For starters, someone’s own gender identity is a process that may come naturally to some, though for others it may not be as easy. Whether it be exploring your own gender identity, sexual orientation, or even just working through your own curiosities, everyone should have a support system to help them along the way. Here we will discuss LGBTQIA+, the different sexual orientations, gender identities, as well as how seeking therapy can support you in this process.

Firstly, here are gender definitions to become familiar with:

● Gender Expression - the outwards expression of gender, typically expressed/observed through people’s names, pronouns, clothing, behaviors, body characteristics, and more.
● Gender Identity - invisible to other people, one’s internal definition of their own gender. Some people may feel comfortable with the gender that they are given at birth, though others may not.
● Sex - oftentimes confused with one’s gender, but someone’s sex identity is more-so biological than anything else. Someone’s sex is the combination of body characteristics (hormones, chromosomes, reproductive organs, etc.), thus being more than just two sexes.

There is a wide range of gender identities that people fall under and identify with. It is crucial to validate the feelings of someone who may be uncomfortable with their gender identity, as it is a significant life event that causes stress. Whether you already know your own gender identity, or if you are currently exploring that area of your life, seeking support can be helpful!

Secondly, here are some LGBTQIA+ sexual orientations:

● Asexual - someone who experiences minimal to no sexual attraction, though may still experience romantic attraction.
● Bisexual - someone who experiences an attraction to others of the same gender as well as people of another gender.
● Gay - someone, typically a male, who experiences attraction to someone else of the same gender.
● Lesbian - a woman who is attracted to another woman, ‘lesbian’ and ‘gay’ are sometimes interchangeable.
● Pansexual - someone who experiences an attraction towards another person regardless of their gender
● Queer - an umbrella term for anyone who does not identify as heterosexual or cisgendered.

Even though these are just a few definitions, there are many more sexual orientations that people feel attached to. Some people may question why there is a need for so many orientations or why there is a necessity to bring about awareness to this subject. However, it is so crucial to spread the word and to educate on these matters to increase the inclusivity of this community. Many people find plenty of comfort in connecting with one of the above, or many other, sexual orientations. Something as simple as “putting a label” to what one may be feeling can offer a sense of freedom as well as offer someone answers they didn’t have before.

Walking on the path of self-discovery at any stage of life can become too much for some to handle at times. Seeking mental health treatment is a great way to support yourself on this journey. Historically, the LGBTQIA+ community has faced discrimination as well as prejudice which is why our mission here at Long Island EMDR is to be a guide for those who may need it. We believe that therapy should be a place of comfort and safety, therefore we will do our best to ensure that we offer the best support that we can. There’s no reason to change who you are, only a reason to find out who you truly are on the inside!

-Conor Ohland, MHC-LP

In the chaos and rush of the modern world, do you feel stressed, tired, and disconnected? Do you experience racing thoughts, feel “on edge” to meet the demands of a deadline, or yearn for a break? If so, forest therapy is for you! Forest therapy is found to reduce the production of cortisol, a stress hormone.

Do you experience depression or anxiety?

Forest therapy can help. It is clinically supported to improve cognition and mood.

Do you struggle to concentrate or pay attention?

Forest therapy is shown to improve directed attention and boost executive functioning skills.

Do you love the outdoors, but have limitations due to mobility challenges or a significant health issue?

Yes, forest therapy is for you, too. Unlike hiking, forest therapy is a slow walk, generally in an accessible area, which makes it suitable for various populations. Forest therapy can even be done remotely, only requiring access to a window.

Do you want to improve your physical health?

Forest therapy is evidenced to lower blood pressure, improve cardiovascular health, boost immune system function, and even combat cells associated with cancer risk.

And finally… do you want to try forest therapy, but fear the possibility of injury, illness, or accident?

All forest therapy guides (or “guides”) are required to be certified in Wilderness First Aid and Infant/Child/Adult CPR, at minimum. They also have training in herbalism, thus can teach you of edible and medicinal plants.

At Long Island EMDR, we proudly have a certified forest therapy guide, Valerie Smith, LMSW, who's been trained by the world’s leading school on the topic pf Forest Therapy. 

Join Valerie in experiencing simple yet powerful techniques to help you feel whole and well again, while celebrating our kinship with the earth. Mindful and bodyful practices that bring about serenity and can foster a newfound awakening for what is most significant to you. Valerie will lead you through sensory encounters which allow for care, compassion, and connection toward yourself and all other beings in this world.

What is a Forest Therapy Walk?

