July 7, 2019

Is Online Therapy As Good As In Person?

Let’s face it we live in the digital age. From cyber social structure to buying groceries, the Internet has become the go to place, not only for information and advice, but also for services and products. I admit I love technology. I’ve always loved cameras, gadgets, and yes, the Internet! But I also love an old school, off grid experience. No power, no problem.  I’m not sure why I love these two extremes but I do and I also love both traditional in person therapy as well as online therapy. Both have their place in our ever busier, stressed out lives.

The reality is, online therapy can be face to face when using a video platform, this is my approach. Sure, there is a screen in front of you, but you still experience facial expressions and other non-verbal communication not available with phone or text which are also other forms of teletherapy.  So, it’s important to see what is being used when choosing an online therapist to find the right fit for you.

Let’s look at some research that’s been done on online therapy versus traditional therapy and see what site says about the effectiveness. “There was support for the application of psychotherapeutic interventions through the Internet; online therapy was especially effective for treating anxiety and stress-effects that lasted after therapy ended and on average was as effective as face-to-face intervention.” 1  Online therapy is especially effective when using CBT (cognitive behaviour therapy), one of the main tools I use with my clients in both life coaching and counselling.2 

Some of the pros to online work are pretty obvious:
  • Availability. The client is able to get therapy without going anywhere. This has a whole host of benefits within itself. For example the client may be mobile limited and housebound. The client may live in a small town where there are no therapist. The client may have difficulty arranging their schedule to see a therapist due to work hours. Also because there’s more flexibility in scheduling on behalf of the practitioner this makes them more available to clients. For example a therapist could Offer sessions for two hours on the weekend without having to go into work open up the office and so on.
  • Confidentiality. The client doesn’t run the risk of someone they know seeing them walk in to the therapist office. This is especially beneficial for professionals or those who live in smaller towns.
  • Comforts of home. One online therapist reported their clients actually felt more comfortable in sharing vulnerable issues and disclosing how they feel because they’re in a familiar setting there at home3. They feel like they can relax and really share what’s on their mind.
  • Flexibility & Convenience. As already mentioned with the client not having to go anywhere this makes it very convenient for clients to book an appointment and to attend a therapy session. Whether they are a mother with small children or they work long hours this convenience provides an opportunity for those who might not otherwise be able to get therapy.
  • Opportunity & Specificity. Clients can find a more specific therapist to meet their needs and this provides them with more effective tools. For example not only can they find a therapist Who understands depression but also is of the same faith or similar faith. Both therapist and client can be far more specific in choosing who they work with and in line with the clients needs. Clients Are not limited to just the few therapists in their area but can search for wider for therapist not only skilled in their particular issue, But also works with the tools the client might already be interested in. For example I had clients come to me because they wanted a Christian therapist who is well-versed in cognitive behaviour therapy for relationship issues. That’s pretty specific.
So while this is a benefit I am leaving it off the bullet points because it’s not exclusive to online therapy. Nor will all online therapists be testing their clients and thus you may not know their effectiveness. But competition combined with ratings and reviews, lead to greater effectiveness. Often ratings are more available for online therapists. Because there’s more competition online therapists are learning they’ve got to be more effective. In fact there are companies working on platforms to rate therapists based on client progress reports. This maybe a ways off in becoming the norm, I do believe it will eventually be a standard of care. Well many studies report traditional therapy is about 50% effective, those doing testing with their clients using some firm of progress report are generally far more effective than 50% since they can address failures in therapeutic alliance and see what methods are and aren’t working. I have colleagues that even offer a money back guarantee because they’ve yet to have a client who’s not improved. This is not to say good therapy can cure all mental illness, but rather there should be a significant improvement in symptoms or the client should be informed the therapist does not have the skills to help them so they can find someone who can.

What about the limitations of online therapy. What are some pretty obvious ones first of all you have to have good Internet connection. And even with a good Internet connection there still technology glitches with computers freezing, Internet hiccups, software issues, and other hardware mishaps. Clients who are not well-versed in technology may find it frustrating at first to have to figure out their camera and their microphone as well as complete online tasks such as filling in reports and surveys. Additionally, just as in gave to face therapy there are some legal issues that need to be considered based on location of the therapist and the client. Another con is confidentiality problems if the clients email is not private. Because a lot of people have their computers and phones easy to access by the family members it is possible for there to be a breach of confidentiality at the clients end and the therapist has no control over that. Many online therapist refused to use email for that reason and do everything through secure platforms. Other therapists like myself warn the client about this potential invasion of privacy and encourage our clients to use a private email for all correspondence and scheduling. And lastly online therapy would be inappropriate for suicidal clients or those requiring physical intervention such as major addictions, those experiencing ongoing psychosis, or severe eating disorders. These need an appropriate treatment facility.

