Have you ever thought about seeing a therapist and turned down the idea because you couldn’t find a therapist you liked closeby, or the therapist didn’t have hours that matched with your schedule? Maybe you’re intrigued by the idea of online counseling and don’t know where to start. Ads for online counseling services are popping up everywhere lately, touting the benefits of using technology to provide a service that is usually linked to a one-on-one meeting in a private office. What is this all about?
What is online counseling? Most practitioners use this term to mean therapy that consists of mostly or entirely work through live video conferencing, email, texting or instant messaging, real-time chat, or phone service over the internet. For this post, I’m using the word online counseling to describe using a video service to connect and have sessions with a therapist who is not physically present.
What are some of the reasons people use online counseling? People utilize online therapy for a wide variety of reasons.

• Some people may live in isolated areas where there are not many therapists to choose from.
• Others have chronic illnesses, which can make it difficult to physically get outside of the house.
• Online therapy is useful for those who don’t have readily accessible transportation.
• Caregivers for children and the sick/elderly find that online therapy is very convenient.

What are some of the benefits of online therapy? There are many, which makes it easy to understand why the field of online counseling is rapidly growing all over the world.

• Comfort: I have had clients tell me that they find it easier to open up when they’re sitting comfortably in their own space. They can have therapy in their pajamas and slippers if they wish, or curled up on their couch with their dog and a cup of tea.
• Time: Saving time is a big benefit of online counseling. You don’t have to spend time in traffic driving to an office which may or may not be close to where you live or work. It’s very possible to fit in a 45-minute video session during a 60-minute lunch.
• Discreet: Unfortunately, the stigma for psychotherapy is still out there. Some people don’t want to have to explain to their boss or coworkers or kids that they’re seeing a therapist. Being able to have a session online solves that problem.
• Clients who are extremely shy/anxious. Clients appreciate the semi-anonymity of online counseling. People who struggle with anxiety have told me that they were able to open up easier because they did not have to be with their therapist in person. Sometimes things are easier said online. Think of how much the people on your social networks or chat rooms know about you and how easy it can be to be open with someone who is not physically present.

So what about the concerns? Online therapy isn’t for everyone. Here are some contraindicators for online counseling.  If you are actively suicidal, having a therapist who is physically present is crucial for that higher level of support needed. Not having a secure, strong internet connection during your session can lead to technical problems. If you’re being abused by someone, online therapy could open the door for your abuser to listen in or threaten you during your session, so this is another time when therapy is best done in person. If you have any concerns if online therapy is right for you, discuss your thoughts and concerns with the therapist you’re interviewing.
How do I find an online counselor? There are several companies that provide online therapy utilizing a ‘membership’ type style where you pay a fee and get access (often unlimited) to a therapist of your choosing for a set period of time, usually a month. But if you look, you’ll find that many therapists who have a brick-and-mortar office offer online services as well. If you’re seeing a therapist in person, you might want to ask if this is something they provide or are willing to look into.
What to look for in an online counselor: It can be overwhelming looking for an online therapist. In the United States where I practice, each state has one or more regulatory boards that provide laws and guidance regarding how a therapist or counselor can work online. For most states, and in my own state of Ohio, the therapist must be licensed in the state where you, the client, lives. So I can’t legally and ethically provide therapy for someone in California but can for anyone anywhere in Ohio. The laws are constantly changing, though, so keep an eye on it. Of course, it’s your therapist’s job to ensure that they are legally allowed to treat you.

• Check their license. Ask them where they are licensed, and go to that board’s website to verify their credentials. This is also the way you can check and see if there have been any restrictions placed on the therapist.
• What platform are they using? Is it HIPAA compliant, meaning, is the information that is transmitted securely? You want to make sure your privacy is a priority.
• Does your therapist have expertise in the areas you are looking for help with?
• Do you feel a connection with them? Warmth and sincerity can be displayed through a video screen as well as in the tone of voice.
• How are the sessions set up? Is it the traditional weekly 45-50 minute therapy ‘hour’ appointment?
• Are you able to reach the therapist outside of your scheduled time slot?

The world of online therapy is exploding. Many insurance companies are even covering it. The more online therapy I provide, the more I realize that it can be a very helpful way of connecting with and helping people that I normally would not be able to reach.
If you’ve used online therapy, what has been your experience?

It seems like there's an app for everything these days. I was interviewed about this question. Here's a link to the video. 

By Jen Hargreave and Jenise Harmon

Here are a few things I've learned about supporting a loved one with mental health issues:

