In general people see a therapist when there is a problem. This is true. Most people need some sort of problem that’s uncomfortable enough that they will take the step to begin therapy. It’s of course not comfortable opening up with a stranger and telling them all your deep darkest secrets. It takes a lot of courage and internal motivation to take that step.

Most people also think when they are starting to feel better that therapy has worked and they can now stop coming. For some people this can be true. But with most of our trauma folks, “better” simply signifies not being in constant crisis mode. Yeah, that is an awesome feeling. But because you were in constant crisis mode your therapist likely was helping you develop coping skills and maybe change your behavior a bit so you could stop the cycle.

The truth is that deep work cannot be done when you are not stable. I cannot start EMDR with a client that is chronically suicidal, self-harming and self-sabotaging. I cannot do deep work with client’s coming in with a new fire to put out every week. I can help them learn to manage the moment and self-regulate better. I can help them set boundaries so they are less overwhelmed. I can help them build up their social support so they feel less alone. All of that is still gold. It’s great life changing stuff that ends the roller coaster.

But the deeper stuff that triggers them jumping back on that roller coaster. The inner voice that feels “not good enough”, “alone”, “unlovable”, “responsible”, “guilty” etc. will end up creeping in again and those great behavior changes will likely fade away again and you're back in crisis mode.

Why Stay in Therapy

So that deep stuff. That inner child that still gets “pinged” when you get a critic at work, or your husband says “did you change the diaper genie?”, or your friend cancels plans. That work is best done when you are stable. It’s hard work. But changing that inner voice and those automated thoughts and responses is  what truly puts you in the driver's seat of your life. It is also what ends the intergenerational trauma from continuing forward with your children.

That inner voice comes out so often and so unconsciously that it perpetuates us in the cycle. The woman that struggles with self-esteem, ends up criticizing her daughter’s weight and making food comments- that cause her daughter to feel the same as her “unlovable” or that love is conditional or that my value is based on my appearance. It’s surely unintentional and likely not in any way what that mom wants for her kid. But when we don’t have full operational control of our inner voice we end up sending mixed messages to our children, our loved ones and our colleagues.

Why Low Stress Times is When Real Work Happens in Therapy

When it is smooth sailing it’s the perfect time to dive deep. There are less stressors from school, work, life problems which is why you now feel “there’s no stress. I don’t need therapy”. The lack of stress allows for you to now really dive into some deeper issues that are going to bring up some uncomfortable thoughts, memories and emotions. It is the best time to do that work because now that your daily stressors are gone you have the emotional bandwidth to add the work- and healing yourself is work.

When Do I Not Need Therapy

So now you're probably like, “Okay, Jamie. If even when I am not stressed I need therapy,  when do I not need therapy?” Valid question.

My answer is when you can easily silence that inner voice that pops up. Whether that be the voice that makes you feel responsible for others, not good enough, unlovable, damaged, guilty, or that you cannot trust your judgment. When you can easily stop playing whack-a-mole and that voice doesn’t pester you- end therapy. When you have worked through and healed that inner child- end therapy. When life is stressful and you don’t want to rip out your hair, or feel your skin is crawling- end therapy. Don’t end when there is no stress. End when you can manage your stress without being in crisis mode.

But if you are a constant crisis mode client that is finally off the rollercoaster. Please talk to your therapist about doing some deeper work. About exploring those core beliefs and truly processing the memories associated with them. We want you to feel better. Truly better and in control of your life.

Looking For A Therapist?

If you are looking for a therapist our counselors at Long Island EMDR would love to help you. What sets us apart from most therapists is that we are authentic humans. Imperfectly perfect I like to say. We are real, down to earth people. We love what we do and who we work with. We do evidenced-based work and are not afraid to challenge you when needed. Because we are down-to-earth genuine humans we truly care about our clients. Even though we will push you, we are probably some of the most compassionate, empathetic, and empowering people you will meet. Give our office a call today to be matched with a therapist who truly understands your concerns. And sleep a little better tonight knowing you took that first step.

-Jamie K Vollmoeller, LCSW

What Does it Mean to be an LGBTQ Affirming Therapist?

As LGBTQ Affirming Therapist in Suffolk County, NY we take an approach to therapy that embraces a positive view of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) identities and relationships. We also are intently aware and proactive in addressing the negative influences that homophobia, transphobia, and heterosexism have on the lives of our LGBTQ clients.