So of course I am writing this from a biased perspective being that I’m an online therapist. I really do find it to be easy to use with my clients. And since I’ve been the tech-support in my home for many years I don’t mind guiding clients in using the technology either. So for me it’s been a great opportunity to provide services to those who live near or far. If you want to give online therapy a try I do offer a free 15 minute consultation book yours below:

June 22, 2019

Herd Mentality: When you don’t need evidence to back up your claims.

It’s out there. What out there? Every thing! If you have a question someone has an answer. Whether it’s forums or blogs or online magazines or social media. People have always been opinionated but with the Internet it was the dawn of mass support for an idea and the right to express an opinion, how ever you feel like, whether or not there’s enough evidence to back it up. Freedom of speech we say, yet at what point is it ‘bearing false witness’?  Just because you see something on the Internet with 40 doctors backing it up or thousands of people agreeing on social media, it doesn’t make it true. The scary thing is something might only have a limited presence online, with a minority agreeing with it, and it truly is a saving grace. A pivotal key component of people’s happiness or health gets lost in the shuffle of nonsense and noise.

Because there are billions of people online, 3.2 billion in fact as of April of this year1, you can find support for just about anything. Flat earth - Yep, Coffee is good - of course, coffee is bad - for sure, Low-carb diets good, plant-based diets good (which are mostly carbs by the way). After awhile it gets so confusing that the easiest thing to do is just pick one that sounds good to you or seems right. How do you think superstitions began? A few ladies sitting around the stew pot over the open fire start chatting. One says, “You know a black cat crossed my path the other day and then my husband got bit by a goat.” Another lady pipes up, “Weird a couple months ago a black cat crossed my path and I couldn’t find my sewing needle for three weeks.” I don’t know how black cat crossing your path became bad luck started but this is how a lot of concepts get going. It’s called anecdotal evidence. There are two things that happen with enough frequency it looks like there’s a correlation.

The problem with that is we tend to pick things that agree with us if we are not using critical thinking and we aren’t in the mood to change. We like things that don’t rub us the wrong way or that seem better. Maybe easier and more to our liking. Or sometimes the opposite is true, if you love conflict you’ll pick the most controversial idea. Or, if being unique is at your core essence, you might pick something that is most obscure. But no matter how many people all post they agree it and share it, it doesn’t make it right. It might be partially true in certain circumstances but not to the extend we see it blown out of proportion in the media.  Case in point: keto diet, low carb, has had some limited success in helping small children with severe epilepsy but plant based diets (not always vegan or exclusive) are well documented to ward off most lifestyle diseases like cardiovascular disease, diabetes, even cancer, and it is the most common for longevity and vitality in later years. So, yes, there are some positive things about a low carb diet and it may even have a place in the treatment of some disorders but that doesn’t make it the best diet for everyone.

Balance and context are absolutely critical for finding what’s right for our needs in this moment. What’s good for one person might not be good for another. What’s good for you and one circumstance might not be the best choice now. There are teens who game for hours every day that would love to hear research on how video games help with math. But they neglect articles on being sedentary for so many hours a day is harmful for other aspects of their intellect and physical health. A professional athlete might read an article on pushing yourself through the pain. They want to win that metal and are willing to do what they have to get there. Never mind the research on pushing through the pain was in terms of someone who’s had an injury and needed physiotherapy. And how much pushing must be guided to prevent further injury.

Context is very important. I once wrote an article in a tongue-in-cheek sarcastic tone designed for people to use for introspection. However if you read that article with the mindset that this applied to everyone it sounded mean and/or if you aren’t prone to sarcasm. That certainly wasn’t my intention to be mean or make sweeping statements about the human condition.  There are a lot a little one liners on Facebook that really fall into this category. The little one liners like “Just say no” “Peace comes from within” “Be yourself” can sound awesome and inspiring or shallow and meaningless depending on what state of mind you are currently in and what your life circumstances are.

I did a article years ago on how to do the right kind of research to decipher truth so I’m not going to talk about how to do proper scientific research here. Here we are talking about mindset. Your mindset when you’re looking at information. And how to recognize the cues in yourself because you to believe something that may not be in your best interest. I already mentioned a few. Did you catch some of them? Herd mentality, appealing to the senses like tugging at your heart strings or fear tactics, and using your current goals, likes, and dislikes to sway you.

