In therapy, the therapeutic relationship between a client and their therapist is crucial to the success of the treatment. However, there may come a time when a therapist has to say goodbye to a client, not because the therapy is complete, but because the client needs a higher level of care. This can be a challenging and emotional process for both the therapist and the client. In this blog post, we will explore what it's like for therapists when they have to terminate treatment due to the client needing a higher level of care, how to cope with feeling like they failed their client, and how to best support the client until the last session and during their transition to higher care.

Understanding the Need for Termination Due to Higher Care Levels

The realization that a client necessitates a higher level of care is a pivotal moment in the therapeutic process. This determination is grounded in the therapist's professional assessment that the client's current needs surpass what can be provided within the existing framework of care. Such a decision is deeply rooted in the commitment to the client's well-being. It acknowledges that their journey toward healing which may require specialized interventions or a more intensive therapeutic environment. Navigating this phase involves a thoughtful consideration of the client's mental health journey. Recognizing when their progress or challenges indicate the need for an escalated level of support is important. This juncture underscores the therapist's ethical duty to advocate for the most beneficial path forward for the client. Even when it means stepping aside to allow for the engagement with a more fitting therapeutic approach or setting.

The Emotional Impact on Therapists During Termination

Navigating the emotional landscape of terminating therapy due to a client's need for higher care brings a unique set of challenges for therapists. It can evoke a complex mix of emotions, from deep sadness at parting ways to unwarranted guilt over perceived insufficiencies in their care.

Such moments can lead therapists to introspect, pondering on their professional journey with the client and questioning their efficacy. It is critical in these times for therapists to cope by engage in self-care and seek peer support, allowing them to honor these emotions without being overwhelmed.

Psychological wellbeing directly impacts successful treatment outcomes for clients. Processing these feelings is a step towards resilience, enabling therapists to maintain their emotional well-being and readiness to support others. This emotional processing is about closure and a testament to the significance of the bond formed in the therapeutic relationship. Its underscores the therapist's profound commitment to their client's healing journey, even when it leads to a goodbye.

Coping with Feelings of Failure as a Therapist

When therapists must navigate the complex feelings that arise from initiating a client’s transition to a higher level of care, it's not uncommon to grapple with an internal sense of failure. This emotional response, though challenging, offers an opportunity for professional growth and self-compassion. To mitigate these feelings, therapists are encouraged to engage in reflective practice. They are to consider the ethical responsibility and courage it takes to prioritize a client’s well-being over the continuation of a therapeutic relationship that no longer meets their needs. Engaging in dialogue with mentors or colleagues can provide invaluable perspectives. It helps therapists to reframe their experience as an integral part of their role in facilitating the best possible care for their clients, not a failure. Such conversations can illuminate the strength embedded in making difficult decisions, fostering a sense of professional integrity and resilience.

Strategies for Supporting Clients Until the Last Session

In the sessions leading up to the termination, it’s vital for therapists to maintain a supportive and empathetic stance. This only creates a space where clients can express their thoughts and feelings about the transition. Focusing on the strength and resilience the client has shown throughout therapy can be empowering for them.

Therapists should collaborate with clients to develop a clear plan for the transition. It includes setting goals for their future care and discussing how they can continue to build on the progress they've made.

Providing information on the next steps, equips clients with a sense of preparedness. Such information can be, what to expect from higher-level care and how to navigate these new settings. Encouraging clients to voice any concerns or questions they may have about the transition can also alleviate anxiety. Fostering a sense of agency in their own treatment journey can make it easier on he client.

Facilitating a Smooth Transition to Higher Care

Ensuring a seamless transition to higher care is a critical aspect of ending the therapeutic relationship. This process often involves coordination with both the client and the upcoming care providers. This is to share essential insights about the client’s therapeutic journey, challenges faced, and milestones achieved. It's crucial for the therapist to guide the client in understanding what to expect in the new setting and to make introductions or recommendations as needed. Such recommendations may be how they usually cope and what support they need.

