What is the purpose of therapy?

The purpose of therapy depends on the individual. For example, one person may have the goal to quit smoking or overcome panic attacks when he gets into an elevator; another may want to improve her relationship with her mother while the third would like to feel better about going to work everyday. Goals created in therapy (whether short term or long term goals) are solely based on what the person would like changed.



Many times I have seen someone initially choosing therapy in order to improve one aspect of their life but realizing other STUFF in their lives that needs changing.



Basically, therapy is about "working on yourself".



The ultimate goal is to feel better, change maladaptive thoughts or behavior which prevents you from feeling good, improve relationships and an overall enjoyment of life.... Sounds good? Great!

Cognitive Behavioral Therapy, automatic thoughts and the million dollar question: is the point to be happy all the time?

Have been getting asked recently, whether the point of Cognitive Behavioral Therapy is to "think happy thoughts" all day long or be in a constant state of ecstasy. I WISH that we lived in a world/life/mindsets/existence where we knew no unhappiness OR this was easily attained through therapy... but we don't! In fact, everyday we may experience a whole rainbow of emotions!

Cognitive behavioral therapy does not eliminate all negative thoughts and strive for constant joy: CBT helps individuals reframe negative thoughts to something more realistic that can improve our mood and change behavior.

Automatic thoughts suggest exactly what they sound like: thoughts which come on automatically, seemingly out of no where. Automatic thoughts may occur in response to our internal or external world (WILL WRITE ON ABC of CBT in a later post which will explain activiating events and relation to thoughts!). An example of an automatic thought could be "I will never graduate" as a response to failing an exam. A CBT therapist may suggest changing "I will never graduate" to "failing an exam is disappointing but it's only one exam and I will study harder next time". SEE THE DIFFERENCE?

In conclusion, examining our automatic thinking leads to learning how to monitor and substitute with something realistic (and yes, more positive but also realistic!). Modifying our thoughts has a direct impact on changing mood, emotions, perspective, and behavior. I've seen amazing transformations in clients JUST from understanding what they are thinking.

This is why as a therapist, I practice CBT-- it WORKS!

What do you think?

Shoot!

Just wrote a blog that seemed to have vanished into the internet vortex!

I used my mindfulness and acceptance skills to overcome this disappointment. Truth is, disappointments happen to all of us and how we handle and regulate our emotions after the fact, determines whether we will have a truly horrible day and miserable life OR experience disappointment, then move on.

In my case, I had spent nearly an hour writing and referencing and attaching a youtube video to a blog post. As I was about to press "publish", the post simply disappeared. Has this happened to anyone else? Has something similar happened to you?

After the fact, I could have allowed my mind to spin into victim-hood, catastrophic thinking, black or white thinking, all or nothing thinking ("poor me", "this ALWAYS happens to me", "all my hard work down the drain", "why did this happen to me"? etc). Instead, I shrugged, laughed, took a break and accepted that these things just happen. Mindfulness skill redirected my attention to how I feel at the present moment until I was ready to move on.

Reality is, life has hurdles and set backs. Reality is, how we perceive the glitches (our "self talk") will determine whether we are happy or just "eh" or truly unhappy in life.

What do you SAY to yourself after you experience disappointment? Please share!

All about Motivational Interviewing.

What is Motivational interviewing?

Motivational interviewing was created by Miller and Rollnick in the 1980’s. More than 80 randomized clinical trials have been published demonstrating its effectiveness in changing unwanted behaviors. The number of publication is doubling every two-three years in the past decade (Moyer, Miller 2006).

Motivational interviewing helps to change behaviors by exploring ambivalence to change (Parson, Rosof et al. 2005). Motivational interviewing is defined as “directive, client centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence (Rubak, sandboek et al., 2004)”. 

Motivational interviewing is a client centered approach, however, unlike Rogerian treatment (which is more open ended), MI is more goal directed. Motivational interviewing emphasizes the use of open ended questioning and a communication style to help foster changing results while respecting a clients autonomy and self determination (Resnicow, McMaster 2012).

Change

Motivational interviewing puts a focus on change as a normal human development and growth: change can move forward, fall back or stop periodically and then continue moving forward. There are three main components to motivational interviewing: 1. Collaboration, 2. Evocation and 3. Autonomy. Collaboration suggests teamwork between the therapist and client and working together to accomplish goals. Evocation refers to building on the clients intrinsic motivation for change. Autonomy suggests a clients right for self determination and direction (Kress, Hoffman 2008). 

Five stages of change

Motivational interviewing is composed of five stages of change: precontimplation, contemplation, preparation, action and maintenance. Precontimplation suggests an unwillingness or lack of recognition or denial that there is a problem. Contemplation involves a consideration to change using a pros and cons measure. Cons suggest consequences of the behavior. Preparation implies a determination in the form of a commitment in the future to change. Action suggests the change steps have begun to take place.  Maintenance occurs 3-6 months after the change. Maintenance involves lifestyle modification to avoid relapse (Shinitzky, Kub 2001). 

References

Rubak, sandboek et al., (2004), Motivational Interviewing, British Journal of General Practice, UK, P. 305-312

Miller, W. R., & Moyers, T. B. (2007). Eight stages in learning motivational interviewing. Journal of Teaching in the Addictions, 5(1), 3-17.

Ken Resnicow and Fiona McMaster. Motivational Interviewing: moving from why to how with autonomy support. International Journal of Behavioral Nutrition and Physical Activity 2012, 9:19 Available online: http://www.ijbnpa.org/content/9/1/19.