The Therapy For Real Life podcast translates therapy concepts into everyday self-care strategies. But wait — What do we mean when we say ‘therapy’ anyways? Host Anna Lindberg Cedar MPA LCSW answers your burning therapy FAQs, including: What is therapy? How does therapy work? and Why does therapy work?

Learn about different therapy styles, including: motivational enhancement therapies, relationship counseling options, and acceptance-based strategies, such as mindfulness. Learn about therapy options, how to get access to therapy, and tips on how to pick the right therapy style for your needs.

This is not therapy. This is Real Life. 

• Anna Lindberg Cedar introduces the podcast, emphasizing that it is not therapy but an opportunity to learn about therapy concepts and self-care strategies.
• The podcast aims to practice strategies from various therapy styles, including Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and mindfulness.
• Anna explains that therapy is a broad term, often confused with other types of therapies, and highlights the importance of the therapeutic relationship.
• She mentions the mental health crisis in the United States and the unique aspect of therapy as a relationship-based intervention.

• Anna discusses the definition of psychotherapy and the different licensed professionals who can provide clinical therapy services.
• She emphasizes that therapy is built on the quality of the relationship, which cannot be replicated by apps or other resources.
• Therapy provides an outside perspective and tailored feedback, which is different from what one gets from friends, family, or partners.
• Anna shares her passion for therapy, comparing it to a form of bilingualism, helping people put words to their experiences and find validation.

• Anna explains that more than 50% of individuals report an improved mood after an initial therapy appointment.
• She shares a client's question about why therapy works and explains that therapists help build skills and motivation.
• Therapists provide feedback based on research and teach skills like mood hacks and motivation boosters.
• The role of a therapist is to help clients build motivation, which is intrinsic and cannot be deposited by others.

• Anna compares the role of a therapist to that of a personal trainer, providing strategic advice and accountability.
• She explains that therapy is flexible, with different needs requiring different levels of support and frequency.
• Anna advises listeners to ask potential therapists about their personal philosophy and approach to therapy.
• She emphasizes the importance of understanding the different types of therapists and their specialties.

• Anna introduces motivational enhancement therapies, which are pre-therapy options for those who are not ready to make changes.
• She highlights cognitive behavioral therapy (CBT) as a commonly known and brief, skill-based therapy.
• CBT helps individuals understand and rewrite their thinking patterns to develop a more empowering narrative.
• Anna explains dialectical behavior therapy (DBT), which integrates change-based and acceptance-based skills, and its practical approach to improving life quality.

• Anna elaborates on DBT, emphasizing its skills-based approach and the importance of mindfulness and acceptance.
• She discusses Acceptance and Commitment Therapy (ACT), which focuses on psychological flexibility and aligning actions with personal values.
• ACT helps individuals observe painful experiences without additional suffering and decide on actions based on their values.
• Anna mentions the Gottman method, a couples counseling style based on research by John and Julie Gottman, which tailors skills to each couple's needs.

• Anna emphasizes the flexibility of therapy, with different needs requiring different levels of support and frequency.
• She advises listeners to ask potential therapists about their personal philosophy and approach to therapy.
• Anna highlights the importance of understanding the different types of therapists and their specialties.
• She introduces other therapy styles, such as exposure therapies and emotional response prevention, and their unique approaches to addressing specific issues.

• Anna Lindberg Cedar discusses the importance of relationship research and mentions dialectical behavior therapy as a method that connects mood to relationships.
• The Gottman method, developed by John and Julie Gottman, is highlighted as a couples counseling style that assesses each couple's unique dynamic.
• The method involves online questionnaires to tailor skills to each couple's strengths and struggles, making it a directive and research-backed approach.
• Anna Lindberg Cedar emphasizes that individuals can seek relationship counseling alone, which can still benefit their relationships and personal growth.

• Anna Lindberg Cedar explains that exposure therapies and emotional response prevention help individuals rewire their habits to create new reinforcing cycles.
• Exposure therapy can address various avoidance behaviors, such as fear of flying or difficult conversations.
• The therapy involves preparing for emotional responses and planning alternative responses with the help of a therapist.
• Building tolerance through exposure therapy is likened to building muscle memory, with the therapist acting as a coach for support and accountability.