A forest therapy walk (hereon also referred to as forest therapy for simplicity purposes), is a platform for fostering wellness, healing, and wholeness through engagement in natural settings. Forest therapy is inspired by the Japanese practice of shinrin-yoku (“forest bathing”), but they are not synonymous concepts.

Research indicates forest bathing carries a myriad of health advantages in the immune and cardiovascular systems, as well as psychological benefits such as mood improvement. From this foundation, forest bathing seeks to move beyond the health benefits alone and to instead celebrate that humankind is in kinship with nature, not above or separate from it.

Forest therapy is a practice; a gateway to allow a relationship of reciprocity to develop and strengthen, whereby the guide and forest (or other setting) partner together to allow for both to feel complete. The guide is useful in that they can navigate the participants through a particular sequence of events that provide a foundation for the experience. However, there are no set expectations of what should or could happen – participants are given freedom to interpret the experiences as they desire.

Forest therapy is about creating relationships between humans and the more-than-human world, in which the relationship itself becomes a source of healing and joyful well-being. Besides being a deeply healing practice, Forest Therapy is also an emerging community of friends and activists who are making a global impact. As we learn to love the forests, this connection leads naturally to an ethic of tenderness and reciprocity, we become more engaged in working for their well-being.

Most importantly, such walks are focused on the heart rather than the brain, and they celebrate the significance of the kinship between humans and nature. Forest therapy walks are effective, non-prescriptive, and simple, which encourages each participant to have the experience on their own terms and to bring meaning to it all on their own accord, rather than expecting the participant to feel or think a certain way. As a result, forest therapy should never be mistaken for psychotherapy, which is about the treatment of a diagnosis and/or life issue.

Ultimately, the aim for all forest therapy guides is to serve as the “doorway” between humans and other beings, in which the relationship becomes the source of healing and serenity. And so by having a reciprocal relationship with the more-than-human world, we all benefit in increased connection and wellbeing — from the smallest mushroom to the grandest of trees.

“And into the forest I go, to lose my mind and find my soul.” – John Muir

Forest Therapy is Not...

Forest therapy should not be confused with hiking. When a person hikes, they tend to have a set destination in mind. They want to ascend to the summit of the mountain, reach that hidden beach, or traverse that one crevice at the top of the mesa. Hiking also tends to be a timed event, with people competing against each other for the newest record.

Forest therapy is different because it uses the aspects of nature in a way that amplifies our senses to let us know the forest in a new way. For one, a forest therapy walk is slow and usually is restricted to a small area. A walk can last for up to 3 hours and the entire experience can be held in a few acres. Furthermore, beings are not things to be passed by on by, but rather to be recognized and explored. Beings are not only organisms, such as the birds and the plants, but also include abiotic entities such as rocks, sunshine, and weather.

Thus, it is more appropriate to think of such forest therapy walks as sensory immersions to foster mindfulness and body-fulness in a natural setting. Whereas mindfulness is about awareness of the present moment without judgment, body-fulness is for harboring that awareness through the senses and experiences within the body. The immersion is done through a sequence of invitations (activities) that participants are allowed to adapt if needed.

Finally, forest therapy should never be mistaken for psychotherapy, which is about the treatment of a diagnosis and/or life issue.

Health Benefits of Forest Therapy

As was previously stated, forest therapy is inspired by shinrin-yoku.

Shinrin-yoku is a wellness practice that came from Japan in the 1980s by the Ministry of Health to promote improved health across the urbanized, changing population. At the time, Japan was transforming into a technological leader, which the government noted was resulting in diseases related to sedentary lifestyles and chronic stress.

Over the next two decades, Japanese research has showcased the myriad health benefits of forest bathing. These include, but are not limited to:

• Lower stress
• Reduce blood pressure
• Improve metabolic and cardiovascular health
• Weight loss/weight management
• Lower blood sugar levels Improve memory and concentration
• Improve mood disorders, especially depression
• Increase pain tolerance
• Boost energy
• Improve the immune system with an increase in natural killer (NK) cells

In more recent years, research across the United States and the United Kingdom has supported the association between time spent in nature and directed attention. Directed attention is one of the primary functions of the frontal lobe in the brain, which is also in control of other executive functions like critical thinking and problem-solving. The stressors of modern living burden us with attention demands that are more exhausting versus that of mankind in the past. This is a reason why we may “space out” when trying to complete a task, feel sluggish, or struggle to concentrate. Much like a computer needs to be rebooted when it freezes, so too, do our brains.