If something appeals to you because it seems easy or fun or it allows you to continue to do something inherently that’s probably the biggest red flag. We want to hear chocolate or coffee is good for you. Or you should rest when something is sore and achy. Most of us would love to just take that at face value, depending on our state of mind or circumstances. Where this hit home for me was in terms of exercise. I’ve been diagnosed with fibromyalgia, an autoimmune disorder. There actually very few experts in the field of fibromyalgia because for a long time it was viewed with skepticism. So those of us with the disorder often rely on each other for information along with our general practitioner and rheumatologist. Almost all those with fibromyalgia will tell you doing too much makes them exhausted and in pain. So, we love to hear go slow, take it easy, rest as soon as it starts to hurt. The only trouble is it almost always does and inactivity is the worst thing you can do for fibromyalgia. Really inactivity is the worst thing you can do for your health for anyone. Yes, there are certain injuries requiring rest but the body also needs some motion for circulation the corner stone of health.

Obviously there has to be a balance based on the needs of the individual person. We don’t like to push ourselves for several reasons maybe it’s too much effort, we don’t have the time, we are avoiding pain, we want to do something else, and the list goes on. The interesting thing is when I push myself, I mean really push myself, the pain does go up a little bit but my enjoyment in life goes up exponentially! So is avoiding pain and not doing the things I love worth it? When I do that, not only am I not getting to do the things I love, but it’s slowly making me worse because the body atrophies very quickly. And truth be told the pain eventually gets less the more activity I do, if I am consistent and alternative what muscles are being worked.

So how do you pick whether or not to believe something without doing a ton of research? How do you know what the truth is?

Step one, be willing to see the truth. Really? What does that have anything to do with if something is right or wrong.  Nothing of course!  Your mindset doesn’t change whether or not a diet is good for you. BUT it does change how you view the information!  Perspective is an integral part of knowledge.  Know how you think and process information. It’s quite amazing how obvious truth becomes when we just follow a few simple steps. I’ve already mentioned the first one you have to be willing to see the truth. You have to be willing to take a look at yourself and make changes. Once you’re willing to honestly look for what’s right for you, the answers become more clear and easier to decipher.

Step two. Get to know yourself better. Are you a skeptic or accepting, are you easily swayed by emotions, how easy is it for you to stand against the crowd?  Sometimes our gut is right, depending on your personality and if you really do want to know the truth. But for others who are easily swayed because their initial gut reaction is to accept what they hear. We call it gullibility (a real gene in the DNA2) but that’s sounds negative so I prefer accepting and the Big Five personality traits adds this as a factor to agreeableness. So it’s clear gullibility/accepting is not a negative character trait. It’s just a predisposition like any other. Accepting people are open to ideas and often friendly and less cynical. Ok, back to our mindset and truth. If you know you’re more accepting/agreeable then maybe your gut instinct isn’t a good first choice or only choice but you can still listen to it. Sometimes that first instinct says I’m not so sure about this, but we actually talk ourselves into it because some part of us wants to believe it. Or we might be predisposed to believing herd mentality (especially if we have low confidence), “Look how many people are saying this is good.” That many can’t be wrong.

Thus step 3 is be slow to accept new ideas but not impervious to them. There’s a good balance between being wishy-washy believing anything that comes around the corner, and immovable no matter how much evidence is presented. This is similar to the first step being willing to be wrong. So be willing to give up a preciously long held idea and open to new ones but require solid evidence.

I want to digress a bit back to herd mentality. It’s not about how many people agree with an idea but who those people are and if they are experts in that field. You might have five doctors all agree that this particular diet is wonderful. You might also have some really close friends that are smart and dear to you that also believe in that same diet. But to really know if the diet is healthy you need to check out what do registered dietitians think about it. Clinical dietitians are far more well-versed in diet the doctors. I know that sounds strange but doctors get very little training in nutrition while dietitians do years of study just in food, how it affects the body and what foods have what nutrients. So it’s not about how much you like the expert or how well they explain something but is this expert truly an expert in his field or her field. Logic isn’t always right, but I talk all bout that in my article on proper research.

And I want to qualify that a true expert is someone who not only is trained generally in that field, but has studied the particular aspect you are looking at. For example I’m a nutritionist but I’m not an expert in blue zone diet’s. I have not sat down and research them in particular for years as much as Dr. Colin Campbell. That’s not to say I don’t know enough to share information but I would not call myself an expert. I think this is where we get lost. Lots of people can talk really well, they are logical, and make sense. How are we to know if they’re actually an expert? Simply look at their biographies. I would generally trust one specialized expert in the field over 100 professionals in that same field. Another words you might have thousands of fitness trainers all with degrees and general experience, all claiming a new exercise routine is the best thing since sliced bread. Physiologists also get on board, and general practitioners start promoting it to their patients. The world gets excited and it’s in magazines and all over the internet. But a researcher comes up who is been studying this particular exercise for 10 years and they say it could possibly hurt your knees. I’m going to go with that one expert because they’ve taken the time to really look at all the critical details that are missed by the others, often because the media fails to report those tiny but vital pieces of the puzzle.