• Anna Lindberg Cedar addresses the challenges of accessing therapy due to the mental health crisis and stigma.
• She advises balancing cost, quality, and access when choosing a therapist, and suggests using insurance to cover therapy costs.
• Health savings accounts and flexible spending accounts can also help individuals save for therapy appointments.
• Anna Lindberg Cedar encourages asking family and friends for tips on local resources and considering counseling centers for lower-cost options.

• Anna Lindberg Cedar emphasizes the importance of giving and receiving feedback in the therapy process.
• She advises using evidence-based methods that are matched to individual needs and being an active participant between sessions.
• Engaging with therapy concepts between sessions can enhance the overall therapy experience.
• Anna Lindberg Cedar encourages defining a personal philosophy of therapy and discussing it with a therapist to ensure alignment and effectiveness.

• Anna Lindberg Cedar addresses the challenges of accessing therapy due to the mental health crisis and stigma.
• She advises balancing cost, quality, and access when choosing a therapist, and suggests using insurance to cover therapy costs.
• Health savings accounts and flexible spending accounts can also help individuals save for therapy appointments.
• Anna Lindberg Cedar encourages asking family and friends for tips on local resources and considering counseling centers for lower-cost options.

• Anna Lindberg Cedar emphasizes the importance of giving and receiving feedback in the therapy process.
• She advises using evidence-based methods that are matched to individual needs and being an active participant between sessions.
• Engaging with therapy concepts between sessions can enhance the overall therapy experience.
• Anna Lindberg Cedar encourages defining a personal philosophy of therapy and discussing it with a therapist to ensure alignment and effectiveness.

• Anna Lindberg Cedar shares information about Therapy for Real Life's workplace workshops, such as the burnout prevention hackathon, which teach self-care strategies backed by research.
• The workshops help teams manage stress, prevent burnout, and build relationships.
• Therapy for Real Life has adapted the burnout prevention hackathon for virtual and work-from-home environments.
• Interested parties can contact Therapy for Real Life to discuss their needs and how to adapt these trainings for their team.

Welcome back to the Therapy For Real Life Podcast. I'm your host Anna Lindberg Cedar, MPA, LCSW. This is not therapy. This is Real Life. -- But wait a second -- What do I mean when I say "this is not therapy"? 

As you know, the Therapy For Real Life Podcast is designed to expand awareness about therapy concepts, and adapt these evidence-backed therapy ideas into self care strategies that anyone can use on a daily basis. Let's slow down...

As I was getting the show ready for today, I really gave myself pause to think about what we're doing here with the podcast. As you know, each episode is an opportunity to practice strategies that are drawn from different therapy styles. So you'll hear me talk a lot about Dialectical Behavior Therapy, or Cognitive Behavioral Therapy, mindfulness strategies. And even later in today's show, we'll dive in a little bit deeper to define some of those strategies. But the other thing you'll keep hearing me say over and over again, is that -- This is not therapy. This is a podcast. This is an opportunity for you to reflect on your self care and get educated about different strategies that are available to you and then my hope is that you try them and experiment with them in your everyday routine. Again, this is not therapy. 

So what is therapy? That's our goal for today is to think about that what is therapy? So therapy is a general word. Usually when I introduce myself -- say a dinner party or get together, I'll say I'm a therapist, and they'll say, "Oh, what kind?" They might guess, physical therapist, massage therapist, occupational therapist... And that's good to remember. There are all different kinds of ways to use the word 'therapy'. 

On this show, I mean psychotherapy, -- and that has a legal definition and only certain licensed professionals are considered psychotherapists because they are trained to offer clinical therapy services. So you might be thinking of licensed clinical psychologist, licensed clinical social workers, marriage and family therapists.... Some states in the United States allow licensed professional counselors. And each profession -- just like doctors who have different residencies and specialize in different areas -- have different requirements for the number of hours that you need to get specialized in, say, couples counseling or child therapy. 

So therapy is a really broad term to describe a person who provides support to people in both difficult moments of their life and joyful moments of their life and helps them get the support that they need. So we'll define that a little bit more. But what we know is that at least in the United States, and I imagine this is this is worldwide... I'm sure the World Health Organization has good statistics on this, but we are living in a mental health crisis. We don't have enough therapists for the need that we're facing. And I think anyone observing this political moment would notice that this is these are very stressful times. 

