Group Therapy: What Therapists Want You to Know

Have you ever considered group therapy?

Many people have an idea of group therapy as something that is awkward or ineffective, but many people actually find it to be a helpful source of support. Group therapy can be effective on its own as well as in conjunction with individual therapy. 

When you think of therapy, you might automatically imagine sitting in a room, one-on-one with a therapist, but that’s not the only style of therapy that can be helpful. Like individual therapy, group therapy is a powerful tool for personal growth and healing, and it has many benefits to consider. 

What is group therapy?

Group therapy is what it sounds like - a small group of people, usually facing similar challenges or circumstances, who meet regularly with a therapist to share experiences, offer support, and practice new coping strategies together.

Unlike one-on-one therapy, where the focus is solely on you and your personal struggles, group therapy provides you an opportunity to connect with others, hear new perspectives, and realize that you’re not alone in what you’re experiencing. While it may feel unfamiliar at first, the support, community, shared understanding, validation, and insights you gain from a group setting can be deeply healing and transformative.

What are the benefits of group therapy? 

Group therapy can be a gathering of people talking about their problems, but it’s also more than that. It’s a structured, therapist-facilitated space designed to help you heal, grow, and learn. 

These are some of the benefits of choosing group therapy:

Guidance from a professional

Therapy groups are typically led by a licensed therapist who ensures a safe, respectful, and supportive environment. Group therapy facilitators provide psychoeducation about the challenges that members are experiencing, and teach coping skills that can help members navigate those challenges more effectively. Whether it’s strategies to manage distress, tools for improving communication, or insights into emotional regulation, group members receive expert guidance throughout the process.

Connection and validation

One of the most powerful aspects of group therapy is the realization that you are not alone. When you’re struggling with your mental health or a challenging situation, it’s easy to feel isolated and even hopeless. In a group setting, you’ll meet others who have faced similar challenges and can relate to your experiences. You’ll hear stories of things that helped them, and things that didn’t. You may even find your sense of hope restored as you hear from people who have gone through what you’re going through. It’s incredibly reassuring and uplifting to receive support and validation from people who have been where you are. In addition, the connections you build in a group can help you feel more confident in connecting with others in the future. 

Lowering shame and stigma

While it’s becoming less taboo to discuss mental health struggles, many people still feel a sense of shame for what they’re going through. Group therapy helps normalize mental health challenges, which can help lower the sense of shame you feel. When you see others openly discussing their struggles, it becomes easier to acknowledge your own without judgment.

It’s often more affordable 

One great thing about group therapy is that it’s often more affordable than individual therapy while allowing you to access professional mental health support. For those who may not be able to afford weekly one-on-one therapy sessions, group therapy can be a more financially accessible way to receive guidance and support.

Offers new perspectives

Members of therapy groups gain insight, not only from the therapist, but also from each other. You will hear perspectives that you may not have considered before, and you’ll get to hear how others have navigated challenges similar to yours. Learning how others have approached similar situations can be eye-opening and inspiring. 

Builds confidence

Learning how to talk confidently in a group of people is a great skill that will help you outside of the therapy group. In addition, group therapy can help you improve your social skills in a safe, non-judgmental setting, so you can feel more confident interacting with others outside of therapy. 

Provides accountability and motivation 

It can be very helpful to find a source of accountability and motivation when you’re trying to heal and grow. Having a group of people who are rooting for you and who can help you stay on track with your goals can make a huge difference, especially in how you feel. Some people find it motivating to have updates to share with the group.

What happens in a group therapy session? 

We often hear about people who are hesitant to join a therapy group because they don’t know what to expect. While every group is slightly different, most follow a structured format designed to create a safe and productive environment for all members, no matter what the focus of the group is. Most group therapy sessions consist of some combination of the following:

• Introductions and Check-Ins: Sessions often begin with introductions, as well as a check-in where members can share how they feel or provide updates since the last session.

• Discussion Topics and Exercises: The therapist may introduce a specific topic, such as coping with stress, setting boundaries, or improving self-esteem, and guide the group through discussions or exercises. 

• Sharing and Reflection: Group members will have the opportunity to share experiences, thoughts, and feelings (though if you’re not comfortable sharing, you’re never forced to). 

• Closing and Takeaways: The session may end with reflections, takeaways, or goal-setting for the week ahead.

Common misconceptions about group therapy

These are some of the most common misconceptions that we hear as therapists about group therapy (and why they shouldn’t stop you from trying group therapy):

It Will Be Awkward

Yes, the first group you attend might feel a little awkward, but that can be true of any new experience! Group therapy facilitators are trained to create a welcoming and supportive environment, and many people quickly find that their initial discomfort fades as they get to know the group and become familiar with how the process works. 

I Have to Talk to Benefit

While sharing during group therapy can be beneficial, it’s not a requirement, and you can benefit even if you don’t share. It’s pretty common for new members to listen in the beginning and gradually become more comfortable contributing. Even if you don’t speak much, you can still learn a great deal from hearing others’ experiences and the therapist’s guidance.

