Tag: online therapy

relaxed

How to be less uptight

By Uncategorized, , , ,

It’s easy to be less uptight when you know how. Many of us don’t even realise how stressed out we actually are. Bills to pay, queues, all sorts of daily problems that many of us can’t avoid…what do you do? Sometimes when I lie in bed and focus on loosening my muscles, I realise how tensed up I am, especially in my neck and shoulders. Stress has become an inescapable part of life.

There are ways to be less uptight, some you can do instantly, and others will take time to get into the habit of doing.

Grounding techniques

When we are stressed, our bodies feel it. Adrenalin and cortisol are released, our muscles tense up ready for action. Our nervous system activates fight, flight or freeze response and relaxing becomes impossible. Grounding techniques help your body turn the panic alarm off, so it’s a good place to start.

Try taking deep breaths – what’s great about this is you can practise this anywhere, anytime. Box breathing is a good technique for helping you de-stress. Breathe in slowly counting to 4, then hold your breath and count to 4, breathe out slowly counting to 4 and finally, hold your breath once more counting to 4.

Get out of your head

Spending time worrying is the worst waste of time. All it does is increase anxiety when we go down the “what if” tunnel. We imagine all sorts of awful scenarios that might never happen. Focus your attention externally on the world around you. This takes practise but remember that the real world is out of your head – most of the ideas in your head aren’t backed by evidence and are up for negotiation.

Don’t believe every thought you think!!

CHALLENGING QUESTIONS SHEET

Below is a list of questions to be used in helping you challenge your maladaptive or problematic beliefs. Not all questions will be as appropriate for the belief you choose to challenge.

ANSWER AS MANY QUESTIONS AS YOU CAN FOR THE BELIEF THAT YOU HAVE CHOSEN TO CHALLENGE BELOW:

BELIEF__________________________________________

• Is it logical?
• Would a scientist agree with my logic?
• Where is the evidence for my belief? What is the evidence for and against this idea?
• Where is the belief written (apart form inside my own head!)?
• Is my belief realistic?
• Would my friends and colleagues agree with my idea?
• Does everybody share my attitude? If not, why not?
• Am I expecting myself or others to be perfect as opposed to fallible human beings?
• What makes the situation so terrible, awful or horrible?
• Am I making a mountain out of a molehill?
• Will it seem this bad in one, three, six or twelve months’ time?
• Will it be important for me in two years’ time?
• Am I exaggerating the importance of this problem?
• Am I fortune telling with little evidence that the worse case scenario will actually happen?
• If I “can’t stand it” or “can’t bear it” what will really happen?
• If I “can’t stand it” will I really fall apart?
• Am I concentrating on my own (or others’) weaknesses and neglecting strengths?
• Am I agonising about how I think things should be instead of dealing with them as they are?
• Where is this thought or attitude getting me?
• Is my belief helping me to attain my goals?
• Is my belief goal focused and problem solving?
• If a friend made a similar mistake, would I be so c critical?
• Am I thinking in all-or-nothing terms: is there any middle ground?
• Am I labelling myself, somebody or something else? Is this logical and a fair thing to do?
• Just because a problem has occurred does it mean that I/they/it are “stupid”, “a failure”, “useless” or “hopeless”.?
• Am I placing rues on others or myself (e.g., shoulds or musts, etc.)? if so, are they proving helpful and constructive?
• Am I using words or phrases that are extreme or exaggerated (for example: always, forever, never, need, should, must, can’t and every time)?
• Am I taking things too personally?
• Am I blaming others unfairly just to make myself (temporarily) feel better?
• Am I confusing a habit with a fact?
• Are my interpretations of the situation too far removed from reality to be accurate?
• Am I thinking in all-or-none terms?
• Am I taking selected examples out of context?
• Am I making excuses (for example: I’m not afraid, I just don’t want to go out; The other people expect me to be perfect; or, I don’t want to make the call because I don’t have time)?
• Is the source of information reliable?
• Am I thinking in terms of certainties instead of probabilities?
• Am I confusing a low probability with high probability?
• Are my judgements based on feelings rather than facts?
• Am I focusing on irrelevant factors?

Problem-solve

This is the only time you should spend inside your head – when you problem solve you look for solutions instead of ruminating. Brainstorm solutions to your problems and do your best to action the plan where possible. Know the difference between what you can and can’t control something and find a way to accept the things you can’t change currently.

Attitude of gratitude

This is an instant pick-me-up. Focusing on what is good in life can automatically improve your mood. Remind yourself regularly of what is good in your life – there is always something but our brains’ tend to focus on the negative things in an attempt to keep us safe. Do you have someone who cares about you? Are you healthy? Do you have a roof over your head? These are some of the pertinent questions to ask yourself.

Accept what you can’t change

There are things you can change and some you can’t. Resisting what you can’t change is futile and will lead to misery.

Care less about what others think

Dance to your own beat. Act dumb. Do whatever you have to but don’t take on board what others think. It’s your life, your decisions and choices. Others love to judge, and why should you care if they do? Only you define yourself, so let them be amused if it makes them happy. When you care too much about that others will say, you live your life for them and not yourself.