And what all therapists would agree that makes therapy really unique and different than some of the other resources that we have-- like a podcast-- is therapy is built on a relationship with another person. So when we talk about evidence-based strategies and look at why different strategies are effective, you-- If you really dive deep into the data, it always comes back to the quality of that relationship. And there are certainly things you can do to improve the quality of your relationship in therapy. But just to consider that for a moment that that is the active ingredient in therapy, it's the thing that you will not get from an app. It's also different than what you'll get from a friend, or a family member or a partner. It is an outside perspective and is feedback. It's tailored to you. So that's different. And, you know, we'll talk about how to get it and how to get access to it. You may not always have it, but that is that is therapy. It's different than some of the other tools and strategies that we'll talk about when we think about self care. Therapy is a form of self care. 

Okay. I'd like to think of therapy-- You know, anyone who's met me or heard me talk about my job knows that it is my dream job. I mean that from the bottom of my heart, I love what I do. And the best way to describe why I love what I do is to understand that I think of, I think of therapy, like a form of bilingualism. And I'll tell you why I think that. 

So, for one, I did the first 20 years of my career primarily working in Spanish -- So that was doing public health work in Latin America... that was doing counseling with immigrants and their families moving here to escape violence, and sometimes torture abroad and coming here looking for safety. So, you know, for for me - a lot of my work has just been done in another language. So, thinking of therapy is another language makes sense to me because a therapist, their job is to help you put words to your experience. Often that experience can be really painful. That's what draws people to therapy in the first place is because they're experiencing some kind of emotional or life pain. And you know what? -- there is something soothing, to be able to put words to that, to be seen in a moment of pain by another person and to be validated.

So I like thinking of therapy as a form of bilingualism, and I'll even see it in my clients. Sometimes they'll come and they'll say, "Oh my gosh, now I have a word for that experience. And you know what? -- I talked about it to a friend, and they said the same thing and you know what? -- I'm hearing it everywhere!" So it's kind of like, have you ever had that experience before where you learn a new word, and all of a sudden you hear it everywhere? Therapy can be like that, you talk in private with another person about your personal experiences, and that person gives you feedback : "You know what? -- Based on what you've told me before -- that sounds a lot like this or that human experience." So there's a lot of learning that comes in therapy. 

And my favorite thing is when those therapy concepts become contagious. So sometimes it's only one person in a family unit or one person in the office that's doing really good self care, and scheduling those therapy appointments. And they may or may not share the fact that they're doing that with anyone else in their life. But you know what? -- I bet you could tell. You might notice a change in the way that they talk with you... their demeanor, their perspective, the way they do things... That's, that's pretty amazing to think about how even an individual going to therapy can make shifts in their own life that could potentially become contagious and make an impact broader than in themselves. I think that's really cool. So when I say, this is my dream job, I mean, I think that's so cool. 

All right. Well: Why does therapy work? We know that more than 50% of individuals report and improve mood immediately after an initial therapy appointment --so there's just that initial kind of responsiveness, It feels good! And then we have really good research for certain problems like depression and anxiety and trauma.... We know what tools work for that, and that's based on a lot of research. 

But why does it work? I had a client of mine asked me this question, and I do love it when people ask me these questions. They give me an opportunity to peel back the curtain of what therapists do and explain it, because it's really cool to think about why therapy works. So when my client asked me that question, they said to me, "You know what, every time I come in, I always feel a little bit better. And I noticed the things that I said I wanted to work on or are changing -- and... Why is that happening?" 

So the reason that you might notice some of those lessons or positive changes in therapy is because when you think about a therapist's job, you have to keep in mind that there they their job is twofold. It's 50/50. 

Half of their job is to help you build skills... Okay? So they might give you another way of looking at things. They might teach you mood hacks, or motivation boosters. So you know, if you're feeling depressed, you might want to do X, Y, or Z pleasurable activities, kind of like your natural anti depressant, even if you don't feel like it. They're going to teach you the value of those things. And some of those skills may even sound familiar to you. So half of a therapist's job is to give you feedback about what the research says can be helpful to people in a situation like yours. That's not it...

