Deciding to start therapy is a huge milestone in life. What could be more important than committing to work on yourself and become the best version of you? Who you are and who you become influences every part of your life. This is why choosing the right therapist is SO important. It’s essential you and your therapist are a good fit and that the person you choose has the experience and expertise to get you to the next level in life, whether you’re working on career goals, relationships, self-exploration or all of the above.
One of the considerations you might take into account when looking for a therapist is whether that therapist accepts your insurance. For many people, this is a deciding factor when choosing someone.
After all, you’re paying a premium every month for your insurance so why wouldn’t you want to use it? It can save you money on your session costs and it can help you narrow down your search by ruling out therapists who don’t accept your plan. You use your insurance for all other doctors so why not do the same for therapy, right?
New therapy seekers with this belief are often confused and frustrated by the number of therapists they find that do not accept insurance. It can be really difficult to find someone that specializes in your area of need, is close to home, fits your personality, and accepts your insurance.
Why are there so many therapists out there that don’t accept insurance?
Many consumers don’t realize that there are several downsides for both therapists and clients when using insurance to pay for therapy. Here are a few of the downsides of using insurance to pay for therapy.
1. Less Confidentiality
Everyone knows that what happens in therapy stays in therapy. Your therapist is required to keep everything you say confidential no matter what, right? When you use insurance to pay for therapy, your therapist is required to provide your diagnosis and treatment notes to your insurance company in order to get paid. This undermines the basic premise of therapy and also gives a lot more people access to private health information about you. (Out of network benefits require a diagnosis, but notes are not shared) If this is news to you, you’re not alone. It’s all written into the HIPAA document you get when you start therapy or any Dr's office but most people don’t read all the fine print.
2. Insurance-Driven Treatment Plan
When therapists take insurance, they are required to use treatment methods that are covered by your plan. This means they have less say in how to treat you based on your specific and individual needs. Ironically, the people who work in your insurance company and decide which methods of therapy can be used, are usually not even therapists. And they certainly haven’t met and assessed you personally like your therapist has.
3. Quality and Quantity
The going rate for a great therapist in most major cities is between $150-$300 per session. Most insurance companies pay therapists between $40-$90 per session.
Submitting insurance claims is time-consuming and confusing, it requires a lot of paperwork and usually takes months to get paid by insurance companies. Many therapists have to hire a billing professional to help them manage insurance claims to make sure they actually get paid. Oftentimes, insurance companies decide they will not reimburse for sessions and the provider is left unpaid. Therapist who accept insurance have to see more clients which may tax them emotionally and most insurance companies will only pay them for 40-45 minutes which means shorter session times, these factors effect you as a consumer.
People who pay more for therapy are usually more invested and it shows in their results. They make the most of every session, they do their homework, and they get great results. You are worth it. If you take the work seriously, you will see your investment pay off in every area of your life.
What if you can not afford to pay the full fee but you also want to make sure you get a great therapist? Fortunately, there is sometimes an in-between option.
Depending on your insurance, you may be able to get reimbursed for out of network benefits, which can mean a savings of up to 80%. This is typically available with PPO plans. To find out, call the number on the back of your insurance card and ask how much your plan pays for out of network therapists.
Then, if you do have out of network benefits, ask your therapist if he/she can provide a superbill for you to submit to your insurance for reimbursement. You will pay your therapist for the sessions up front but your insurance company will reimburse you for some of the session fees. Not every insurance plan has this benefit but it’s definitely worth a phone call to ask.
The other option is that you can use your Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for therapy. This allows you to save money because you are paying with pre-tax dollars.
Therapy often does not take as long as you think and is a worthwhile investment.
Make a point to stay connected with your spouse on a weekly basis. Dedicate time for some real conversation. Here are a few questions to get you started:
What are some of our best stay at home dates?
Describe your ideal date night.
How important is physical affection in our relationship? How am I doing?
What are the things you are most grateful for in our relationship?
What do you remember about our first kiss?
Relationships need time and attention. Be sure to give your relationship the time and attention it needs to thrive.