Offering to facilitate a meeting or a hand-off conversation can greatly ease the client’s anxiety about the change and reinforce the continuity of care. Additionally, providing the client with resources, can further assist in preparing them for this next phase. Resources can be in the form of reading materials or support groups related to their new care environment. This diligent approach underlines the therapist’s ongoing commitment to the client’s well-being and growth beyond their direct care.

Reflecting on the Therapeutic Relationship Post-Termination

Post-termination, therapists often benefit from introspection on the therapeutic journey shared with the client. This period of reflection is an opportunity to harvest insights and growth from the experience, enhancing future therapeutic engagements. Recognizing the strides made by the client, as well as appreciating the mutual learning and connection that occurred, can be incredibly affirming. It's a chance to consolidate personal and professional development, acknowledging the complex emotions while celebrating the progress and resilience witnessed. Such reflections fortify a therapist's practice, imbuing them with deeper understanding and empathy for navigating future therapeutic relationships. This reflective practice not only honors the shared journey but also enriches the therapist's capacity to support others moving forward. If you are a therapist that needs more support and a way to cope, getting your own therapist is recommended as well.

When faced with a cancer diagnosis, the journey through treatment can be incredibly challenging, both physically and emotionally. The impact on mental health can be profound, as patients navigate the fear of the illness itself, as well as the often grueling treatments necessary to combat it. Finding ways to cope with these emotional stressors is essential for overall well-being during this difficult time.

The Psychological Impact of Cancer Diagnosis and Treatment

Upon learning they have cancer, individuals often experience a whirlwind of emotions that can significantly affect their mental health. This period is characterized by a high degree of uncertainty, leading to heightened levels of fear, anxiety, and potential bouts of depression. The thought of facing potentially life-altering treatments, coupled with concerns over side effects and changes in physical appearance and function, can amplify these emotional responses.

This psychological turmoil can also impact a patient's ability to adhere to treatment protocols and engage in self-care practices. This only further compounds the challenges they face. It becomes imperative for individuals to acknowledge these emotional struggles and seek appropriate support. That support can be from therapy, support groups, or mindfulness practices. Recognizing the interconnectedness of physical health and psychological well-being is the first step towards cultivating a more manageable and holistic approach to cancer treatment and recovery.

Understanding EMDR and Its Role in Mental Health

Eye Movement Desensitization and Reprocessing (EMDR) stands out as a significant advancement in psychotherapy, particularly in the realm of trauma treatment. This innovative approach relies on bilateral stimulation, typically through guided eye movements, to facilitate the processing of traumatic memories and mitigate the emotional impact they have on an individual. The principle underpinning EMDR is that much of the long-lasting psychological distress is due to unprocessed memories. When properly processed through EMDR, these memories can lose their painful intensity, leading to a reduction in trauma-related symptoms.

For individuals grappling with the emotional fallout of a cancer diagnosis and the anxieties tied to treatment, EMDR offers a beacon of hope. By directly addressing the traumatic aspects of their experience, patients can find a path to emotional healing that complements their physical treatment plan, fostering a more integrated recovery process. This therapy is adaptable, making it suitable for a broad spectrum of emotional challenges, thereby underscoring its role as a versatile tool in mental health care, especially for those confronting the psychological hurdles of serious illness.

Combating the Fear of Treatment Through EMDR

Navigating the fear of cancer treatment presents a significant psychological hurdle for many patients. This fear often stems from anticipatory anxiety about the side effects, the outcome of the treatment, and the potential for pain and discomfort. EMDR therapy steps into this realm as a transformative tool, focusing on the psychological underpinnings of this fear. With the guidance of a trained EMDR therapist, patients embark on a therapeutic journey, identifying specific traumatic or stress-inducing memories related to their illness or past medical experiences.

Through the structured phases of EMDR, these memories are reprocessed in a way that reduces their emotional charge. The process involves a dual-attention stimulus, where patients are asked to recall distressing events while simultaneously focusing on a therapist-directed external stimulus, typically eye movements. This bilateral stimulation is key to EMDR's effectiveness, facilitating a shift in how these memories are stored in the brain. As these memories lose their potency, the overwhelming fear of treatment begins to diminish, allowing patients to approach their care with a more balanced and less fearful mindset. This therapeutic approach not only aids in managing the fear of current treatment but also equips patients with coping mechanisms for facing future anxieties, supporting a more emotionally resilient journey through cancer treatment.

