How to Cope with Stress

How to Cope with Stress

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Ah, Stress…we all have it. Most of us wish we had less of it. And yet, more often than not, the impact it has on us is mainly determined by how we perceive and respond to it. You CAN learn to manage stress instead of stress managing you. Take a look at some of the ideas below and see if you can begin incorporating them into your daily habits. You should begin to notice the effects immediately!

  1. Get Active – exercise daily even if it’s just a brisk walk around the block. Moving our bodies helps to activate our brain and provides an opportunity for indirect processing. Give yourself a break from stress by engaging in physical activity!

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  2. Get good sleep – it’s tough to cope if your basic needs are not getting met and sleep is one of those basic needs! Practice good sleep hygiene (see worksheet). Most healthy adults need at least 7 hours of good, uninterrupted sleep, but many people need up to 9 hours. Keep in mind that substance-induced sleep is not good sleep.

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  3. Improve your eating habits – talking about basic needs, here is another one. Eating healthy, nutritious meals is vital to our coping abilities. Fast food, fats, sugars, etc. all place strain on the body in various ways thus reducing our resiliency and tolerance for stress. If you find yourself eating in your car and chronically at the drive-thru, it’s time to slow things down, re-evaluate your habits, and make some changes to better support your diet. Fruits and vegetables, baby!

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  4. Practice mindfulness – we are all in a hurry. There are a million things to be done and never enough hours in the day. While it sounds contradictory, you will be more effective and efficient if instead of multi-tasking, you focus on doing one thing at a time and giving it your undivided attention. We call this mindfulness and there is another handout about it if you’d like to know more!

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  5. Practice active relaxation techniques – our stress levels can increase without our even noticing so it’s a good habit to periodically practice a relaxation exercise. Try deep breathing (5-7 minutes), complete a body scan, progressive muscle relaxation, etc. Even a stress ball or other sensory item can help interrupt the stress accumulation process and help you regulate.

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  6. Play – ensure you take time each day for something fun. Our brains and bodies REQUIRE periods of levity and recreation. If you can, try something new each day. The only rule is that it’s an activity that doesn’t cause any harm to you or anyone else. If you have difficult thinking of ideas, reference the pleasurable activities worksheet.

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  7. Talk it through – without looking for advice or solutions, talk through your stressors with someone safe. Just voicing our problems helps with processing and stress relief. Even better if you have someone in your life who can be nonjudgmental, objective, and supportive.

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  8. Write it down – start a stress/anxiety journal and track the things and situations that seem to exacerbate your stress levels. Again, this is a form of processing and purging. It is also an excellent tool to begin looking for patterns and begin problem-solving those issues which are intolerable to you.

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  9. Develop a mantra – Mine is “it is what it is.” It reminds me that even though something may feel intolerable and overwhelming, feelings are not facts and they will pass or the situation will be resolved. Think of an inspirational or meaningful phrase that you can focus on to redirect tension from a problematic internal experience to something more tolerable and constrained. “Be brave,” “One day at a time, “Calm, cool, and collected,” and “This too shall pass,” are some good examples.

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  10. Say “no” and set effective boundaries – you are one person and you have limits. This is a fact. Practice setting boundaries and protecting those limits so as to have enough time for self-care and relaxation. Saying no is a powerful and important skill. You cannot help others unless you are in a good place yourself. So even if you are externally focused, try to shift that focus regularly onto yourself so that you can stay in a good place.

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  11. Never give up – no matter how hard or stressful things are right now, the one thing guaranteed is that they will change. Everything does. It will get better. It will get worse. And your job is to hang on throughout the ride and just do the best you can to be the best you can.

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Download a printable version of this worksheet HERE

CCWS Crisis Safety Plan

Crisis Safety Plan

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The holidays are upon us and as such, it can sometimes feel like we are drowning. We all go through rough periods, often times unexpectedly. If you are already struggling with mental illness or have a lot of stress in your life, this can increase your vulnerability during times of crisis. The outline below guides you through the development of an informal safety plan to be referenced in times of need. Complete this plan now so that you have it ready to go should it be needed. It can also be helpful to review it with your doctor or therapist if you have the chance.

