modules, many individuals are wary about sharing information with the counselor if they don’t want it to be shared with the whole group. And although this might sound kind of shady, it’s not just about keeping major secrets. Often, it’s about protecting family members’ feelings, or being embarrassed or worried about our own feelings.

Since family systems therapy is ultimately about repairing relationships and empowering healthy communication and cooperation, a counsellor can help individuals identify what information is important to share, and how to go about it in the best way. However, there are some challenges that are best talked out one on one with the therapist, and not in the group as a whole. It’s important for all parties involved to understand that they can still control the information that’s shared, and the way they choose to do it… or not.

 

It’s Not All Talk Therapy

Although sometimes all that’s needed in order to strengthen a family’s power to communicate and cooperate is an outsider guiding the conversation, other times talk therapy can be frustrating for families, as they’ll find themselves going around in the same old circles and arguments that they would on their own. That’s why most counsellors will utilise other techniques and approaches to achieve family goals.

For example, sometimes it’s useful to utilize experiential therapy, which could include anything from a cooperative ropes course, to role playing exercises. You can learn more about those options here.

 

Practicing Outside of Therapy Sessions Is Vital

One common assumption of family therapy is that the work will get done in therapy sessions, and it doesn’t have to change the way things are outside of therapy. Family therapy can only be successful when it creates changes to habits and systems within the family dynamic that aren’t serving individuals as well as they should.

Most of the time, a therapist will give family members assignments and goals that they can do–both by themselves, and as they interact with the rest of the family–in order to improve family relationships. Often, these are small habits in the way that we talk and the way we share duties in and out of the house.

 

This article was written by expert on family therapy Christine H

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Life Mental Health Update and the Liebster Award!

Its been a really interesting week for me. I firstly decided after not getting the right NHS therapeutic support that I had to take life into my hands in two ways. Firstly, I needed to see if I could get funding for private therapy to help my anxiety and panic attacks about work. I was able to and then I have booked an appointment to see a recommended psycho-dynamic counsellor. I am hoping that my counselling sessions will help the anxiety and fear around certain things.

Secondly, I decided that if I want to live my dreams and have a life that is fulfilling and true to myself, I have to pursue them. Obviously I have to make my dream achievable too so I have been applying for jobs that feel right for me. My dream has been to be a teacher and I hope to get there one day. I have been interviewing for various positions in schools and hopefully the right one for me will come up soon. I will leave it to God and the universe to decide and do all I can.

So, its been quite a whirlwind for me this week and definitely being pushed a little outside my comfort zone, putting my heart and dreams on the line. However, I am really proud of myself for doing this. I have wanted to seek therapeutic help for years and while its a shame I can’t get it for free on the NHS, I hope it helps me to change my life. My family are a great support for me with this. I am starting this week and will see what happens.

So I have been going to job interviews and its really scary being asked so many questions and waiting for feedback. I know though that I can do it and make myself and my family proud (I hope anyway!)

As well as the above, I am very excited to be going to see Aladdin the musical at the theatre with my boyfriend for our anniversary. He is a wonderful support to me and I love disney!

Lastly, a blog friend, the Happiness Hunter https://thehappinesshunt.wordpress.com   has nominated me for the Liebster Award which celebrates new blogs. My blog has been going almost 2 years but I feel so thrilled to receive the award. Thank you so much! Due to time constraints I can’t nominate other blogs for the award but dedicate it to all my blog followers who are battling mental health stigma and writing so amazingly.  

Go and visit the above blog too, its wonderful! Thanks again 🙂

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Living with Bipolar Disorder: my True story- for Counselling Directory Website

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Be Ur Own Light author Eleanor tells her story for Counselling Directory. 

Article: http://www.counselling-directory.org.uk/experience_236.html

I was diagnosed with bipolar affective disorder at just 16 years old. I had been admitted to hospital after a year of depressive and anxious episodes, followed by a hypomanic episode (a lesser episode of mania). People with bipolar have a mood disorder which means our moods can become extreme and oscillate between low and high.