It’s easy to buy into the pack mentality. That the majority is right. But history has repeatedly shown the majority is often not right. You need to be an individual and while there’s a wisdom in a crowd for certain things in life we also have to stand on her own 2 feet when it comes to making decisions for ourselves.


May 25, 2019

Removing Truth from Error.

Imagine you just spend 2 hours in an alpine meadow on your knees picking wild strawberries. You finally have 4 cups of tiny power packed morsels of goodness. If you’ve never eaten a wild strawberry, image five of the very best strawberries you’ve ever eaten packed into the size of a very small grape.  Amazing, right? So, you can’t wait to mix them up with a little whip cream and top a freshly baked shortcake. You hike down the mountain and drive home. 

Finally after that day’s journey you arrive at home. Joy and a feeling of accomplishment washing over you. As you walk toward the house you are so happy, you are almost ready to bite into these gems.  Your mouth is already watering as you smell the sweet red jewels. But as you almost read the house you trip, wobbling you try to regain your balance but alas, you drop the basket spilling it's delicate cargo all over the gravel driveway. Your heart sinks and joy fades as you watch the precious fruit roll in all directions. You scoop up as many as you can find, but now, stuck to the tiny fruit are bits of gravel. So, now what do you do? Do you take the fruit in and wash it or do you just throw it out frustrated and disgusted it's been tainted? I don’t know about you, but I would wash it! I'm not going to give up on those little beauties I worked so hard for. Really, I reason, it’s only a little more work to clean them with the gravel than without. True, the strainer doesn’t get rid of the larger pieces of rocks, those you have to individually pull out. But it’s worth it right? Why would you give up on something you’ve worked so hard to obtain?

Yet, in spiritual, philosophical, emotional, or other matters we can be in danger of throwing out the fruit when we find a bit of gravel in it.  We see error and fear grips us. Most of us have been programmed, hard wired, to desire truth over error. Disclaimer, just because we believe we are right or know something to be true doesn't make it so. But we rarely think we are wrong and are ok with that. There is something about being right that drives us. So when falsehood raises its ugly head we are quick, especially Bible believing Christians, to see it and stomp on it. 

But what would happen to our little berries if we stomped on them? Would that get rid of the gravel? Well, you certainly wouldn’t have to worry about the gravel that's for sure. It's one way to deal with it. But you won't be able to eat the fruit after that. It just becomes a mess once they are mixed through and through. But you miss the blessing when that happens. The fruit is ruined. But if instead you wash the fruit, you get rid of the gravel, or error, while keeping the fruit, or in our analogy truth.  Our desire to crush lies can actually hurt the truth!  Wow, not something we think about very often is it?

Wait! Am I saying we should be ok with a little error when it comes attached to some precious fruit? No, not at all. Remember in the analogy, we need to wash the fruit for it to be safe to eat, otherwise we can chip a tooth if we were to eat the berries with even one piece of gravel on it.  Just one tiny rock can ruin the experience.  That's symbolic! 

So what does this mean practically? When you listen to a sermon or read a self help book will it always be 100% true? Do you then cloister yourself from all human influences? God is working to save all humanity would you agree? Does that include Christians? Other religions? Atheists? Of course.  One of my career mentors uses little proverbs from the Bible, and sometimes Buddha, and all of them fit in line with my understanding of scripture. Do I throw out a truth which can be support by the Bible because Buddha said it? What if Mohammad said it?  Just because I come from one belief system doesn't mean there is ONLY truth in that ONE system and that EVERYTHING else is false.  I’ve seen people so fearful of error they throw out important truths, like throwing out the strawberries with gravel stuck to them.  

The good news is it’s very easy to separate truth from error, just like washing dirty fruit. We simply look for, and embrace the truth. It’s not that hard or complicated. There maybe some deep and more profound truths in symbols and metaphors hidden in scripture but that’s part of washing preconceived ideas from our own minds. None of us know everything perfectly.  We all make mistakes, have biases and hidden assumptions buried in our minds.  The more we embrace truth the quicker we will see errors, but it's all contingent on us being willing to accept that truth when we see it.  

So, be careful not to throw the baby out with the bathwater.  (An old German proverb dating back to Medieval times with truth relevant for all cultures today.)

Is Online Therapy As Good As In Person?

Let’s face it we live in the digital age. From cyber social structure to buying groceries, the Internet has become the go to place, not only...