The Practice of Gratitude

Ahhh, the wonderful time of year where everyone goes around the table and talks about what they are thankful for. Personally, I love winter holidays but, the idea of expressing what we are thankful for is something I strive for daily. Yep. You read that right. Every single day. This can be difficult when everything starts to pile up on your plate. One day your car breaks down, you don’t have a place to sleep, you find your counselor isn’t a good fit but you’re stuck, you break up with your partner, or you are struggling at work or school. The list goes on and on with what could go wrong. We know this can be really tough.

How About What Goes Right?

When we focus on what is going right in our life, we tend to realize that we have a lot to be thankful for. We are ready to show appreciation for others and things in our life. Practicing daily gratitude can lower depression and make you happier. Not only can it help you as an individual, but for couples, it can improve your relationship. We are often quick to criticize and not provide positive affirmation to our partner.

“Well, I say thank you.”

That’s great! Saying thank you to people is not only polite, but shares that you are thankful. This is where gratitude can grow. Gratitude is deep. It’s the moment when someone gets a popped tire with three kids in the car and is stranded on the road. Then, someone stops to help out of the kindness of their heart. The parent is grateful, and might even feel they owe something to the individual who helped them out. It’s the idea that someone was extremely extremely grateful for something. A half “thanks for doing that” is totally different from, “thank you so much for helping my family out”. Next time you go to say thank you, see if you are saying it slightly out of polite habit, or because you recognize and are grateful for the fact someone went out of their way for you.

Two Components

Gratitude has two components to it. The first would be affirmation of goodness, such as affirming the fact that there are good things in the world (gifts and benefits we receive). The second would be recognizing the sources of happiness are outside of ourselves (in this case). We totally get you can have happiness within yourself (and we hope you do!) but in order for there to be gratitude, someone has to be providing something. The “something” does not have to be an item though. People can be grateful for company, time, and much more. The idea is that you feel a strong compassion.

How do I do this?

Practicing daily gratitude takes time and, you got it…practice. Just like any other change in your life, it does not typically happen over night. We want to provide you with some basic ways to start changing your mindset. Some of these won’t be for everyone, but making the small changes provides the opportunity to make big changes! Start a little outside of your comfort zone and push yourself just a bit!

Don’t Be a Picky Person.

More often than not, we tend to focus on the big things we are grateful for whether it be finally conceiving a child, getting a promotion, or getting married. These are all big steps in your life and absolutely worth being grateful for. However, did you wake up grateful that your nostrils were clear and you don’t have allergies? How about that you were able to have internet to be reading this (amongst other things)? Were you grateful that your favorite shirt was clean? How about the fact that the weather changes and you got to experience leaves falling one day and snow the next? All of these are small things that happen in our life that we can appreciate and find value in. Don’t focus on only the big stuff. True gratitude comes form valuing the small things.

It Is Not All Positive.

I really like this one. Sometimes, when we go through a crummy situation like depression, grief, or loss of a job; we should be grateful then as well. I am not saying everything is full rainbows and sunshine. It’s okay to still feel upset. This should not be the focus when practicing gratitude. Without sadness, we do not know what happiness is. We explore what makes us happy or sad. With grief, we realize that we have had the opportunity to love and care for something so deeply that we grieve at its loss. This loss can even leave openings for new opportunities. A typical example of this would be when you lose your family pet. This loss opens the door for a “replacement” pet (because let’s be honest, each pet is individual and never replaceable).  Look into some experiences you have considered negative and take a look at how they have created who you are as an individual.

Write About It.

I have recently began implementing this one myself. Writing is not for everyone. It takes time. I recently picked up Count Your Rainbows as my daily gratitude journal. On one page, it asks me to write a couple of things I valued about the weather. I had to think back and realized I hadn’t paid any attention to the weather that day because I had not been outside. Now, I focus on the weather and appreciate aspects of it. These small changes can create positivity in your life. Writing does not have to be a novel, although it totally can be! The point is to find something that works for you. For you, this might not be writing, and that is a-okay, my friend.  

