Author Archives: Coretta Rego, MA, RP, CCC

Therapy in the digital age

Posted by: Coretta Rego, MA, RP, CCC on July 2, 2020 1:29 pm

I had originally written this article prior to the outbreak of Covid-19. The pandemic however has put a spotlight on this topic and has added some urgency to the discussion.

The internet offers us many conveniences. From online banking, to ride sharing and food delivery, the internet is not only making things more convenient for us, it is also providing us with life changing opportunities that previously did not exist. During a global pandemic, the internet has allowed many services to continue functioning in a way that would not have otherwise been possible. Virtual or digital service platforms have allowed clients to access mental health care services without interruption/with minimal disruption. This has no doubt provided a lifeline for many people who are experiencing challenges with their mental health that may have been exacerbated by the pandemic.

As a therapist, I have spent a large part of my career providing services to clients over the phone and using digital technologies (email-based counselling, live chat and video counselling). The demand for mental health services that are more accessible is growing steadily, as is the recognition by therapists that not all clients are well served through in person counselling.

There are a few reasons why clients request online services:

  • In a country as large as Canada, location can often be a challenge. Most mental health services tend to be concentrated in urban areas. If services exist in smaller communities, waiting lists can be long and often the service provider is personally known to clients, making them feel uncomfortable with accessing service and disclosing personal things.
  • Convenience is also an important consideration. The need for a client to travel to a therapist’s office can pose significant challenges including cost, time and physical barriers for clients with mobility issues
  • Demographics: there is a generation of people who have grown up doing almost everything online. The online world is their comfort zone and being able to access mental health services online can significantly increase the likelihood of them doing so.

Even prior to the pandemic, there was demand for online services, but many therapists were resistant and or uncomfortable. This resistance to digital services could be attributed to a few different thought processes.

  • Some therapists believed that therapy at its core is a process that must occur in person. Physical presence is vital, and without it the therapeutic process cannot be effective.
  • Some therapists also held the view that online services can be complementary to but cannot replace the in-person experience.
  • Lastly, some therapists do not feel sufficiently skilled with technology to deliver quality therapeutic services effectively.

Since the onset of the pandemic, I have spoken to many therapists who have had to confront and have successfully overcome the aforementioned criteria and are themselves surprised by how much they enjoy a virtual medium and how effective it is for clients. Many therapists have advised that even when they are able to resume in person practise, they will likely devote some portion of their practise to online service delivery.

Outside of the restrictions placed on us by the pandemic, virtual therapy is not about replacing the traditional in-person experience. Rather it is about increasing accessibility for clients who may not be able to engage in person. Providing digital therapy is not about simply replicating the in-person experience in another medium. Successful digital therapy requires planning for the benefits and challenges of each medium.

As an example, let’s consider video counselling. There are numerous benefits to the client and therapist as location does not pose a challenge. The client and therapist can be in two different locations with hundreds (or thousands) of kilometers between them. This helps a therapist avoid the cost of renting an office and affords them some convenience. This also enables a client to access good quality therapeutic care that may not be available in their geographic location. The client may also feel more comfortable/safe in their own physical environment and may be more engaged in therapy as a result. While the benefits are undeniable, we also must be mindful of some of the challenges.

  • What does the therapist’s regulatory college/association say about providing online therapy?
  • Do the client and therapist have enough knowledge about the online platform which is being used?
  • Do both the client and therapist have a private space in which they can engage in the therapeutic process?

None of these issues are meant to be deter a therapist from offering digital services. Rather, being aware of these issues, helps one plan accordingly. For example, many insurance companies who provide professional liability insurance now explicitly list digital services as something that is covered within the policy. Additionally, there are a number of secure digital platforms through which therapy can be conducted. elivering online services might require us as service providers to behave differently but this method of service delivery can be beneficial to clients and therapists.

Offering digital therapeutic services even after the pandemic restrictions are lifted, is going to be essential if we want to ensure that everyone who needs mental health services can access it. We are seeing an increase in academic and professional coursework that aims to equip therapists with the skills to effectively deliver digital services. Regulatory bodies and insurance companies are also recognizing the efficacy of digital services. It is now up to us as therapists to understand and explore whether incorporating digital services in our practises would be suitable for us and our clients.




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Making and Achieving New Year’s Resolutions

Posted by: Coretta Rego, MA, RP, CCC on December 20, 2019 11:59 am

The hustle and bustle of the holiday season will soon give way to thoughts and plans for the new year. Many of these discussions will invariably touch upon the changes that people plan to make when January arrives. This might include lifestyle changes, like eating better and exercising more, learning how to better manage one’s money, or a desire to pick up a new hobby. Regardless of how we choose to do so, a new year often presents us with an opportunity to reinvent ourselves.

