WHERE WERE YOU FIVE YEARS AGO?
Considering where you came from and how you got to where you are—however you want to interpret those questions—will help you identify your patterns of behavior. Most likely, these patterns have affected your goals and aspirations in ways both positive and negative. Alternatively, you may learn that you have not been adequately intentional about where you were going. Skip the self-shaming and start exploring how to create more self-direction.
WHAT ARE YOU WILLING TO GIVE UP?
Setting an intention for self-development or improvement in some area in your life may involve sacrifice. We only have so much time every day, and setting priorities for what we want often requires letting go or replacing. A great way to evaluate what you may need to give up is to regularly ask yourself,
“How is what I’m doing right now getting me closer to where I want to be in five years, and if it isn’t, what am I willing to sacrifice?”
HOW SELF-DISCIPLINED ARE YOU AND HOW CAN THIS IMPROVE?
This examination is related to the previous one. Any sort of change takes a certain level of discipline. If you decide your self-discipline needs improvement, then exploring ways to practice is helpful, if not necessary. Discipline can be developed in many ways. (Refer back to Chapter 14 on self-discipline, if you’ve skipped ahead.)
LET GO OF LIMITING BELIEFS
Exploring which of your beliefs serve you well, and which ones don’t, will help to not only develop your five-year plan, but also to carry it out. Fear often gets in the way of exploring goals by convincing you that you may not be able or ready to achieve them. Reducing fear and limiting beliefs will allow you to recognize and contemplate available options and set more realistic goals. (See Chapter 13 and all of Section 7 for more details on letting go of limiting beliefs.)
CHANGES IN MOTION ACTIVITY
This activity will use the questions above, but in a different order. Follow the steps to get the most out of this activity.
Step One – Answer some (or all) of the questions below before writing out your five-year plan.
Where were you five years ago? What were you doing, how were you feeling, and what did you want?
What are you willing to sacrifice to get what you want?
What can you give up now, so that you’ll have more time/money/energy to get what you truly want later?
What current patterns and habits can you work on modifying to increase the likelihood of success?
How can you improve your self-discipline? Think of a time when you felt satisfied with the discipline in your life. What did you start, stop, or do more of to institute this level of discipline.
What limiting beliefs do you need to let go of? Do any of your beliefs, currently or historically, get in the way of your success? Which ones?
What patterns or behaviors do you want to create or eliminate?
In five years, how you want to be thinking differently?
In five years, how will you be more emotionally available and resilient, and what emotional reactions will you better manage?
What behaviors or practices will be totally different in five years?
How will you be taking care of your body in a way that you have never done before?
What kinds of positive risks will you be taking in five years that you won’t allow yourself to take today?
How will the friends, community, activities or work you are engaged in be different in five years?
What beliefs might you challenge over the course of the next five years, and what will you choose to believe that is very different than what you currently believe?
Step Two – Use the insight you gained from answering the questions as a springboard for creating your plan. Don’t skimp when answering the questions. Include specific details to create a clear vision for yourself.
Step Three – Finally, write a few achievable goals to help start you on your path.
Now, what is your five-year plan? Write it out and then write out your first three goals.
This section of the book is not connected to the self-initiated work of Part One. It is not about the CHANGES model, although some questions in Part Two may sound a bit familiar.
I hope that by going through the exercises in Part One, you’ve made strides toward achieving the positive change you were seeking. If you are still feeling you’re not quite all the way there, no problem. Sometimes, additional assistance is needed. Believe me, I get it. And so, this personal development book will now pivot to address that concern.
As I’ve said, this book is about understanding the various aspects of ourselves and how they influence our success and failure. Still, even with the best of intentions and most vigilant work on all the right things, it’s extremely helpful to have third-party support. We are going to unpack that process a bit.
Some of the most common questions I’ve received over the course of my career as a professional coach, consultant, and therapist, include variations of the following:
How do I find the right coach or therapist?
What’s the difference between coaching, therapy and other helping professions?
How do I know which one to hire? A coach, or a therapist, or someone else?
In the pages ahead we’ll answer all three questions and you will be prepared to choose, hire, and work with the right helping professional… should you want to. Remember, if you need help, that’s ok. The complexity of our life experience often requires assistance to untangle. This complexity is a beautiful paradox: in its specificity, it makes us unique, but in general, it connects us to each other.
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Therapy - Separating Fact from Fiction
What is therapy, anyway? Why would anyone pay money just to sit and talk to someone else? Why not just talk out my problems with a friend, co-worker, or family member and save all that money?