Stop taking life so seriously

We all end up in the same place so get some persepctive. Something that upsets you now probably won’t matter in a few days/moths time. Keep perspective and keep a sense of humour. See life as an adventure and stop catastophizing. It’s probably not as bad as you think it is.

 

 

Further reading:  https://www.thoughtsonlifeandlove.com/10-things-stop-caring-happier/75376/

 

Photo by Tim Mossholder on Unsplash

digital technology

The impact of digital technology on psychological treatments

By Employee benefits, Uncategorized, , , , , , , , , ,

The treatment of mental health is looking at a whole range of changes going forward. The widespread access to digital technology has seen the creation of many online mental health platforms to enable accessibility to employees and increased engagement. The great majority, currently, of digital mental health platforms offer information and resources along with self help therapy. Many of the online platforms have been developed from Cognitive Behavioural Therapy but are limited and far less responsive than real-life therapy with a skilled CBT therapist.

Mental health online platforms often have a large educational component than counselling with a trained therapist. Indeed, some interventions present themselves as educational programmes rather than treatments, and deliver the intervention in “lessons”, not “sessions”. They vary in the extent to which they retain the strategies and procedures of the original treatment. The interventions also vary in their structure. Some are linear, progressively leading users through the intervention step-by-step, whereas others have a variety of modules which may be used with partial or total flexibility.

Research findings:

  • Direct-to-user digital treatments are popular and can access underserved groups. A leading example is MoodGYM, a free online intervention for depression that has been available since 2001 () and has been used by over three-quarters of a million people.An important shortcoming of direct-to-user interventions is that completion rates are low if there is no accompanying support. Certain forms of psychopathology may prove to be more amenable to direct-to-user treatment than others. The eating disorders bulimia nervosa and binge eating disorder might be particularly suitable as binge eating is a repeated highly aversive experience which responds well to self-help interventions () yet many sufferers do not seek treatment because of the associated shame and secrecy ().
  • Online clinics can faciliate easier collection of statistics. Clinically relevant change can be monitored on a large scale.
  • Supported digital interventions are more effective than unsupported ones. It is generally thought that the explanation lies in better treatment adherence in the presence of support ().
  • When accompanied by support, digital interventions are as effective as face-to-face treatments. This is the conclusion drawn by several systematic reviews and meta-analyses (e.g., , ).  It would not be surprising if it emerges that different forms of mental health issues (eg.anxiety/depression) respond differently to the two forms of treatment delivery.
Not surprisingly, many important questions have yet to be answered. Here are some examples.
First, as there have been few head-to-head comparisons of different digital interventions for the same mental health problem, it is not clear which ones are the most effective ones nor is their relative cost-effectiveness known ().
Second, it is not known whether the functionality of a digital intervention has a bearing on its effectiveness.  The nature of the psychopathology being addressed may also need to be taken into account when designing interventions; for example, users with depression may struggle to complete interventions which require sustained concentration. In addition, there is a need for research on how these interventions work; who is accessing them; who benefits most; and whether the changes last. Also, more needs to be known about any negative effects of digital treatment ().

Autonomous and supported digital treatment

The most scalable way of providing a digital treatment is without support (“autonomous digital treatment”) but, as noted earlier, the provision of support improves outcome.There are many ways in which the support can be delivered. It can be via brief face-to-face sessions as exemplified by the use of supported self-help in the treatment of eating disorders () or it can be via telephone or videoconferencing.

Blended digital treatment

The concept of “blended treatment” is a new one. Generally, it refers to face-to-face treatments which include a digital intervention or component () although the clinician involvement need not be literally face-to-face; for example, it could be via telephone or videconferencing. Blended treatment is gaining in popularity, a particularly early adopter being the Netherlands ().

Global mental health innovators have attempted to address two major barriers to reduce this gap, viz. their low acceptability due to contextual differences between the settings in which psychological treatments were developed and those in which they are to be used, and their low feasibility due to the lack of mental health professionals to deliver them (). This body of research has shown that psychological treatments are effective in widely different cultural and social contexts even when delivered by people with little or no prior mental health training (). However, there remain two significant barriers: the continuing reliance on face-to-face formats for training and supervision, and the low demand for mental health care in formal health care settings, not least due to the high levels of stigma attached to mental health problems. Digital technologies offer a genuine opportunity to leap-frog both barriers.

While the “digital divide” undoubtedly remains a problem, particularly in low-resource settings, the divide is closing and there is no reason to think that this will not continue. Digital interventions that can be used without support are of particular importance as they have enormous potential to improve access, and additionally they have the value of being inherently empowering. They need to be optimised and “task sharing” needs to be expanded to embrace digital self-help. National and international organisations concerned with mental health need to endorse and support digital technologies as they are likely to be transformative.

Above all, the international psychological treatment community must strive to engage digital entrepreneurs and innovators, particularly those who are championing initiatives in global health, to partner with them to exploit the many opportunities for using digital technology to transform mental health care worldwide.