Step 1: Identify your personal warning signs by answering the question “I know that I could be heading for a crisis when I experience….” (e.g. crying spells, isolating from others, feeling “crazy” in general)

  1. _____________________________________________________________
  2. _____________________________________________________________
  3. _____________________________________________________________

Step 2: Identify your go-to coping and distress tolerance skills by answering the questions, “What makes me feel better when I begin to struggle” and “What can I do to feel better now, without making things worse in the long-run?” (e.g. use distraction coping skills, journal, go for a walk)

  1. _____________________________________________________________
  2. _____________________________________________________________
  3. _____________________________________________________________

Step 3: Identify your supports by answering the questions, “who can I trust to talk to about what I’m going through,” or “who could help distract me from this immediate crisis long enough to begin feeling better?” (e.g. a parent, friend, pastor, etc.) Include their names and phone numbers below:

  1. _____________________________________________________________
  2. _____________________________________________________________
  3. _____________________________________________________________

Step 4: Identify places to go to ensure safety by answering, “where do I feel safe and good,” and “where is a place that will provide distraction and/or fun?” (e.g. the movies, church, a local park, etc.)

  1. _____________________________________________________________
  2. _____________________________________________________________
  3. _____________________________________________________________

Step 5: If all of the above is ineffective and you believe that you might be a danger to yourself or others, it’s time to increase the intensity of the plan as follows:

  1. Call your doctoror therapist: ___________________________________
  2. Call, text, or online chat with the National Suicide Prevention Lifeline (available 24/7): 1-800-273-8255 and/or
  3. Go to the nearest Emergency Department– they will connect you with a mental health professional for an assessment and treatment if needed
  4. Call 9-1-1if your safety is in imminent danger

There is only one you. There will never be another. No matter how low you are feeling now, you are still a unique, important and valuable being. Don’t do something permanent when there truly is hope and help out there for you. You matter!

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Download a printable version of this safety plan here: CCWS Crisis Safety Plan

Mindfulness Practice

Mindfulness Practice

Now that you know what it is and have a basic guideline for how to do it, it’s time to actually practice some mindfulness. These are some quick and easy exercises that you can do anytime and anywhere to start working your mindfulness muscle. Enjoy!

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Get mindful using your five senses. Our basic senses send information to our brains that help us understand and make sense of the world around us. They inform our experience on every level, so what better place to begin practicing mindfulness.

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Sight/Vision: Quick! Close your eyes and try to describe in as much detail as possible everything that is in front of you from memory. Now open your eyes and contemplate your surroundings. Can you observe something you’ve never noticed before? What emotions do you notice while observing with your eyes? What colors jump out at you? What shapes seem to be repeated? What are your favorite things to gaze upon? Do you have a cherished painting or piece of art? These have been used since the beginning of humanity to tell stories and evoke emotion. Take a moment to notice how what you see impacts you and appreciate that – learn from it or just observe it.

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Sound/Hearing: Even in silence there is sound. Have you ever noticed when it’s super quiet it seems then that you can hear your blood pumping? Try putting on your favorite song and listen to it without doing anything else. Immerse yourself in the music, the sound, the lyrics and let go of everything else. Ask yourself how the music makes you feel, how it impacts you. Are there elements that strike you in a particular way? How hard is it to sit through an entire song one-mindfully? Did you struggle with this exercise? If so, you may want to practice it until it becomes easy. Remember to be gentle with yourself. We are trained to multitask, so unlearning that generally unhelpful habit will take time and practice.

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Smell: Why do you suppose we have such an industry in candles, perfumes and colognes, aromatherapy, etc? Smells are compelling. They are one of the most powerful triggers for memory and can evoke strong emotions for better or for worse. So again, take a mindful moment to appreciate an aroma fully and one-mindfully. You can light a candle, enjoy the fragrance of your shampoo, notice the dish soap while cleaning up. Go outside and breathe deeply. What can you perceive? Is the air fresh or stale? Are there any flowers or trees in bloom? Car fumes, mold, barbecue, animals? Notice what is there, but remember to be nonjudgmental in your observations. Describe what is, but leave your personal opinion out of the equation as to whether it’s good or bad.

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Taste: This is one of my favorites. We have at least five different types of taste receptors in our mouths which makes food a very potent mindfulness activity. You can do this activity with just about anything edible. I often use raisins when I do this exercise in group. Place the food in your mouth and simply notice it. Notice the weight and texture as it sits on your tongue. Notice any initial flavors. Now roll it around your mouth a bit – does the consistency change? How do the flavors change as it comes into contact with different areas of your mouth? Give it a chew now, slowly, and notice any sounds or resistance. Is it crunchy or gooey? You get the idea. Try it sometime with a Hershey’s kiss – can you let the kiss melt completely in your mouth while you one-mindfully observe the experience? It can be harder than you might think, but the payoff is worth the effort.

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Touch/Feeling: Last but not least is our ability to feel sensations with our bodies and skin. Pause and notice what you can feel right now. Are you sitting or standing? Is your seat firm or soft? Can you perceive the ground or floor through the soles of your feet? Feel that connection. Are your clothes restrictive or loose? Soft, silken, cottony, scratchy? Are you feeling warm, chilled, or just right? Is the air humid, dry? You get the point. What all can you sense that is in contact with your body right at this moment? Practice observing it and describing it without using judgmental (good/bad) terminology. That itch on your back?… Observe without reacting (just kidding, you can scratch that itch!).

Once you have a good handle on using the five senses for mindfulness, you can integrate these skills into every moment of every day. Here are some ideas:

  • Take a shower or bath…mindfully
  • Wash the dishes…mindfully
  • Weed the garden…mindfully
  • Drive to work…mindfully
  • Listen to the news…mindfully
  • Read a poem or chapter…mindfully

The options are endless. Keep working your mindfulness muscle and you will begin to notice positive effects throughout your being.

Download a printable version here

More on Mindfulness

Mindfulness in a Nutshell

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Mindfulness – whether you love it or hate it, it is one of those universal things that just about all of could use more of – think of it like a muscle that needs regular exercise and when you take the time to work it out, the payoff is huge!

Whether you are just starting out, or looking for strategies to grow, the following is a brief primer with helpful tips.

As a refresher, remember that:

Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally…It’s about knowing what is on your mind.” – Jon KabatZinn

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Google mindfulness and you will find literally thousands of how-to guides, but the version that I still prefer and use in my own sessions comes from Marsha Linehan, PhD, developer of Dialectical Behavioral Therapy. She breaks the process of mindfulness down into 6 concrete, but interrelated skills – the “What” skills (as in what you are doing) and the “How” skills (how to perform each action).

“What” Skills “How” Skills
1. Observe 4. Non-judgmentally
2. Describe 5. One-mindfully
3. Participate 6. Effectively

Seems pretty straightforward so far, right? Here are the details:

  1. Observe– this involves noticing your experience and what is happening around and within you. Many people find it helpful to start with the five senses – what can you see, hear, feel, smell, and taste right now in this moment? Build from there – what thoughts are you having? What are you saying to yourself? What emotions are occurring? What situation do you find yourself in? What’s happening around you?
  2. Describe– put words to the things you noticed while observing. Label your experiences in order to make sense of them. Remember words are powerful though – be as accurate and objective as possible.
  3. Participate– jump into your moment with both feet. Observing is an action word – don’t stop living or stop an experience in order to observe it. Actively practice your new skills in day-to-day life. Participate in life. As Linehan wrote, “become one with your experience, completely forgetting yourself.” Don’t be a wallflower and don’t worry too much about what others may be thinking about you – odds are they are struggling with their own insecurities anyways.
  4. Non-judgment– Practice observing, describing, and participating without evaluating the experience as either positive or negative. Accept things without judging them. It can be harder than you might expect, but it has tremendous impact on mental health. And in those situations where you find yourself unable to be non-judgmental, just notice what is occurring, call it what it is, and remember not to judge yourself for judging.
  5. One-mindful– this is often the hardest thing for people these days. In a culture that encourages and celebrates mindless multitasking, I am asking you to slow yourself down. Complete one activity at a time, with mindful and conscious attention. Concentrate and focus on that one experience, noticing every minute detail and appreciating that moment fully. Let go of distractions. Give each action your full attention.
  6. Effectiveness– do what works for you. Avoid judgments, avoid the shoulds and musts, avoid comparing or competing. Focus on your experience and finding ways to augment it based on what works for YOU. Act skillfully and from that place of mindfulness that you are now learning to tap into. 

Ready to practice? Try some of these suggestions from Mayo Clinic here.

**Adapted from Marsha Linehan’s Skills Training Manual for Treating Borderline Personality Disorder which can be bought on Amazon here.

Download a printable copy of this worksheet here: CCWS Mindfulness

What the Heck is Mindfulness??

What the Heck IS Mindfulness??

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Mindfulness is one of those universal things that we all need more of and something which can always be improved. I like to think of mindfulness as a muscle that needs to be regularly exercised and developed. If you are new to mindfulness and still working to build your understanding of the general concept, the following is a collection of definitions from various sources to get you started. Next week, we will get into the nuts and bolts, so stay tuned!

  1. starts us off with the overview that “Mindfulness is about waking up, connecting with ourselves, and appreciating the fullness of each moment of life.”(
  2. According to Oxford Living Dictionaries, mindfulness is 1) The quality or state of being conscious or aware of something, and 2) A mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.(
  3. Per Greater Good Magazine, “Mindfulness means maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens. Mindfulness also involves acceptance, meaning that we pay attention to our thoughts and feelings without judging them—without believing, for instance, that there’s a “right” or “wrong” way to think or feel in a given moment. When we practice mindfulness, our thoughts tune into what we’re sensing in the present moment rather than rehashing the past or imagining the future.” (
  4. On, the discussion emphasizes that, “Mindfulness also involves non-judgment, meaning that we pay attention to our thoughts and feelings with the attitude of an impartial witness — without believing them or taking them personally.” (
  5. As written in a client handout by Cindy Sanderson, Ph.D., “Mindfulness is “awareness without judgment of what is, via direct and immediate experience”. (

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  6. And finally, from one of our leading minds on the subject, we have Jon Kabat-Zinn who says that “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally…It’s about knowing what is on your mind.”(

As you can see, the running themes include awareness of situation and personal experience, without judgment or expectation, and without reaction. Mindfulness means noticing your thoughts and emotions, without trying to either fuel them or terminate them. Simply seeing, naming, and accepting…without judging. And that also includes not judging yourself when you notice yourself judging. Especially because judging is a normal part of being a human being, we just want to notice when we are doing it. Mindfulness gets a little complicated. Check in next week for more information and strategies for getting started!

For a printable version of this post, click CCWS Mindfulness Definitions!

Activities List

Action: At the core of well-being!

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We all get into a rut sometimes. Whether you are working through a period of depression, working to improve your self-care, looking for a new hobby, or just wanting to experiment with something new, here is a list to help get the creative juices flowing and to eliminate that lame excuse of “I just can’t think of anything to do!” As much as possible, try novel activities and complete them mindfully. Pay attention to your automatic reactions and judgments. What do you like, what do you despise, what did you find boring or exciting? What did you learn about yourself?

  1. Take a walk around the block
  2. Watch/feed the birds
  3. Try a new game on your phone or Facebook
  4. Email/text someone you haven’t spoken to in awhile
  5. Teach yourself a new recipe

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  6. Listen to a different station on the radio
  7. Open maps, find a nearby town you haven’t been to yet, drive there and explore
  8. Try a coloring book
  9. Learn a new language
  10. Eat something you’ve never had before
  11. Go to the local park and sit on a bench
  12. Take a bath
  13. Try a new herbal tea
  14. Do a puzzle
  15. Try a new podcast
  16. Grind your own coffee beans
  17. Pet an animal – preferably not a wild one!
  18. Read a book or online article
  19. Plant something outside or in a pot – nurture it
  20. Find a pet rock and give it a name and story
  21. Find three things you don’t use anymore and donate them
  22. Feeling frisky? Find three things you don’t use anymore and try to sell them online or using an app (stay safe!)
  23. Watch a YouTube video
  24. Talk to a neighbor
  25. Do a crossword puzzle
  26. Finally organize those old photos
  27. Alphabetize your CDs/DVDs – pitch the ones you don’t want anymore
  28. Try a new workout

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  29. Sleep in the buff
  30. Begin a list of things you are grateful for
  31. Clean out the refrigerator
  32. Go to a movie by yourself
  33. Meet someone new
  34. Repair something in the house
  35. Wear an outfit you haven’t seen in awhile
  36. Spend the day nude (don’t get arrested!)
  37. Window-shop – either in person or online – start a wish list for yourself and loved ones
  38. Find an inspirational quote and write it in removable marker on your bathroom mirror
  39. Try a new sport
  40. Fly a kite
  41. Doodle or draw without self-judgment or critique
  42. Plan a date night
  43. Reorganize your furniture
  44. Sing
  45. Take a nap
  46. Learn or practice a musical instrument

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  47. Handmake a card for someone
  48. Do some baking and give the excess away
  49. Begin writing your memoir
  50. Write a poem or compose a song
  51. Deep clean a room in your home
  52. Take a different route to the store or to work
  53. Hang out with a child (one that you know)
  54. Play solitaire. Don’t know how? Take an online tutorial or ask a friend.
  55. Find a vegetable or fruit at the grocery store that you can’t identify, find out what it is, and figure out a way to eat it (safely)
  56. Give yourself (or somebody else) a massage
  57. Seriously. No one can see you….just dance
  58. Play ‘hot lava’ with your furniture (safely)
  59. Start your bucket list
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Don’t like my examples? Try googling “pleasurable activities list” or create one of your own! Post your ideas in the comments section for others to benefit from JRemember that you don’t have to like an activity in order to benefit from it, and by trying something new you may discover a passion you never knew you had!

If you would like a printable version of this worksheet, click here: CCWS Activities List

Sleep Hygiene Tips and Tricks

Sleep Hygiene Tips and Tricks

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The importance of sleep cannot be over-rated and yet it oftentimes remains elusive. Use this checklist to begin getting your sleep back in order as you continue your path to mental / physical well-being and recovery.

Sleep Hygiene Pre-checklist

– Get exercise during the day / Spend time outside during the day / Breathe deeply and get some sun

– Practice basic mindfulness during the day – NO NAPS!

– Limit alcohol consumption and avoid mood-altering substances except those that are prescribed / No stimulants past noon and this includes coffee, soda, and caffeinated teas

– Turn your bedroom into a sanctuary – the only thing your bed should be used for is sleep and sex – keep your work and your electronics out of the bedroom / reduce clutter in the bedroom / invest in a quality mattress and pillows / wear loose-fitting PJs, or better yet, sleep in the buff

– Treat any underlying medical conditions – talk to your doctor about sleep difficulties

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Sleep Hygiene Checklist

– Establish structure and a schedule – go to bed and wake up at the same time every day / Begin your sleep hygiene rituals at the same time each evening and start about 1 hour before bedtime – whenever possible, complete each task in the same order

– Dim overhead lights / turn down the temperature / reduce stimulation overall and practice self-soothe behaviors

– Eliminate electronics – tv off, phone off, no more Facebook, etc. / If you need entertainment to help wind down, try a book or listening to calming and soft music

– Complete physical hygiene necessities – bathing, teeth-brushing, pajamas, etc.

– No food or drink within 1 hour of bedtime, better even if you can make it 2-3 hours

– Try some gentle yoga or stretching / A warm bath

– Once in bed, complete a body scan – observe any tense muscles and consciously relax them – progressive muscle relaxation is a wonderful tool for this

– Develop a bedtime mantra and use it with deep breathing exercises

– If you are lying awake for more than 20 minutes, get up and do something calming until you feel tired and ready to try again. Lying in bed tossing and turning will only sabotage you.

Miscellaneous things to try

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– Guided meditation

Essential oils including lavender, chamomile, etc. / Soothing tea / Melatonin

– Try a weighted blanket (I personally love this one)

– If its anxious thoughts keeping you awake, keep a notebook and pen near your bed and jot down things to be worried about tomorrow.

– Seriously…avoid the booze. I hate to break it to you, but drunk sleep is not good sleep.

– Consider whether your sleep issues could be a matter of sleep avoidance, and if so, seriously consider seeing a specialist.

Sleep hygiene is a very personal thing and what works for one person may not work for you at all. Use these ideas as a guideline, but don’t be afraid to experiment and learn what is truly effective for you. If something isn’t working, chuck it out the window and try something else! And if sleep truly remains elusive, consider talking to your doctor or therapist about alternative treatments or options that you might try. Good luck and sweet dreams!

