How Do I refer someone for therapy?
Sometimes I am asked how people can recommend therapy to someone they care about who is in emotional pain. It may be uncomfortable to say, “I’m in therapy and finding great results”, or “You really ought to see a psychologist”. It may be easier to say, “I know of a therapist who specializes in treating _______” (anxiety, depression, relationship issues, addictions, etc.). Or, I have heard of a local therapist who has written about _______”. Just letting someone know where he or she can obtain more information about an emotional problem, can provide a step toward getting help.
You might also recommend looking at the increasing resources available on the Internet. On Dr. Nightingale’s website site there are anxiety and depression questionnaires for people wondering about their symptoms. This site also has free articles, including one on how to choose a therapist. Tell him or her that financial arrangements can be made by calling the therapist’s office. Often office staff will explain different payment methods, what the fees are for individual therapists, what if any discounts are available for paying at the time of visit, and may even check on insurance benefits for potential clients.
Therapy is about personal growth, exploration and finding coping skills to enjoy life again. Therapy is not a place of coercion, confrontation or where only seriously mentally ill people seek treatment. Therapy is more like having a coach for the most important sport you can play…your life.
Good results in therapy are best attained when a person has a good rapport with the therapist, is highly motivated to change painful aspects of life, and has specific treatment goals he or she wishes to attain.
© Lois V. Nightingale, Ph.D., 2018 Clinical Psychologist, (lic. #PSY9503), Marriage, Family and Child Therapist (lic # MA21027), director of the Nightingale Center, author, national speaker and mother 714-993-5343
Symptoms of Post-Traumatic Stress Disorder
(It is not necessary to have all symptoms to indicate PTSD)
After a serious trauma (in childhood or as an adult) hidden symptoms of Post-traumatic Stress can plague victims for years. Many sufferers can’t discuss these life-changing symptoms unless offered a safe environment in which to discuss them.
Re-experiencing the trauma, flashbacks as though it was happening all over again;
Increased anxiety and low frustration tolerance;
Intrusive disturbing thoughts of the trauma;
Nightmares or other sleep disturbances;
Emotional distress when reminded of the trauma;
Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)
Avoiding activities, or places that remind one of the trauma;
Inability to remember important aspects of the trauma;
Loss of interest in activities and life in general, feeling detached from others and emotionally numb;
Sense of a limited future, depression, hopelessness;
Irritability or outbursts of anger;
Difficulty concentrating, hyper-vigilance;
Feeling jumpy or easily startled;
Anger, irritability, guilt, shame, or self-blame, survivor guilt;
Substance abuse;
Feelings of mistrust and betrayal;
Suicidal thoughts;
Feeling alienated and alone;
Physical aches and pains.
Traumatic events that can lead to PTSD
Serious accident, war, childhood abuse/neglect, natural disaster, sudden death of a loved one, rape, assault, kidnapping, sexual abuse, terrifying emotional abuse, witnessing a violent incident, or any shattering event that leaves you feeling trapped, helpless and hopeless.
Things you can do for someone you care about with PTSD
Compliment their courage.
Be respectful of anniversaries of incidences, losses, etc.
Don’t take their anger personally. Anger is always a protective emotion for some underlying fear.
Listen respectfully to redundant stories. It’s one of the most precious gifts you can give.
Be kind. Don’t try to “educate” them about why they should feel differently or that their feelings are out of proportion to any current circumstances. Never say, “You should be over it”.
Remember, you may be oblivious to triggers that set off their flashbacks or painful memories. You did not survive the details of their trauma and the accompanying surrounding stimuli.
Never miss the opportunity to keep your mouth closed when you are tempted to judge.
Always create the opportunity to tell your loved one how lucky you feel to have them in your life.
Offer to participate in life-style changes, like healthy eating and exercise with them.
Books for you to read about PTSD
Shock Waves: A Practical Guide to Living with a Loved One’s PTSD, by Orange
When Someone You Love Suffers from Posttraumatic Stress: What to Expect and What You Can Do, by Zayfert, DeViva
The Post Traumatic Stress Disorder Relationship: How to Support Your Partner and Keep Your Relationship Healthy…by England
Supporting Children with Post Traumatic Stress Disorder: A Practical Guide for Teachers and Professionals, by Kinchin and Brown
When Someone You Love is Depressed: How to Help Your Loved One Without Losing Yourself, by Epstein Rosen and Francisco
How You Can Survive When They’re Depressed: Living and Coping with Depression Fallout, by Sheffield, Wallace, Klein
I Am Not Sick, I Don’t Need Help! How to Help Someone with Mental Illness Accept Treatment, by Amador
When Someone You Love Has a Mental Illness, by Woolis
Healing Together: A Couple’s Guide to Coping with Trauma and Post-traumatic Stress, by Phillips, Kane
Dr. Nightingale’s Interviews and Media Appearances
Therapy by Dr. Lois Nightingale on April 9, 2016
Dr. Nightingale’s Interviews and Media Appearances
Articles and Interviews:
Interview with Divorce Central: http://www.divorcecentral.com/DCLive/expert/nighting.html
Brilliant Star Magazine: https://www.brilliantstarmagazine.org/parents-teachers/building-character/developing-virtues
Interview with Anderson Cooper CNN: http://edition.cnn.com/TRANSCRIPTS/0306/17/se.08.html
Dr. Nightingale writes as a Psychologist and Topic Expert for the psychology site Good Therapy.
More of her articles can be found at Network Therapy
What is Cognitive Behavior Therapy?
Anxiety by Dr. Lois Nightingale on April 8, 2016
What is Cognitive Behavior Therapy?
Cognitive Behavior Therapy is an action-focused psychotherapy that focuses on addressing thought patterns (cognitions) that lead to disruptive behaviors and uncomfortable emotions. It is a relatively short-term form of therapy based on the concept that the way we think about things affects how we feel emotionally. CBT focuses on changing current mal-adaptive thought patterns, behaviors and communication rather than on past experiences. It is oriented toward current problem solving.
CBT is based on extensive empirical research. It is the primary psychological treatment being studied in research today. CBT has been shown to be as useful as antidepressant medication for individuals with depression and is superior in preventing relapse. Studies indicate that patients who receive CBT in addition to medication have better outcomes than patients who do not receive CBT as an added treatment.
While CBT acknowledges many of the core beliefs contributing to “automatic thoughts” in response to life situations, may have been developed in childhood or during times of crisis, the predominant focus is on helping clients feel better and behave better their current lives.
CBT clients need to be motivated, as CBT can be hard work. Clients may feel uncomfortable at times as they practice new behavioral habits. Clients are expected to do work outside of therapy. Homework assignments, journaling, role-playing, cognitive rehearsal, relaxation techniques, systematic desensitization, deep breathing exercises, reinforcement strategies, and validity testing, are all techniques used in CBT. Clients who seek CBT can expect their therapist to be active, problem-solving and goal-directed.
The harder clients work, the better their chances of recovery.
Cognitive therapy is not about “positive thinking” in the sense that you must always think happy thoughts. Rather, it is a way to gain control over racing, repetitive thoughts which often feed or trigger anxiety or depression. In CBT people learn how to change their behavior and their feelings to live more fulfilled lives.
Dr. Lois Nightingale, Psychologist PSY9503 714-993-5343