While any day of the year that we choose to make changes to help us live a happier and healthier life is a good day to start, the dawn of a new year is particularly promising. While many a joke has been made about the success (or lack thereof) of new year’s resolutions, many people do find success with making and sustaining changes at this time of year. What sets these people apart from those of us who may be less successful with our new year/new us plans? Much of it comes down to having a plan.

Step 1: Make a resolution

If you are considering overhauling an area of your life in the new year, I would encourage you to start by picking one area. We often overwhelm ourselves by picking too many things to do at one time and it becomes hard to sustain all changes simultaneously. Instead, start with one change. As you start to see success and have been able to maintain this, you can add on another change. The confidence and adrenaline that you experience as a result of succeeding with your first change will build momentum for the next one. Success builds success!

Step 2: Make a plan

Success in any area of life is rarely due to luck, and more due to planning and ongoing hard work. This holds true for whether you are learning to dance, losing weight or building an empire. The reason many of us are unsuccessful with our new year’s resolutions is because we often come up with well intentioned ideas but do not give much thought as to how we will implement them. When we then encounter a challenge with our idea, we do not know how to overcome it, and we often give up.

As an example, let’s look at a frequently cited new year’s resolution: losing weight. Despite how many people cite this as a resolution and the amount of services catered to helping people with this, many (not all) still struggle with accomplishing this goal. The difference between those who succeed and those who struggle is not simply a matter of will power. Having a plan for how to modify your life so it becomes more conducive to losing the weight is an important step towards achieving a positive outcome. Furthermore, the more detailed the plan, the greater the likelihood of success

Plan A: Lose weight. Eat heathier. Exercise more.

Plan B: Lose weight. Eat healthier. In lieu of buying lunch from a fast food place during the work week, pack a home-made lunch which includes fruit as snacks. Meal prep with a friend every Sunday evening to avoid it feeling like a chore. Exercise 3x during the work week. Join the gym at work so that exercising can be done before or after the workday to reduce the likelihood of a missed workout.

While the intended end result is the same, the person who made the second plan is more likely to be successful because they have given thought to how they will implement this plan in their life, including considering potential obstacles and coming up with ways to counter them. It is important to note that plans don’t need to be extravagant, they just need to be specific to how you live your life.

Additionally, when making your plan don’t overlook all the things that you might already be doing that can help you meet your goal. By doing more of these things (or doing them more frequently) change is less overwhelming. For example, perhaps you already bring a homemade lunch to work every day but buy snacks which is where you succumb to the unhealthy options. By packing additional items to your lunch which you already spend time making, it is easier to make a healthy choice when the 3pm craving hits.  Your plan should make you feel empowered and should build upon good things you are already doing.

Step 3: Pace yourself

You have 365 days (and not just until January 31st) to make it your new reality. Be kind to yourself when you stray from the plan. Be patient with yourself when you experience a setback. Celebrate when you achieve smaller milestones as you get closer to the goal.

Happy New year! Happy New(er) You!

Coretta Rego, MA, RP, CCC




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

The Holiday Season and Why It’s Not Always the Best Time of the Year

Posted by: Coretta Rego, MA, RP, CCC on November 8, 2019 12:24 pm

It won’t be long before the fall leaves have been raked up, the trick or treaters have come and gone and the countdown to the end of the year will begin. In the midst of all of this revelry, there will be many opportunities for gatherings with loved (or not so loved) ones. Diwali, Hanukkah, Kwanzaa and Christmas are all celebrated closer to the end of the year. Even if one isn’t religiously inclined, the end of the year tends to bring with it multiple occasions for celebration. Unfortunately, along with the food, drinks and presents, there also tends to be a large serving of stress.

There are different reasons why people find the holidays so stressful. It can be busy with every evening or weekend committed to a celebration of some kind. It can be expensive with the list of people to buy gifts for getting longer each year. It can also involve social interactions that can be uncomfortable or downright unpleasant.

In some cases, holiday stress can often turn into distress.  As therapists, we are aware that holidays can be a difficult experience for people.  Family estrangement, grief and financial pressure are some of the reasons why people struggle at what is often promoted as the most wonderful time of year.

So how do we support our clients, loved ones and ourselves to remain emotionally healthy during the holiday season? Unlike other life events that may happen less frequently and are therefore a little easier to grin and bear, the holidays are inescapable. It can be beneficial if we take some time in advance to think about what we anticipate the challenges of the season will bring, and come up with a coping plan. While the hope is to create a plan that can help us thrive, in some cases, simply surviving and making it out to the other side is also a valid goal.

Here are some suggestions to help you plan for the upcoming holiday season:

  • When possible, try declining invitations to certain events. Regardless of how much fun an event is promoted as being (like an annual reunion with your high school friends) or how obligated you feel to attend (a family dinner), saying no to an event or two has multiple benefits. To start with, it gives you back some time in your schedule, spares you the expense of attending, as well as allows you to avoid any unpleasant social encounters. It also helps to build some comfort in saying no and not feeling guilty about it, which is an important life skill.

