I'm Dreading My Next Therapy Session, What Now

Therapy is a wonderful, vulnerable and sometimes difficult process. 

It can be incredibly rewarding to go through when you commit to the process, but that doesn’t make it an easy thing to do. There is a lot of vulnerability involved in learning to trust your therapist, and building a relationship where you can spend intentional time talking about your fears, things you feel ashamed about, skills you want to work on to improve the relationships most important to you, conflicts you wish you showed up better in, etc. 

It takes a lot of bravery and a lot of patience with yourself. You might say something you’ve never shared with anyone, or bring up something you’re particularly sensitive about, and your therapist might respond in a way that hurts your feelings. 

Sometimes, even if you’re doing great work and you typically leave therapy with a new understanding of yourself (no matter how small), you might start to feel a little dread come up at the thought of going to your next session. 

If that feeling comes up, it’s important to take a step back and get curious about it. Your initial reaction might be to cancel it, but before sending your therapist a text or an email letting them know you “can’t make it” ask yourself a few questions to make sure that’s really what is best for you. 

When did this feeling start?

Was there something that came up between your last appointment and now? Was there something you didn’t handle well and don’t want to talk about? Or, was there something said in your last appointment that made you feel unseen, unheard, or abandoned in some way? While obviously never the intention, therapists are just human and might respond incorrectly once in a while. It can be extremely beneficial for the relationship to address and explore it–and doing so in therapy can give you practice in a safe space for when similar conversations need to take place in your day to day life.  

Where in your body are you feeling this the most?

When your feelings are so strong, it can be hard to figure out exactly what it is you are feeling. But our emotions don’t show up just in our minds, and learning how to connect the body sensations you’re experiencing to your feelings can help you decipher what is happening for you and what you need. For example, maybe you get nauseated when you’re anxious, or feel a certain type of headache when you’re frustrated. If you can identify what it is you’re feeling, you can use your next appointment to explore it–where it’s coming from, how it’s showing up, what you and your therapist can do to prevent or address it in the future, etc. 

 How often does this feeling come up?

Having the occasional feeling of not wanting to go in and do some hard emotional work is not a red flag in itself. Modern life is very busy, and it does take a significant amount of energy to show up in therapy, not to mention the logistical time it eats up. If you’re having a super busy week where it feels like there’s not enough time to get everything done, of course you’re going to wish there was one less thing on your plate. Or maybe you’ve had a couple unexpected expenses, and you’d rather save a little bit of money this week. 

But, if you’re constantly feeling dread before going to your appointment, there could be a deeper issue. You might not feel the safety you need with your therapist to get into the work that would help you the most. Depending on why there’s a lack of safety for you, it’s up to you to decide if it’s best to address the issues with your therapist, or let them know it’s time for you to move on and find a better fit for your care needs. 

If you’re looking for support in the process of finding a therapist, contact us and we can help personally match you to a therapist based on your needs. 

4 Best Practices for Fact Checking #InstaTherapy Content

Mental health is a popular topic on social media. 

And because mental health care can often be inaccessible for a number of reasons (finances, insurance barriers, location, family/community culture, etc.) that can be a great thing–talking about mental health openly can help to destigmatize the need for care, and to normalize the idea that we all have things to work on. 

But there are a few dangers to relying on social media exclusively for mental health care:

1. You don’t get the full therapy experience, which needs a relationship in which to provide space for healing

2. There’s no factual requirement for posting on social media–meaning the mental health information you’re getting, might not be accurate. 

That doesn’t mean there’s no good information out there on social media–Hope+Wellness is on Instagram where we share bite sized posts from topics we’ve covered on the blog, and we follow plenty of other mental health professionals on that platform who are doing great work! It just means you need to have a bit of care when taking in content related to mental health. 

So what can you do to vet how reliable a mental health resource is on social media?

First ask: Who is the source of this information? 

What are their qualifications? Are they a licensed provider? Are they actively practicing? Is their license bound to any sort of ethics board?

Qualified resources will have their credentials listed publicly. Their qualifications/license type should be either: 

1. Listed in their account bio 

2. Stated clearly on the website linked in their account bio

If you can’t find credentials listed in their account bio, click over to their website to check the home and about pages. Credentials should be easy to find and where you expect them to be–if they are hidden away somewhere that you have to dig for, that’s a warning sign. 