I’ve heard all these questions and more. And yet, therapy is estimated to be a $15 billion per year industry.88
A little FYI before we get started: the term, behavioral health, is often interchanged with “mental health” and the term, therapy, is also often interchanged with “psychotherapy” and “counseling.” These terms are not meant to be limited to those who struggle with a disorder. From time to time, we all run into challenges such as depression, anxiety, stress, anger, etc. This is normal. There are also diagnoses for some of these challenges if they meet certain criteria. But I don’t want to bore you with the details. Think of it this way, mental health and behavioral health are umbrella terms to cover services, which help people cope with, resolve, or manage challenges regarding emotional, mental, or behavioral issues.
We all experience various levels of functioning on any given day. We refer to these emotional, physical, and behavioral fluctuations as health. Sometimes we present strong, healthy versions of ourselves, and sometimes we present weak, sickly versions. Even if we do accurately identify what is going on within us, we may lack the training, skills, and wherewithal to understand and manage these variations in our health. This is where therapy can be truly beneficial.
When seeking a therapist, narrow your search by considering your objective. Keep in mind that within the field of therapy, there are different concentrations. Most states require that anyone seeking to become a licensed therapist first obtain a master’s degree in one of four disciplines.
Psychology – The American Psychological Association defines Psychology as “the study of the mind and behavior. The discipline embraces all aspects of the human experience—from the functions of the brain to the actions of nations, from child development to care for the aged. In every conceivable setting from scientific research centers to mental healthcare services, the understanding of behavior is the enterprise of psychologists.”89
Social work – The National Association of Social Work defines social work practice as “the professional application of social work values, principles, and techniques to one or more of the following ends: helping people obtain tangible
services; counseling and psychotherapy with individuals, families, and groups; helping communities or groups provide or improve social and health services; and participating in legislative processes.”90
Marriage and family therapy – The American Association of Marriage and Family Therapy defines marriage and family therapy in the following way, “A family’s patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn’t just the person—even if only a single person is interviewed —it is the set of relationships in which the person is imbedded.”91
Counseling – The American Counseling Association defines counseling as “a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.”92
The field of Psychiatry is related to the four disciplines above, but it requires a medical degree.
Psychiatry – Psychiatrists sometimes practice as therapists. The main difference between Psychiatry and the others is that a psychiatrist can prescribe medication. Also, the definition by the American Psychiatric Association states that “Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems.”93
When seeking a psychiatrist, you may also encounter the term, Psychiatric Mental Health Nurse Practitioner. The American Psychiatric Nurses Association states that Psychiatric Mental Health Nurse Practitioners “apply the nursing process to assess, diagnose, and treat individuals and families with psychiatric disorders or the potential for such disorders using their full scope of therapeutic skills, including the prescription of medication and administration of psychotherapy.”94
Granted, there is a lot of overlap among these descriptions. There are differences among these disciplines, but when it comes to finding a therapist, I believe they are mere technicalities and that what matters far more are the particular qualities of the person in front of you.
For the purposes of this book, I will add to the mix the term, coaching, which I’ll be discussing more in the following chapters. For now, I’ll make the basic distinction that counseling/therapy is about resolving pain, while coaching is about developing or improving a characteristic.
To lay the groundwork of understanding, we should look at the different options within behavioral health. Approaches and styles vary widely.
Before we dive into some of the specializations within therapy, a small note about the process. If all you know about therapy comes from TV and the movies, allow me to dispel some myths. While styles vary, each therapy session consists of a conversation between client and therapist about what is working well and what is causing pain in the client’s life. The depth, the emphasis on history or on the future, and the kinds of questions discussed, will vary, depending on the therapist.
Therapists can specialize in different areas, including, but not limited to:
Couples therapy
Child therapy
Sex therapy
Trauma therapy
Family therapy
Substance abuse therapy
While the subject matter differs among these specializations, the basic therapeutic framework is similar. In the pages to come, we’ll explore how to sift through all the options of finding a therapist.
WHERE TO FIND A THERAPIST
Here are a few tips on where to start your search for a therapist in terms of location and other considerations. The behavioral health specialists working at these venues may be credentialed in any one of the disciplines mentioned previously.
All of the options you’ll find in the coming pages have advantages and drawbacks. By exploring these resources, you’ll develop a good sense of which option is the most appropriate for you.