EMDR for Alleviating Uncomfortable Body Sensations Linked to Emotional Trauma

EMDR therapy offers a unique avenue for addressing the intertwined nature of emotional and physical discomfort during cancer treatment. This psychotherapeutic technique specifically targets the unresolved emotional distress that often manifests as physical symptoms, including pain, tension, or general discomfort. Through the structured process of EMDR, individuals are guided to revisit traumatic or emotionally charged memories in a safe and controlled environment. The therapist facilitates bilateral stimulation, such as eye movements, allowing the patient to reprocess these memories in a way that lessens their emotional impact.

This reprocessing can lead to a significant decrease in the associated physical sensations that are often exacerbated by stress or emotional turmoil. By tackling the emotional roots of these symptoms, EMDR provides an opportunity for patients to experience relief from the somatic symptoms that compound the difficulties of cancer treatment. It's a powerful reminder of the mind-body connection and how healing emotional wounds can have a profound effect on physical well-being, helping patients to navigate their treatment with less physical discomfort and emotional burden.

Keeping Focused on What is Important During Cancer Treatment

In the midst of the rigorous demands of cancer treatment, anchoring oneself to core values and personal priorities becomes crucial. This phase of life requires a delicate balance between managing medical appointments and nurturing aspects of life that foster inner strength and happiness. Establishing clear, achievable goals can serve as a guiding light, offering direction and purpose amidst the chaos of treatment schedules and health concerns. Maintaining connections with loved ones provides a vital support network, offering both emotional sustenance and a sense of normalcy.

Immersing oneself in hobbies and activities that spark joy can also be a powerful antidote to the stress and uncertainty that often accompany cancer treatment. These pursuits not only serve as a distraction but also as a reminder of the beauty and fulfillment life offers beyond the illness. Prioritizing self-care is another key element; it encompasses both physical care, such as adequate rest and nutrition, and mental health practices, including mindfulness or therapeutic interventions like EMDR to address the emotional challenges of this journey. By focusing on these important aspects, individuals navigating cancer treatment can cultivate resilience, find moments of peace, and empower themselves to face their treatment with a sense of purpose and hope.

In a recent episode of the "Good Enough" podcast, I had the pleasure of sitting down with Dr. Barbara Schwarck, the founder and CEO of Clear Intentions International. Dr. Schwarck specializes in neuro emotional coaching, a technique designed to help individuals overcome fears, break free from limiting patterns, and rewire their brains to confidently pursue their dreams and goals. Here are the key takeaways from our conversation.

What is Neuro Emotional Coaching?

Neuro emotional coaching is a transformative approach that delves into the deeper layers of consciousness, including the subconscious and unconscious mind. Dr. Schwarck emphasizes the importance of neuroplasticity—the brain's ability to reorganize itself by forming new neural connections. This is crucial for breaking free from limiting beliefs.

The 15-Step Proprietary Technique

Dr. Schwarck employs a 15-step proprietary technique that includes muscle testing and kinesiology to identify and address emotional blocks. The goal is to neutralize negative responses, allowing individuals to respond differently to triggers and transform past traumas into stepping stones for personal growth.

Understanding Intergenerational Trauma

We discussed intergenerational trauma, particularly in the context of current events in Israel, where Dr. Schwarck resides. She highlighted the pervasive PTSD in the country, stemming from historical events like the Holocaust and ongoing conflicts. These historical events re-trigger many individuals, leading to heightened anxiety and stress.

Coping with Intergenerational Trauma

Dr. Schwarck emphasized the importance of addressing deep-seated issues to break the cycle of trauma and foster emotional well-being.

The Effects of Chronic Stress

We explored the impact of chronic stress on mental health. Dr. Schwarck pointed out that people in high-stress environments, such as those experiencing domestic violence or conflict, often lack the resources to escape their situations, leading to anxiety, depression, and PTSD.