Next: Is what they’re sharing within their scope of practice?

What sort of mental health professional are they? What is their area of expertise and scope of practice? Is the information they are sharing within that scope–or is it unrelated to what they are professionally qualified for? 

For example, mental health professionals shouldn’t be giving the advice of a primary care doctor and vice versa. 

Qualified mental health care professionals should also be making it clear on their profiles that their online presence is intended as therapeutic education, not a replacement for the treatment they offer or a method of seeking diagnosis.  

Check the comments:

While this isn’t always helpful, it’s good to do a quick glance through comments of popular mental health content on social media. If others in the industry are disputing the information in the comments, that’s a good sign to proceed with caution; look up what’s being shared and read more information on it from reputable sources. 

Check in: do they get specific about clients?

Talking about common concerns from the general clients or population they see is one thing–that can be helpful in destigmatizing care or addressing misconceptions, etc. But no mental health professional should be describing their client cases or bragging about their client successes as a way to prove their legitimacy. 

If you’re questioning how specific they are, consider if the person they were talking about found the content; would they be able to identify themselves as the subject of the content? If so–it’s too specific, and actually a HIPAA violation. That’s a big red warning sign that they aren’t considering how their ethical practices need to be translated to social media! 

Keep these best practices in mind when engaging with mental health content on social media: 

• Be selective with who you follow: take your time to check their credentials and make sure they’re creating content within the scope of their practice

• Consider each post on it’s own–don’t just assume something is factual because it’s from a source you followed 

• Use information shared as a jumping off point; go further with resources they provide or begin to look into the topic from other reputable and reliable sources 

• Bring up anything you’re unsure about with your therapist! 

If you’re looking for support in the process of finding a therapist, contact us and we can help personally match you to a therapist based on your needs. 

What Do I Need to Know Before my First Therapy Session?

First: take a second to feel proud of yourself.

Starting therapy is a big step. While therapy has been more normalized and less taboo to talk about socially in recent years, it’s still a difficult step to take for yourself. It requires a lot of vulnerability and self compassion–and hope! Taking the step is incredibly brave, and if you haven’t heard it somewhere else, let us be the first to say, we’re proud of you. 

Starting something new–especially something like therapy, which asks us to be present and raw and honest–often brings up some anxiety. If you’re feeling nervous or apprehensive before your first session, know that that’s completely common and nothing to be ashamed of. And if you’re willing to bring it up, it’s something you can tell your therapist in your first session so they can more specifically address what you’re concerned about! 

To help cover some more general concerns, here are our tips on how to prepare for your first therapy session:

Check your therapists website:

It’s common for therapists to have a page on their website that covers what goes into getting started with them. It’s possible any questions you have about the process have already been answered there! Ours includes a frequently asked questions section, but some practices have this as a separate page. While it’s not necessarily required, you could also review the modality your therapist will be utilizing so you can familiarize yourself with what it means and what that looks like in practice. 

Review contact from your therapist: 

How did you make your appointment? Did you get a confirmation email or a message from your therapist with any info on what to bring to the first session? For example, at our practice, once patients are scheduled they get an email with our welcome packet to complete in our online patient portal–this includes any paperwork we need from patients we need to get started with care. Be sure to check if you need to have paperwork completed before your first appointment! 

Prepare for some housekeeping: 

Starting therapy isn’t jumping into the treatment right away. First, you need to meet with your new therapist and go over what brings you in, what could impact your care, what steps your therapist thinks are right for you, etc. In these consultation sessions, your therapist will get some background information on you as a client and go over potential goals for your therapeutic treatment. This time is important for both you and your therapist to assess your fit together!

Ask yourself what you need to feel safe being vulnerable: 

Just as your therapist will be assessing the fit of their practice for your needs, as you begin your work together it’s up to you to decide how you’re feeling about the fit as well. Do you feel comfortable being honest with this person? How does your body react to being with them? If you’re tense or anxious or nervous in your body, is it a discomfort that you can sit with and overcome, or is it more severe, trying to tell you something doesn’t feel safe for you? If it’s discomfort you can sit with, take some time to think about what it is that is causing the discomfort. Are these things you can address with your new therapist? They may be able to help you overcome what might block you from being honest in that space. 

