So here's the deal. I'm a mental health professional, schooled in the traditional mental health counseling method. I've been doing this for about 8 years now, and in my estimation, the traditional way doesn't work for everyone.

Some in my field would disagree, and say that we need to continue to work this way. My gut tells me that there have to be more and better ways to help people improve and get better.

So my question to you is this: If you could change something about mental health treatment, what would it be? Personally, I collaborate with all my clients and try to find a method that works best for everyone involved. Sometimes my method doesn't work for them, and I have to refer them out (it doesn't happen often, but it happens). So I would much rather have a collaborative approach with clients, than a "I'm the wizard of Oz, figure it out for yourself" sort of approach.

What do you think? Gimme what you got!  :)

Tags: Mental Health Stigma Mental Illness Counseling Therapy Collaboration

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Here's an entry from my own blog that I thought would be a propos for this site.

Today’s topic is Mental Illness! And what do we think of when we hear the words Mental Illness?

Usually something like our buddy Johnny Depp as the Mad Hatter from the forthcoming Disney remake of Alice In Wonderland. We think of mental illness as something scary, creepy and bad.

So what do we always do when it comes to things that sound bad? We change it around to make it sound a little better. You know what I’m talking about: the Politically Correct movement of the late 80’s. No one says “retard” anymore (well, teenagers do, but that’s to be expected), they say “developmentally disabled.” No one faults anyone for being developmentally disabled, but you have to admit, that phrase doesn’t instill hope in the future of that person. Another example of this is anything with the word “challenged” after it.

Mental Illness is kind of the same way. I think that Mental Illness is even a politically correct term, to try to make it more acceptable as a legitimate illness, so insurance companies can pay for treatment. No harm there, right?

But then it got me thinking: People who are sick don’t call it “physical illness.” They just say “I’m sick.”

 So I tried that: “I’m Mentally Sick.”

Somehow that didn’t exactly work very well.

On that same note though, no one is physically “well” all the time. Based on that logic, no one is mentally “well” all the time, either. It follows that if everyone has their fair share of physical illness, they also have their fair share of mental illness.

Just like physical illness though, you always have those people who don’t go to the doctor when they need help. Take me for example. I have to be dying to go to the doctor’s office. Generally I can handle whatever comes my way, so I don’t really go that often. Same thing with mental illness. Some people probably can handle theirs a little better than others, and as a result, they don’t go to get help, because its likely they don’t need it as much as some others.

Can anyone tell me what the equivalent of a mental cold is? How about a mental flu? Mental pneumonia?

So if we all have been mentally sick, or how about this, “Mentally Unhealthy”, can we really sit here and continue to give mental illness such a raw deal?

The answer is severity. You got 3 categories – Mild, Moderate and Severe.

Mild Mental Unhealthiness is probably most of us out there. You freak out because your girlfriend is hanging out with her ex. You get depressed when the weather gets cloudy and cold. You obsess a bit about whether or not the guy you met is going to call you.

Moderate Mental Unhealthiness is an issue that significantly affects your everyday life. You can’t stop thinking about your anxiety. Your depression gets you fired from your job. Your obsessions cost you relationship after relationship.

Severe Mental Unhealthiness is what will likely get you hospitalized. This is typified by life and death situations. Anything that can lead to the harm of self or others would be considered here.

See that? A little change in Thinking goes a long way. How we percieve mental illness determines our Emotions about it.

What’s the point? The point is that Mental Illness has a nasty stigma attached to it. The goal is to be Mentally Healthy, just as you would strive to be physically healthy. There’s nothing wrong with addressing mental health, and just like getting tested for cancer or an STD, it can mean the difference between catching something early, or having it affect your life in a dramatic way.

So allow yourself to recognize when you have a bit of Mental Unhealthiness. Its OK, we all have it from time to time.

Tags: Mental Illness Stigma Crazy Unhealthy

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Whenever you’re combing through 200+ pages of legal jargon, it tends to get a little tedious.

Anyway, I’m here to talk about really serious business. Mainly the HR3200B, which in case you didn’t know, is a bill being proposed in the House of Representatives to reform health care, and namely health insurance, as we know it. It sounds like its providing a “public option” for healthcare, which would allow people to buy a federal form of health insurance to cover themselves.

Frankly, until this weekend, I hadn’t heard anything but what the pundits have to say about it. I could not with good conscience sit here and take a side about it without reading it over myself. I’ll condense it down so you don’t have to go nuts reading it yourself, because after all, that’s probably why your reading this anyway.

OK, now why do I give a crap about this anyway? This isn’t a politics blog, right? This is about helping yourself and touchy feely stuff! Very true. However, its also about counseling, and how I help others, and how I help you. Since counseling really IS my bag, I stopped to realize that this bill could affect how I do counseling, how I run my business, and how much I get paid. Suddenly, it was clear that this bill became VERY important to me. Even though the ACA (American Counseling Association) is behind it, I figured I needed to know what it meant for me, and also for you.