SCHOOLS
There are usually therapeutic resources available to students at all levels of education, ranging from grade school and high school counselors to therapists at universities. If you are searching for therapy as a student or for a student, it is likely that, at the very least, the school will offer you a referral to a local therapist based on the concern you have. At the collegiate level, you may access therapy services directly, usually right there on campus. Many universities have robust departments dedicated to serving the mental health needs of students and staff. Resources will largely depend on the particular educational institution.
COMMUNITY MENTAL HEALTH
Most communities have access to some kind social service program. These places are referred to as community mental health centers, which are great resources for a variety of reasons.
For new therapists just out of graduate school and seeking career experience, community mental health centers are a common starting point. This does not mean that such venues are operated exclusively by inexperienced therapists doing residency programs. I worked in the community mental health system for years and found nearly all of my colleagues to be educated, insightful, and compassionate therapists. There are a variety of advantages to working with someone in this environment, including the fact that these programs often accept all kinds of insurance. If you don’t have insurance, community mental health centers often allow clients to pay for services at a reduced rate. There are even some grant-funded programs that offer free services. Such financial matters are dependent upon the funding and availability in your state and local community.
Of course, there are also a few drawbacks to community health centers. The environment is not as personalized, the practitioners are often overworked and stressed, and you may experience longer wait times.
PRIVATE PRACTICE & GROUP PRACTICE
There are many advantages to working with a therapist in private practice. Private practice therapy offers independence and flexibility. For the client, private practice therapists allow out-of-pocket (private) payment, which eliminates the necessity for a specific diagnosis or a billing submission to insurance companies—a definite plus for many people. More about the complexities of mental health diagnosis and insurance in the coming pages.
Group practices offer the same flexibility and independence as individual private practice, but with additional support. In certain cases, group practices offer options to see practitioners who offer complimentary therapeutic services. For instance, topics such as nutrition, fitness, and alternative medicine are sometimes integrated in group practices. Group or private practice environments are also usually designed to be less institutional and more casual.
EMPLOYEE ASSISTANCE PROGRAM
Employee Assistance Programs (EAPs) are benefits offered to employees that are either a component of a medical plan or offered as an additional employee benefit outside of the medical plan. Yes, some companies sponsor therapy services for their employees.
During my time in the EAP industry I was surprised that so many of the employees were unaware of the services available to them. EAPs allow employees to seek counseling services free of charge within certain criteria. To see if your organization has an EAP, contact your human resources department. Larger organizations are more likely to offer EAPs. This excellent resource may provide free services; if nothing else, it will support you in your search for the right service.
VETERANS ADMINISTRATION
Veterans Administration (VA) locations have become hubs for therapy because of recent demands for the services of social workers, psychologists, psychiatrists, and counselors. Behavioral health specialists working in the VA deal with a wide range of issues, including Post Traumatic Stress Disorder (PTSD), addictions, trauma, and family-dynamics issues. Thanks to the recent expansion of mental health services within the VA system, there are now many more resources available for veterans.
HOSPITAL
Mental health services in a
hospital encompass an array of roles, depending on the needs of each patient and family. There is evidence to show that hospitals are becoming more popular settings for mental health workers.95 Experts attribute this to healthcare transitioning to an integrated care model.96 For those of you seeking mental health services, this is good news as it broadens your range of options.
CRISIS INTERVENTIONIST
The role of a crisis interventionist may vary depending on context, but it usually involves helping individuals or organizations debrief from a specific crisis and providing them with necessary resources and support. Crisis workers are often brought into hospitals to intervene when someone is in need of emergency therapeutic services. Crisis workers also provide “safety checks” in the community, such as when someone poses the risk of harming him/herself or others. When called in, crisis interventionists explore other immediate resources for clients and in extreme cases, recommend involuntary psychiatric hospitalization. In addition, most hospitals will either have internal services or a contract with agencies that can provide help for those in need 24 hours a day. To learn more about crisis intervention, contact your local community health agency or, in an emergency, dial 911.
CORRECTIONAL FACILITY
I add this section to emphasize the importance of rehabilitation. The right kind of mental health services can impact sustainable change, no matter the context. According to an article in the journal, Law and Human Behavior, mental health intervention has proven effective in reducing recidivism.97 According to a 2014 article in The American Journal of Public Health, 26 percent of almost 20,000 inmates surveyed had been diagnosed with a mental health condition in their lifetime. In addition, more than 50 percent of inmates in this study were not receiving the medication they needed upon entry to prison.98 Thankfully, according to a 2017 article in the journal, World Psychiatry, there is an emergence of treatment approaches within prisons and within the legal system as a whole.99 And as these types of therapeutic services expand, we see more and more benefits.
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