While you can always bring things up throughout your relationship, making intentional space with your therapist to go over what you need to feel safe trusting them with your vulnerability can help lay a strong foundation for the therapeutic relationship right from the beginning. 

If you’re looking for support in the process of finding a therapist, contact us and we can help personally match you to a therapist based on your needs. 

Healing through Relationships: Why the Therapeutic Relationship Matters

There’s a lot of mental health advice on the internet right now. 

Take this blog for example! Our blog is full of resources, thought exercises and tips meant to help support you in your journey to better mental health. But are the blogs themselves therapy? Are the social media posts describing different mindfulness exercises to try for your anxiety the same thing as therapy?

Short answer: nope!

Long answer: therapy is so much more than the tools you learn. Therapy is comprehensive mental health care, where the relationship between therapist and client is a crucial component to the treatment and healing process.

While there are lots of differences between the tools a therapist or therapy practice may provide online and the actual mental health services they offer, the part we’re going to focus on today is a part that is often overlooked: how the therapeutic relationship itself is crucial to healing. 

That’s part of why you can’t get the same experience reading a therapists blog as you would seeing that therapist in person–while they can provide you helpful tools to practice on your own, you’re missing the practice of showing up in relation to someone and writing new social scripts based on how they’re able to hold space for you. 

Okay….what does that all mean?

Let’s go back to our example from a few weeks ago about talking to your therapist about when they’ve hurt your feelings. 

The social script you’re working from might make telling someone they’ve hurt your feelings a scary, anxiety provoking conversation. Maybe you were yelled at as a child when you got upset or expressed your feelings. Maybe you’ve never been in a relationship where someone apologized after hurting your feelings. Or maybe you’ve never been in a relationship where you were safe to express that your feelings were hurt at all. 

In therapy, you get to practice showing up and telling someone they hurt your feelings.

While it’s not quite practice practice–you’re still communicating your real feelings and it was based out of a real situation, not just a theoretical scenario–you’re still given the assurance that you’re in a safe space where you won’t be punished for expressing how you’re feeling. That makes it an easier stepping stone to use to practice expressing those feelings because you have that safety net of knowing therapy is the space where you’re supposed to come in and discuss your feelings. 

This sort of relational healing is a crucial component to good therapy–and it doesn’t just come up in the moments where you need to manage conflict with your therapist!

You’re also engaging in relational healing in therapy when: 

• You express something you feel shame about and instead of responding with anger, repulsion, or what you fear they will respond with, your therapist responds with curiosity and compassion

• You come to therapy frustrated with how something is going, and you find support in collaborating with your therapist to figure out what to do next, rather than managing it all on your own 

These are two other simple and common examples of how the relationship between therapist and client is an essential part of the therapeutic process! That’s also why it’s so important to be sure you have a safe and trustworthy relationship with your therapist.

If you’re looking for support in the process of finding a therapist, contact us and we can help personally match you to a therapist based on your needs. 

3 Tips for Telling Your Therapist They Upset You

Telling someone that they’ve done something to hurt your feelings is never easy. 

It’s vulnerable–you’re exposing yourself as someone who isn’t infallible. It’s opening yourself up to the risk that the person you’re trying to communicate with will misunderstand you. And while sometimes this sort of communication is exactly what we’re working on in therapy, it can still happen that your therapist says something to upset you in session. 

Maybe they poke at an old wound, maybe they misunderstand something difficult you’re struggling to communicate, maybe they’re reactivating old dynamics that hurt you in the past. No matter how it comes about, it’s possible–and in fact normal–that at some point, your therapist will say something that upsets you, rubs you the wrong way, or just generally hurts your feelings.

But, isn’t therapy supposed to be a safe space?

Yes! But your idea of a safe space might be different than what that safe space actually needs to be. Feeling safe and being safe–while both important!–are two different things. Things that make us feel safe might not actually be things that keep us safe in every context. If you grew up in a dysfunctional home, avoiding conflict may have literally kept you safe. Now however, in a different context, that avoidance can create more problems and be a hindrance to your emotional safety. 

A safe space isn’t a space where you will never face discomfort or conflict, it is a place that provides safety to you while you navigate those things. 

In that way, going through the experience of telling your therapist that they’ve hurt your feelings can be an extremely valuable tool in the healing process. Part of how therapy works is through relational healing–your therapist is someone who is there to hear you without judgment, who won’t be mad at you for expressing something unpleasant, and who will demonstrate healthy ways to navigate those moments with you, so you have a model for how it looks outside of therapy. 