It Won’t Be Confidential

Confidentiality is a cornerstone of all therapy, especially group therapy. Just like individual therapy, group members are expected to respect each other’s privacy and maintain confidentiality about what is shared in sessions. Facilitators set clear guidelines to ensure a safe and secure space, and if you have any questions or concerns, it’s okay to bring them up. 

People Will Judge Me

It’s very natural to worry about being judged, especially when you're struggling with something as personal as your mental health. Remember that most people in group therapy are experiencing similar challenges and are there to heal and not to judge. In fact, you may find that the therapy group is one of the most understanding and accepting spaces you’ve ever been in, because everyone can relate to one another. 

Remember—healing doesn’t have to happen alone. In group therapy, you can find connection, support, and the reassurance that you are not alone on your journey. If you’re interested in joining a group therapy session, we offer two therapy groups, a Young Adult Process Group and Empowerment Process Group for Women in Their 30s. Contact us to learn more!

I Want to Start Therapy: What Do I Need to Know?

I’m thinking of starting therapy, what do I need to know?

Starting therapy can be overwhelming. If it’s been something in the back of your mind for a while, you might feel yourself stalling, rather than getting a jump on the process, simply because there’s no clear path to know when or how to get started with therapy. 

How do you know it will be helpful? How do you find a therapist that’s right for you? What should you prepare for, in your first session? How much of therapy takes place in therapy, and how much work will you have to do outside of your one on one time?

These are common questions, and we want to help you feel informed and prepared. Below are five blogs you may find helpful as you embark on this new journey: 

• Finding a Psychologist: What to Consider

• 9 Commonly Asked Questions About The Therapeutic Process

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

• Healing through Relationships: Why the Therapeutic Relationship Matters

• How to Make the Most of Your Time Between Sessions

What types of therapy exist?

Therapy is not one size fits all. There are many different modalities and approaches your therapist may specialize in, and the speciality or approach you need may depend on your specific circumstances. At Hope+Wellness we have many different therapists with many different specialities, some of which you can find an introduction to below: 

• What is Spiritually Integrated Therapy?

• What You Should Know About Internal Family Systems (IFS) Therapy

• Cognitive Behavioral Therapy: 5 Things You Should Know About It

• What You Should Know About EMDR

• What You Should Know About Exposure and Response Prevention (ERP)

How can therapy support me?

Therapy can offer a wide array of support–whether it be navigating a current crisis, exploring your identity, working on your communication skills, strengthening your relationships, therapy can offer the space and tools you need. While it’s definitely not an inclusive list, below are five ways therapy can help support you:

• How Can Therapy Help Me Navigate Big Life Changes?

• How Therapy Can Help Entrepreneurs Thrive Instead of Survive

• How Can My Therapist Help with My Chronic Pain?

• IMPROVE the Moment: Coping with Distress with DBT

• Who Can Benefit from Inner Child Work?

How can I navigate difficult moments in therapy?

While therapy can be transformational and validating, it’s not always easy. It can even be difficult to address things with your therapist sometimes! If your therapist says something that hurts your feelings, or you find yourself dreading going to therapy, it’s not always a sign that things aren’t working for you–it may be a sign that some uncomfortable conversations need to be had. These blogs can help you prepare to navigate those situations, and recognize when they’re a sign of a larger problem: 

• I'm Dreading My Next Therapy Session, What Now

• 3 Tips for Telling Your Therapist They Upset You

Are you interested in therapy? Our clinicians at Hope+Wellness offer therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

How Therapy Can Help Entrepreneurs Thrive Instead of Survive

Entrepreneurship can feel like a thrilling adventure, but let's be honest—it can also be incredibly lonely, high-pressure, and exhausting. 

If you're a business owner, you're likely juggling an endless to-do list, constantly making decisions, and facing uncertainty on a daily basis. It’s a lot of pressure to have the livelihoods of people rest on your shoulders! Starting a business is a ton of work, any way you slice it. It can be hard for non business owners to relate to what you’re going through, so working on your own business can be a lonely prospect, even when you’re passionate about it. While the excitement of building something from the ground up is undeniable, the weight of that responsibility can take a toll on your mental health. This is where therapy can be a game-changer. 

Working with a therapist doesn’t just help you survive as an entrepreneur—it helps you thrive. 

As an entrepreneur, therapy can make a real difference in your business and personal life, while meeting you right where you are. Here’s how:

Improve Work-Life Balance 

Entrepreneurs often blur the lines between work and life, especially when starting a business. It can seem like there aren’t enough hours in the day when you’re running your own business, and it can be hard to know when to stop when you still have so much to do. Pouring everything you have into your business can come at a steep cost to your health and your relationships. 

Therapy can help you step back, re-evaluate how you're balancing your time, and find ways to create more joy, meaning, and fulfillment across all areas of your life. A therapist helps you ensure that you're thriving not just professionally but also personally.