Practical Strategies for Nervous System Regulation

Dr. Schwarck offered practical advice for managing chronic stress and regulating the nervous system:

1. Sleep Hygiene

Importance of Sleep: Sleep is crucial for regulating the central nervous system.

Tips for Better Sleep: Establish a consistent sleep schedule, reduce screen time before bed, and be mindful of your eating habits.

2. Hydration and Nutrition

Stay Hydrated: Proper hydration is essential for overall well-being. Dr. Schwarck suggests adding a pinch of Himalayan salt to water for electrolytes.

Balanced Diet: Maintain a balanced diet to support your body's needs and reduce stress.

3. Mindfulness Practices

Mindfulness Techniques: Mindfulness is a powerful tool for calming the nervous system. Dr. Schwarck encourages taking moments to observe surroundings, journal, or engage in activities that promote stillness and self-awareness.

4. Intermittent Fasting

Benefits of Fasting: Dr. Schwarck shares her positive experience with intermittent fasting, explaining that it allows the body to rest from constant digestion, which can help reduce stress.

5. Emotional Release Techniques

Freeform Writing: One of Dr. Schwarck's favorite techniques is freeform writing, where individuals write down their thoughts and emotions for a set period and then burn the paper as a form of release.

Embracing Self-Forgiveness and Overcoming the Inner Critic

We discussed the concept of the inner critic, which Dr. Schwarck calls the "gremlin." This inner voice often serves a protective role. Dr. Schwarck encourages getting to know your gremlin and assigning it a new, supportive role.

Self-Forgiveness

Importance of Self-Forgiveness: Self-forgiveness is crucial for personal growth. Dr. Schwarck shares her journey of forgiveness, illustrating how it can lead to profound healing.

This episode of "Good Enough" provides valuable insights into neuro-emotional coaching, the effects of intergenerational trauma, and practical strategies for managing chronic stress. Dr. Schwarck's expertise offers a pathway to better mental health and emotional well-being through self-care practices, mindfulness, and emotional release techniques.

For those interested in exploring neuro-emotional coaching or seeking support, Dr. Schwarck invites you to connect with her through her website, https://clearintentions.net, and various social media platforms. Remember, everyone is inherently good enough, and with the right tools and support, you can learn to forgive yourself, embrace your true self, and confidently pursue your dreams.

Imagine a world where your very existence is regularly questioned. Or where a short everyday interaction with a random person you meet can completely shatter your sense of self. Well, if you’re queer, you probably don’t have to imagine. This world is a reality for many LGBTQ+ individuals who, on top of their usual everyday stressors, also have to deal with the added weight of societal discrimination and stigma. That’s precisely why many LGBTQ+ members also struggle with mental health challenges. Addressing these issues is even more important in California, the state with the largest lesbian, gay, bisexual, and transgender population of 2.8 million people. Now, let’s explore the intersection of identity and mental health in LGBTQ+ communities further and what steps should be taken to ensure culturally competent care.

Mental Health Challenges Common Among LGBTQ+
Individuals

According to the Trevor Project 2023 National Survey on LGBTQ+ mental health, 67% of LGBTQ+ young people reported experiencing symptoms of anxiety.

At the same time, 54% reported experiencing symptoms of depression.

When you compare these stats with the general population, it becomes pretty apparent that people in the LGBTQ+ community have higher rates of mental health issues. However, it’s not just that these challenges are more common—they’re different. For LGBTQ+ people, these challenges are deeply intertwined with issues of identity, social acceptance, and the stress of navigating a world that can be hostile or dismissive of their experiences. One of the primary causes of these mental health disparities is minority stress. Minority stress is the persistent stress experienced by members of stigmatized communities.

Stress can come from a variety of causes, such as:

● social discrimination
● and the pressure to adhere to heteronormative norms.
Persistent minority stress can have a significant influence on mental health. In the end, it can
result in feelings of isolation, low self-esteem, and an increased risk of mental health issues.

The Stress of Coming Out

One of the most significant and emotionally charged experiences for many LGBTQ+ individuals
is the process of coming out. Although people have become somewhat more accepting in
recent years, the decision to come out and disclose your sexual orientation or gender identity
still isn’t quite a walk in the park.