Basically, therapy helps us to heal wounds we’ve gotten in other relationships by giving us a relationship where conflict is managed safely. 

So when you tell your therapist that something they’ve done has hurt your feelings, you’re giving yourself an opportunity to write a new script about what happens when you do that. When before it may have gotten you yelled at or berated, your therapist is there to listen to what you’re saying to them, to hear what you’re trying to communicate. When you do this more and more, you’re learning that conflict doesn’t just mean danger–it can also mean an opportunity for deeper understanding, stronger communication, and an emotionally safe relationship. 

That doesn’t mean it’s easy to do! We know it’s hard. If you’re trying to figure out how to let your therapist know they’ve said something that upset you, here are three tips: 

Acknowledge the difficulty of the situation: 

Starting the conversation is hard. But in therapy, you’re in a very unique position where the person you’re talking to you knows a lot about your emotional world, the history you have, and the general bravery it takes to be vulnerable in this way. It’s okay to start with “I’m struggling a lot with how to say this,” or “I’m nervous about bringing this up.” That’s actually helpful information for your therapist to have–they can help address the root of those fears as well as the specific issue you’re hoping to talk about. 

Tell them what you’re worried about: 

Are you worried they’ll be mad at you? That you’ll get kicked out of their office? That they’ll yell at you? Tell you your feelings don’t matter? There are so many reasons we avoid conflict, and they’re often informed by how we’ve experienced conflict in the past. It’s okay to call those fears out, right away. No matter how outlandish that fear may seem in comparison to the conflict, your therapist is there to hold space for those feelings, not judge them. And sometimes, just voicing what you’re afraid of lessens the feeling of fear!

Focus on the feelings it brought up in you: 

When someone says something that hurts our feelings, it’s often about something we’re a little sensitive about anyway. When your therapist says something that hurts your feelings, before you bring it up in session, reflect on what feelings that hurt brought up in you. Did it bring you back to a moment where you’d been hurt before? It’s okay if they seem totally unrelated–brains are funny little things and sometimes they latch onto moments that don’t make any sense to us. If you can let your therapist know not just what hurt your feelings, but how you experienced those hurt feelings, they can help address both the moment in your own relationship, and the history it brought up. 

Do you struggle to communicate when someone has hurt your feelings? We can help support you. Reach out today to get in touch with one of our clinicians! 

How to Make the Most of Your Time Between Sessions

Therapy can be a powerfully transformative process and an integral part of our support system, but going to therapy isn’t where the work starts and ends. In session, you’re able to do deep emotional work and get tools to help support you while you’re out of session, but that out of session work is just as important as what you do while you’re there with your therapist! 

It’s in that time outside of your usual session that you get to see how you’re able to apply the tools you’re developing with your therapist, how well you’re able to navigate obstacles, and how your progress looks out in your daily life! 

So how can you make the most out of the time between your therapy sessions?

Well first, remember it will be different for everyone. What helps you and your healing might not help someone else. And, what helps you one day may not be helpful the next. It’s important to not just get in a routine so you’re checking things off of your “mental health to do” list, but actually engage with how you’re feeling after your session and during the time between in order to do the most impactful work! 

For example,  some sessions may be helping you connect patterns to better understand your behavior or work to prepare for big changes in your life.  After those types of sessions, you might be ready to take some risks and push your boundaries. That can be a good way to take intentional steps forward with your progress! Other sessions may be heavier than, they may feel like you slow way down and dive deep into just one thing. After those sessions, taking big steps would probably be taking on too much too soon. You need time for reflection and emotional processing, too, so there are other things you can do between those types of sessions. 

Here are a few ideas of what you can do to make the most of your time between therapy sessions: 

Journal + Reflect: 

What did you talk about in the session? How did you feel while you were talking about it? Were you uncomfortable? Did you hold anything back? Write about all of these things, write about what you chose not to talk about and why, what your therapist helped you understand, what you wish you had time to talk about, how you think you’ll see your newfound insights show up throughout the week, etc. This can be a good practice to do just after the session so you can reflect, and then keep notes on things you notice throughout the week to bring back to your next session. 