1. Anyone can suffer from depression. A person with depression could be your neighbor, your best friend, your child's teacher, your pastor, your partner. It can be you. Depression doesn't play favorites.
2. Someone who has depression may not appear to have it. It doesn't matter how positive, optimistic, "together" they are. They can still suffer from depression. You could be a politician, a steel worker, a homemaker, a professor, an actor and be depressed. Often people with depression hide their distress and can hide it well. Your outgoing, bubbly friend who is always up for going out and having fun could easily suffer from it, and your melancholy, introverted teacher may not.
3. Your well-meaning advice may not help in a moment of deep depression. Your intentions are good, but someone who is depressed is driven by pure emotion.  Whether or not those feelings are reasonable is a moot point. Their feelings are very real and very painful.
4. If you want to help someone one with depression,  don't tell them what to do, but ask them how they feel. Never tell them that they shouldn't feel that way, or reason with them about why they shouldn't.  Acknowledge their feelings. and love the person outwardly.
5. Put your love into action by helping with the things that are overwhelming them. Make a dessert or meal, help with housework, send a card, text or check in on them regularly. There are many things you can do, great and small. Saying you love them and support them but not actually putting that love into action is meaningless. Words are bullshit. Sorry, but they are. If you won't actually do something (and there's plenty you can do regardless of distance and money to show support) then don't bother with the words. It's just painful and counterproductive. That's not to say you can't reach out regularly with love and encouragement, but an occasional "I support you and love you" is absolutely meaningless when that's all you offer on the rare occasion.
6. A person who suffers from depression struggles to do the things they know they need to do. From small things like taking a shower, to bigger things like go to work or care for their children/pets/home. Tackling the task of getting out of bed and brushing one's teeth may be so overwhelming the person is incapable of doing it or uses every bit of physical and emotional energy they have to do it. If they are able to dig deep within themselves and manage to do the basics of daily life, they get drained. Then they feel so depleted that doing anything else is impossible. Going to the grocery store and taking care of their home becomes insurmountable. There will be times they can't be in public, or outside of their comfort zone without great anxiety and or absolute exhaustion. Sometimes they won't even be able to leave the house. They may not even be able to ask for help, even though they want and need it.
7. Don't take it personally if your loved one breaks plans or doesn't stay in touch the way you'd like. That day they cancelled on you might have been the day they barely managed to get up, get ready for work, resist the deep urge to wrap their car around a tree, and carry through their day without losing their calm in front of their coworkers, and they simply have nothing left to give by the end of the day. It also might be the day that they need someone there with them or an outward show of love,
8. If a loved one reaches out and shares their struggle, recognize this was probably a really hard thing for them to do. No one wants to feel like a burden, or to be that "negative Nancy". No one wants to feel like they're imposing on another person's happiness. No one wants to bring others down. Reaching out might just be the bravest and most difficult thing that person could do. Honor that. Don't respond with "well let me know when you're better so we can get together" or "you should just CHOOSE to be happy!" Or "you need to learn to stand on your own two feet". I promise you, that person will never, ever reach out to you again and they will feel as if they've lost a lifeline.
9. The guilt and shame and embarrassment people feel are real. It is terribly hard for a person who is depressed to allow others to see this part of them. If they share this deep part of themselves with you, let them know that having depression is nothing to be ashamed or embarrassed about. They have trusted you with a very fragile part of themselves. Don't destroy it by minimizing their pain or joking about it. Mental illness is not funny.
10. A person suffering from depression feels worthless. Unloved. They may KNOW that's not the case but that's not how they FEEL. The most common thing for their loved ones to say is, "you know I love and support you!" Again, in a state of deep depression, a person can know these things, but their feelings are driving them and unless they are being shown that love, knowing it exists on some other plane is meaningless. These feelings need to be responded to not with logic/reason, but with the most basic of things: love put into action. It might be just the thing that pulls them through.

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A person suffering likely can't tell you what they need at the moment. The pain and feelings of isolation and worthlessness feel permanent, and they feel like they're drowning. Just like you wouldn't ask an actual drowning victim how you can help, don't ask a depressed person what you can do. Jump in. DO something. Saying "I'm bringing you by some dinner" is more powerful than saying "can I bring you by some dinner?" Declining help that is offered is much easier than asking for things.
Here are some links and resources to help friends and family of people suffering from depression and other mental health issues. National Alliance on Mental Illness, Help for Friends and Family Members of People with Depression,
There are many resources out there for family members and loved ones of those suffering from mental Heath issues as well. It's important to take care of yourself, too- be sure not to allow caring for another to negatively affect your health.

People seek marriage or relationship therapy for many reasons.  For some people, it’s because of a crisis, such as infidelity, job loss, illness or accidents.

Others come in because they feel distant and want to grow closer, or they seek counseling before they marry to sort out any difficulties and ensure that they’re ready for life together.

Some couples simply know that something feels wrong but they don’t know what, and they want to fix it.

But once you and your partner have decided to seek counseling, how do you make the most of it? Here are six things to consider.

1. Find a therapist who has experience in what you’re seeking therapy for. If there is addiction involved, ask about a potential therapist’s experience. If there is infidelity, has he or she worked with many couples who have been unfaithful?
2. Think about your goals and compare them with your partner. Your goals do not have to be the same; most likely they’re not. But consider what you’re hoping for. Do you hope to make your marriage better? If so, how? Are you looking to try and figure out if your marriage will work? Are you looking to improve communication, heal old wounds, be happier? Your goals may change and expand as you work with a counselor, but it’s a good idea to go in to your first session with an idea of what you hope to get out of counseling.
3. Be honest, both with your therapist and with each other. It can be really hard to talk about negative feelings or experiences, or to bring up past hurts, but without honesty counseling won’t progress much.
4. Don’t stop working once the session is over. Talk to your partner about it, journal, think about your thoughts and feelings. Most of the work in therapy doesn’t happen in the office, it happens outside the office.
5. Ask about privacy and confidentiality. Some therapists will want to meet with each partner individually, and you will want to know ahead of time if what you say in your individual session will be brought up in joint sessions. Different therapists deal with this differently.
6. Make therapy a priority. Marriage counseling works best if it happens regularly. When I work with couples, I prefer to see them weekly in the beginning, and as things get better we often taper off before deciding to end. Make the time in your calendar, get a list of babysitters, put the cost of therapy in your budget, and go regularly, even if you don’t feel like it.

Marriage counseling is difficult. You’re confronted with the parts of yourself that you or your partner is unhappy with. You will hear things that will be painful, and you’ll say things that are painful.
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You will be asked to make changes in your behavior and how you think about things. But marriage counseling works. It can help people find more joy in one another. It can promote growth and healing.
Hopefully you will walk away with a better understanding of yourself, your partner, and your relationship. And these are things you can use for the rest of your life.