The other half of a therapist's job is to help you build motivation. All right, that makes sense. Oftentimes, when we come to therapy, we know exactly what we need to do. That doesn't mean we're always very good at doing it. This is this is the human condition that we're talking about here. 

So a therapist's job is to help you build motivation. And how do they do that? This is this is very interesting if you've paid attention to --- There's even a good episode...  in the in the podcast of Motivation Boosters if you want to hear the research on how to boost motivation quickly, you can go back to that episode... And one of the things I explain is that a therapist cannot deposit motivation into another person. Motivation is intrinsic and organic to a person. Okay? So you can't cajole or nag or push... I'm sure you've had the experience trying this. You can't push someone to do something they don't want to do. 

What a therapist does is to ask you about your motivation... and really inquire about that and draw that motivation out of you. That's what a good therapist will do. They'll help you tap into the motivation that is already there. And that happens through gentle inquiry and getting to know each other and strategic accountability. Once you say something is important to you, your therapist knows that about you. So that is collaboration.

Okay, now we know a little bit about why therapy works. And for me the best way I like to think about -- at least my role as a therapist, I think it's very similar to a personal trainer. And it's also flexible in that way because if you needed to go to a personal trainer, you might have something really specific in mind, like an injury you wanted to work on... And you might get some short term strategic coaching about your alignment, or things that you might want to take in mind or consider as you develop a new exercise routine... A therapist is very, very similar [editor's note: except from a mental health perspective]. You go to them on a weekly basis - or many therapists are more flexible, and if there's not an immediate crisis, you might go more bi weekly, or even more variable coaching or counseling scheduling than that. So it's really flexible in that way. So you could go short term and get really strategic advice. Or you might need an ongoing relationship with your therapist to hold you accountable to certain goals, or work through more complicated issues, right like grief or trauma might require a little bit more time and attention. So like a personal trainer, they -- or even like a physician, they would assess your needs and then give you their best recommendation. 

Now, it's important to understand that they're all different kinds of therapy and I don't want anyone to get overwhelmed when they start to hear about all the different names, a lot of those are kind of like insider baseball details between therapists to explain to each other different orientation styles and philosophies when it comes to therapy. So you might get intimidated or confused by some of the acronyms that you'll hear out there. But it's just an opportunity to find out more about your therapist.

And if you're picking a therapist, it's good to to ask maybe one of the first questions that you might ask them is "What is your personal philosophy when it comes to your approach, as a therapist..?" and they will tell you probably a little bit about their training or maybe why they were drawn to the profession. And if you are coming to therapy for a very specific reason, you can ask them "How would you approach X situation...?" And you can fill in just a case example it could be your case example or not. And that gives you just a mini opportunity to interview your therapist and hear more about their style.

So, just like you wouldn't go to a dermatologist for an evaluation for a heart condition. It's good to know about the different kinds of therapists that are out there. So there are play therapist for children. There are couples and marriage counselors for couples and partnerships. There are individual adult therapists, there are group therapy options. There are even more intensive outpatient therapy options where someone might go kind of like a marathon style several days in a row to get a quick boost of therapy training. 

Let's talk about some of the therapy styles that are offered by Therapy For Real Life just as some examples of therapy styles. Therapy For Real Life is located in San Francisco and Oakland, and I offer online therapy as well. And I'm just going to talk about the therapy styles that I do as an example. And as you research more if you even just Google what are all the different therapy styles available for and then you might want to insert anxiety, depression, relationship problems, or whatever you're thinking about. You're going to see a lot of options. And it's really good to just listen to what's out there, hear the different philosophies and then choose for yourself, which one feels like a really good match. 

Okay, so something you might hear from time to time is people will say "You can't go to therapy unless you're ready" or "You can't get anything out of it unless you're really motivated." Now, you can't force someone to go to therapy, And that's not a good idea. We want someone to go to therapy consensually, and we know that that buy-in is really important. For the individual, they should know that going to therapy does not mean that your therapist is going to make you do something you don't want to do. That's really important to understand. And something I wish everyone knew about therapy is that you you can go even if you're not ready to make any changes at all. 