Why is it important to you? Well, if you are going to get counseling using your insurance, it does make a difference if the rules are going to change about insurance. So I think its worth mentioning, and telling others, because no one else is doing it; I know, I’ve looked.

Without further ado, here’s how I think the HR3200B will affect counseling as it stands:

1. The bill allows LMHC’s to bill for Medicare: Long ago, in a galaxy far, far away, only Licensed Social Workers and Psychologists could take Medicare. This bill seems to change that to include Licensed Counselors, and Licensed Marriage and Family Therapists. Why are they doing this? Because according to the bill, you can’t provide service under the public option unless you can accept Medicare. Makes sense

2. The bill pays out at the same rate as Medicare: I guess that’s ok, I don’t know what Medicare pays (but the bill explains something like 75-80% of what is billed). I’m not sure if that involves the billed amount or the allowed amount (yes, these are two different things). If its the allowed amount, that may not be very much fun for me, but probably fine for those seeking counseling.

3. Employees can opt out of the plan offered by Employers: I might be wrong about this, but it looks like employees can opt out of the employer offered plan if they want to go with the Public Option. You’ve got 30 days, but that’s it. Then the employer is required to enroll their employees into a health insurance plan.

Ok, let’s stop here and take a look at just this stuff. Sounds OK so far, but I have a few concerns.

1. If the federal system is like the state system, then we may be in for some trouble. I have many reasons why I don’t accept Masshealth, the state run health insurance in Massachusetts. Here are some of the reasons why:

- The require that children and adolescents take a test that asks them about their sexual history, and all kinds of other prying questions. They probably have a reason for this, but I think its in poor taste. Understandable in some circumstances, but it could be a turn off for some parents.

- They audit charts every quarter or every half year. If they don’t like the way I write my progress notes, or conduct my charts, they take money back. Not to mention the invasion of privacy.

- They take about 3 months to pay, and take every day of it to do so.

- Did I mention that they don’t pay very well.

OK, don’t get me started, but those are the main reasons why I don’t take it. I hope to heck that Medicare isn’t this way, because as a small business, I wouldn’t be able to keep the ball rolling.

2. How will this affect my business, and businesses on the whole? Honestly, I don’t think anyone has the answers to this question. A lot of people are thinking that the Public Option will reign supreme and that it will ruin the insurance industry. However, Masshealth has been in Massachusetts as long as I can remember, and the other companies are still competing. I think it will depend on how the Public Option goes, the ability to choose providers and whether or not providers get on board with it or not. My main concern is with the cost of the public option going down, the private costs will go down to compete, and the rate that providers (like me,…Hi) get paid will go down. Which determines whether or not I can keep helping people.

How does this apply to you:

1. The world is not going to end. Whether you think this is a good idea or not, the world will go on much as it always has. No one knows for certain what this will do to other insurance companies, but there will always be something they can offer that the Public Option does not.

2. Read the Bill and figure it out for yourself. Listen to other people and what they say if you want (like me, duh), but its always best to educate yourself. Yeah, yeah, I know that involves reading, but no one is going to sit there and tell you what it says without having their own agenda in mind. I mean, I have my own agenda too, but its in my effort to save my own butt.

To bring it all home, I started researching this because I felt fear about my ability to provide for my family. I was concerned about how this would affect my life and my overall livelihood. Then I realized as much as this bill could change the way I do business, there really isn’t much I can do about it. Sure, I could learn more about it, and I could teach you guys about it, but that’s about it. If it goes through, and things change, then I must change with it.

The point is flexibility with things that you can’t change. I can’t change what happens, but I can change what I do about what happens. Its got the WATER Method (the name of my blog) written all over it. So here’s me applying my own stuff to my own problems. I hope it helps you too!

Jim

My Blog

Tags: Healthcare Obama Health Insurance Counseling Therapy Coverage

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So I did this TV interview about internet addiction, because I think its a big problem in our society, and its one of the more mainstream forms of addiction out there. As a result, I wanted to share that interview here, because I think its relevant to the overall goal of NKM2.

However, since NKM2's site is fairly basic with regard to blog posting, and seeing as I really can't do much in the way of posting video here, I decided to just post a link to my blog entry that does allow this. I did it for a local access show called Stop and Think Radio, and they're doing stuff along the same lines of NKM2, only probably not as public. Here's the link:

http://jimvaleri.com/2009/07/13/internet-addiction-the-next-great-dilemma/

Its a 30 minute interview. Let me know what your thoughts are about the interview and also what you think about the subject. Discussion is encouraged! Have a good one everybody!