As a therapist who works with addictions, I am often asked, "Aren't there good addictions?" Great question! On the surface it seems to have a ring of truth to it. The thought behind a good addiction is that behaviors such as exercise, eating healthy, working, recreating, playing sports etc. are good, add value to life and are therefore beneficial.
In the addictions field, experts identify a true addiction by the following basic components:
1. A pattern of repetition.
An addiction, is a pattern of behavior that is repeated at various intervals. Example, an alcoholic may drink daily, just on weekends, only on days off or every few months but the behavior is still repetitive. This pattern by itself of course does not constitute and addiction.
2. Progressive degeneration.
An addiction will intensify over time. There is a tolerance effect associated with an addiction. A person will require more of the activity or substance to achieve the same effect. The food addict will need to increase intake of carbs, sugar, etc. A pot smoker will need to smoke more to relax or relieve their anxiety. Some folks believe behaviors that don't involve a substance (i.e. sex or exercise) can't form a tolerance because you are not taking a substance into your body. On the contrary, both sex and exercise create a flood of neurochemicals to the brain that are highly potent and do in fact over time create a tolerance. The implications again are the same, more is needed to achieve the same result.
3. Progressive unmanageability.
Have you ever promised yourself that you are, never going to do "it" again and found yourself unable to keep that promise? "I'm never going to drink that much again", "I am done eating ice cream!" "I am not going to work that many hours anymore." In spite of your best effort, you find yourself down the same road time and time again. The eventual outcome? Feelings of despair, shame and powerlessness.
To some degree, most of us use substances or behavior to alter our mood from time to time. When my children were younger (and sometimes now) I would find them standing in front of the pantry staring. I'd ask," Is it possible you are confusing your feelings of boredom for hunger?" Mood elevating behaviors may include shopping, eating, working, gambling, exercise and sex. When medicating emotions becomes the main go to for someone, it robs them of the growth and development that happens when a person works through difficult emotions in a healthy way.
Is my dedication to work, the hours spent and the energy invested causing me to neglect my spouse and or kids?
Does my life revolve around my hobby to the degree that I am often putting my needs/wants above those most important to me?
Do I spend large amounts of time fantasizing about .................to the degree that I am less productive at home or work?
Are my food choices causing my health to suffer?
Is my level of present exercise damaging my body but I am unable to cut back or stop?
Is my emotional well being tied to my team winning?
In the end, addictions can create devastation; emotionally, relationally, spiritually, mentally and physically. If you or anyone you know has ever struggled with an addiction you know this to be true. Conflict, divorce, legal consequences, physical ailments, ruined vocations, the list goes on.
Often, when people speak of "Good Addictions" they are referring to positive outlets in their life. These outlets may serve to enrich relationships, improve physical well being as well as provide positive focus and drive toward a productive goal if enjoyed in proper balance. Keep a healthy awareness that it is possible to have too much of a good thing!
If you or someone you love is dealing with an addiction, there is hope. There are many resources in the community that offer assistance. The first step to getting help is to acknowledge there is a problem.
Christmas. It is supposed to be the “most wonderful time of the year,” and yet it has a way of turning into the most stressful time of the year.
Maybe it’s because the family is staying with you for a week or you’re anxious about over-spending on gifts but want to be generous, or maybe you’re spending the holidays alone this year and are feeling a little lonely. Whatever the source —family, finances or painful memories—you’re not alone.
The stressor : Change
Loss of a loved one, loss of a job, a divorce, illness, empty nest for the first time. Even at the best of times, the holidays are stressful -- but when there's an additional emotional burden, they can be especially difficult.
When there's a loss or a change in our lives, our traditions change -- and that's hard because we will miss our favorite things. Anticipate how changes will affect those traditions. It's important to be open to new traditions. Take the best of the old, borrow from new people in your life, and create new traditions.
The stressor: You like things perfect — and things aren’t perfect
So you want everything to be perfect, but inevitably, something goes wrong. How can you let it go and just enjoy your time with your loved ones?
Many of us have a tendency to set unrealistic goals for ourselves, especially this time of year. Striving too hard will only further cause stress and anxiety.