So that's the first therapy style I want to highlight is a group of therapies called motivational enhancement therapies. And you maybe have heard of Motivational Interviewing... it is the motivational enhancement therapy with the best evidence. A lot of evidence supports this. And it's not even considered a traditional form of therapy. It's considered a "pre-therapy." This is the kind of therapy you would do if you were getting ready to make a change. Or let's say, you know, you need to make a change, but you don't even know which one that is. You know... "Should I give up drinking completely? Should I cut down? Should I go abstinent on weekdays? What's the best option for me?" 
So, I do wish everyone out there knew that therapy is a fantastic option. If you don't know what to do, you should just know that you don't have to have the answer before you go into therapy. You don't have to have all the motivation in the world... And old-school therapists used to say, as an example, "I won't see a client in therapy unless they've been sober for a whole year..." because old-school therapies used to say it was "too destabilizing." I like the motivational enhancement therapies because it says, "Come on in, come on in! -- Wherever you're at!" And let's start there. So I find that really encouraging and welcoming to know that I don't have to be in any kind of way, shape or form before I get to participate. Okay, so motivational enhancement therapies... What other options are out there when it comes to therapy? 

A lot of folks have heard of Cognitive Behavioral Therapy. That is one of the most commonly known kinds of therapies. It took off in great popularity with the rise of managed care... and fits in well with a lot of the medical model. So you'll notice that that it tends to be brief and short term therapy that is one of the skill based kinds of therapy styles out there. And what makes cognitive behavioral therapy unique from other kinds of therapies is that it looks at your way of thinking. 'Cognitive' is how you see things. And Cognitive Behavioral Therapy helps us understand that you shouldn't believe everything that you think.

Have you ever made a mistake in your life? Have you ever thought something was one way? and turns out it was it was another way? We have thinking mistakes all the time. So Cognitive Behavioral Therapy would be great for someone who perhaps worries too much about things that are outside of their control... Or thinks about things in the past, perhaps bad things that have happened to them...Or worries about the future... Cognitive Behavioral Therapy offers someone like that some really good tools to be able to rewrite some of those thinking patterns and develop a narrative that is more empowering. So it's the difference between waking up on a cloudy day and seeing those terrible storm clouds and thinking "This is such an ugly day -- It is going to be terrible.!" And waking up on a cloudy day and saying, "Wow, look at look at the shape of those clouds. It's really cloudy. I'm going to do something cozy and comfy today." And it's the difference between those two experiences and and how we think about them. So that's Cognitive Behavioral Therapy. Each one of these, you could dive in for whole eight week lecture series, right? But we're just going to give a little brief snippet of each. 

Dialectical Behavior Therapy. That one is one of my favorites. If you listen to the podcast, you already know that that is where a lot of my training comes from is Dialectical Behavior Therapy. And I'm big fan because it integrates a lot of the core concepts that we just talked about from Cognitive Behavioral Therapy, which is an example of a change based therapy style. So I want to feel better or I have problems I want to solve them. Or I feel stressed and I want to feel relaxed, I want to change my mood state. So DBT, like CBT is one of these counseling programs that has a lot of research behind it. And it is skill based. And it's designed to help you improve the quality of your life. And half of the skills from that counseling program are change based skills. 

But what makes DBT different. It comes from the name, the dialectic, are the other half of the skills are acceptance based skills. And that includes mindfulness. It includes flexing the way you think about things to boost your awareness without judgment. And it draws in a lot of core concepts from Eastern philosophy that are perhaps a little bit more abstract and nuanced than some of the Cognitive Behavioral strategies that we just took a look at. That we see that those types of skills - change based skills - and acceptance based skills -- really complement each other really, really well. So the traditional form of Dialectical Behavior Therapy includes a weekly individual therapy sessions where you take a look at your goals for the week, whether it's mood management or relationship skill building, stress management, problem solving, and your therapist would help you stay accountable to those goals, and help you continue to boost that motivation. And in that traditional model of DBT, in addition to the individual skills, you would go to a weekly group or workshop and get that in a class setting. So it's not a process group. You're not encouraged to talk about your most private details. You take notes and you learn mood hacks and motivation boosters and relationship skills, and mindfulness. It really targets those areas of skill building. 