Take Creative Risks and Develop Business Instincts

Being an entrepreneur often requires taking risks, and that can be terrifying. Therapy offers a safe space to explore the fears and insecurities that might hold you back from reaching your full creative potential. Working with a therapist can help you learn more about your strengths and help you tune in to your sense of intuition, so you can trust yourself more and take those big leaps with confidence in your business. 

Freedom from Anxiety, Stress, and Depression

The weight of entrepreneurship can sometimes lead to anxiety, depression, or burnout. Stress is often a daily experience when you’re running your own business. Working with a therapist can give you the tools to navigate the mental health challenges that often accompany running a business, helping you gain freedom from the constant stress and pressure. When you're feeling overwhelmed, a therapist helps you ground yourself and find ways to ease the emotional burden, while giving you a safe space to discuss what’s going on. 

Find Your Voice as a Leader

You are the driving force behind your business, but do you feel confident in your leadership? Therapy can help you discover and develop your unique voice as a leader. Whether it's practice making tough decisions, learning how to build a team, and developing your management skills, therapy helps you refine your communication skills and grow into the kind of leader that inspires trust and connection. 

Connect to Your Core Values

Many entrepreneurs struggle with staying true to themselves amid the demands of running a business. Therapy allows you to understand and connect with your core values, which can help you find your "true north" so you can make decisions from a place of authenticity. Exploring what’s truly important to you can be a powerful guide in both your personal and professional life, because knowing what you value helps you make decisions that feel more aligned with who you are. 

Build a Community

Building a business can feel isolating, but therapy can help you find and connect with your people—whether that's your clients, a supportive community, or a business network. A therapist can also teach you how to communicate in a way that maximizes your impact as a business owner, helping you build relationships that truly matter in and out of work. 

Redefine Failure and Keep a Growth Mindset

All entrepreneurs face failure—it’s inevitable when you’re starting something new, both in big and small ways. Remember that failure doesn’t have to be something that stops you in your tracks. Through therapy, you can reframe how you view setbacks, seeing them as opportunities for growth instead of evidence of your limitations. You can learn from your past without punishing yourself for it, which can help you grow. Maintaining a growth mindset helps you stay adaptable and open to change, no matter what challenges come your way.

Enhance Emotional Intelligence and Leadership Skills

Running a business isn’t just about strategy; it’s about people, but we don’t always have the people skills we need to do things effectively. Developing emotional intelligence through therapy improves your ability to connect, influence, and lead others. You’ll learn how to communicate with empathy and foster an environment where both you and your team can thrive. Therapy can also help you practice emotional regulation, which is essential for effective leaders. 

Practice Stillness and Intuition

In the hustle of entrepreneurship, it’s easy to lose touch with yourself and what you need. Working with a therapist can help you to develop practices of stillness and reflection, allowing you to tune into your intuition. When you cultivate this practice, you’ll notice how it strengthens your decision-making and keeps you grounded, even when the chaos of running a business threatens to overwhelm you. Therapy offers you a chance to learn how to create kind, compassionate space for yourself — and others, which is essential for successful businesses. 

Celebrate Strengths 

As an entrepreneur, it's easy to focus on what’s not working or where you feel inadequate. Our brains naturally focus on the negative, and it takes real practice to notice and celebrate the positive. Therapy offers you a safe place to acknowledge and celebrate your successes and strengths, and build upon them. 

Get Support That Fits Your Schedule

One of the challenges of being a business owner is finding time for everything, including self-care. That’s why online therapy is a perfect fit for entrepreneurs. You can meet with your therapist from anywhere—whether you’re at home, at your office, or even traveling for work. Scheduling therapy sessions around your busy life gives you the flexibility you need, without sacrificing the mental health support that can help you thrive, in your personal life and in your business.

Achieve Alignment in Life and Business

Therapy helps you align your life and your business in a way that feels sustainable and fulfilling. You’ll gain the self-awareness, emotional intelligence, and leadership abilities you need to navigate challenges, seize opportunities, and create a business that supports the life you want to live.

Your journey as a business owner is unique—and you deserve the support that empowers you to keep moving forward. If you’re looking for a safe place to explore everything that comes with being an entrepreneur, working with a therapist can help. Our clinicians are accepting new clients, so reach out to us today to begin. 

What You Should Know About Internal Family Systems (IFS) Therapy

There’s not just one way to approach healing, which is why there are so many different types of therapy modalities. Different healing modalities work better for different people and different situations. Some modalities that we use at Hope+Wellness include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Psychodynamic Therapy, Cognitive Behavioral Therapy (CBT), EMDR, and Exposure and Response Prevention.

One therapeutic approach we’ve found particularly powerful is Internal Family Systems (IFS) therapy. Whether you're dealing with anxiety, chronic pain, disordered eating, or relationship challenges, IFS offers a compassionate, non-pathologizing path to self-understanding and healing. Internal Family Systems therapy can be an effective way to heal and transform your internal world. Here’s what you should know about it!

What is Internal Family Systems therapy?

Internal Family Systems (IFS) therapy was first developed by Dr. Richard Schwartz in the 1980s, and has since evolved to support individuals, couples, and families.