 

  • If there is a social event that you must attend, recruit a buddy to go with you. Think about what your biggest concern is about attending this event. Is it the small talk with colleagues you only see once a year? Turn to the person in your social circle who is skilled at banter. Is it seeing a family member who often berates you? Take a loved one who can calmly but firmly put an end to the conversation. If necessary, make an appearance and have a signal in case an early exit is required. The benefit here is twofold: you get credit for attending, while also allowing you to avoid some of the more challenging aspects of the social gathering.

 

  • If you feel that hosting a social gathering is an important though stressful element of the season, consider choosing an alternate venue. For example, in lieu of a potentially tense dinner with the entire extended family in your home, consider inviting family members to a public event in the community a few days before or after the holiday season (for example, ice skating at the local rink). This is an opportunity for the family to be together while removing some of the one on one interaction that is often the source of conflict and stress. It also gives an objective goal to focus upon…

 

  • If the holiday season is difficult due to grief, give yourself permission to not celebrate if you don’t feel capable, or to celebrate on a smaller scale. Carve out time and space to grieve. If possible, do something specific that addresses your loss so that it doesn’t feel minimized in the midst of the celebration occurring around you.

 

  • If the holiday season fills you with dread to the point that it is interfering with your well being, consider speaking to a therapist. A therapist can work with you to not only address the source of the struggle, but also to come with strategies for how to manage it. Holidays can have a negative impact on mental health and well being regardless of how well one has been throughout the year. Seeking the appropriate professional support can be very beneficial.

For some people, the holiday season is truly the most wonderful time of the year. For others, there is less joy and more strain. Regardless of how you feel about the season, remember to take care of yourself, as that is the best gift you can give yourself and others.

Coretta Rego, MA, RP, CCC




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Coping with Political Fatigue

Posted by: Coretta Rego, MA, RP, CCC on October 7, 2019 2:14 pm

I was channel surfing recently and came across a commercial for the upcoming federal election. I changed the channel and came across another commercial. After having watched bits of each I thought to myself that I was ready for this election to be over and wasn’t particularly concerned about the outcome. That thought caught me by surprise as I am a political aficionado. I follow what goes on in government both nationally and internationally and I also love to discuss various hot button issues at length. It occurred to me that if someone like me can be so tired of the political cycle, many people must not only be fatigued but quite possibly overwhelmed by it.

Politics no longer lives in a realm outside of us. Instead, politics are now deeply personal, which means that there is a lot at stake in any given election. Recent elections have focused on issues that are deeply personal and inextricably linked to the type of world we want to live in and build for the next generation. However, with the promise of change and betterment that an election might bring, also comes the possibility that the outcome might be the polar opposite of what we wanted. The consequences of which can feel dire.

Additionally, discussions about politics have become inescapable. With the upcoming federal election in Canada and what seems like an ongoing election cycle for our American neighbours, politics remain constant even when the seasons change. Whether it is the onslaught of 24 hours news channels that are constantly dissecting every piece of information, or online message boards where people openly share antagonizing opinions without any responsibility to fact check, it is easy to get caught up in the negativity.

So how do we not just survive but thrive in this increasingly politically charged atmosphere? How do we remain engaged in political dialogue without becoming disillusioned about the world we live in? How do we support our clients as they navigate relationships with family members, friends and colleagues that quickly become hostile due to divergent political and personal views?

It is important to begin by recognizing that how we approach these issues will determine the outcome we achieve. Responding angrily to a tweet or getting into a heated argument with a family member over dinner is unlikely to produce civil discourse. Recognizing that what we talk about has an impact on the daily life of the other person can help build empathy. The point of a discussion cannot be to change the other person’s opinion. Discussion is about planting seeds and exposing people to things they may not have considered. We cannot go into conversations expecting to change someone’s opinion. If we do, we are bound to be disappointed.

Let’s also give ourselves permission to tune out or disconnect as needed. While smart phones and app notifications make it easy to constantly be plugged in, periodic breaks can help us avoid becoming overwhelmed by the information. Unless it is your profession, political engagement doesn’t have to happen 24/7. Taking a break from the deluge of information can help us process the information better and also provides an opportunity to focus on other equally important things.

Lastly, when it all seems too much, let’s take a moment to reflect on how far we have come. Let’s celebrate all that we have accomplished, the battles that were won by previous generations that have had positive impacts on our lives. History books are filled with stories of human triumph. Let’s use this to energize us for what lies ahead.

Political engagement is important; our democracy depends on it. However, political engagement should not compromise our mental health or well being. Maintaining optimism in the current political climate is not easy, but it is possible.

Coretta Rego MA, RP, CCC




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA