All good things must come to an end – at least that is what some health insurance plans would have us believe.  While health insurance benefits for mental health treatment has improved over the years, thanks in large part to the 2008 mental parity act, your insurance company may still limit the number of sessions allotted each year.  Some health plans are stingy, allowing only 10-15 visits, whereas others are more generous – allowing up to 40-50 visits per year (and that’s a lot even for the most devoted therapy client).  But one thing most insurers have in common is that at some point they say enough is enough and try to end reimbursement for psychotherapy sessions.

So what is a person to do when therapy is working, but there is a need to continue?

• Call your insurer. Before you get too upset, call your insurance company and ask for more sessions.  To find the correct number to call, look on the back of your insurance card for the number for “Mental Health” or “Behavioral Health.”  If all else fails, call “Customer Service.”  If you are lucky enough to reach a live person, (my trick: keep pushing “0”) tell them your situation and ask for more sessions—sometimes they say yes!
• Ask your psychologist to call too. If you don’t have luck with your insurer, ask your psychologist if he or she would be willing to give it a shot. I haven’t had too much luck with this approach myself, but it has been known to help, especially if the insurer requires additional information from your provider to authorize more sessions.
• Ask for a deal. If you have tried the above and are still empty handed, try talking to your psychologist about a payment plan that will work for you.  Maybe they are willing to work out a schedule so that session fees can be paid over time, rather than at the time of the appointment? Maybe they offer a sliding scale for clients who don’t use insurance?  Don’t be afraid to ask. You never know what you might be able to work out.
• Call your human resources rep. Many employers offer mental health benefits through Employee Assistance Programs.  It may not be well-promoted, but it’s always worth the phone call to see if you qualify.  If you get your insurance through a spouse or partner, you may be eligible for benefits too.  And the best part about the sessions is that they are often FREE, so don’t miss the boat.

Just starting out in therapy?  Read my previous post about how to use insurance for mental health treatment.

Filed under: Being in Therapy

Guest blog post from Dr. Rosalind Dorlen, a clinical psychologist in New Jersey

The subject of money in marriage is always a psychologically hot topic, and it’s even more of an issue during tough economic times.

When one partner loses a job, stress can skyrocket and have severe effects on marriage and relationships—not just a couple’s finances.  In my practice I see many couples who are dealing with the job loss of a partner and the psychological effects can be cataclysmic, particularly when one of the partners becomes acutely anxious and is unable to manage feelings of fear, rage and helplessness.

What seems to be adding even more stress to marriage in this economy is unemployment is often more than six months and thus becomes a chronic issue rather than acute and short-lived. This ultimately affects the whole family since stress “filters down” to the children.

The loss of a job can create feelings of worthlessness, loss of power, self-esteem and identity. Gender issues have an impact as well since men have been harder hit with job losses and often women are the only ones bringing home the bacon. This can be tough on a male, particularly if his source of identity rests on being the economic driver of the family, which is often the case.

So what can a couple do to keep their relationship on an even keel during this crisis?

• Acknowledge the loss. There is grief when a job is lost. It can be helpful in a marriage to be able to talk about the consequences of this loss.
• Consult experts to find out the best ways to manage your existing finances.
• Focus on communication. It is normal to have fears, uncertainties and anger over a job loss. You need to be able to talk about these feelings without blaming each other.  It helps if you can try to put yourself in the other person’s shoes and appreciate his or her feelings. Encouraging and supporting your partner will go a long way toward improving communication and sensitivity in your relationship.
• Understand the powerful effect of stress on the body and take good care of yourself. Schedule time with friends, get rest, eat well and try to get exercise. You don’t need fancy gyms to get exercise. If you are able, just get outside and walk.
• Networking is important not just for finding a new job, but for retaining social interactions and feelings of normalcy.
• Strengthen your family relationships by spending fun time with each other. Spending couple and family time doesn’t have to be expensive or elaborate. Try to find ways to stay close to family and friends.
• Cultivate an attitude of gratitude. It’s good for your mood, your spirituality and your relationship. Try to focus on appreciating what you have and the many joys and pleasures in life.
• Don’t lose hope. If you find that you can’t seem to move forward with your attitude, or if you are continue to be depressed and overly anxious, consider talking to a psychologist or other licensed mental health professional.

Remember, that sometimes going through a crisis like job loss can actually strengthen your relationship. Many couples I have seen report that their marriages improved through mutual support, understanding and demonstrating resilience during the hard times.  

Rosalind Dorlen, PsyD, is a clinical psychologist in Summit, N.J. Among her interests and services are therapy for individuals and couples for many issues, including stress related to finances and money.

Photo by adwriter (via Flickr)

Filed under: Relationships, Stress, Work/Life

I am sure that most of you are as horrified as I am at the increasing number of media reports of teen suicides due to bullying. This past month alone, 4 teens have been in the news for killing themselves in relation to bullying.

Bullying is an act of repeated aggressive behavior in order to intentionally hurt another person, physically or mentally. Bullying is characterized by an individual behaving in a certain way to gain power over another person.