Take one small risk: 

Or take one action that supports what you and your therapist were talking about in session. Is there a conversation you’ve been dreading? Can you initiate it? Is there something new you’ve wanted to try but haven’t? Think about what’s been coming up over and over in session, and see if you can come up with a small action to support it. 

Be proud of yourself: 

Keep a running list of things you notice between sessions that you handle well, that you’re proud of yourself for, etc. What came up this week that showed you how far you’ve come? When did you wish you had more support? 

Let yourself be present: 

While self reflection is good, and doing it between sessions is important so you can continue to see the work you’ve done in therapy show up in your day to day life, you don’t want to get so caught up in your own head that you’re unable to be present. Too much self-analyzing isn’t helpful! It’s also important to just let yourself be present in your life. While your healing is important, part of that is allowing you to exist without doing any work to “earn” it. Let yourself enjoy your day and see a friend without putting every action under a microscope. 

Are you looking for more ways to support yourself both in and out of session? Working with us can help you learn more about yourself and your patterns so you can make changes if you want to. Get in touch with our office today to get started. 

5 Things to Know if Your Teen is Dealing with Depression

It can be scary and overwhelming to learn that your teen is depressed. You want to support your child, but don’t quite know how. You watch them struggle to get up in the morning in order to make it on time to school. They aren’t getting much sleep and don’t seem to find much enjoyment in things anymore. You worry about their grades and how this will impact college admissions. Nothing you’ve tried seems to help. When they were younger, you were able to swoop in and help. But now that they are older, they don’t seem interested in it.

One of the first things to know is that you’re not alone. Many other parents are worried and experiencing similar struggles with their teen. The second thing to know is that depression is treatable and there are things that parents can do to best support their child. Below are 5 ways to help if your teen is dealing with depression.

1. Be Supportive

Listen to your teen. Let them know you are there for them to listen and support them. Try to understand things from their perspective. Empathize and try to validate their feelings without supporting any unhealthy behavior. For example, you could say, “it sounds like you’ve been feeling really low, and I know it must be difficult to get through each day. How can I support you?”

It may feel challenging to support your teen when you feel frustrated and afraid for the way their depression has been affecting them. However, your support is invaluable. Try not to be judgmental or critical, but to remain calm and compassionate.

2. Avoid Trying to Control or Fix Their Problems for Them

It may feel passive to listen and support. As a parent, you can see what they need to do and all you may want to do is problem solve and resolve their issues for them. It is natural to feel this way. However, increasing your control over their behavior and problem solving for them can come across as judgmental, controlling, or invalidating. Your teen will need to learn how to manage their feelings and problem solve on their own. Your guidance, relationship, and support are essential during this time.

3. Encourage Positive Behaviors and Coping

Depression can result from a lack of positive experience in the environment. With the pressures of high school and college admissions, this can particularly be the case. Try to notice when your teen is engaging in healthy, positive behaviors such as spending time with friends, or going on a walk to relax and unwind. Spend quality time with them and encourage them to engage in activities that will improve their activity and functioning, such as taking a run, walking the dog, spending time with friends, engaging in a hobby. Encourage these opportunities without criticism or judgment. It’s understandable that your teen may be doing less of these activities, as that is a sign of depression. Gently let them know you understand, validating their feelings, while encouraging them to continue engaging in life’s activities.

4. Learn about depression

Try to learn more about the signs and symptoms of depression. Speak with other parents and connect with resources available to you. This can help with understanding how best to support your teen, particularly if you have not experienced depression yourself. Some helpful resources include:

Child Mind Institute - Childhood and Teen Depression

Parent’s Guide to Teen Depression

Mayo Clinic - Teen Depression

5. Get Your Teen Treatment

Therapy can be a great source of support and treatment for depression. In therapy, your teen will have a safe place where they can work through their feelings and learn skills that have been found helpful and effective in managing depression. Many studies in particular, have found cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) for the treatment of depression.

Your teen may or may not be interested in therapy. This is normal. Try to involve them in your search for a therapist. Have them look through websites and meet with different therapists to get a sense of fit and connection. While the therapist will meet with teens for one on one sessions, its also important you feel comfortable with the therapist and will be able have time meeting one on one with the therapist as a parent for guidance on how best to support your child.

Overall, it can be overwhelming when your teen begins to experience symptoms of depression, but know that much can be done to help support them.