The main idea behind Internal Family Systems therapy is that our mind is not a single entity but a system of parts, each with its own perspectives, feelings, and roles. These parts are often in conflict, which can lead to emotional distress and mental health issues. Rather than there just being one true version of ourselves, IFS recognizes that we often have subpersonalities and different parts that can contribute to distress when they are not in alignment. These parts each play different roles, like different members of a family. 

IFS helps individuals understand and heal their internal world by focusing on the relationship between these parts. Internal Family Systems views everyone as having a Self that is wise, compassionate, and capable of leading the internal system (your internal family of parts) toward healing and harmony. 

What are the different “parts” in IFS?

Within our Self, we are made up of many different parts, that each play a role in our internal system. Each part plays a different role. There are no “bad” parts, but sometimes a particular part will play an extreme role that impacts the whole system, which can lead to distress. 

Imagine your different parts like a family - they may all share the common goal of wanting what’s best for you, but they may have different ideas of how to make that happen. These differences between parts can lead to tension and distress. 

The different parts in IFS often include:

• Protector parts: Parts that have developed to protect the Self in difficult or upsetting situations

• Manager parts: These parts help us direct our daily functioning, enable us to meet our own needs, help us stick to our goals, and try to avoid perceived danger

• Firefighter parts: These parts respond when we perceive danger and try to help us cope, sometimes through self-destructive behaviors.

• Exile parts: These parts hold on to burdens - trauma, intrusive thoughts, bad memories, etc. These parts are often child-like, and we often do our best to push them away or ignore them. 

How does IFS work?

IFS therapy can help you take a non-judgmental look and help decrease conflict between your parts, which can help you feel more resilient. It involves working with a therapist to explore and understand your internal system. Here’s a basic overview of how it typically works:

1. Identifying Your Parts: You and your therapist will identify and get to know the various parts of your internal system. These parts can include protectors, exiles, and more.

2. Understanding Roles: Each part has a role or function. Protectors, for example, work to keep you safe from pain or harm, often by employing strategies that may have been useful in the past but are no longer helpful.

3. Building Relationships: Through compassionate dialogue, you build relationships with your parts, understanding their fears, concerns, and needs.

4. Accessing the Self: The goal is to help you access your core Self, which can then interact with and heal the wounded parts. The Self is seen as a natural leader capable of bringing calm, clarity, and confidence to your internal system.

5. Healing and Integration: As parts feel heard and understood, they can begin to trust the Self and let go of extreme roles, leading to greater internal harmony and well-being.

Healing through IFS takes time. Each session builds upon the last, gradually uncovering and addressing deeper layers of your internal system. Like any therapeutic process, IFS requires commitment - regular sessions and active participation in the process are essential for meaningful progress. 

It’s important to choose a therapist you feel safe with, and who is experienced in IFS, because a safe and supportive therapeutic relationship is crucial for effective IFS work. In addition, IFS can be integrated with other therapeutic approaches, so you can discuss with your therapist how IFS can complement other methods you may be using.

What are the benefits of IFS?

IFS therapy offers numerous benefits, making it a valuable approach for many individuals.IFS addresses the whole person, integrating mind, body, and spirit in the healing process. As it is a non-pathologizing modality, it doesn’t focus on diagnosis, instead viewing symptoms as normal reactions to life’s stressors or trauma. This can be especially powerful to people who have been pathologized or discriminated against due to a diagnosis in the past. Even though IFS doesn’t focus on diagnosis, it can be helpful with anxiety, PTSD, OCD, depression, substance use, bipolar disorder, dissociative identity disorder, and eating disorders. 

Learning to understand and empathize with your internal parts can help you cultivate a deeper sense of self-compassion and acceptance. IFS can also help heal emotional wounds and trauma by addressing the parts that are holding painful experiences. 

Increased insight into your internal world can help you improve your relationships with others, because you’ll be less distressed by internal conflicts that then spill over into your interactions. Finally, learning how to access and trust your Self is empowering. Knowing how to tune in to your internal system can help you to navigate life’s challenges with greater resilience and confidence.

If you’re dealing with issues like anxiety, burnout, or trauma, IFS can provide the tools and insights you need to create a more harmonious and fulfilling life. If you’re interested in learning more about IFS therapy or working with a therapist who utilizes IFS, reach out to our office today for more information. 

Finding a Psychologist: What to Consider

Are you looking for a psychologist?

If you’ve never been through the process before, it feels daunting! How do you go about finding a psychologist? Not just an effective one, but one who truly cares and connects with you?

To help, we put together this guide of considerations and steps to take when trying to find a clinical psychologist that’s right for you:

Take time to figure out what you’re looking for: 

At the start of your search, it’s important to take time to reflect on what issues you’re looking for professional support with. The type of psychologist you’re looking for may change depending on what particular issues you’re struggling with, and what treatment they specialize in. 

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. 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.

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..

Consider What Your Preferences Are

There are a lot of questions to consider when exploring your preferences: 

• 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 psychologist? 

• Are you open to virtual care? 