Write a list of what you're going to focus on today — the stuff that deserves priority in your life — and realize that stressing over the little things isn't necessary.
The stressor: You’re lonely
Being single, especially during the Holidays can be difficult.
Between Disney fairy tales and Hallmark, it's no wonder so many singles think finding the right one is the be-all and end-all. Remind yourself that you're OK on your own.
Being alone is sometimes a choice—maybe you’re single because you broke off a relationship with someone who was selfish or non-attentive or who just didn’t make you feel as special as you deserve to feel. If that’s the case, solo is definitely the better option! Reach out to friends, do not isolate.
The stressor: Your bank account balance is dwindling
Are you totally stressed over how much you spend during the Christmas season—and who you should spend it on? You don’t want to leave anyone out but how can you give without going overboard?”
Money is tight for just about everyone this time of the year, so odds are the people in your life are experiencing the same kind of stress over gift-giving that you are. So why not take the worry out of it for both of you by acknowledging it and making a date to spend some time together instead.
Research suggests we often derive more lasting happiness and satisfaction from experiences than from material items, so you’ll both get more out of it—without putting a serious dent in your savings accounts. It’s a win-win-win!
Have a very Merry Christmas and happy New Year.
adapted from Self Magazine
Social anxiety is defined as an intense, persistent fear of being judged, negatively evaluated, or rejected in a social or performance situation. Those who live with this may struggle with school, work, church and other social situations such as parties, weddings, and family celebrations. Are you constantly self-aware, scared of doing or saying the wrong thing?
In social anxiety, words and gestures are often blown out of proportion, you may fear that the smallest thing that you have said or done may impact the way that others see you. This fear can become debilitating and prevent you from attending events that others take great pleasure in.
There are methods that can help you to keep social anxiety manageable, so you can begin to relax and enjoy yourself this Holiday season. Things to Start Doing if you Have Social Anxiety.
A recent conversation with a coach at my gym got me thinking. How do the principles I apply at the gym translate into my work? As a therapist in private practice, I don't have a physically demanding job, the extent of my physical activity is getting up and down from my chair. Getting good a squats has increased my efficiency in doing so. Seriously though, as I thought this through, I came up with 7 transferable concepts that apply to my work at Jaeger Counseling.
Proper form = less injury and more efficient execution of moment.
When I first started exercising at the gym, my form was terrible. I looked awkward (and still often do), was prone to injury and sore in places afterward where I was not supposed to be sore. In my work, I teach the basic skills necessary for success. One example is in the area of communication. Often, when couples come in they are talk over one another, don't listen or validate one another and at times volatile, creating relational and emotional damage. By teaching and coaching couples through foundational skills in healthy communication, much progress is achieved.
A goal is accomplished one step, one day at a time. One of my favorite quotes is by a Chinese philosopher, Lao Tzu who said, "A journey of a thousand miles happens one step at a time". No matter what one's health and fitness goals are, the journey to achieve them happens in this manner. When I first started exercising, I had goals in mind, tone my aging flabby body, lower my cholesterol and strengthen my core to help my bad back. I wished I could achieve my goals overnight. Many gimmicks exist that promise instant results, however, we all know that there is really no shortcut to hard work over time. The same is true in counseling. Setting realistic expectations and breaking goals down into small manageable tasks that can be accomplished daily, creates change. Often when we reach our goals and reflect back we realize that it was really more about the journey.
Accountability helps with perseverance. How many times do people start an exercise program, a diet or new habit only to find themselves quitting. Left to our own devices most of us default to a pattern that we are accustomed to, one that is most often one of comfort and least resistance. When I first started exercising as an adult I did so at home with my wife as my workout partner. Her presence and commitment spurred me on to continue. Since starting at a gym, my coaches and classmates provide accountability. This is a principle I discuss with all of my new clients and is one of the great benefits of seeing a therapist. As they set goals, I hold them accountable to working toward their goals. When they succeed, I celebrate with them, if they fall short, I help to evaluate what can be learned from the failure and encourage them to get up and keep pressing on. The awareness each week that someone who cares will ask you, "how did you do", keeps a necessary pressure and awareness in the back of your mind to continue at times when you don't feel like it.