Give Your Time to Someone Else

With the holiday season right around the corner, volunteering can be an optimal way to practice gratitude. Nothing is more humbling than realizing all that you have that someone else does not. Giving back to others in your local community not only helps them, but studies have shown that volunteering in order to benefit others can increase our own well-being. How could we not want to help ourselves sand improve someone else’s life?

Say it

I know I mentioned above saying “thank you” is not enough. I am not saying we don’t need to say thanks. We surely do. Think of a time when you have told someone thank you. Handing me a tissue comes to mind for me. I could have reached them on my own, but they were nice enough to do so for me. I said, “thanks.” Now, imagine if I had snot running out of my nose, I saw no tissues in sight, and they whipped one right out of their bag. Then I would have been more likely to say, “Wow! Thank you soooo much.” I truly would have been grateful while the first was more, “That was kind.” See the difference? I get it’s a bit of a silly example, but being handed a tissue is something we might take for granted. Now, every “thank you” should be more like the second. If you already do this, awesome! Expressing gratitude in more ways than just “thank you” is important as well.

Why Should We Do This?

As we continue practicing gratitude, our mindset will shift. One can begin to focus on what is important and what they already have versus what they do not have. This can change our attitude when presented with different situations. The great news is that this change in your life can decrease anxiety, provide clarity on who you are, and make everyday happier! Who doesn’t want that?

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 ABOUT THE AUTHOR

Machaela Rausch
Counseling Intern & Client Liaison | The Counseling Hub

Machaela is currently in her second year of the Master of Science in Clinical Counseling program at Central Methodist University (CMU). She is the client liaison for The Counseling Hub where she assists with getting individuals set up with a counselor. She obtained her Bachelor of Arts in Psychology with a minor in Sociology and a minor in Multicultural Studies from the University of Missouri.

 Machaela is currently receiving experience in the Counseling Center at MACC’s Columbia Campus, providing counseling services for students around the topics of identitiy crisis, school-related stressors, depression issues, coping with anxiety, and body image issues. Machaela has attended conferences regarding LGBTQ+ community and currently works for a non profit organization where she provides Applied Behavior Analysis (ABA) Implementing to individuals with developmental delays. Machaela has worked here for three years. Machaela is an active member of the American Counseling Association (ACA).

 Machaela enjoys working with diverse populations and aims to always be open to new learning experiences. Machaela seeks to be a comforting and kind individual for the first contact with The Counseling Hub. Machaela understands the process of getting into therapy can be difficult and aims to provide people with a smooth process.

What is Premarital Counseling Like?

Premarital counseling is one of the many services offered by our team at The Counseling Hub! As you may know, we specialize in individual counseling and couples therapy or marriage counseling. Premarital work definitely falls under the couples therapy or marriage counseling umbrella, but it’s slightly unique than other types of couples work that we do, and here’s why.  

First of all, when people are seeking out premarital counseling, it’s usually assumed that they don’t have a significantly pressing issues with regard to conflict, affair, or communication. People often seek premarital counseling because, well, they’re getting married.  With that said, it frequently does happen that people come in for premarital counseling and end up doing a little bit more than just to premarital work.  

Premarital counseling is usually done with a variety of assessments and a pretty structured format. You and your beloved would complete some assessments and then you would go through said assessments with your counselor to see where the two of you differ and overlap. The assessments aren’t designed to be a measure of your relationship health, and they are not designed to predict weather your relationship will succeed or fail (we offer Gottman therapy for that!). The purpose of the premarital assessments are, quite literally, to see where you overlap and differ with your partner on a variety of topics, including but not limited to finances, sex, communication styles, personality traits, kids, and a host more.  