After a year of not understanding what was happening, I finally came to accept the diagnosis. You see, bipolar runs in my family. There is evidence it can be genetic but, as I was so young, no one suspected that my depression and hypomania could be bipolar disorder. I was hospitalised as a teenager in 2004 due to a mixed state of depression and psychosis (where your mind loses touch with reality).

Luckily, with medication and support, I was able to live a fairly ‘normal’ life for several years. Despite having to go down a year at school, I made it to University and completed a Bachelors and Masters degree. I went travelling with friends to India and Ghana, regularly took my medication – mood stabilisers and antidepressants – and was supported by various psychiatrists and therapists, as well as my wonderful family and friends.

But the trauma of what I went through caused an increase in my anxiety levels and I developed social anxiety, fearing what others thought of me. I also became slightly agoraphobic and suffered from panic attacks. Bipolar is such a complex disorder and sometimes anxiety can be a part of the depressive side of the illness.

Over time, I believe that my main medication stopped working. This coupled with several life events, meant I became unwell fast. In 2013, I began to sink into a very low depressive state which led to suicidal thinking. I became very unwell, but supported by my family and upped dosages of medicine, I got better again. However, this was short lived.

In 2014, I spiralled into the worst manic episode of my life. I had racing thoughts and pressured speech, was very fearful of those around me and began to experience delusions (false beliefs about the world). I was incredibly vulnerable and unwell. Unfortunately, the episode happened very quickly and although I hadn’t been in hospital for 10 years, suddenly I found myself there, waiting to be treated.

Being in hospital this time was hard; it took a while for the psychiatry team to bring me down from the manic state. I was in hospital for four months, attending therapy groups (I loved art therapy) and working with occupational therapists, nurses and a wonderful psychiatrist who believed I would get well again.

I did get better again in time. I had a further four months of support when I left hospital, where I was put on the correct mood stabiliser for me – Lithium – which has helped keep the moods at bay. I attended day therapy sessions on anxiety management, recovery, art and social groups and I slowly came out of my shell again. I was in shock and quite traumatised at what had happened to me. However, over time and with support, I accepted it and began to recover.

Since that difficult time, I have worked for and volunteered with mental health charities and supported communal projects. I also started my blog, Be Ur Own Light, in 2016 to explain to family and friends about my mental health. It has been read worldwide and its aim is to tackle mental health stigma and share real-life stories.

I also began to write for the Huffington Post UK, Rethink Mental Illness, Time to Change and Bipolar UK, amongst others. Writing is therapy for me.

My message would be that the right medical team, coupled with support networks, psychotherapy, medication and doing things you love to do, can help you feel much better and find recovery. I, like so many with mental health issues, am still a work in progress but to reach any form of recovery is a big milestone and I will fight to remain well. You can too.

On being kind to myself: Mental health update

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Life at the moment is much slower than normal as I am not in full time work. I have the time to write and blog and pitch articles, and to work on social media. I have the time to read and I have started a book blog (bookstagram) on Instagram. I can see friends and catch up with family.

However, for me, I am waiting to see my Doctor next week to discuss ways they can support me better with my morning panic. I desperately want to be working and be doing all I love. Its quite exhausting if I am honest, because I so want to be applying for jobs and doing and feeling 100 percent .

The key is being kind to myself and practising self care. I know I can get better again from the anxiety and be productive again but I need proper and sustained support from my medical team. I hope I can get it soon and that they will really help me. I have so much support from my family, boyfriend and friends but they can only do so much.

Life with this is not easy at all- but I know, like my other mental health challenges, that I will overcome this again. I just must have the support in place from my medical team and the right therapy. So lets hope that my almost 2 year wait for therapy will end soon!  I am reading self help books too in addition and trying to do all I can. I just hope that help for my anxiety disorder will finally arrive.