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

• What is your budget?

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

For example, when considering your budget, take a second to think about if you are willing to seek care from predoctoral clinicians currently in training. 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.

Start a List of Potential Licensed Clinicians. (Don’t be afraid to ask around!)

Do you have any health care providers that you enjoy seeing, whose care seems comprehensive and genuine? They’re a great resource for patients looking to expand their care. Ask them if there are any psychologists they would recommend–oftentimes, providers in the same community know of other providers who are well known for their clinical skill and effectiveness, and can refer to professionals they trust. 

Consider your social circle as well. Your friends and family may be able to offer referrals with their own firsthand experience and perspective. 

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 what connects with you, or to look at their education, training, and work experiences, as these would deeply inform their therapeutic approach and style.

Below, is a list of 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

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. Take notes on how the conversation left you feeling or what concerns/questions it brought up. 

Are you interested in CBT? Our clinicians at Hope+Wellness offer CBT therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

What You Should Know About Exposure and Response Prevention (ERP)

Did you know that there’s a treatment for Obsessive Compulsive Disorder (OCD) that’s been shown to be effective for up to 80% of people with OCD? It’s a type of Cognitive Behavioral Therapy (CBT) called Exposure and Response Prevention (ERP).

What is Exposure and Response Prevention (ERP)?

ERP was developed to treat OCD, and it can be an incredibly effective form of treatment for folks dealing with obsessive thoughts and compulsions. 

To understand ERP, it can help to understand more about how Obsessive Compulsive Disorder works. OCD involves intrusive thoughts that are disturbing and unwelcome. Often, these thoughts create a lot of distress for the person who is experiencing them. When these thoughts pop up and cause distress, people with OCD attempt to relieve the distress through compulsions, which may work briefly. 

After a while, though, the thoughts come back, and the cycle starts again. The compulsions that a person uses to relieve their discomfort eventually become part of their daily routine, which can get in the way of work, family, and other relationships. 

When we think of OCD, we often think of someone who is obsessed with cleaning, but that’s not actually how most people experience the disorder. People may have recurring, unwanted thoughts about harming people they care about, or that something bad will happen if they don’t follow through with their compulsions. Some people experience intrusive sexual thoughts, or thoughts of doing something violent or illegal. These thoughts are not in the control of the person experiencing them, and they can be extremely frightening. 

To try to lessen the fear they feel from these thoughts, people with OCD may develop compulsions or rituals like checking to make sure the smoke detectors work, making sure the baby is still breathing, making sure that the emergency brake is on, or checking that the security system is on. The overwhelming feeling is that if they don’t practice these compulsive rituals, something terrible will happen, and that can be an exhausting way to live. ERP was designed to interrupt this cycle and reduce the anxiety that feeds these intrusive thoughts. 

How does ERP work? 

There are two parts to ERP - the exposure and the response prevention. Within the safety of a therapist’s office, you’ll be exposed to the triggers and thoughts that cause you distress. Then, you’ll practice resisting the urge to perform the corresponding compulsions or rituals. 

First, you’ll work with your ERP therapist to determine what all of your triggers, intrusive thoughts, and compulsions are, so you can work through them in a safe place. This helps you and your therapist determine which triggers and obsessive thoughts cause you the most distress, so you can work your way up from lower levels of distress to higher levels over time. Exposure and Response Prevention works gradually. You aren’t going to be asked to confront your worst fears right away. As you move up the hierarchy of distress, you’ll gain confidence and experience, which help when it comes to the more distressing levels. 

As you’re exposed to your triggers or your intrusive thoughts in ERP therapy, you’ll learn skills from your therapist to help you learn how to sit with discomfort and resist your compulsions. Working with a therapist can help ensure you avoid replacing one compulsion with another, in addition to teaching you skills to help lower your distress level when the unwanted thoughts come up. 

Exposure and Response Prevention works for two reasons - habituation and inhibitory learning. Repeated exposure to your triggers will help you learn to tolerate your distress and discomfort more effectively, which reduces your overall distress level over time. This is known as habituation. Inhibitory learning happens when you learn that your intrusive thoughts don’t always come to pass when you’re exposed to your triggers. ERP helps to prove your obsessions wrong, which helps to lessen their impact. 

What are the benefits and drawbacks of ERP?

ERP is generally known as the gold-standard treatment for OCD, because research has shown that it can be extremely effective. However, it’s important to note that Exposure and Response Prevention takes work, and it’s not always easy. 

Confronting the things you’re afraid of can be terrifying. Effectively learning how to break the cycle of obsessions and compulsions requires work in between therapy sessions, which can be intimidating, especially at first. Folks with OCD are practiced at avoiding discomfort, so learning how to be okay with discomfort takes time and practice. 

Can ERP help with anything else?

Yes! ERP can help with disorders besides OCD, including: 

• Anxiety

• Eating disorders

• Phobias 

How to find an ERP therapist

If you or someone you know is struggling with intrusive thoughts, ERP might be a good fit. Our clinicians at Hope+Wellness have experience supporting clients who have Obsessive Compulsive Disorder. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. 