I, like many other clinicians, educators,  parents and even celebrities, have blogged, written articles for newspapers, participated in community presentations and spoken about this on radio and television. Yet, the situation continues to get worse.

It seems that as technology advances, kids and even adults are finding new and more toxic ways to hurt others. The consequences can be lifelong and devastating, if not lethal. No longer is bullying limited to the school playground or the walk home. Kids receive horrible taunts via text and email 24-7. To make matters worse, the remarks, photos and videos are now being posted on the web. Few of us can tolerate the knowledge that millions of people know we are “ugly,” “stupid,” “gay” or whatever else someone decides to post, let alone teens struggling with their self-esteem and identity.

Tyler Clementi, a bright and very talented student at Rutgers University killed himself this week in the aftermath of another student’s cruel behavior. This past month, Seth Walsh, 13,  Asher Brown, 13, and Billy Lucas, 15,  died because they were or someone thought they were gay. How many more kids are we going to let die because of our own cruelty?

I am begging all of you to take action. First, talk to your children. First find out if they are being bullied. Look for signs they are being emotionally hurt.  Let them know that talking about bullying is not tattling. Let kids know that the Trevor Project is an online resource for kids who are or think they are gay.

Next, let your kids know that you will not tolerate them bullying or being cruel to others. Let them know you will check their phones, computers or Facebook pages. Get involved in your kid’s school. Find out what their policies are regarding bullying and what they are doing about the problem.

And finally, remember that kids learn what they see. If your home does not promote a culture of kindness, if you are abusive to your kids, or you and your spouse call each other names and are cruel to each other, don’t be surprised  if you find your kids being disrespectful and outright cruel to others.

Please think about joining in on this blog topic. I, and others, would love to know about your experiences as a victim or bully, or what you as a parent, educator or clinician are doing to help this unacceptable situation.

Photo by r.f.m. II (via Flickr)

Filed under: Children, Lifestyle & Behaviors, Parenting, Relationships, Resilience, Stress, Work/Life

Did you know Oct. 7 was National Depression Screening Day? Psychologists and other mental health professionals from around the country were on hand with questionnaires and other assessment tools that helped people know if their feelings or moods were an indictation of depression.

In Meriden, Conn., Dr. Elaine Ducharme spoke to a group of older adults about aging and depression. Here’s coverage of the event — as well as some good things to know about depression — from New Haven’s WTNH.

National Depression Screening Day has passed for this year. But depression can happen to anyone at anytime. Pay attention to your thoughts, moods and feelings. And if you think depression is effecting you, find a psychologist or other professional to help out or take an anonymous online screening.

Filed under: Lifestyle & Behaviors

The stories of teens and young adults being bullied online are abundant and sad. But in the midst of tragedy, we’re seeing some good. And sometimes it’s even coming from the same technology that people are using to torment.

Celebrities have been speaking out and producing videos for YouTube, sending messages to gay teens that “It Gets Better.” People around the country rallied online for “Spirit Day,” wearing purple on Oct. 20, showing their support of GLBT teens and awareness of the effects of bullying and suicide. Word of the event spread via Facebook, blogs and Twitter.

When I first wrote about the devastating impact of bullying earlier this year, I was unaware that bullying would soon hit me very close to home. A week later, my 15-year old daughter came home from her high school – Evanston Township, just north of Chicago – and mentioned that a group of students had put up a Facebook page called “Evanston Rats.” It was demeaning and humiliated students by name. The page was incredibly nasty, accusing other students of a variety of personal crimes, from stealing someone’s boyfriend to cheating on tests and much more.

Like most schools nowadays, ETHS has a strict no-bullying policy, and administrators immediately sprang to action. The principal quickly called all 4,000 parents, alerting them to the page, which was later taken down. The school notified police and launched an official investigation. All students were told, in no uncertain terms, that if they had participated in harassment and bullying, there would be disciplinary action.

Swift and bold action, indeed. But what happened next, is truly the most inspiring part of this story.

Many of the students took it upon themselves and developed a fresh and wonderful way to thwart the bullies. Two seniors created a Facebook group called “Evanston Mice,” designed for students to send positive, complimentary messages to their friends, classmates and even the teachers. Teens have wished each other happy birthday and complimented their classmates’ prowess in baseball or talent in singing. In just five days, over one third of the student body had joined the “Mice,”and it’s still going strong into another school year.

The students’ solution to the bullies was not only clever, but potentially more effective and long lasting than the more punitive solution imposed by the administrators. And psychologists know that positive support is much more effective in changing behavior than negative reinforcement or punishment.

We often want to blame or demonize the method to bullying – the Internet can spread any ridicule farther and wider than the heckling and mocking that was once seemingly limited  to the schoolyard. But the Internet and its many tools can also serve as a way to positively galvanize groups and people in a very public and quick way.

My daughter has shared with me the kind and thoughtful comments her friends have posted about each other, and maybe it’s just me, but I notice a kinder gentler tone when I am around the girls as well.

Photo by Daniel Greene (via flickr)

Filed under: Children, Parenting, Resilience