Guest Post: The Efficacy of Online Cognitive Behavioural Therapy- CBT by Dr Stacey Leibowitz- Levy

We are delighted to have Dr Stacey Leibowitz-Levy, psychologist writing about Cognitive Behavioural Therapy for us. As with any therapeutic practice, it is very much individual as to whether it will work for you and CBT will not work for everyone- but has been proven to work for many. Here Dr Leibowitz-Levy explains how it can work online.                        

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Online counselling is a growing field with more and more people turning to the internet to seek out counselling help. Counselling services offered online incorporate the range of therapeutic approaches that have been developed within the field of psychology. Approaches to understanding mental ill health and treatment include therapeutic approaches such as logo therapy, psychodynamic therapy, systemic therapy, psychodynamic therapy and Cognitive Behavioral Therapy (CBT). How do these therapeutic modalities translate to the online environment? This article will address the compatibility of CBT in particular as an online counselling approach.

CBT is a widely-utilised mode of therapy that focuses on an awareness of the relationship between thoughts, feelings and behaviour. The aim of CBT is to address difficulties through modifying distorted thoughts, unhelpful behaviour and unpleasant emotions. In order to achieve this end, the client works collaboratively with the therapist in building awareness and understanding of his/her condition, and an accompanying skill set for evaluating and changing distorted beliefs (as well as modifying dysfunctional behavior). The therapist develops clear objectives and a treatment plan that requires active participation from the client during sessions, and follows through on homework assignments between sessions.

This form of therapy is characterized by a structured, time limited and outcome focused approach to managing mental health challenges. Often CBT is focused on a specific issue such as anxiety or managing depressive thoughts and, as such, many CBT interventions are available in a protocol format. CBT offers a delineated and clearly defined intervention that is largely directed by a clearly defined process and structure. This is in contrast to many other therapeutic approaches that have less defined parameters and take their cue on a session to session basis from the client.

The format and approach of CBT lends itself to an online format in that the structure and process are not only defined and constrained by the relationship between therapist and client but are also defined by a clearly delineated therapeutic procedure. This procedure offers a framework within which to deliver support which can easily be translated to an online process. CBT follows a set format. It is driven by the imperative of building an understanding of the issues the client is experiencing and imparting a certain skill set to assist the client in managing his/her mental health issues. CBT is thus based on specific content and has a strong psychoeducational aspect, which means that delivery online can be located in tangible and clear cut content and outcomes for the client.

This also allows for versatility in the delivery of CBT online. While face to face time with a therapist may be desirable for some clients, the option of online delivery of psychoeducational as well as skills based elements in other formats also works well. For instance, the psychoeducational aspect could be communicated very effectively through a video delivery. CBT lends itself to the format of online courses where clients are guided through a process of identifying and understanding their particular issues and developing the skills to manage them. Interspersing this with face to face time or the opportunity to clarify or ask questions in a chat or e-mail format makes for a very effective online intervention.

While many of the issues addressed in CBT are personal to the client, the possibility of locating these issues within a more general format is very much part of the CBT approach. There is a set way of getting information from, and accessing and understanding the client’s experience, with the client having to act on this information between sessions. This more “scientific” process also makes for an approach that lends itself to an online format.

The efficacy of CBT as an online intervention is borne out by the number of sites specifically offering online CBT in a variety of formats (for some examples, see here and here). The online availability of this well researched and well-verified approach to managing mental health problems offers increased affordability, accessibility and greater choice for mental health consumers.

Dr. Stacey Leibowitz-Levy is a highly-experienced psychologist with a Master’s Degree in Clinical Psychology and a PhD in the area of stress and its relation to goals and emotion. Dr. Stacey has wide ranging skills and expertise in the areas of trauma, complex trauma, anxiety, stress and adjustment issues. Stacey enjoys spending time with her husband and children, being outdoors and doing yoga.