Fortunately, through immersion in nature, the executive functions of our brains are allowed to rest and become replenished. This results in improved directed attention later. In addition, nature experiences offer other psychological benefits such as overall improvement in mood, including in people with depressive disorders.

Perhaps most fascinating of all, ongoing research from Nippon University suggests that phytoncides, the chemicals found within conifers and some other plants, may be effective in cancer prevention. When breathed in, the phytoncides fight infection while also increasing the number of NK cells, which increase anti-cancer proteins.

For more information on the health benefits of shinrin-yoku, along with links to the studies to support the research, please click here.

Want a Forest Therapy Walk?

Valerie Smith hosts forest therapy walks throughout Suffolk and Nassau. These walks are open to the public; thus, you do not need to be a client at Long Island EMDR to participate. Bring your friends and family!
Please note: All walks require prior registration, payment, and completion of paperwork. Valerie cannot accommodate “walk-ins”.
To learn more and/or to arrange a walk, contact valerie@ericam206.sg-host.com

 

-Valerie Smith, LMSW

California was the first state to legalize marijuana for medical purposes in 1996, having come a long way since marijuana was placed as a Schedule 1 drug in the Controlled Substances Act of 1970. Since then, there have been many debates surrounding the medical benefits of marijuana.

While many states have legalized marijuana for medical purposes, the FDA has only approved the use of medical marijuana for two rare forms of epilepsy, Dravet syndrome and Lennox Gastaut syndrome. With regards to mental health, some states have approved medical marijuana in the treatment of PTSD. While research into medical marijuana and its effect on PTSD is underdeveloped, clinical trials and anecdotal evidence from PTSD sufferers demonstrate the positive impact of the drug on their symptoms. This may be due to the fact that cannabis can reduce activity in the amygdala, the brains “fight or flight” center. There is also some evidence that demonstrates the plant’s cannabinoids could play a role in extinguishing traumatic memories.

Advocates for the drug claim it has therapeutic benefits for a variety of mental health conditions, including insomnia, depression, anxiety, stress, and schizophrenia. An internet search on the topic will lead you to believe that medical marijuana is a “cure all”; a natural remedy that has endless benefits. However, when you take a closer look at the information available, one thing becomes clear: there is just not enough research to draw any substantial conclusions regarding the benefit of medical marijuana for mental health. 

Research on medical marijuana extremely limited in the United States. This is due to the fact that it is still not legal on a federal level. From 1968 until now, researchers have only been allowed to use cannabis from one source for research, a facility at the University of Mississippi. However, as of May of 2021, the DEA stated its plan approve more growers, which will allow for more widespread research to be conducted.

Until then, here’s what we know when it comes to marijuana as it pertains to mental health. The main psychoactive ingredient in marijuana, THC, stimulates the part of your brain that responds to pleasure. This results in production of the dopamine, a neurotransmitter that results in relaxation and euphoria. Subjective experiences and limited research indicate marijuana may have a positive effect on anxiety and insomnia. However, not everyone’s experience with marijuana is the same. Some users experience increased anxiety, fear, panic, or paranoia. Using marijuana also has the potential to increase the likelihood of clinical depression, or worsen the symptoms of any mental health challenges you already have.

Due to the above risks and lack of evidence of the benefits, self-medicating with marijuana to manage your mental health symptoms is not advisible. However, whatever you chose to do, the most important thing is to talk openly with your doctor, psychiatrist, and/or therapist about your usage and how it impacts your mental health. If you believe medical marijuana to be of benefit for your mental health, ideally it would be prescribed and regulated by a doctor. Due to current laws in the state in which you reside, this may not be an option. In the meantime in addition to being honest with your providers, be sure to explore alternative techniques to manage your symptoms, including mindfulness, psychiatric medications, meditation, herbs/supplements, and exercise.

- Alexandria Baxter, LMSW

Because therapy and mental health are much more than just showing up every week!

What we know and understand about mental health has come a long way in recent years. Between that and everything else going on in the world, it’s no surprise that many people have been more open to receiving mental health treatment. This is great news, but it can also be hard to know where to start and how to get the most of this to improve mental health, especially if this is your first time in therapy. So, where do you begin?

1. Do your mental health related research

It’s always a good idea to do a little bit of research to find a therapist that best suits your needs. Although most therapists are educated and trained on a wide range of issues, some therapists have spent a lot of time working with specific populations and consider that to be their ‘specialty.’ If you’re seeking help for a specific issue, it may be beneficial to see someone who already has experience in that area.

