Along the Way of a Peaceable Life
I hope that you find it helpful. Grab a snack and get comfy.
If you take anything from this Blog I want it to be this:
Invest in you!**
- Telehealth options have been permitted by most states and approved for coverage by most insurances, enabling therapists to be more accessible to those in need.
- Many states have adopted temporary provisions allowing licensed mental health providers to practice across state lines. This has allowed therapists to be able to reach people in areas with limited numbers of therapists available.
- HIPAA (Health Insurance Portability and Accountability Act) restrictions have been waived which limited the ways that therapy could be conducted. This has enabled people in rural areas with limited internet or those with limited technology or technological savvy to access their therapists through a simple phone call in the comfort of their won home.
- Ask a friend – Word-of-mouth can be a great way to find out about local therapists. Asking friends who are comfortable with sharing their therapy experience for recommendations will usually provide a pretty good starting point. They can give insight to their perspective of a therapist’s personality, methods, and overall things to expect.
- Ask a Professional – Asking another professional how to find a therapist is another great way to find a therapist. Your primary care doctor will most definitely have a list of therapists in your area! This is part of your doctor’s overall wellness resource package! Give them a call and ask!
Also, your school counselor can help you start your search! Whether you are in elementary school, middle school, high school, public school, private school, college, grad school, technology school, trade school…there are counselors and advisers who can connect you with names of therapists! Reach out! Let them know you are looking for a therapist!
- Check the Insurance Directory of Network Providers – Some health insurance companies have a directory of providers that are in-network with their insurance. This is true of therapists. Starting with the provider directory will not only give a list of mental health providers but will also assure that the therapist you choose can take your insurance.
- Check the Licensing Website – Every state will have a licensing board or two for therapists. Typically therapists will be one of two educational backgrounds: social work or professional counseling, although they may have a different title. Both have to be licensed by their respective licensing boards in order to practice.
A search for “board of social work” or “board of professional counseling” in each state should offer a link to the licensing board. And each web page for the licensing board should have a link for “license search” or “counselor search” and a way to search the therapists that have an active license with that state. A general search for a city can yield a list of ALL licensed therapists in that city who are licensed through that board.
- “Google It” – Though this has become a lighthearted representation of our technology-full lives, searching for a therapist in your area is another way to get a list of therapists, though it may be tiring and it may require a good deal of time browsing. Likely, the first several recommendations may be from www.psychologytoday.com, or www.goodtherapy.org, or other such professional listing sites. This is an association and the therapists on this site have paid membership or advertising fees to be listed there with their bios and pictures. These therapists are some of your choices, but are not all of the licensed therapists in your area. Keep scrolling and you will find other recommendation compilations as well, such as www.healthgrades.com, which will list therapists who have registered for credentialing, meaning they have signed up to be reviewed and considered by insurances companies. Again, this is some but not all of the licensed therapists in an area. But it is a start.
Googling a therapist you are given as a recommendation by some of the other methods can give you more insight about that therapist. Many therapy practices and individual therapists have websites with pictures and bios and a list of things that they generally treat that you can read and review. You can tell a lot by their websites, such as what their philosophy is about mental wellness or what kind of language they use to talk about their work.
- Cold Calling – Calling a therapist’s office and asking questions is a great way to directly find out about that therapist and practice. If there is a receptionist answering the phone, they can usually give you a pretty good overview of the therapist and their work. And if there is not, we therapists are usually happy to answer questions you might have about us and about therapy in general.
It can be anxiety provoking to call people directly and ask questions. Sometimes it helps to write your questions down so they are ready when you call. They might look something like this:
- Do you have openings?
- Do you work with adults/children/seniors?
- Do you take this insurance?
- Do you work with people who have _____ (anxiety, depression, stress, developmental struggles, relationship issues, and so forth)?
Often, people will call my office and will just explain what is going on in their world and we will work through their questions from there. For example, they may call and say, “I think my child may need to see someone. They have been really struggling with the COVID changes and are having a hard time in school. They don’t get to see their friends and they are staying to themselves a lot.” I will pick up right from there and we will talk about everything they need to know to make a decision about therapy.
- Insurance – Most insurance companies, especially since the Affordable Care Act, have included mental health services under their covered services. You can call your insurance company and ask if it covers therapy and if there is a limit to how many visits you can make on the plan. Many times, you and your therapist can negotiate for additional visits based on your need.