Now not everyone can go to weekly therapy x2 -- This is why I started the podcast so that people could build skills between therapy sessions if they need to or want to. So that's Dialectical Behavior Therapy. It's drawn from a lot of research. It's very practical. Folks who like a directive coaching self care skills style would be really well match for that.
Okay, we've already looked at a few different therapy styles. Let's look at a few more examples. So if you scroll back in the Therapy For Real Life Podcast feed, you'll see it an episode called What is Psychological Flexibility? ... and that's a deeper explainer if you want to find out more about Acceptance and Commitment Therapy. ACT is another one of those third wave therapies, which means that it includes an acceptance based approach, a mindfulness approach, which means that ACT is a very helpful therapy style if you're trying to come to terms with realities that are perhaps very painful, or beyond your control.

So ACT is the counseling style that we go to when we want to teach someone psychological flexibility. And if you're curious what that counseling style might look like, you could you could listen to that episode and find out more in detail but basically, you would learn about The six different ingredients active ingredients that go into psychological flexibility. And those include perspective taking, being able to situate yourself in your own point of view, accepting things that are difficult and taking committed action based on what's important to you. So ACT  is a therapy style that helps you practice seeing reality from a new perspective. Your therapist will help you see things as they are from a new perspective. And then the individual going through that process gets to think about what values are most important to them. In Acceptance and Commitment Therapy, you may even look at a list of values along list of values, such as... you know, I want to have safety and security in my life or I want to have adventure, or pleasure, or compassion or gratitude, power, control, intimacy -- those values are personal. Not everyone has the same values. And even if you don't acknowledge them, you have them. They are there.

So Acceptance and Commitment Therapy is a great example of one of the counseling options if you're looking for something to help you change your thinking about a painful situation, or look at things from a new perspective, or develop practical tools for coping with things that perhaps will not change anytime soon. The interesting thing about the research supporting ACT is that is not shown to reduce anxiety or depression or stress. But it is actually shown to decrease suffering associated with those experiences. So, people report feeling like they can observe those painful experiences without having that added extra pain of beating themselves up for it. So ACT is one of those counseling styles that could help you come to terms with some really difficult experiences and then decide how to align your actions with your values. That one's a lot of fun. 

Great, so we've covered a lot already. What other therapy styles are out there? What about relationship therapies? We have a lot of good options when it comes to relationship research. We already mentioned Dialectical Behavior Therapy, which is something that's often designed for individuals. And that's one of the first therapy methods that really connected your mood to your relationships. And so it teaches a bunch of skills, not only how to manage your mood, but how to improve your relationships and we find that that interacts those those two things interact with each other. We have a lot of other options when it comes to relationship research. 

I really like the Gottman method. John and Julie Gottman are known as a power couple in the couples counseling field because they have been married for a long time and they are researchers on long lasting happy marriages and relationships. They've been doing this work for decades and have boiled it down to about seven critical ingredients they say that are found in the relationship masters. And the Gottman method is a couples counseling style that first assesses each couple because each couple is different, their dynamic is different. And so the couple each partner gets to do a series of online questionnaires to get that feedback. And the therapist tailors the skills that that couple needs to their areas of strength or struggle. 

So the Gottman method is a couples counseling style that very directive, its research backed. iI's very feels like a coach in that way. And a lot of couples find it very practical. And they learn a lot from the process. So that's one style of relationship therapy. There are other couples counseling options and styles like Emotion Focused Therapy, and you can research the different options that are available to you and pick the one that's best for you. 

Sometimes people will ask me, about couples counseling as an option, but their partner just isn't there yet. And I want to remind those folks that you do have the option of going to couples counseling by yourself. And in fact, there's a whole lot that you can do for your relationship just starting on an individual level. So, relationship counseling on your own might look like realizing what is important to you and what is not -- and bringing those conversations home. It might be realizing what your limits are, and reinforcing those at home, or in your work relationships or friendships or other non romantic relationships. So there are many flexible options when it comes to relationship counseling. And in my experience, people come into counseling for a lot of different reasons, including anxiety, depression, trauma. Oftentimes, relationships are what motivate them the most. So it's just interesting to notice that what other therapy options are out there, we won't have time to go through all of them. 

