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Holding Hope Services

Julie Fanning LCSW

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therapy

A Therapist’s Promise

I found this on a Facebook page and I absolutely loved it.  I searched the internet trying to find the source but had no luck but it is attributed to a D. Welsh.

I liked this because ideally this is what I’d like the therapeutic relationship to be.  This is what I strive for.  I don’t always succeed but it is the standard I’d like to which I’d like to hold myself.  This is the kind of therapist I’m trying to be.  This is what I’d like our therapeutic journey to be.

A Therapist’s Promise

“I will do my best to understand who you are.  I will do my best do be who  I am.  I will not judge you or try to control your life. I will not tell you what to do.  I cannot make you grow or do your growing for you.  I will help you become more aware, more loving, more able to fashion a richer, fuller life for which you accept responsibility.  I cannot protect you from the pain and suffering of life.  Pain will be part of the experience we share.  I will help you to face it, accept it and use it to grow.  I will be present.  I will not hide from you, even when I am afraid.

I will be with you as long as I see, in the smallest way, that you are trying to grow.  I will not journey with you to help you become ‘normal, adjusted, self-satisfied’ person.  Nor will I help you whine and wallow in the misery of your life.  I will help you take charge of your life and reinvent it.

I invite you to tell your story as honestly and truly as you are capable of telling it.  I may tell you part of my story when it is appropriate and helpful to do so.   I will say hello to you as honestly as I know how, but my commitment is to encounter you in such a way that you will decide to say good-bye.

I will help you die.  I will help you let go of outgrown and worn-out ways of being so you can be renewed.  It may be painful and terrifying to let go of the old you.  I will not run away from the experience.

I believe there is something in this world, here, now in each of us, restlessness, a trembling of something that will not lie in stillness, which seeks renewal, which seeks to bring us together in responsible love, which invites us to grow and become.  We can deny this human spirit. We can deny its expression and be miserable. Or.  We can encounter one another in such a way that we will honor it by freeing each other to grow and be.”   D. Welsh

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May is National Photo Month

May is National Photo Month. 
I like photos.  I think it is a throwback to my mom who had (and now I have)  about 50 or more photo albums.  With social media and the digital age it is probably less likely that people have photo albums but it is generally easier to share pictures.  Photos are a snapshot in time which hold our memories.  I don’t think I encourage it enough but I love when clients bring photos – whether a hard copy or on their phone or whatever- to a session to share.  It allows me to get a bit better picture of the client. 
 Below is a link to one of the worksheets I occasionally use to encourage the sharing of photos.

May is Mental Health Month

May is National Mental Health Month.  A whole month to celebrate mental health.  So often we overlook our mental health.  Maybe we don’t see it as being vital.  Having a positive outlook or good mental health can improve our physical health.  If you are struggling there is not shame in asking for help.  So many people have undiagnosed mental health issues because of stigma, fear and buying into the whole “pull yourself up by the bootstrap” mentality.  Getting help is not a sign of weakness – it is being courageous, giving priority to taking care of yourself and in turn helping those around you.

For more information visit on National Mental Health Month visit Mental Health America.

Couple’s Counseling

I am just jotting down some quick random thoughts after reading a short article on why couples therapy might not work.  I actually agree with several things in this article.  Nothing earth shattering, just things to consider when embarking on couples counsleing.

Personally, I believe people often wait too long to go into therapy – a last ditch effort- to be able to say everything was tried.  I am a firm believer that improving communication skills and strengthen relationships is always a good idea so why not go to therapy before things get too bad.  Find a therapist who can believe in your relationship and fully commit and you are on your way.

10 reasons couples counseling may not work

Insurance – My thoughts.