Jim Valeri, LMHC

Tags: Internet Addiction Mental Illness Mainstream

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So over the course of the last couple of weeks, I’ve started to wonder about the reasons why people come into counseling with me. I mean let’s face it; you go to counseling for a number of reasons: You want to change something, you want someone to listen to your problems, your wife is ready to kick you out of the house…you know, the usual reasons. And I’m OK with all of those reasons, really. These reasons usually come down to one of two roles: The Wizard or the Listener.

An active therapist is much like a Wizard.  I can’t give you a brain or a heart or courage, but I can help you find them within yourself. They’re there, you just haven’t found them yet. Don’t expect any real magic here. Like Gandalf, who used his magic peacemeal throughout the Lord of the Rings trilogy, I’m not some conjurer of cheap tricks…just a guy who has a bit of wisdom to share with you in a way that can help your life in a dynamic way. It feels like magic when the techniques we use together actually work.

A listening therapist is usually one you go to just to dump your issues onto, and that helps you feel better. I like to think I’m a good listener too, but I can’t read minds, like the main character in the NBC show, the Listener. It would be nice to be able to know what you’re thinking, but I can only hope you will be open enough to share with me what is affecting you so that we can work together and help you feel better.

However, I have to say I take issue with some people who come into therapy, specifically to change something, and then expect me, the therapist, to do some sort of wizard magic to change their circumstances. I can’t tell you how many people I have worked with who expect me to give them something more than what they can do themselves. Don’t get me wrong, I give them my best: I tell them what I feel they need to do, and how they could do it. I instruct them that if they don’t at least try some of the suggestions I make, that they probably won’t see very much change. You know what happens?

Nothing. Nothing changes, and they wonder why therapy “isn’t working.”

So then my question is, what do you want out of counseling? What do you expect to get? I have my limitations as a therapist: I can only offer tools that I know are going to help people based on experience. I wish I  could go and apply these tools to people for their own good. I really wish I could make things better for them, and make them feel better. But unless, they take advantage of the tools, and take the time to use those tools, I can’t help people beyond handing the tools to them.

So I guess I ask the question, and I’ll do one better. I’ll throw you some suggestions on how to get the most out of counseling sessions.

1. Know what you want out of counseling and tell your therapist up front. If your therapist should be able to handle this. Be clear about what you want, and more often than not, your therapist will give it to you.

2. Be up front with what you’ve tried. The more information you provide to your counselor about what you’ve tried before, the less likely they are to waste oxygen giving you information you’ve already tried.

3. Your therapist is obligated to let you know if they can, and can’t,  help you. Ask your therapist if they can do what you’re asking them to do. I have no problem telling clients that I do not work with schizophrenia or psychotic disorders. I know my limitations, and your counselor should know theirs too.

4. Know when to get out. If your therapist isn’t helping you, then it may be time to start looking. This doesn’t mean if you don’t “feel good” when you’re doing counseling. If your uncomfortable with doing work, or changing behavior or thought patterns, counseling isn’t likely going to feel good. However, if your counselor is boring, unhelpful, or ill equipped to handle your situation, then it may be time to get out. If you have a good rapport with that counselor, and they step on your toes, address it with them in session. Also, if you’ve accomplished your goal, decide if you want to set up a new one, or just end treatment until something else comes up.

Maybe it might be good to think about what role you want your therapist to play. What do you want out of counseling? Comments Welcome!

My Blog

Tags: Counseling Therapy Decisions

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So a long time ago, before HD TV, Bob Newhart played a therapist on Mad TV with a new spin on therapy.

http://www.youtube.com/watch?v=T1g3ENYxg9k

The reason why this is funny is because people usually come to a therapist to figure out HOW to STOP IT. If people knew how to stop it, why would they come to therapy anyway? At the same time, I look at this as sort of the obvious answer to dealing with what we can't control. If something you can't control is making you anxious, then stop thinking about it. Seems simple, right?

But then, I consider that some people don't know how to stop thinking about it. If you look at my previous post, Feeling Overwhelmed: Tools to Reduce Stress, I give some tools on how to manage overwhelming thoughts and change your state so you can deal with today.

I guess my point is, if you don't like how a thought is affecting you, Stop It, and think about something that is going to help you improve your situation. This method is ironic, considering I just did an interview with Stop And Think Radio and TV, and the theme here is along the same lines. Their bag is addiction of course, but you can't start doing something new, unless you stop doing the old behavior that got you where you are. You have a choice, so make the choice to improve and change your thinking so you can change how you feel.

What do you think? Comments and suggestions are welcome, provided I'm not a complete noob and erase your comment like I did to the nice young woman who posted earlier (sorry about that, it will never happen again. Note to self: READ your spam folder BEFORE you delete).

Tags: Think Change Feelings Therapy Counseling

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