The last one I think I'llmention is the whole class of the exposure therapies, or Emotional Response Prevention is another kind of exposure therapy. A lot of people are curious about exposure therapies, maybe, you know, seen a version of it on TV, -- eg. someone who is scared of spiders. And so they might imagine a spider or look at a spider or even a (gasp!) hold a spider. That's just one kind of stereotypical representation of exposure.

It turns out, that we as human beings, we avoid all kinds of experiences. So we avoid difficult conversations. We avoid asking for a raise at work. We avoid asking for what we want. We avoid difficult feelings that are really unpleasant. And what exposure therapies and principles teach us is that we can rewire our habits to create new reinforcing cycles and habits. 

So just as an example, let's say let's say you have a fear of flying. And every time you go on a business trip, let's say you have to travel a lot for your work. You spend the whole trip on that plane worrying that the plane is going to fall down. You without realizing it, you could potentially convince yourself in a muscle memory kind of way, and a habit forming kind of way. You might convince yourself that worrying is what keeps the plane in the air. So if you were doing a kind of exposure therapy, or an Emotional Response Prevention therapy, you would do a lot of preparation with your therapist who acts like a coach, and they would help you fantasize... "Okay? What's the response you would like to have in this situation?" -- not ignoring all those obstacles and stressors that will pop up, but simply planning for them. Anticipating your emotional response could be avoidance or whatever road rage or critical thinking, worrying to keep the plane in the sky... You would plan an alternative response, and it's going to feel tough. It's like going to the gym after not working out for a really long time. But with that coaching, that supportive accountability coaching, you continue to do the actions that are important to you, regardless of anxiety or difficult feelings. When you flex those muscles of doing those behaviors that are important to you build up tolerance. So exposure therapies and emotional response prevention give you a structure and a coach to help you build up that tolerance, to do the things that are important to you. Those are only some examples of the different kind of therapy options that are available to you. 

Once you start researching, you are going to learn more terms and names. I hope that with just those examples of what therapy for real life offers as part of our counseling options, you start to get a sense that you can mix and match your therapy needs with the therapy options that are out there and it is good to ask questions. 

So again, when you're picking a new therapist and in that initial consultation call or reading over their website, you're really looking for an answer to that question of: What's your philosophy? What's your approach to therapy? And how might they approach your situation? And then you have to do a gut check. And just know that not every therapy match is for you. And trust what feels comfortable because you should feel comfortable in that space. 

How do you access therapy? This is a really anxiety producing question for a lot of people. We started out the episode talking about how we have a mental health crisis and we don't have enough practitioners out there to provide the therapy that we need right now. There's also a lot of stigma, unfortunately, that hangs around and gets in the way of people feeling like that is for them. I've had a lot of individuals tell me "It's funny because I'm a big fan of therapy. And I'm always encouraging my friends or family to go. But I still have my own hangups." So once we get over the stigma and realize that, you know, prevention is a really great tool that we can all use for our own emotional wellness, and we get on board with that idea, you still have to ask how to access therapy. 

So when I think about accessing therapy, I do think you have to balance cost, quality, and access. Right? So if you're trying to access a therapist, it doesn't make sense if you found maybe the best therapist in the world, but they live all the way on the other side of the country, and they charge a million dollars. That's not really going to be feasible for you. Even if you get one session with that person. It's not going to be the most magical session in the world that you're done in 45 minutes. So let's just be realistic and acknowledge that this is a challenging system that we're working with trying to access mental health. So how can we balance all of those considerations? And what are some, some supports that we might want to access to help us with that? 

So the most common way for people to access mental health benefits is often through their insurance. And if you have insurance, I would suggest that you call the 1-800 number on the back of your insurance card and ask about mental health or behavioral health coverage. That's what they call that. You could say "I'm looking for counseling" and describe what you need. And we do have certain protections, certain mandates around coverage, we're supposed to have mental health parity. Health insurance is supposed to offer equal access to mental health. And unfortunately, people often have the experience where the systems are still catching up to that ideal of parity and it can be hard to access providers. But it doesn't hurt to start.