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therapist in mclean, tysons corner, merrifield, falls church, arlington and vienna

Victoria Chialy Smith, PhD is a licensed clinical psychologist serving the Falls Church, McLean, Great Falls, Vienna, Arlington, Alexandria, and the greater Washington DC region. She provides individual therapy to children, teens, and adults with stress, anxiety, and depression. Our practice provides Cognitive Behavioral Therapy (CBT), mindfulness and acceptance based therapies, and other top, premier evidence-based treatments. Call, email, or schedule an appointment with us online today. We’re happy to help!

15 Quotes That Describe What Depression Feels Like

People who are depressed often feel sad, experience changes in appetite and sleeping, and as if they are dragging themselves through a heavy quicksand. Things which used to hold enjoyment are no longer pleasurable, and life becomes empty and devoid of meaning. One of the most difficult symptoms of depression is also the loneliness that one experiences. When feeling depressed, it can often feel as if no one in the world can possibly understand what you are going through, as if there is no way out.

But the truth is that there are people out there who do understand, who have experienced depression, who have made it through the darkness, and survived. Below are 15 quotes describing what depression feels like.

1. “I can't eat and I can't sleep. I'm not doing well in terms of being a functional human, you know?”

   ― Ned Vizzini, It's Kind of a Funny Story

2. “I don't want to see anyone. I lie in the bedroom with the curtains drawn and nothingness washing over me like a sluggish wave. Whatever is happening to me is my own fault. I have done something wrong, something so huge I can't even see it, something that's drowning me. I am inadequate and stupid, without worth. I might as well be dead.” 

   ― Margaret Atwood, Cat's Eye

3. “Its so hard to talk when you want to kill yourself. That's above and beyond everything else, and it's not a mental complaint-it's a physical thing, like it's physically hard to open your mouth and make the words come out. They don't come out smooth and in conjunction with your brain the way normal people's words do; they come out in chunks as if from a crushed-ice dispenser; you stumble on them as they gather behind your lower lip. So you just keep quiet.”

   ― Ned Vizzini, It's Kind of a Funny Story

4. “because wherever I sat—on the deck of a ship or at a street café in Paris or Bangkok—I would be sitting under the same glass bell jar, stewing in my own sour air.”

   ― Sylvia Plath, The Bell Jar

5. “I don't want any more of this try, try again stuff. I just want out. I’ve had it. I am so tired. I am twenty and I am already exhausted.”

   ― Elizabeth Wurtzel, Prozac Nation

6. “When you're lost in those woods, it sometimes takes you a while to realize that you are lost. For the longest time, you can convince yourself that you've just wandered off the path, that you'll find your way back to the trailhead any moment now. Then night falls again and again, and you still have no idea where you are, and it's time to admit that you have bewildered yourself so far off the path that you don't even know from which direction the sun rises anymore.”

   ― Elizabeth Gilbert

7. “Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough. You're frightened, and you're frightening, and you're "not at all like yourself but will be soon," but you know you won't.”

   ― Kay Redfield Jamison, An Unquiet Mind: A Memoir of Moods and Madness

8. “The sun stopped shining for me is all. The whole story is: I am sad. I am sad all the time and the sadness is so heavy that I can't get away from it. Not ever.”

   ― Nina LaCour, Hold Still

9. “And I felt like my heart had been so thoroughly and irreparably broken that there could be no real joy again, that at best there might eventually be a little contentment. Everyone wanted me to get help and rejoin life, pick up the pieces and move on, and I tried to, I wanted to, but I just had to lie in the mud with my arms wrapped around myself, eyes closed, grieving, until I didn’t have to anymore.”

   ― Anne Lamott, Operating Instructions: A Journal of My Son's First Year

10. “Depression is the most unpleasant thing I have ever experienced. . . . It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it's a healthy feeling. It is a necessary thing to feel. Depression is very different.”

    ― J.K. Rowling

11. “It seemed silly to wash one day when I would only have to wash again the next.

    It made me tired just to think of it.”

    ― Sylvia Plath, The Bell Jar

12. “I saw the world in black and white instead of the vibrant colours and shades I knew existed.”