It is important that you have some understanding and conversation about these topics with your partner prior to getting married. We see plenty of people for couples counseling down the road who didn’t get clear with one another on basic differences about really important things. The things aren’t important because of anything inherent about the topic - the things are important because they show up so consistently in relationships that we need to make sure that we at least understand where  our partner is coming from. So while we would say that talking about these topics doesn’t reduce you’re potential for future problems, it does allow you both to learn how to discuss things you’ll agree and disagree on (the latter being way more important). In other words, it can help you learn to argue effectively with your partner. Ha! Sounds funny, but we’re being serious.

I would also throw in that we are probably a fantastic fit for premarital counseling because not only do we assess those different topic areas, but we are especially skilled at helping people learn how to communicate in ways that are healthy and effective and increase people’s understanding of their partner, as well as increase respect and compassion for their partner.  Doing these things from the outset will absolutely set you up for success down the road. 

Another bonus to our premarital work is that it’s for both secular and religious counselors.  Lots of folks will go through their church (if their religious), which we completely understand, but there are a subset of people who aren’t very religious, but also want premarital counseling. You are for sure in the right place, if that’s you.

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ABOUT THE AUTHOR

Tara Vossenkemper | Couples Counseling in Columbia, Mo

Tara Vossenkemper is the founder, owner, and therapist with  The Counseling Hub, and a counselor (LPC) in the state of Missouri. She specializes in couples counseling using the highly effective Gottman Method Couples Therapy (and is currently obtaining her certification, which requires three levels of training and ongoing consultation - it's a necessarily rigorous process that she loves).

Tara has a diverse set of clinical experiences, working with both adolescents and adults on issues ranging from eating disorders and anxiety to spirituality and existential crises. However, she is most passionate about couples counseling. Tara enjoys working with couples looking to decrease or enhance conflict, relearn healthy and effective communication, or are healing from an affair. She's also been formally trained as in the Prepare-Enrich Premarital Couples Counseling approach and the PREP Approach for couples counseling.

Tara is also earning her Ph.D. from the University of Missouri - Saint Louis. She's "ABD" (all but dissertation) and furiously researching and writing to finish things up. She's presented at national, regional, and state conferences, as well as locally, on the topics of discrimination, sexual minority distress, spirituality, healthy lifestyle and mental health, and private practice.

Social Support & Community: Chosen Family

I want you to think back with me for a second. Did you have a friend growing up who meant the world to you? Did you have someone you could go to with everything? You knew they would not judge you and they always had your back. Some would call this their “ride or die” or “peanut butter to my jelly.”

If you didn’t have this, well I hope it comes. For the LGBT+ community, when your family does not support you, this “ride or die” is a big part of their life. This is known as your chosen family.

Chosen Family

 Your chosen family are the ones you put as your emergency contact when you fill out paperwork because you know your mom would flip. It’s the sister you always wanted, the brother who loves you as you are, or simply a close friend.

 Chosen families are often formed because individuals are rejected by their actual family, experience homophobia at home, or may not feel supported by their family. Due to the fact that they do not have the love and support they hope for, they seek it elsewhere. Without individuals to support us in any journey of our life, we can begin to feel depressed or alone.

Now you’re probably thinking, “Yeah, I have close friends who I would consider the ‘sister I never had’. That’s my best friend. What’s the difference?” The difference is that your friend is an “extra” while for these individuals, it is all they have. This is so common that a documentary has been created called the “Chosen Family” to show how hard it is!

The Hard Truth

It hurts to think about, but unfortunately, of homeless individuals, sexual minorities rank amongst the highest homeless population. Think about that for a second. When I think of how many people are homeless, it brings me to the fact that so many are left or kicked out because of their sexual or gender identity.  The feeling that you are not accepted for who you are can wreck havoc on your mental well being.

In June of 2016, a nightclub was targeted and 49 individuals were killed. Why were they targeted? Due to the stigmas and hatred surrounding LGBTQ community. There are many aspects of this that are hard and upsetting, but in regards to the chosen family, individuals who share no blood lost their family that night. People in the club lost their “chosen family.” This is also a time where chosen family can come in handy. Your biological family might feel very upset or angry if you were a target of a hate crime, but they do not know what it is like to be a target unless they are apart of the community.