Go ahead and start with your insurance because you might find someone in your network that's fully covered. Or maybe they reimburse a portion of it, it's always good to check with your insurance because every plan is different. If you can't find someone who's in-network, this is true for most therapists in private practice, a lot of them don't accept insurance directly. They might be considered depending if they participate an out of network provider.

So if you have an insurance plan like a PPO, or a plan that offers reimbursement for a provider that is considered out of network, you would have to ask your insurance provider how that works, how the documentation works for that, and what the requirements are. So you might ask your insurance, "Do I need a diagnosis? Would any out of network provider qualify? What is the reimbursement rate? How does that claims process work?" So you would go ahead and ask all of those questions to get yourself really informed about what you need to ask for from your therapist because that person-- if they're an out of network provider, -- means that they don't accept insurance or payment directly from the insurance provider. You would make that payment, and the provider would give you a statement of reimbursement. So this might feel like insider baseball or too many details. The point is if you have insurance, you should definitely get informed and know all of the steps that it takes to get reimbursed. You don't want to be surprised after paying for a bunch of therapy that it's not covered. But insurance is a great way to get some of that coverage. 

Other ways to consider would be health savings account, or flexible spending accounts depending on your state. Depending on your whether it's a workplace benefit or available through the marketplace. Oftentimes, that's a great way to save up money for therapy appointments and be able to pay for it with pre-tax savings. So ask your employer and your family about what benefits are available to you. 

Beyond those direct benefits, you can also look for therapists in private practice. There are a lot of therapy directories out there, like Psychology Today, TherapyDen, you can Google folks in your area. And you can also look for counseling centers like university campuses where they're training PhD or masters level students who need to gather their clinical hours. That's a great way to access sliding scale care if you need lower cost. 

Those are all great ways to access therapy. The good thing is to ask. A lot of people assume that they don't have access or they don't have coverage. And you may even you know, think about who's in your family and if they have experience in this area. You can think about friends or family if anyone's navigated that. They may have some tips for you about local resources. 

So, before we end our conversation for today, the last thing I'll leave you with is to think about: How to get the most out of the therapy process. We already talked about before: Do you have to be totally ready to make life altering changes, when you go to therapy? No, you can just go and you can get feedback and information and you can make change slowly. And when you're ready to do so, even space out your visits if you need to. But when you're ready, if you're going to get the most out of that process, it is going to require that you give your therapist feedback about the process and that your therapist gives you feedback about the process. And that might include satisfaction surveys or conversations about how to make the process better. 

A lot of times, well sometimes, clients might suddenly drop out of therapy, whether it's because of scheduling or you know, some kind of pick up and they might feel bad about coming back, like embarrassed. And just to know that, you know, it's good to talk about that. And you can bring those feelings back to the process. So if there's ever anything that keeps you from fully engaging therapy, just to know that, that feedback is really important to improving the process. 

Other ways to get the most out of theray to use evidence based methods that are matched to what you need, we talked about all those different therapy styles before going. Go to a specialist in you know, how to get a divorce, if you want to stay married forever, you want to pick this specialty that's designed for what you need at the time. So listen to your gut when you think about that. 

And the other way you can get the most out of therapy is by being an active participant between between those sessions. So your therapist might give you homework, whether that's something to write down or simply think about... You're going to get even more out of that therapy process by interacting with the concepts between sessions -- kind of how we treat this podcast, is these are all extra things that you can think about whether you're in or out of the therapy process. So that's also going to help you when you're in therapy is to really take it seriously and, and act as if it's important to you. 

So as you think about therapy and what it means to you, I encourage you to think about some of the things we've talked about today. Maybe you can define for yourself what your personal philosophy is when it comes to therapy. And if you have a therapist, maybe take it back to them and compare notes, see if you're on the same page and see if there's any adjustments that need to be made. Or if you are considering therapy for the first time. I hope I've left you with some food for thought and considerations of what to look for. 

If you have more questions about therapy and therapy resources, or self care tools... Feel free to check out the TherapyForRealLife.com website, where you will see lots of articles describing different therapy styles and you'll find different podcast episodes about tips and tricks to help you manage stress in everyday life. 

Thank you so much for tuning in. And remember that self care is meant to be shared. So if you found this episode helpful, feel free to share it with a friend or leave a review where you found this episode. Thank you for listening and have a great day.