In addition, it’s very important that you feel comfortable with your therapist. People usually go to therapy to discuss challenging things in their lives and mental health issues, and if you’re not comfortable with the person sitting across from you, it will only make talking about those things more difficult. Most therapists post a little bit about themselves in a bio online, or even write blog posts like this one about things that interest them! Doing research about different therapists can give you an idea if he/she would be a good fit for you.

And if you find yourself working with a therapist that you feel isn’t a good fit, speak up about it! Chances are your therapist will be understanding and can even provide referrals for other therapists in the area.

2. Think about you’re mental health goals and what you're hoping to get out of therapy

You will most likely start your first appointment by discussing what brings you to therapy and some of your history. It can be helpful if you’ve already put some thought into the issues you’re hoping to address. Are you looking to change some negative behaviors, or learn healthy coping skills? Maybe you want to improve your interpersonal relationships by learning better communication skills, or manage symptoms of anxiety or depression. Whatever it is you’re looking to address, being prepared with clear goals can help keep your sessions focused so you’re getting the most of your time each week. It can also help to think about any significant experiences from your past that may be impacting you currently, as that can be helpful information that therapists will want to know about you.

3. Don’t be afraid to ask questions

Therapy is a safe place where you should feel comfortable sharing your deepest insecurities or struggles. You should also feel comfortable enough to speak up and ask questions if something isn’t making sense to you or isn’t working for you. Your therapist can only work with the information you bring to the session, so if you feel like those breathing exercises you keep talking about each week just aren’t working, be honest and say that. Then we can try to explore what isn’t working with the breathing exercises, or maybe even discuss different calming techniques altogether.

Therapy is also a great place to practice things like communication skills, setting or enforcing boundaries, and being assertive (like saying ‘hey, these breathing exercises aren’t working for me!’). If these are things you struggle with, discuss it with your therapist so they can be sure to address these issues during the session.

4. Be positive but also realistic

It’s a pretty common misconception that you’ll receive some advice from a therapist in one or two sessions and you’ll be able to apply that advice to your life and move on. It’s important to understand that therapy is a process that often requires some patience. For some people it takes more than one or two sessions to even feel comfortable enough to discuss some of those deepest insecurities, and that’s okay. Treatment will be ongoing. There’s no set number of sessions and it can differ for everyone.

It can be helpful to approach therapy with curiosity. Be curious about the ways you currently behave, think, and feel. Have you experienced anything in life that may be contributing to these behaviors, thoughts, and feelings?

5. Do your homework

Therapy is much more than simply showing up for your session each week. Some therapists may give ‘homework assignments’ hoping to keep you engaged in between sessions. Homework could be asking you to journal and reflect on certain areas of your life. It may be simply noticing when something you discussed in session comes up, or even practicing certain skills like breathing exercises, grounding techniques, and self-care, all which help improve mental health.

Even if your therapist doesn’t assign you specific tasks, you should still be putting in work outside of session. Therapy is a great place to receive tips, guidance, and education about things you’re struggling with, but the actual change takes place when you start applying those tips to your everyday life.

- Jennifer Tietjen, LMSW

Self love is a concept that was first promoted by the Beat Generation of the 1950s, and again in the early 1960s during what was known as the “Hippie Era.” self love has gained popularity in recent years due to psychological research finding it an essential component for positive mental health and well-being. Even despite its rise in popularity, self love can be a challenging concept for many, often confused with being egotistical, self-indulgent, or too “touchy feely”. Despite the many misconceptions regarding self love that exist, the truth of the matter is that self love is a critical part of recovering from mental health challenges. Without self love, it will be extremely difficult to believe you are worth implementing the healthy strategies will allow you to feel better. Here are some simple techniques that can assist you on your journey toward unconditional self love.

1. Engage in Self-Reflection.

We often spend much time and energy moving from one distraction to the next. Taking time out of our busy schedules for self-reflection is an important part of learning to love yourself unconditionally. After all, how can you truly love what you don’t know? Self-reflection can be very simple-taking 5 minutes of your day to sit quietly and assess how you are feeling, journaling, meditating, sitting in nature, or deep breathing. Anything that can stop the noise of your mind and connect you to the present moment can be a great way to get in touch with your true self and bring you closer to loving yourself.

2. Be Kind to Yourself.

Be mindful of the way you treat yourself. “Bring the mind, and the body will follow.” This is a common saying that holds true on the journey toward self love. Often this means going outside of our comfort zone and making positive decisions for ourselves despite not feeling that we deserve it. Increase your healthy intake-be it people, conversation, self-talk, food, exercise, or rest. Treat yourself the way you would treat a friend or loved one; with kindness, compassion, and patience. Although this may feel unnatural, by treating yourself this way you are proving that you are worthy of love and respect, and doing so consistently will allow this belief to sink in.