Download the worksheet here: CCWS Sleep Hygiene Checklist

How Online Treatment Works

One of the most frequent questions I get when talking to folx about online mental health treatment is: “how does that work, exactly?” Usually this is accompanied by a baffled look. So, it seemed this would be an appropriate first blog post.

Online mental health treatment really is simple. There is very little difference between an online session and Face-timing a friend. Sure, because it’s treatment, there are quite a few more steps and expectations, but they are very straightforward and nothing to be alarmed by.

The Initial Logistics: There are a couple of ways to get started with online treatment. Sometimes a referral comes in over the phone and then I do a lot of the initial work for you. I’ll need your name, email address and phone number just to get things rolling. It also helps to get your address, date of birth and some other basic information ahead of time. More often than not this initial referral also serves as a basic consultation so that we can begin to understand what you are seeking help with and whether we are a good fit for working together.

Once I have this information, we discuss scheduling, and after we get off the phone, I begin inputting your demographics into the EHR (electronic health record) platform. I use Simple Practice because it has the video capability and necessary health record features built in, and is HIPAA-compliant. It is also super easy to use. Simple practice will send you an email with a link and a unique PIN. This link takes you to the client portal where you set up your account in a few easy steps. You will receive new client paperwork to review and sign – this generally includes the consent for treatment, payment agreement, etc. You can use secure messaging within the platform and this is also where our sessions will take place. About 24 hours before your scheduled appointment, you receive an email from Simple Practice supplying the unique link. When it’s time to start, you click the link and voila!

Now if you are a new client that is scheduling through my website, the process is a little bit different, but still quite easy. On my website (, the “Online Booking” tab takes you directly to the Simple Practice page where you can select “I’m a New Client.”

This will take you to the scheduling portal where you select the preferred date for that initial appointment. The system then prompts you for the same information I referenced above and you reserve your appointment with a credit card. Once I’m alerted of a new client, I take care of a couple things on my end, and then you will receive the same emails I talked about above. Pretty simple, right?

The Actual Sessions: I’m not kidding when I say that it’s a lot like FaceTime or Skype. This is why it is important for you to ensure that you have a good internet connection to support the video feed, and that you have the privacy necessary for a meaningful session. On my end I ensure your confidentialityby using a secure room with a noise-masking machine, and sometimes headphones to minimize any distractions. Good lighting is always helpful since being able to see each other is a big part of therapy. Also, think about comfortable seating since most sessions last between 30-60 minutes. Other than these basics, online therapy can happen on any computer, tablet, or cellphone.

Pros and Cons: As with everything, there are pluses and minuses to online treatment. I do think there are more pros than cons, but that assessment is ultimately up to you.

The Pros: On the positive side of things, online therapy offers the ultimate when it comes to convenience – there’s no commute, no parking, no waiting room to deal with. I’m never offended when clients appear in their jammies, and you can even do a session while on vacation.

Online treatment gives you the option of uninterrupted treatment without the restrictions of a 9-5, M-F brick-and-mortar office. Another positive is that it is greener and leaves less of a footprint. I literally keep zero paper files because everything is electronic. Security is ensured through Simple Practice and you no longer have to worry about unauthorized access to your private information. Similarly, online practice allows the therapist to minimize overhead costs which then positively impact the cost of services to the client (it’s a win-win). It also increases mental health treatment access to those who may be in more remote areas or lack reliable transportation. Finally, even though online treatment remains still rather new, it is considered effective and comparable to face-to-face in-person treatments. It is used by a growing number of organizations, including the VA, to provide necessary and effective services to clients.

The Cons: The most obvious downside to online therapy and treatment is the potential for internet outages and technology glitches.

The same way that inclement weather may shut down a clinic, it can also sometimes impact online connectivity. Usually these blips will be short-lived, but think about potential backup options for connecting should an outage occur. Another downside is that online sessions can sometimes limit the clinician’s ability to observe body language and facial expressions. This means that we may have to spend more time verbalizing certain things that otherwise might have gone unspoken in an office. So far, I haven’t had any clients complain about this and as we get to know one another online, that familiarity really helps the process.

If you have questions or comments about online therapy, please feel free to email me directly or leave a message in the comments section. I hope this information was helpful!