If you would like to talk to one of our therapists, please contact info@hope-wellness.com or get in touch with us here.

Cognitive Behavioral Therapy: 5 Things You Should Know About It

If you’re thinking of starting therapy, you’ve likely run into the term modality before. A modality is the approach a therapist takes when providing care for their patients. One of the modalities we utilize here is called Cognitive Behavioral Therapy (CBT). 

CBT is an approach that focuses on how our thinking patterns influence our behavioral patterns. The main idea behind CBT is that thoughts influence how we feel and act. Basically: how we act can in turn also affect how we think and feel in a given situation, and our unhelpful thoughts can then lead to unhealthy behaviors and feelings. CBT helps you to understand and break this cycle.

Here are five things you should know about Cognitive Behavioral Therapy: 

1). CBT has been shown to be effective for a wide range of presenting concerns: 

CBT is an active, goal-oriented psychotherapy treatment. As a treatment, it’s been studied and shown to be highly effective in treating a wide range of people (children, adolescents, and adults) with a wide range of presenting emotional and behavioral concerns such as: 

• Depression

• Anxiety

• bipolar disorder

• Perinatal mood and anxiety disorders (e.g., postpartum depression)

• Sleep

• Relationship problems

CBT has also been found to contribute to significant improvements in functioning and quality of life.

2). CBT has been studied extensively in both research and clinical practice. 

CBT is an evidence based treatment. What that means is that its efficacy has been proven to be safe and effective through extensive scientific and clinical research. This research involves thousands of patients and meticulous comparison of effects to alternative treatments. Evidence based treatments help increase the effectiveness of the treatment and helps reduce the risk of recurrence of damaging behavioral patterns. There’s heaps of scientific evidence out there showing that CBT is effective in producing meaningful change and improvements for clients.

3). One of the core principles of CBT is that problems with mood are related to unhelpful behaviors and thought patterns. 

These negative thinking patterns can influence our mood and exacerbate feelings of anxiety, depression, or other feelings of insecurity and self doubt. This can then contribute to a pattern of unhealthy behaviors–which in turn starts the cycle all over again. With CBT, these thought and behavior patterns are explored and new, healthy ways of coping are explored to effectively relieve symptoms and improve quality of life. 

4). Psychologists and clients work together collaboratively to develop goals and to actively target symptoms. 

Time is spent examining present-day issues, thoughts, and behaviors. For example: 

A teen who is depressed might think, "Everything is hopeless," or "There's no point to anything I do." 

Emotionally, these thoughts may occur with feelings of sadness, depression, apathy, and lack of motivation. Behaviorally, the depression may appear as increased isolation, withdrawal from usual activities, refusal to attend school, etc. However, these behaviors only reinforce the negative thinking patterns, and exacerbates the cycle of withdrawing from life due to a feeling that there’s no point in participating.  

For this, treatment would involve teaching the teen to identify and challenge negative thoughts, skills to cope with depressed mood (e.g., activity scheduling), and working with parents to develop a reinforcement system to encourage positive behaviors and use of coping strategies. CBT is highly collaborative, practical, and goal oriented. 

5). Because CBT is very goal oriented, there are many skills clients develop as part of the process. 

They are learning how to face fears, problem solving difficult situations, recognizing patterns of unhelpful thoughts and behaviors, and ways to calm the mind and body. Other skills taught as part of CBT include:

• Problem solving

• Communication training

• Cognitive restructuring aka learning to identify and dispute cognitive distortions. You can read more about cognitive distortions from these posts on our blog: 

• 8 Common Cognitive Distortions to Watch Out For

• 10 More Cognitive Distortions to Be Aware Of

• Managing Cognitive Distortions

• What is All or Nothing Thinking?

• Why “Should” Statements Make You Feel Worse

• Social skills training

• Relaxation training

• Behavioral activation aka intentionally practicing specific behaviors that promote a positive mental state, or avoid negative thinking traps. 

Are you interested in CBT? Our clinicians at Hope+Wellness offer CBT therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

What You Should Know About EMDR

Have you ever heard of EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. It’s a kind of psychotherapy that was developed in the 1980s by Francine Shapiro. Dr. Shapiro was walking outdoors in 1987

when she noticed that the distress she was feeling, related to upsetting memories, was lowered when she moved her eyes back and forth. She did further studies on this phenomenon, and eventually developed EMDR as the treatment it is today, as well as the Adaptive Information Processing model to explain how the treatment works. 

While EMDR is a newer treatment, it’s been shown to be incredibly effective in both research and in clinical settings. Many people experience a dramatic decrease in their distress level after EMDR therapy, and studies show it’s effective for many many mental health issues, including trauma, depression, anxiety, and OCD. 

How does it work?

The basic premise of EMDR is that our minds can heal wounds in the same way that our bodies can, but sometimes those wounds don’t heal correctly and cause pain long after the event in question. It’s almost like the painful memories and emotions get stuck. When this happens, we experience negative outcomes like trauma, anxiety, and other kinds of emotional and mental distress. Resolving these issues requires us to access and process these stuck memories and emotions, which happens through EMDR. 