3. Forgive Your Mistakes.

You are human and are bound to make mistakes. If there is a name for what you did, someone else has done it. Giving yourself permission to be human is one of the greatest gifts you can give. Forgiveness is not an easy journey, however letting go of the past allows you room to become the person you are truly meant to be. Someone who forgives and loves themselves is also less likely to hurt others in the future. One strategy is writing down a letter of apology to those you’ve harmed, including yourself. You can make amends to others when enough time has passed, and to do so will not cause additional harm. Most of all, let go and remind yourself that you are much more than a few bad decisions.

4. Maintain Healthy Relationships.

People are not born hating themselves. Oftentimes, a lack of self love comes from life experiences/relationships that cause you to internalize the belief that you are not good enough or defective in some way. Take note of the relationships in your life and how they make you feel. Everyone is accountable for their own happiness; however, some individuals (due to their own flaws) can trigger feelings of unworthiness in us. Work on setting healthy boundaries with these people, and focus the majority of your attention and energy on pursuing relationships that allow you to feel safe, happy, and cared for.

5. Accepting Yourself as you are Right Now.

Everyone is a work in progress. It is easy to fall into the trap of “I’ll love myself when…” and fill in the blank with whatever goal or next level we want to reach. There is always going to be room for improvement, so don’t waste time putting off loving yourself. After all, achieving your goals will be a lot easier with the help of self love. Stop comparing yourself to others, or telling yourself you “should” be a certain way. You are exactly who you are meant to be at this moment. Embrace the journey.

-Alexandria Baxter, LMSW

Poor mental health can affect so many parts of your life including your relationships with others, your
performance at work, and even day-to-day tasks such as daily hygiene. Daily hygiene such as
taking a shower, brushing your teeth, and doing your laundry may seem like simple tasks for
some, but for someone struggling with mental illness these same tasks can feel like pushing a
300-pound boulder up a hill. But why?

Why does mental health make it so hard to take a shower?

For starters, depression is often characterized by diminished interest in activities and feeling
fatigued. In other words, you probably have little motivation or energy to maintain your hygiene
when you’re feeling depressed. But depression isn’t the only mental health diagnosis that affects
daily hygiene. Schizophrenia, Bipolar Disorder, Anxiety, and PTSD have all been linked to
negative impacts on daily hygiene.

So what can you do when mental illness is affecting your hygiene?

For starters, you can try some of these techniques:
If taking a shower seems like a lot of work, try starting by just standing under the water for a
minute. Yes, you may not be as clean as if you used soap, but it will make the task of showering
seem less intimidating and can help you both physically and mentally.
Think convenience! Use things like antiperspirant, dry shampoo and wipes regularly. You can
buy cleaning wipes (usually made for kids) almost anywhere, and they don’t require any water!
If you have days where taking a shower seems like too much work, there’s no shame in doing
what you can to maintain hygiene.

If you absolutely cannot bring yourself to brush your teeth, use mouthwash with extra fluoride
and rinse liberally for as long as you can. You can also take more preventative measures such as
using a toothpaste with extra fluoride so you have extra protection when you do brush, and visit
the dentist for more consistent checkups (say every 6 months versus every year).
If you’re struggling to do your laundry, ask for help. A friend or family member may be willing
to help you tackle the overwhelming pile of laundry that’s been building for the last few weeks.
If you have social supports, utilize them! You can also use this as a time to catch up with your
loved ones.

What if all of these are still too overwhelming?

If you’re struggling to practice hygiene even when you know you should, you may need help.
In general, you should reach out for help if an issue is making it difficult to function. If your poor
hygiene is starting to affect things like work, school, personal relationships, or your health,
consider contacting a professional. A therapist can help you further explore your struggles with
hygiene, and provide you with appropriate skills to make managing your hygiene a little bit
easier. If you think psychotherapy may benefit you, feel free to reach out to our office to
schedule an appointment.

-Jennifer Tietjen, LMSW

Many of my clients have difficulty living the life they want and need to feel truly happy. They struggle with expectations placed on them by others, feelings of guilt if they put themselves first and most days feel like they cannot catch their breathe. Trauma therapy can help you to end old patterns and put yourself first. Self-care isn't selfish- I know it's a clique but it is true. You need to take care of you to be your best self for your family, friends and career. If this is speaking to you, strap in- I have some Pro-tips for you.