While it can be very liberating, coming out can also lead to strained relationships with loved
ones and the loss of their support. Many people, especially teens and young adults, find that
this process is filled with anxiety, dread, and fear of rejection, ostracism, or even violence.

Even in supportive environments, coming out can be exhausting. You must often keep doing it
in different contexts—at work, with new friends, or in public spaces. The mental toll of constantly
assessing whether disclosing your identity is safe cannot be understated.

The Impact of Discrimination and Stigma

Discrimination and stigma have probably the biggest impacts on high rates of mental health issues within the LGBTQ+ community.

Despite recent improvements in our society, LGBTQ+ individuals continue to face prejudice and discrimination in many areas of their lives. This includes the workplace, healthcare settings, and social interactions. Sometimes, this discrimination can be overt, such as being refused work or housing. However, it can also be more subtle, such as encountering microaggressions or being excluded from social activities.

No matter the severity of it, discrimination inevitably leads to feelings of worthlessness, anxiety, and humiliation. Over time, this can lead to the development of mental health issues. Furthermore, the fear of being judged or rejected can also prevent LGBTQ+ people from seeking treatment or using mental health services. This, in turn, usually only further aggravates their mental health problems. According to the data from 2022, in California alone, 14% of LGBTQ youth attempted suicide in the previous year. The figures clearly highlight the severity of the issues this population faces.

Internalized Stigma

While prejudice and stigma most often come from people outside of the LGBTQ+ community, that’s not always the rule. Internalized homophobia or transphobia occurs when LGBTQ+ people internalize the negative messages and stereotypes about their identities that they encounter in society. These internalized ideas can manifest as self-hatred, regret, or shame.

If left untreated or unrecognized, internalized stigma can erode your self-esteem and exacerbate your mental health issues, trapping you in a cycle of negative self-thinking. However, it’s not impossible to recognize and challenge these harmful beliefs. Overcoming internalized stigma requires time and patience, but it does wonders for your self-love and self-esteem.

The Connection Between Identity and Mental Health in LGBTQ+ Communities

Intersectionality refers to how different aspects of a person's identity interact and can lead to overlapping challenges or discrimination. In LGBTQ+ terms, this means that the mental health of queer individuals can be influenced by multiple factors. These include a person's race, ethnicity, socioeconomic status, or disability.

For example, a Black transgender woman may face not only transphobia. They will also face racism and sexism, all of which can negatively affect her mental health challenges.

Similarly, LGBTQ+ individuals from lower socioeconomic backgrounds may experience additional stressors related to financial insecurity, housing instability, or lack of access to healthcare.

Culturally Competent Care

Culturally competent care is something that needs to be provided as a way to address the mental health needs of LGBTQ+ members. It is necessary to provide a secure and supportive atmosphere where LGBTQ+ people can express their concerns without fear of judgment or prejudice. However, for it to take place, mental health providers must first understand the identities and experiences of queer individuals, as well as the community's specific issues. In a 2022 California survey, a staggering 62% of LGBTQ youth who wanted to get mental health care stated they were not able to receive it.

That said, for LGBTQ+ individuals facing both mental health challenges and addiction, culturally competent care at an adequate facility can provide the specialized support necessary to address these interconnected issues. We Level Up California treatment center provides an understanding environment and uses a holistic approach that fosters healing and empowers LGBTQ+ members to reclaim their lives.

Family and Social Support

Loved ones affect queer individuals in more ways than you think. Affirming and accepting relationships can safeguard against mental health issues, but rejection and alienation can have the opposite impact. That’s precisely why the process of coming out to family and friends met with negative reactions can have long-term implications for their mental health.

On the other hand, positive responses from the people closest to us can give us a sense of belonging and self-worth. Therefore, it’s important to surround yourself with an understanding community that supports you just as you are.

Identity and Mental Health in LGBTQ+ Communities Are Connected

The intersection of identity and mental health in LGBTQ+ communities is a complex issue that requires a nuanced and compassionate approach. And while it’s not likely these issues will be suddenly solved any time soon, it’s important to keep advocating for LGBTQ+ rights and mental health awareness. After all, that’s the only way to make a difference.