Community is key! Many of us experience community in a variety of settings such as school, work, places of worship and in our families. A good gym is a place that fosters community. It is a place where people build friendships, support and encourage one another and do life together. It can be a place where you support and invest in others as they do at times for you. In my work as a therapist, I see people struggling with depression and anxiety. In many if not most cases, these individuals lack an adequate community for social and emotional support. It's always a goal to help them develop that.
Acknowledging weaknesses leads to improvement. When I started exercising, I informed my coach that I had a number of weaknesses. Bad knees, back and a set of the most pathetic chicken legs you ever saw. Without acknowledging these weaknesses, my coach would not have known what exercises I needed to concentrate on and which ones I needed to stay away from to not injure myself. As I made progress, I was able to increase weight and add in movements that I was ready for. Most people I see in my office are there because they realize they have a weakness and are asking for help. These people generally tend to be motivated toward change. From time to time, I will have a teen or a spouse who come because they are appeasing the requests and demands of someone else. Often, they don't acknowledge problems or the need to make changes and therefore progress is stunted.
Working at things during times of low stress helps with times of high stress. A number of my fellow gym rats are competitors. They take their workouts seriously and spend their time in the gym working toward the goal of doing well in the next competition. The day to day work is focused on building the skill and strength necessary for when they are put to the test. Much like this, I help couples develop conflict resolution skills when they are not in conflict so that when conflict comes, they know how to deal with it more effectively. In addictions work, I help individuals with skills and strategies so that when they are under pressure they know how to react. Performing a repeated action over again develops muscle memory, we can execute precise movements without even thinking about it.
Working through adversity creates positive change and growth. The common saying is "No pain, No gain". As difficult as it is to consistently press yourself beyond what is comfortable, everyone knows it is necessary in order to achieve a positive benefit. This is a principle that is true in all areas of life. Pain is something that most people avoid. We live in a day and age where there is a pill you can take to deal with many of the pains you may experience. A question I ask people is, "Is what you are experiencing the pain of harm or the pain of growth"? When you have an injury you should be resting but work out anyway you cause pain that leads to harm. The pain of growth is the pain you feel from sore muscles you worked out or the gasping for air after a hard run. The same is true in many scenarios of life. I often tell couples who are dealing with adversity and differences that working it out together affords them the opportunity to grow as a couple. A parent who sticks to their boundaries in parenting and has to listen to their child throw a tantrum is affording that child an opportunity to internalize boundaries and be able to accept no. It all creates growth!
If some of the pain in your life has caused you to consider getting help, I encourage you to act on it. Often our experience of emotional or relational pain ebbs and flows. During those times when things seem ok, we often dismiss that nagging sense that all is not well and we need help. As always, my services are at your disposal to help facilitate growth in your life. If you have ever considered prioritizing your health and fitness and are ready to commit, may I recommend Crossfit Palm Beach. Their friendly staff and highly competent coaches would be happy to assist you on your journey.
Do you ever look at pictures of your kids when they were little and feel a pit in your stomach? Have you noticed an increase in irritability, conflict or general sense of emptiness? This is the state I find myself in at times lately. You see, my kids are 19 and 16. Over the years, I have enjoyed a wonderful relationship with them. Has it been perfect? By no means. We have had our share of challenges to work through, however, the closeness and bond we share is healthy.
In recent years, as with most teens their focus has been redirected from mom and dad to peers, a normal developmental stage in the growth of children. Knowing this does not change the fact there is an emotional impact. My intent in writing this is not to discuss what's normal and healthy in a child's stage of life, but rather to consider the emotional impact and journey that many of us parents need to consider. Our children do not love us any less, but they do find us a bit less interesting. The questions go from "what are we going to do this weekend Dad?" To "can I have the car key's please"? How we handle this new stage of family life and parent-child relationship will determine the degree of potential conflict in your home as well as the inner turmoil you may experience. I want to offer a few suggestions that have been working for me:
Don't take it personal
Your teen is not pulling away to intentionally hurt you or send the message that she no longer loves you. If you find yourself getting angry when he/she chooses an event with friends over time with you it may be an indication that you are personalizing. This choice is normal, just as it was likely for you at their age. Certainly, spending too much time with peers things could become out of balance, however, if this is not the case, remind yourself of the times they are engaged with you and use this to balance out your thoughts and emotions.