1. Evaluate Your Values

What is most important to you? List 3 things. Could be family, honesty, integrity, compassion, trust etc. Then you need to start seeing if your actions actually align with your values. Those that do keep at them- those that don't make an effort to change them. For example, if you choose "family, compassion and health" and you are offered an additional work shift. Is taking this shift detracting from your family time? Do you need a mental health break or day off to take care of you? If so say no. If it's to help a colleague who is going through a rough time and you feel you have enough time on another day to take care of you and spend time with family and you want to honor that "compassion" value you can also say yes. Seeing how our actions are in align with our values helps us to begin living a life that makes us happy- not a life that is spent trying to appease or please others.

2. Set Some Boundaries

In set with setting those values is setting up some boundaries with those around us. When we have no boundaries- meaning we having difficulty saying no or often do things out of pleasing others even if it's not what we want- we continue to feel exhausted, unhappy and overwhelmed. Boundaries despite what childhood may have taught you are actually healthy. Saying "No I'm sorry I can't go out tonight", "No I won't be able to take on that extra project with my current workload as it stands",or "I would appreciate if you refrained from "xyz" in front of my children" is the first step to reducing our triggers, reducing your stress load and giving yourself the time to focus on you and do what makes YOU happy.

3. Let Go of the Guilt

Often times my clients struggle with boundaries because of the guilt they feel in saying no to others. They feel responsible to take on the problems of those around them. They are accustom to the role of "fixer". Those around them, often family members but sometimes even colleagues or bosses sometimes push back on boundaries set and plead or ridicule them if they don't get what they want. I'm not going to say setting boundaries is an easy task when you are accustom to saying "yes" to everything because your role has always been to put others before you. But I will say the more you stick to your boundaries, the less others push back over time. It helps to see if keeping those boundaries is in alignment with your values or the type of person you are aspiring to be. Simple answer my look like "yes, I value helping others". With a closer look though it's easy to see it is hard to be our best self for others when you are running on empty. As I often tell my trauma therapy clients, and as they say on the air plane "put your mask on first" before you help those around you. It also helps to make a list of the short term positive gain of letting others violate your boundary and the long term consequences. For example, lets say you have difficulty saying no at work and are constantly taking on additional tasks asked of you.

After making this list you may decide to have a conversation with your boss and say "I would love to be able to help with that project but I already have 3 other projects I am currently working on. I will need to finish those first before I can take on any more. It's important to me that the quality of my work meets the standard and I am afraid I won't be able to complete all projects to our client's expectations." Starting an honest dialogue can help you feel more in control and will likely make you a better employee. Same with friends and family, when you are happier and more relaxed you can be your best self for your spouse, children, parents and friends. If this seems daunting, trauma therapy can surely help you work through your fears and doubts.

Need Help?

If this sounds daunting, you may need some extra support in navigating beginning to set boundaries and taking back control of your life. This is really common with clients who have trauma, are children of alcoholics, were parentified children (children that functioned more as parents), and those with low self-esteem and attachment difficulties (as they often fear boundaries will push others away). Trauma therapy can help! Just like my clients you can take back your life, begin to feel in control, less overwhelmed, more peaceful and joyful. You deserve happiness too. If you need the extra support in getting there give our office a call. We would love to help you on that journey.

Sending love & light,

Jamie Vollmoeller, LCSW

Having an Emotional Support Animal (ESA) has grown in popularity over the past 10 years, however animal assisted therapy is not a new concept. The Greeks were the first to notice that horses could lift the spirits of sick patients as far back as 600 BC. Animal assisted therapy was again present during the 1600s, when horses were utilized to help improve the health of their patients physically and mentally. During the 1800s, Florence Nightingale noted the reduction of anxiety in her psychiatric patients when they spent time with animals. 

You may ask yourself this question, “Isn’t just having a pet enough?” Having a pet has been proven to have innumerable mental health benefits, for example:

• Lowered stress levels due linked to lowering blood pressure and heart rate
• Helping cope with depression due to the elevation of mood, encouragement of physical activity, and healthy distraction from negative thoughts
• Reduction in feelings of isolation and loneliness
• Improved sense of well-being
• Improved sense of control over one’s life due to the consistency and routine of caring for a pet 

So, with all of these benefits, you may question the need for an emotional support animal. Here are some notable differences between having a pet and having an emotional support animal:

1. An emotional support animal is prescribed for a specific mental health diagnosis, such as anxiety, depression, panic attacks, PTSD, and Autism Spectrum Disorder. Without one of these qualifying diagnoses, it is unlikely that your pet will be approved as an emotional support animal.
2. Emotional Support Animals will spend more time with you, both inside and outside of the home. They often accompany individuals to work, school, traveling, and other situations that may trigger mental health symptoms to arise.
3. Emotional Support Animals are allowed to stay in rental properties where pet restrictions are in place. The Housing Amendments Act states that landlords must make reasonable accommodations for tenants to live with their emotional support animals.
4. Emotional Support Animals have more access to public spaces. Although it is up to each public space to make their own judgement about whether or not an emotional support animal can enter their domain, individuals are much more likely to be accommodating for an Emotional Support Animal. 
5. And finally, Emotional Support Animals can travel with you via airplanes as a result of the Air Carrier Access Act, which means you do not have to spend your vacation apart from one another.

Next steps

If you believe an ESA will aid your mental health, the next steps are to talk to a licensed mental health provider to gain the proper diagnosis and documentation in order to do so. Your existing pet can become an Emotional Support Animal, or you can obtain a new animal solely for this purpose. Certain breeds offer more benefits than others, however there are no restrictions on what qualifies as an ESA. As with any healthy coping skill, you will gain the most benefits for your mental health from having an Emotional Support Animal in conjunction with mental health treatment/therapy, so keep this in mind when making your decision. 

By Alexandria Baxter, LMSW

Long Island EMDR is proud to be offering Telehealth services for our current and incoming clients, but we understand that it also may be a foreign concept to our community. We hope to address any questions and concerns you may have about this revolutionary platform for providing and receiving mental health care.

What is Telehealth?

Telehealth is the process of engaging in mental health therapeutic treatment through an online, secure video platform. Telehealth involves a licensed mental health clinician connecting with and providing therapeutic services to clients in need of mental health support and help through a HIPAA-Compliant online video/audio platform. Telehealth is not a new concept, but has been evolving and refining as technology progresses and is now a nearly-comparable experience for certain in-person mental health therapies.

What does Telehealth look like?

The practice and platforms of Telehealth are constantly updating as advancements in technology are made, but the bare bones of Telehealth involves speaking with a live Licensed Mental Health Provider through audio and ideally video. Most Hipaa-compliant platforms facilitate video conferencing, but some go further and provide interactive elements such as a collaborative whiteboard or handout sharing. Mental Health Therapists are trained to operate in a quiet and confidential setting, void of interruptions or people within ear-shot. Tele Therapists encourage their clients to set up a laptop or table with video access in a quiet and private setting in their homes. Clients are typically given a link to open which will give them access to the confidential video conference. Most platforms do not require clients to create a log in or profile, but some may ask for a client to input their name and basic identifying information for therapists to know who is entering the video. Sessions typically last for the standard 45 minutes but may be adjusted based on the specific needs and capabilities of the client. In order for Telehealth to work, both parties need reliable internet access. In cases where reliable internet is not accessible, speaking on the phone may be permitted on a case-by-case basis.

Is it Confidential?

Confidentiality is the state of keeping and maintaining privacy and is the foundational element to mental health therapy that helps clients to feel safe to explore their deepest thoughts, worries, memories, and struggles. Therapists are bound by ethics and the law to maintain confidentiality so long as everyone is physically safe, with a few exceptions involving judge orders and parental rights. Because of the importance of confidentiality, health care companies have developed platforms that align with standards of the national HIPAA Act, which is a legal regulation that establishes the protection of every individual’s personal health information. Because of the HIPAA Act, therapists are unable to utilize less regulated platforms like Facetime and Skype to conduct therapy sessions, as those platforms do not adhere to HIPAA standards. Therapists who conduct Telehealth sessions are enrolled in a specific program that facilitates secure dialogue. These programs are designed to be user friendly and easily accessible to clients with internet.

Would I benefit from Telehealth?

Most mental health providers that offer in-person therapy utilize Telehealth as a “plan B” when faced with circumstances that limit or prohibit face-to-face interaction. Not all types of therapies operate best through telehealth, but many can be effectively conducted through secure online platforms. Licensed Mental Health Providers are trained to discern which therapies would be most effective when conducting therapy through Telehealth. Likewise, a trained and licensed mental health professional will be able to help you navigate your struggles and decide if Telehealth is the appropriate platform to use. Many people do prefer in-person therapy, but Telehealth opens the doors to certain populations that are unable to access in-person therapy due to mental or physical challenges. Likewise, certain environmental or safety circumstances may limit or prohibit in-person therapy as an option, thus making Telehealth a great resource to have available.

If you are struggling with a social, emotional, or mental challenge and are experiencing limitations or hesitations to seeking in-person therapy, Telehealth may be a great option for you. All of our therapists at Long Island EMDR are undergoing trainings and peer supervisions to advance their abilities in providing quality and effective Telehealth services for you and/or your family. In response to the limitations and restrictions caused by COVID-19, our therapists are working diligently to provide Telehealth services for our community. Please reach out today if you or a loved one is in need, and our therapists can help guide you to finding the best fit for the care you need.

TF-CBT may sound like an intense acronym and a bit overwhelming. We therapists love our acronyms! It stands for Trauma-Focused Cognitive Behavioral Therapy. In everyday terms, it is a trauma-focused intervention that is specifically for people from ages 3 to 18 that are diagnosed with PTSD due to experiencing a traumatic event. The key components of TF-CBT that make it a unique intervention is it utilizes measures to track symptoms, it emphasizes gradual exposure, it includes the caregiver throughout the entire treatment, and it provides the client and caregiver with multiple skills to utilize at home to combat symptoms. Also, to become fully certified and recognized on the roster, a clinician must complete a year-long intensive training that includes multiple two-day in-person seminars, biweekly supervision with a consultant, monthly group consultation calls, and an exam at the end if the clinician chooses to become nationally certified. Throughout the training, the clinician is working with at least two cases and receiving constant supervision to ensure fidelity to this model.

The Measures

Within the first couple of sessions, the clinician will ask the client and caregiver to complete some pre-treatment measures. These measures will be completed before treatment and then after treatment to show exactly how and where the client and caregiver have improved. Trauma and PTSD symptoms in a child have a significant effect on caregivers as well, so some of the measures will be specific to the caregiver. TF-CBT has a significant amount of research to back up why and how it works. Measuring symptoms before and after treatment continues to add to that research as clinicians can track symptoms with clients and provide clients and caregivers with straight numbers to show improvements. Often it can be difficult for the client to feel the changes at first, so tracking symptoms is helpful to instill hope as well.

Gradual Exposure

This is another one of those therapy words that we all love. Gradual exposure means that the clinician will not dive into the dark depths of the trauma right off the bat. Flooding is a term that is used often in therapy and it means overwhelming the client by moving too deeply too quickly during trauma treatment. TF-CBT emphasizes gradual exposure every single step of the way to avoid flooding and an increase in symptoms. We want to dip our toe in the water and SLOWLY move into the shallow end and eventually into the deep end of the pool. We never want to jump into the deep end when it comes to trauma. One of the first steps of TF-CBT is teaching the client and caregiver coping skills. Coping skills are used for two main reasons: to begin decreasing symptoms and to provide client and caregiver with tools to use to calm themselves as the trauma is being processed throughout treatment.

The Caregiver

The caregiver is an integral part of treatment for many reasons. The caregiver provides support for the client and is with the client day in and day out. The trauma the client experienced also significantly affects the caregiver. It is difficult to care for a child that has experienced a trauma. It can trigger the caregiver if he/she has his/her own past trauma, it can be traumatizing and cause the caregiver to experience symptoms of anxiety or vicarious trauma, and it is difficult to fully understand the client’s symptoms and behaviors related to the trauma. Education is an important part of TF-CBT, as well. Psycho-education is provided throughout treatment to the client and the caregiver. It is important that both parties understand the ins and outs of trauma to better equip themselves to heal from it. A caregiver can be a parent, another family member, a foster parent, a social worker, or whoever is the primary caretaker of the child at that time. It is ideal to have someone that will be able to commit to the full process of treatment to provide the greatest benefits to the child. TF-CBT treatment works to heal the child and the family because trauma often ripples farther than we realize.

TF-CBT The Skills

As I mentioned earlier, the clinician will provide the client and caregiver with coping skills from the beginning of treatment. These skills will include calming skills, grounding skills, communication skills, and mindfulness skills. The skills will be tailored to the client’s and caregiver’s symptoms. One of the goals of providing these skills is to allow the client and caregiver to see that they can begin to combat the symptoms in a healthy way. It is ideal that the client and caregiver work on these skills together outside of sessions to increase efficiency. These skills are also important as the client continues in treatment and begins to get to the deep side of the pool that involves the details of the traumatic experience. These skills will allow the client and caregiver to be able to walk into those deep dark places knowing they can come out of them and ground themselves and calm themselves. Coping skills can provide a sense of empowerment to the client and caregiver during treatment and throughout life.

Valerie Smith is our lead clinician doing TF-CBT. For more information on TF-CBT please contact us.