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On one of the therapist message boards I look at there is an ongoing debate regarding therapists accepting health insurance.   I do accept insurance and for the foreseeable future plan on continuing.
Many on the boards are against accepting insurance.  Most are or want to be private pay only therapists.  Some will have nothing to do with insurance and will give super bills to the client so the client can request some reimbursement.  Some will submit out of network bills for the client. 
I get it.  There are a lot of negatives to taking insurance.
  • Insurance companies generally do not seem fair to therapists.  The reimbursement levels for therapists vary hugely.  Often reimbursements are way below the therapist’s fees and there are lots of hoops to jump through to get paid.  For a therapist trying to run a practice this can be devastating.  A therapist generally has education, has obtained a license, engages in specialized training and should be compensated for these skills.  Therapists are running a business.  They have overhead of rent, taxes, supplies, utilities, ongoing licensure and training etc.  Being paid a low rate can mean they are unable to provide service at all. Many therapists are unable to run a practice on insurance rates alone.  Also, why would a therapist who is going to want to have a healthy lifestyle of their own want to work a lot more for a lot less pay.  Doesn’t make sense.
  •  Insurance companies require a mental health diagnosis.  Insurance will be provided some information about you.  Most therapists I know try to be discrete and share as little as possible with insurance companies but insurance companies will not pay without a diagnosis.  Some insurance companies have gone as far as to wanting your session notes.  No one wants all this personal information shared with random people.  These diagnoses can follow you throughout life just like a physical diagnosis.
  •  Insurance companies sometimes try to decide treatment for you.   This hopefully happens less with the mental health parity law but it happens.  They may say your diagnosis is not severe enough.  They may question your therapist on why you are not making more progress and why you keep on needing therapy.  Insurance may try to limit your sessions and so many other things.
My experience is that insurance companies are not necessarily going to approve of the best services for the client because they are, after all, business too trying to make money. There are other reasons not to use insurance but the above is a good start of why some therapists refuse to take insurance.
Why I will keep taking insurance (at least for now).
  • Therapy is definitely worth its cost but the reality is that it is expensive.  Lots of therapists will work with you but even a reduced rate of 75 dollars a session can be expensive.  I totally agree with people who say, clients should make it a priority if they are seeking help.  I agree with the sentiment that a client should look at what they can get for the costs.  For example, how much is it worth to have your marriage saved or how much is it worth to have a healthy child or family.  I think people should prioritize these things and should try to find the money to pay for it.  However, I also know the reality is that money is tight.  If a person has the option of paying $100 a session vs. a $20.00. It is hard for many people to justify not paying only the 20 dollars.  If money were not a consideration that maybe no insurance for therapy for everyone would be the best option but finances are often a huge consideration. 
  • Keeping on from the above reason – I don’t want therapy to be only for the wealthy.  Why shouldn’t we all have better mental health?  If someone has suffered trauma should they only be able access services if they have money.  If someone is grappling with anxiety should they just live with it until they get a higher paying job or something?  Therapists will argue that there is lots of low cost therapy out there.  Its true there is high quality, low cost therapy out there.  I worked in an agency and I know lots of good therapists that work in agencies.  However, there are pitfalls.  Often these services are high demand and as a client (and as a therapist) you often get whoever is available.  You might meet your new therapist for the first time and you and the therapist aren’t a good fit.  Well, too bad this is who is available.  There are waiting lists and not always ideal locations and appointment times.  You may get with a phenomenal program but often you lose your choice along the way.
  • I am someone who thinks almost everyone could benefit from therapy so I should do my part to make it affordable.  I can’t offer $20.00 sessions and stay in business but I certainly can take insurance and accept a $20.00 co pay.
  • One of the biggest reasons for me to take insurance is that, for me, it is almost hypocritical not to.  What I mean by that is that I believe that as a society we stigmatize mental health issues and there is often shame related to it.  How can I as a therapist say there is nothing wrong with a mental health diagnosis but then say – don’t tell anyone though.  Maybe if everyone kept giving the message that our mental health is important and any issues we may have are not something to be embarrassed about, stigma might lesson.  I wouldn’t be at the doctor’s office saying “could you not put I have migraines – I don’t want that following me.”  Mental Health shouldn’t be any different.  I understand we live in the world that is not the ideal but I want to work toward the ideal. 
As the client you will need to make the decision if using insurance is for you or not.
Thankfully for you there are a lot of options out there and you can choose the path you want to take.  There are great therapists out there with all sorts of financial options.  And don’t believe that the best therapists don’t take insurance.  It may vary by area of the US but there are plenty of good therapists that take insurance around where I practice.  In fact I know very few therapists that aren’t on at least some insurance panels.  Lots of therapists pick and choose which companies to work for even.  I am even getting off one panel that has ridiculously low rates and are slow payers. 
In the end it is about you and you get to make the choice that works best for you.  I definitely know clients who will pay what they have to in order to keep their confidential information between themselves and their therapist and I know individuals who could not participate in therapy without insurance.
Good-Luck with your therapeutic journey!!!!

Veterans Day

Thursday, November 11th is Veterans Day in the United States. 
Obviously, people have different views but I am appreciative of all those who served this country.  Service is noble and honorable and worthy of praise.
If you are a veteran there are resources and services available to you.  Wherever you live in the US there should a Veteran’s Service Officer who can assist you with obtaining benefits and assistance.  Don’t hesitate to ask.
Veterans Administration  or do an internet search “county veterans service officer”
Another organization, Give an Hour offers mental health counseling for free to individuals who served in Iraq and Afghanistan – and their families with mental health needs.  This is a free service and licensed therapists donate their time to assist military and their families.
Obtaining mental health is assistance is not a sign of weakness but a sign of strength.  Events from 40 years ago can creep up on you and contribute to feelings and behaviors right now.  If you believe talking to someone may help or even if you think that it probably won’t help but you are willing to try, take that chance and find a therapist.
The last of my ramblings is to recommend a book Tears of a Warrior: A Family’s Story of Combat by Janet and Anthony Seahorn.   This book is easy to read and seems beneficial for Veterans, those who love them and even clinicians who treat them, it talks about the long term effects of PTSD.
To all Veterans – Thank You for your service. 
(And of course below are the quotes I can’t help but add.)
“We often take for granted the very things that most deserve our gratitude.” 
~Cynthia Ozick
“America’s veterans embody the ideals upon which America was founded more than 229 years ago.”
~Steve Buyer
“In war, there are no unwounded soldiers.” ~Jose Narosky

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