You are not alone! At this moment, there are parents with teens in your circle of friends and acquaintances that are going through similar struggles. Reach out to those you trust and respect. Compare notes, encourage each other, share what works and what does not. Oftentimes we are too close to the situation to see things clearly. You may be reacting on emotion rather than principles that should guide your responses. Others, may be able to offer perspective and an objective point of view. Seek out a mentor, many have navigated the waters you are treading and can be a storehouse of wisdom. If needed, connect with a counselor that can walk with you through this stage of life.
Tune into your emotions
Are you aware of what is going on in your inner world of emotions? When you are not in tune with what is going on internally, you run the risk of acting out. Some bite their fingernails, others drink or over eat, some displace their emotional stuff into behaviors like yelling or driving recklessly. Unaddressed emotions that stem from loss and change may result in deep sadness or depression. I sometimes find myself dealing with sadness related to my kids growing up. When I am able to identify and verbalize it is related to the stage in family life and the loss I feel, I feel better. There is something freeing and healing about identifying what is going on and to then be heard, understood and empathized with. When you can better understand your own emotions and deal with them in a healthy way, you stand a chance to not negatively impact those around you.
Keep and eye toward the future
Will it be like this from now on? This is a question that I have been asked and ponder myself. The answer is both yes and no. The relationship between parents and children will change. The natural developmental structure of parent-child relationship is a dynamic relationship that morphs. It does not mean that you will never share closeness again. If you do all you can do to keep the relational doors open, your kids will likely return before long with a renewed desire for relationship.
Given all the the distractions and pressures we face on a daily basis we can easily get caught up in life's endless demands and loose sight of what matters most. Whether you are happily married or are facing difficulties in your marriage, these caring gestures may be just what the Dr ordered.
1. Spend quality time together
Power off your phone, turn off the TV and spend uninterrupted time together, talking, taking a walk or sharing a cup of coffee. I know kids and commitments keep us from doing this on a regular basis but it is important! This includes sex, put it on the calendar if you have to, make time for each other.
2. Listen without interrupting
Everyone wants to be heard..Active listening is a skill most struggle with. Stop what you are doing, turn off your phone, be present and let them tell you about their thoughts or their busy and stressful day.
Don't add in your two cents or tell tham what they should do, just lend a listening ear.
3. Share what is really going on in your life
Sometimes it's hard to open up even with those that are closest to you. It is important to make a point to share what is really going on in your life, your spouse wants to know what you are thinking, your dreams, your fears and doubts. Be vulnerable in sharing your life with one another.
4. Know your partner's Love Language
This is very important. You may mow the lawn, detail the car, sweep out the garage, take out the trash and fold all the laundry but that may not impress your partner if acts of service is not their love language. They may need a hug, a kind word or you to sit with them for a few moments. Often couples have complete opposite love languages. If you don't know what theirs is, ask them. If you have never heard the term "love language" take time together to read through Gary Chapman's Five Love Languages or take the quiz.
5. Express appreciation
We all need reassurance. Nothing keeps us feeling secure in our relationships like hearing all of the ways our partner appreciates us. Frequently affirming how much you care keeps the other person feeling safe. Leave a note on her windshield. Say nice things about him and make sure he hears you. Simply say "I love you"
6. Hugs and Kisses
Not talking about a side hug, a full on hug for 20 seconds. Why 20 seconds? Because that is how long it takes for the cuddle hormone (oxytocin) to kick in which gives you the feeling everything is ok in this relationship.
When was the last time you gave your spouse more then a peck on the cheek as you were dashing out the door? Try a full 6 second kiss, the difference is? Well, you will see.
adapted from Dr Jim Walkup, LMFT