EMDR offers a way to locate, access, and reprocess these stuck memories and emotions. The goal is to change the way the brain is storing these stuck memories so that they stop causing pain. EMDR treatment requires a clinician who is trained in EMDR, because the process of accessing and reprocessing traumatic memories is very sensitive. EMDR therapists have extensive training in the background of why EMDR works, and how to adapt it for different situations based on what the client needs.

What happens during an EMDR session? 

EMDR helps you to locate and reprocess traumatic memories, so it’s not something you can just jump into without preparation. EMDR has 8 phases, and each phase is essential, especially the phases where you work with your therapist to develop resources to help you during upsetting moments. 

• The 8 phases of EMDR are: 

• History & Treatment Planning

• Preparation

• Assessment

The first 3 phases are completed before reprocessing can begin. These phases are focused on understanding how EMDR can help the client based on their history, developing a treatment plan, building a rapport between the client and therapist, providing resources for the client to use in moments of distress, and deciding what event or memory to reprocess. 

• Desensitization

• Installation

• Body Scan

The next 3 phases are the reprocessing phases, where the client works with the therapist to access and reprocess the memory until they no longer feel distress around it. These phases include the bilateral stimulation that EMDR is famous for. Some clinicians will have you use eye movements, tapping, headphones, lights, buzzers, or tappers to direct the bilateral stimulation that allows you to access the memory networks that need reprocessing. 

• Closure

• Reevaluation

The final 2 phases help to build safety for the client as each session ends and begins. Each session will end with helping the client return to a calm state of mind, and each session will begin by checking back in to make sure that their distress level stays low around the reprocessed memory. 

Some of the phases go faster than others, and once you are ready to begin reprocessing, most of your EMDR sessions will be some combination of phases 3-8. 

What can EMDR help with?

EMDR was initially developed to help process trauma, and lessen the effects of PTSD, and it is an incredibly powerful way to treat trauma, including trauma from childhood or abuse. However, research has shown that EMDR can be helpful with a number of other mental health concerns, including: 

• Anxiety

• Depression

• Chronic Pain

• Dissociative Disorders

• Personality Disorders

• Addiction

• Eating Disorders

• Grief

• Self Esteem 

• OCD

EMDR is a treatment that can be used for children, teens, and adults. There are some situations where EMDR is not an appropriate treatment, so it’s important to check with an EMDR therapist to determine if it’s a good treatment choice for you. 

What are the benefits and drawbacks of EMDR?

One of the biggest benefits of EMDR is how effective it is as a treatment. Although it’s a newer treatment modality, there have been many studies conducted on EMDR that show it works. The data showed that EMDR was working for people before we even understood why it worked! Many organizations, including the World Health Organization, the American Psychological Association, and the US Department of Veterans Affairs recognize EMDR as an effective treatment for PTSD and other disorders.

Another major benefit of EMDR is that it doesn’t require a person to talk in detail about the distressing memories they have to reprocess them. EMDR does require you to focus on the memories, but you don’t have to put them into words. While focusing on the memories is definitely upsetting, it’s less intense than having to narrate or fully relive a traumatic memory. EMDR is also fully confined to the therapy session - you won’t have homework to do or be expected to process things on your own, everything will take place with your therapist, which can be appealing. 

Are you interested in EMDR? Our clinicians at Hope+Wellness offer EMDR therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

How Can My Therapist Help with My Chronic Pain?

How can my therapist help with my chronic pain?

Suffering from chronic pain, or having a chronic illness with severe physical symptoms might not seem like the kind of thing you can go to a therapist for, but a therapist can be a key element of your chronic pain management. 

While your illness or pain may be physically located in your body, that doesn’t mean it’s entirely separate from your mental health. In fact, mental and physical health are incredibly linked. So, when your mental health suffers, your physical health often suffers, and vice versa: 

You might have experienced swings in mood or energy when you’re not feeling well, and that can be exponentially more intense in the case of chronic illness. In fact, people with chronic illnesses are two times more likely to experience anxiety and depression than people who don’t have a chronic illness…In fact, it has even been suggested that depression is associated with inflammation in the brain, so increased inflammation in the body due to physical illness may directly play a role in depression. 

5 Ways Chronic Illness Can Affect Your Mental Health

So how can your therapist aid in your chronic illness management? Your therapist can help you… 

…unpack and unlearn feelings of guilt and shame: 

We live in a culture that prioritizes hustling, being self made, and never resting. Those goals are often impossible to achieve for folks with chronic illness. There is much more rest, many more limitations, and many more instances of needing help from others when you’re chronically ill rather than able bodied. 

But, because of imposed cultural values like self sufficiency and productivity, taking the rest you need, caring for your body in the way it requires, and asking for help when you need it can all bring feelings of guilt and shame with them. That will be complicated even more by your family history, your history within relationships, and your history of getting your needs met. Your therapist can help you find your way through all of this and help you reduce those feelings of guilt and shame so you can take care of yourself the way you deserve. 