    ― Katie McGarry, Pushing the Limits

13. “Depression presents itself as a realism regarding the rottenness of the world in general and the rottenness of your life in particular. But the realism is merely a mask for depression's actual essence, which is an overwhelming estrangement from humanity. The more persuaded you are of your unique access to the rottenness, the more afraid you become of engaging with the world; and the less you engage with the world, the more perfidiously happy-faced the rest of humanity seems for continuing to engage with it.”

    ― Jonathan Franzen, How to Be Alone

14. “If you are chronically down, it is a lifelong fight to keep from sinking ”

    ― Elizabeth Wurtzel, Prozac Nation

15. "Sleep just isn't sleep anymore, it's an escape."

    — Unknown

Depression Treatment and management

If you are feeling this way, it’s time to get help. Either medication or psychotherapy alone can bring relief from depression symptoms. However, the combination of both medication and psychotherapy has been found to be particularly effective, with significant rates of improvement.

Cognitive Behavioral Therapy (CBT) is an evidence-based treatment that has been found to be effective for depression as well as to prevent its future relapse. Research supports it use with individuals of all ages, including children, teens, and adults. CBT focuses on targeting unhelpful thoughts, beliefs, and attitudes, to promote positive behaviors and emotions. It is a problem focused, and goal oriented form of therapy, in which you are supported in developing effective strategies to decrease symptoms and to address identified goals.

CBT in McLean, Falls Church, Arlington and Vienna

Victoria Chialy Smith, PhD is a licensed clinical psychologist providing individual therapy to children, teens, and adults. Our practice provides Cognitive Behavioral Therapy (CBT), mindfulness based therapies, and other premier evidence-based treatments, and serves the Falls Church, McLean, Great Falls, Vienna, Arlington, Alexandria, and the greater Washington DC region. Call, email, or schedule an appointment with us online today. We’re happy to help!

How to Find the Right Psychologist for You

How does one find a psychologist? Not only an effective one, but one who truly cares and connects with you?

I recently wrestled with this question as I helped a family member find a psychologist for their care. Although I myself am a clinical psychologist, the experience on this other end of things was rather eye opening. I was surprised to learn that many psychologists in private practice can and do accept insurance and that they were sometimes of a similar quality of the ones who charged more. In other words, price charged did not necessarily predict quality, and the effectiveness of the practicing psychologist seemed to be based on the particular individual.

I was also surprised to discover how difficult to find a provider who cared — and how much it meant to finally find one who truly did and what a difference it made in our lives.

With that, I’ve decided to write a guide based on my professional and personal experiences as a clinical psychologist as to how to find the right psychologist for you.

1. Develop an Understanding of What You are Looking For

At the start of your search, it can help to reflect on the particular issues you are currently struggling with. This can inform the type of psychologist you are looking for, including what treatments they may specialize in.

For example, if you are struggling with feelings of sadness or hopelessness, try looking for a psychologist with clinical interest or specialization in working with patients struggling with similar symptoms, such as depression.

Once you understand what your needs are, it can help to develop an understanding of psychological treatment options and the current evidence-base underlying them. It can be tough to understand what’s out there, but fortunately, there are websites that psychologists committed to high quality treatments have developed, to help consumers understand their options.

For example, the Society of Clinical Psychology, has developed this helpful resource on Effective Treatments for Psychological Conditions describing research evidence for psychological treatments. If you click on ‘Browse Diagnoses’, and then ‘Depression’, you’ll see that Cognitive Behavioral Therapy is one of the leading treatments for depression.

If you are looking for a psychologist for your child, find a psychologist with focused training and expertise in working with children. Clinical Child Psychologists often have years of specialized experience in working with children, parents, and the family system.

This information on treatment approaches can help inform your search for a therapist, as you would now understand that you are looking for a clinician who specializes in CBT for Depression, or a child psychologist who specializes in these domains.

Here, it’s important to note that this information isn’t the only factor involved in finding a clinician — instead, it’s just one initial piece of the puzzle.

2. Consider What Your Preferences Are

Would you prefer working with a male or female psychologist?

Are you open to cash only practices or do you prefer to go to providers who accept your insurance?

How far are you willing to drive to see your therapist?

What setting do you prefer? A community clinic, hospital, or independent practice?

These factors all inform your search and will help you identify potential clinicians to work with.

If cost is an issue, are you willing to seek care from predoctoral clinicians currently in training? These predoctoral clinicians are often supervised by the clinicians with years of experience, a passion for mental health care, and a commitment to their work and training the next generation of psychologists. In addition, it is also a source of highly affordable psychological testing and evaluation services.