Some insurances say they cover therapy visits, but may apply those visits to your deductible. (Insert angry-faced-emoji here!) Personally, I think this is ridiculous and therapy should be treated as “primary care” which is generally covered and apart from deductible. This is definitely a question to ask your insurance! If this is the case, your insurance would be billed but whatever they apply to the deductible would be charged to you out of pocket.
- Income Based Options – There are therapy practices, usually non-profits, who offer income based rates, also referred to as “sliding scale.” These practices, and the therapists who work with them, usually get grants or other funding to offset the cost of the services. You would have to apply to be considered which would include providing your financial information such as pay stubs and tax information. This is used to calculate the rate you are charged.
Don’t think that because the therapist is working for a non-profit or a community health facility that they are not as qualified or concerned about you! They have the same requirements for licensure and continued training as all other therapists. If you really struggle to make a living and would like to seek therapy, these programs are available!
- Shorter Session Times at Reduced Cost – Sometimes therapists will offer shorter session times to be able to fit your out of pocket budget. This is something we do at my practice. We offer 30 minute, 45 minute, and 60 minute session with pricing for each when a person either does not have insurance to cover the cost or their insurance is applying their visits to their deductible. We will maximize that reduced time! You may have homework! It will take us working as a team! But we would rather someone have access to therapy, even for less time, than to not reach out and to struggle without it.
- Pro-Bono Work – Pro-Bono means “work undertaken without charge” (Google dictionary). Free services. Did you know, in most states, therapists are required to provide some pro-bono work as part of licensure? Yep! There is usually not a time requirement, like a certain number of hours of pro-bono work per year, but they are required to offer some! They may do this in a variety of ways, of course. In our area, many providers collaborate with outreaches, such as youth outreaches, shelters, detention facilities, and so forth, to give their time and expertise to the community. Reach out to some of the organizations and see what might be available and if you qualify.
- Therapists are as different as people are different. Watch for times when you might assume what they are like before investigating.
- Talk to them, let them know your concerns about past history. See how they respond. If you feel that you can trust them and they are considerate of you as an individual, try a few sessions.
- Therapists do sometimes piss you off. They may challenge you and confront you. They may not tell you what you want to hear. They may not do the therapeutic intervention the way you want them to. The therapist may have to do things, such as make reports, when there is a danger of harm or exploitation. This may happen. But all of this should with full disclosure and with a spirit of compassion, empathy, non-bias, and full commitment to your wellness and healing. Even though these things may be hard to walk through, they can be just what is needed to bring trust and healing during very difficult times.
- Unusual and uncharacteristic behavior for the person, such as not speaking or rapid speech, refusing to eat, not caring for themselves, paranoia, not sleeping for days at a time, engaging in risky behavior such as excessive substance use, reckless driving, aggression. These can indicate a mental health situation and at the very least the person should see their medical professional.
- Threatening to harm themselves or others is a mental health emergency that should not be ignored. If it is safe, this person can be taken for evaluation at their doctor’s office, a nearby hospital, a or community mental health facility. If they are not safe to transport, it may be necessary to call 911.
**Here I want to say that many states and localities have CIT (Crisis Intervention Team) programs in which officers are trained to respond to a mental health emergency in a non-lethal manner. This is a program that is collaborated through NAMI (National Alliance on Mental Illness) and you can find more information on this here https://www.nami.org/Advocacy/Crisis-Intervention/Crisis-Intervention-Team-(CIT)-Programs. If you suspect that the person is having a mental health emergency and the level of danger is high to warrant a 911 call, please indicate it as a Mental Health Emergency and request CIT trained officers. If safe, stay with the person or nearby to facilitate their safety.
- Suicidal thoughts or comments are a mental health emergency and the first step is this: BELIEVE THEM!
It is better to be responsive to suicidal thoughts and comments and find out that it really was not an emergency than to not be responsive and learn that it really was.
Reach out to a doctor, a teacher, a therapist, a trusted adult who can connect them with help.
Call the National Suicide Prevention Hotline at 1-800-273-8255 or https://suicidepreventionlifeline.org/.
Maybe the person has not said that they are suicidal.
Maybe they have just withdrawn, are not engaging in activities that they used to.
Maybe they comment that things would be better if they were not here.
Maybe it is you.
Maybe you feel this way.
YOU ARE IMPORTANT!