…develop self compassion and strengthen your self worth: 

It’s difficult to learn to rest. It’s even harder to learn to be nice to yourself about resting or respecting your limitations. And it’s an additional challenge to unlink your self worth from your productivity. In therapy you can explore what you feel the root of your self worth is, get comfortable with the idea of your inherent worth as a person, and develop habits rooted in self compassion rather than shame. 

…manage increased stress:

Managing an illness or constant pain is stressful. Adding in the logistics of likely needing medication, various doctors appointments, the work it takes to plan outings ahead of time to ensure accommodations, etc. Learning to manage stress to prevent burnout is a key skill practiced in therapy that can benefit anyone, but especially those managing chronic illness. 

…practice communication skills for difficult situations:

With chronic pain, comes limitations. You might not be able to do everything your friends want you to do. You may feel left out when friends or loved ones don’t make accommodations for you. These types of situations necessitate uncomfortable conversations, which depend on strong communication skills. Learning how to let someone know your needs, and finding ways to express your feelings clearly can help to strengthen your relationships as you navigate chronic illness. 

…work through the grief & trauma of chronic illness: 

Life after a chronic illness is very different to life before a chronic illness. And, with any major change or loss, that can bring grief or feel traumatic to us. Instead of trying to ignore that grief, you can take time to honor it in therapy. Your therapist can help you identify what it is you’re grieving, and help you hold that grief and move forward without it controlling you.  

…navigate relationship changes and loss: 

Sometimes the relationships we’re in aren’t able to withstand the challenges that come with managing a chronic illness. Or, if they do, they look distinctly different than the relationship did before there was a chronic illness to manage. That can be a lot to take on between two people, and it’s common to need outside support. Whether as a couple, or as an individual, it can be great to work with a therapist to navigate the changes and losses in your relationships that come along with chronic illness. 

The majority of people in the United States will experience chronic illness at some point in their lives. Treating the whole person is an important way to improve a person’s quality of life overall. It’s critical to take into account mental health when discussing physical health and vice versa. If you are living with a chronic illness and you’re looking for support, we can help. 

How Can Therapy Help Me Navigate Big Life Changes?

Why are life transitions so stressful?

It’s a cliche but it’s true: change is the only constant. So why does it always feel like such an insurmountable task? Change can be exciting, but more often than not, we find ourselves fixated on everything stressful about change: how we’ll soon be navigating something unknown, how we’ll be saying goodbye to things that are not only familiar to us, but comforting. 

Sometimes it’s not until our routine is disrupted that we realize having a routine isn’t the same as being in a rut; our routines can give us structure, provide us with resourceful ways to meet our needs, and give us the comfort of knowing how to take care of ourselves. So it’s natural that when our routines are disrupted with some big life change, we feel apprehensive in the face of losing that comfort and stability. This is just one of the reasons big life changes–even ones we want–are so stressful to us. 

Transitions require a lot more from us than our regular day to day lives. 

The stress of building new routines, the grief of saying goodbye to familiar parts of our lives, the fear of the unknown we have to trust ourselves to make peace with when starting something new–emotionally, life transitions require a lot of us. 

Preparing for specific life transitions isn’t always possible–some changes in life are sudden and unexpected and we have to find ways to navigate them quickly and without hesitation. But preparing for life transitions in a general sense is a key component of the therapeutic process. 

In therapy, along with navigating crises as they come up and exploring your internal experience, you get the chance to practice skills that make it easier to navigate life transitions when they come up. These skills can include: 

• Learning how to stay present when stress comes up 

• Remaining centered and grounded when problem solving and exploring feelings

• Effective and productive stress management 

• Prioritizing self compassion as you navigate stressors and learning to manage them productively

• Examining stress as a means of moving toward the life you want, rather than avoiding it whenever it comes up

• Learning to look critically but compassionately at your own behaviors: which maintain the stress you experience, and which help you break free of them?

• Building a stronger sense of self empowerment

These skills are taught and practiced over and over again in therapy. 

While you may start therapy for support in one area of your life, you’re also building the foundation you need to go back and practice those skills. And every time a new life stress or transition comes up, you get the chance to practice and strengthen those skills once again. These practices help us not just in single instances, but with lots of obstacles we face, like: 

• academic stress (starting a new school, applying for programs, keeping up with requirements, etc.)

• workplace stress (balancing responsibilities, navigating difficult professional relationships, feeling pressure to perform, burnout, etc.) 

• housing stress (finding housing, affording housing, keeping up with housing responsibilities like bills and chores, etc.)

• relationship stress (ending a relationship, starting a new relationship, navigating relationship milestones, managing relationship conflict, etc.)l

• chronic health concerns

We work with kids, teens, young adults, and adults going through various types and times of stress and life adjustment concerns, including academic stress, work stress, divorce, the end of significant relationships, moving, job changes, and chronic health stressors.

If you would like more support in coping with life transitions, our therapists at Hope+Wellness can help.