Some local training clinics in the Washington DC metropolitan area include:

• The University of Maryland Psychology Clinic in College Park, MD

• The University of Maryland, Baltimore County Psychology Training Clinic in Baltimore, MD

• George Mason University Center for Psychological Services in Fairfax, VA

• American University Psychotherapy Training Clinic in Washington, DC

3. Begin Developing a List of Potential Licensed Clinicians. Ask around.

Do you have any health care providers that you currently respect and enjoy seeing, whose care seems comprehensive and genuine? If so, ask them if there are any psychologists they would recommend. Often times, providers in the same community know of other providers who are well known for their clinical skill and effectiveness.

You can also ask family members and friends for any potential referrals. This is a great method as you can get their firsthand experience and perspective, which can be invaluable in your search.

4. Search Online for Clinicians in Your Community

There are a number of websites online where you can search through listings of psychologists in your area and region. Using your understanding of your goals for therapy (e.g., current symptoms, available evidence-based treatments), and preferences (e.g., payment, child vs adult specialization, distance from your home), you can search through the following websites.

There are so many therapists that it can be overwhelming to look through directories. But as you look through, try looking at their personal statements to see if you connect with it, or to look at their education, training, and work experiences, as these would deeply inform their therapeutic approach and style.

Below, I have listed national websites of providers, as well as ones specific to the Northern Virginia region.

• Psychology Today’s Find a Therapist

• Association for Behavioral and Cognitive Therapies: Find a CBT Therapist Directory

• Anxiety and Depression Association of America: Find a Therapist

• American Psychological Association Psychologist Locator

• National Register’s Find a Psychologist

• GoodTherapy.org Find a Therapist

It’s important to note that these directories often do not lists psychologists who work in hospitals and who see patients on an outpatient psychology basis. The care at these centers is often covered by insurance, and can be highly evidence-based and state-of-the-art, with specialty clinics. Many of these clinicians are highly dedicated to their work and to their patients, training top psychologists around the country. Check out the below links if you are interested in pursuing care through this route.

• Children’s National Health System Psychiatry and Behavioral Sciences

• Kennedy Krieger Institute Behavioral Psychology Outpatient Programs

• Johns Hopkins Psychiatry Outpatient Clinics

• Johns Hopkins Mood Disorders Clinic

• Georgetown University Hospital Women’s Mental Health Clinic

If you are interested in using your insurance to pay for therapy, you can search through insurance databases and cross reference with information from the directories listed above.

5. Contact Potential Therapists

Finding a psychologist to work with takes time. Compatibility is important and provides the foundation for therapy, so it is natural to spend time speaking and meeting with different therapists.

Sometimes you can call a therapist and get a sense of how you might like working with them on the phone. During this time, you can ask them if they use evidence-based therapies, and what their policies for fees and scheduling are, and if they are accepting new patients.

6. Meet Your Therapist

If you enjoyed speaking with a psychologist over the phone, schedule a time to meet with them. Often the first session is a time when you both are getting to know each other. The psychologist will likely ask you questions to get a better understanding of what brings you to therapy. Based on their assessment, they will be able to determine whether they can help you or not, and help you develop goals for therapy together.

Above all, finding a therapist is a highly personal process. Finding a match is dependent on so many factors, including style, personality, values, preferences. This is also where the magic and art of therapy come in. Because at the end of the day, therapy is so much more than a manual, a given approach, or educational background. It’s a relationship. It’s an alliance. It’s a partnership. One that can make all the difference in helping to support you or your child through challenges and difficult times to hope again.

So good luck on your search! If you have any additional thoughts or ideas on helpful ways to find the right psychologist, please comment below. I’d love to hear from you!

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cognitive behavioral therapy (cbt) in mclean, falls church, arlington, and vienna

Victoria Chialy Smith, PhD is a licensed clinical psychologist providing individual therapy to children, teens, and adults. Our practice provides Cognitive Behavioral Therapy (CBT), mindfulness based therapies, and other premier evidence-based treatments, and serves the Falls Church, McLean, Great Falls, Vienna, Arlington, Alexandria, and the greater Washington DC region. Call, email, or schedule an appointment with us online today. We’re happy to help!