How We Ensure That Our Providers are Truly Affirming Therapists

1. Self-reflection: All of our clinicians engage in supervision in which we explore and address biases, beliefs and attitudes from their own upbringing. It is important for us as a practice that all of our therapists have either been in therapy and/or are actively engaged in therapy so they are aware of their own biases (not just of the LGBTQ community but also, race, socioeconomic status, ethnicity, etc.).
2. Involvement in the community: Our practice engages in many LGBTQIA+ events and networking with other agencies and business owners who work with and/or are part of these communities. Several members of our team are members of the community themselves and our cis gendered clinicians, when needed, consult with them in group supervision to get their prospective on client’s concerns.
3. LGBT Affirming paperwork: Our intake documents account for those that do not fit the herternormative boxes. For those planning to bill insurance it must be  under your legal name but we do have a “Preferred” name box as well to ensure all staff address you by your chosen name and pronouns. 
4. Education- We encourage and promote our clinicians attending training related to LGBTQIA community concerns.

What You Can Expect From Our LGBTQ Affirming Therapists LGBTQ in Suffolk County, NY

All of our therapists are extremely interpersonal. They want to know you: Your story. Where you came from. What happened to you. We pride ourselves in being a practice of “above and beyonders” who really want to know our clients and understand them. Part of being an LGBTQ affirming therapist in Suffolk County, NY is being a therapist that does not make assumptions about our clients but being open to hearing their stories and experiences. Every coming out story is different. Everyone’s level of comfort and openness about their sexuality and gender expression is different. We won’t put you in a box because you are part of the community. Your experience as a member in the community is still uniquely your own. We wholeheartedly believe and understand that your sexual identity and gender expression is no where near the only thing that defines your you-ness.

Being affirmative means we strive to treat all of our LGBTQ clients and their families with the respect and dignity they deserve. Our role is to support you, to uplift you, to empower you to make the changes you would like to see in your daily lives and heal from past hurts. We want you to know you are absolutely fine just the way you are.

Ready to See an LGBTQ Affirming Therapists LGBTQ in Suffolk County, NY?

Contact us now to schedule an appointment to meet with one of our amazing affirming therapists. We truly would love to help you through whatever is bringing you to counseling. Our providers have a range of expertise including: couples, trauma, grief & loss, anxiety, OCD, depression and BPD. There are also many modalities used within the practice including: EMDR, TF-CBT, mindfulness, CBT, solutions-focused, and strengths-based counseling. Our administrative assistant will match you with a therapist who is not only affirming but can also address the underlying concern that has brought you to seek treatment.

Sending Love & Light,

-Jamie K Vollmoeller, LCSW

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

There are many differences between experiencing trauma as an adult and experiencing trauma as a child. One difference is that experiencing a stressful event as a child can cause an everlasting impact throughout adulthood. This everlasting impact is what affects the ‘inner child’ when those children become adults. The inner child is something that exists within everyone. It is the playful, fun, cheerful, hurt, as well as saddened child we once were. Any traumatic or stressful event that was experienced as a child is remembered by the body, and that is how it continues to affect us into adulthood.

"A child who does not play is not a child, but the man who does not play has lost forever the child who lived in him." - Pablo Neruda

The obstacle to overcome when attempting to heal the inner child is being able to understand, connect with, and accept the child within. Inner child wounds can be because of abuse that was experienced as a child, neglect, distressful events, loss of a loved one at an early age, as well as many more. Tending to the inner child can allow for growth and prosperity for later life.

Some Signs That Your Inner Child May Be Impacting You:

• Having feelings of shame, guilt, inner restlessness
• Having feelings of worthlessness, never feeling satisfied with self
• Negative self-talk
• Having the need to be a perfectionist with responsibilities or tasks
• Self-sabotage, self-destructive behaviors
• Excessive work ethic
• A pattern of unhealthy/unstable relationships
• Chronic overworking and overachievement (to knowingly or unknowingly gain approval, praise or belonging)
• Not being able to be in the here and now (present moment)

Taking steps towards healing the inner child can be done with seeking therapy, practicing mindfulness skills, as well as increasing one’s own level of self-awareness. Navigating inner child work with a therapist can allow you to work through that trauma, distressing memories and emotions. Working through these events can be distressing in and of itself, though having someone who is trained to support people with these types of issues can allow for many doors to open. The goal of inner child work within therapy is to explore these past events, with an emphasis on early memories to learn skills on how to regulate the self. 

Some Inner Child Mindfulness Practice:

Heal Your Inner Child Meditation

-Conor Ohland, MHC-LP

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.