One of the goals I have had since starting Peaceable Life was to write a blog that would provide resources, explanation, strategies, tools, “food for thought,” and opportunities for conversation. These would be related to mental health, parenting, developmental disabilities, wellness, and many other very important things that I see people facing in my role as a therapist and a behaviorist.
I have worked in various settings and with a wide range of clientele over the last 21 years, beginning with adults with developmental disabilities and complex mental health and behavioral challenges, and leading in the last 6 years to mental health counseling as a resident and then as a licensed professional counselor. The one continual observation I have had throughout these last 21 years is that THE NEED IS GREAT!
--The need is great for available support and services.
--The need is great for mental health awareness and understanding in the support to those with developmental disabilities.
--The need is great for well-trained and competent providers of services.
--The need is great for funding resources so that people can afford and access mental and behavioral health support.
--The need is great for education about mental health….
…education for the person who is living with it
…education for the person who is supporting them
…education for the person in the community who makes judgement about them
…education for the person who is assigned to assist them but doesn’t understand their needs
…education for the person who is the professional “expert” but doesn’t listen
…education for the person who responds to the crisis and escalates it rather than de-escalates it
…education, education, education!
There are so many more needs, the list can go on forever.
In thinking of where to begin with this blog in a way that would represent my hope for its impact on individuals, there really is only one place it can begin and that is with DIGNITY.
Dignity by definition generally means “the state or quality of being worthy of honor or respect” (Google Dictionary). Often, we assign conditions to concepts such as this. For example, “I will respect you when you act right,” or “You need to prove yourself worthy” (think Thor’s hammer, here).
The problem with defining a concept is that we attach words to explain it that, in themselves, unintentionally change the interpretation. And then, because these defining words have systemic expectations and conditions attached, we measure ourselves against those expectations and conditions. Follow this thought process, "I struggle with this, so I am not worthy. I don't always make the right decision so I am not respectable. If I am not worthy, if I am not respectable, then I do not have the right to be treated with dignity."
In truth, the right to be treated with dignity is not conditional. It is not based on what you do for me or whether you accomplish something or what you contribute. Being treated with dignity is a basic human right, because each individual person is important, valuable, and worthy because they are here. Being worthy of dignity is not measured by the expectations of others. Being worthy of dignity as an individual person with your own individual thoughts and experiences and feelings and needs and concerns and struggles and victories and hopes and fears is your humanness and cannot be measured. It is founded in the understanding that there has never been, is not now, and never will be another person like you and therefore you have value. You are one of a kind! You cannot be replaced! Your absence would be missed!
The basic belief that all people, regardless of their challenges (or even the things they have done to others) deserve to be treated with dignity as a human right is foundational if we are going to be able to evolve in the world mental and behavioral health. It is also hard, and I want to acknowledge this here as well. If this blog is to be useful and open up opportunities for conversation, then I also have to voice the challenges with any topic that I present. How does a person who has committed great harm to others deserve dignity?
This is where I return to the difficulty with definition of a concept. By definition, a person who has done horrible things has not earned respect, with respect being defined as “a feeling of deep admiration for someone or something elicited by their abilities, qualities, or achievements” (Google Dictionary). How can you respect a person who would hurt others on purpose? After all, that person is not honoring the dignity of the person they have harmed, it can’t be one sided.
This leads to other concepts, such as accountability and the potential for both good and bad, right and wrong. I will address these more in other blogs. But for the purposes of introducing the concept of dignity as a basic human right, it is important to note that dignity does not eliminate accountability. People should be accountable for their actions. There is no personal growth without personal accountability. But in the application of accountability, consideration must also be given to the basic right of human dignity. Consider here humane treatment of prisoners, some who are mentally ill, who have committed crimes.
Dignity in care, treatment, education, services, support, resources, emergency response, institutionalization, and every area that touches those with mental health, behavioral health, substance use, and developmental challenges is a human right. I must embrace this as indisputable if I am to meet the needs or make an impact on the needs of others. As I continue forward posting blogs, I hope to touch on important ways that we can show dignity to others, such as with the language we use and the things we support.
Maybe we can speak a little kinder to our children?
Maybe we can withhold judgement on someone we think doesn’t seem to be “adulting” well?
Maybe we could give ourselves some quiet time when we are feeling overwhelmed?
Maybe we could consider exploring therapy and sharing our hurts?
My wish is that as you consider DIGNITY as a human right that you and everyone share, it leads to thoughts and discussions and exploration and evolution into the world of hope and healing.
by Meneika Chandler, LPC