It doesn’t start as a choice

This is part of the hard truth. Most individuals feel as though they do not have many options. Your family can begin as someone showing you how to ask someone out, pick your first dress, go on a date, and anything in between. They provide information and guidance that your biological family cannot. For some, their biological family members include LGBTQ+ members who can provide guidance, which is awesome. Even then, discrimination can take place. Discrimination can show in all sorts of ways, so it is important to be cautious of how we speak to one another. As a family member of LGBTQ+, it is important to also remember that it does not mean they do not love you. Their chosen family provides a strong bond that makes them feel secure. Family members should be happy that their family member has been able to find such close friends to disclose to.

What does a chosen family bring?

Your chosen family provides you individuals who can relate to you. They provide a safe space to talk about emotionally draining topics. Even if your family is completely supportive, you might have family members who don’t understand. Individuals within the community understand what transgender means. Like I said above, they can help guide you and provide information versus having to be taught all of the information.

Family additions

For some sexual minorities, having children can be difficult. Children can also be expensive to reproduce. This could mean the cost of sperm, testing, and all medical procedures. Your family might not happen in this way. Adoption is a great choice, but even that is expensive. People have to make the decision all the time as to what will be best for their future family. There was once a time where they were also denied the right to marry, so someone could not be your partner by law, so they would be your chosen long term partner. Some individuals still decide to not get married. This would be part of your chosen family.

 There also might be a bisexual 50-year-old who possibly meets a bisexual 20-year-old. They are very fond of each other, but have no romantic interest. Thus, they become friends.  The 50-year-old woman was exiled from her family, but the 20-year-old is loved by her sister who knows and “in the closet” with the rest of her family. She needs guidance on dating and how to show she is flirting versus just being kind, so she asks the coworker. Eventually, they form a friendship. Then, the 20-year-old continues to reach out to the 50-year-old even after their jobs take them different ways. She now refers to her as “like a mother.” This would be her chosen mother. It does not mean she does not love her original mother, but she has found guidance, love, support, and parental advisory within an adult in her population. This would be an addition to her family.

 Community Ties

Think of a time where you had to move and uproot your life. If you have not experienced this, imagine what it would be like if you had to right now.  It’s scary, exhausting, thrilling, and everything in between. Depending on what stage of the coming out process you are in, you might want some places to go and people to meet. Having a chosen family can bring you community ties to find places in the area that are supportive and friendly to your community. Depending on where someone lives, this can be really difficult. This might just be John’s house on 9th street because his parents are open minded. It could be a bar for primarily gay people like we have in Columbia. With the growing community, it is important to know what is available to you. There could be support clubs at high schools, local business that celebrate PRIDE, PRIDEfest in your area, and so much more! By connecting with other members of the LGBTQ+ community and forming your own chosen family, you are opening doors you might not even know were there!

Emotional Support

As I said above, it is nice to have people to talk to. Not only is it nice, but it is proven to support your mental health. Having a family who you can rely on, trust, and feel safe with provides a comfort like no other. By getting involved, you have the opportunity to form a bond with people who are experiencing something very similar or have experienced it before. With the high rates of homelessness and suicide, it is important to find people that you have these feelings with. Our team is always open to providing a safe space to explore who you are, but we would highly recommend forming healthy friendships and relationships with others.

If you are a member of the LGBTQ+ community and are in the final phase of coming out, then think of what you might be able to do for someone else. You might be the one that someone wants to come to. You might be the older person in our example above who finds themselves providing guidance to someone. Your role as a chosen family member can be larger than you think. Are you guiding them to seek help when necessary? Are you teaching them about safe hang out spots? Are they a part of other healthy friendships? Have they mentioned what their home life is like? We aren’t saying it is your responsibility, but you have the chance to possibly be a chosen family member that you did not have. Even better, you have the chance to be like the ones you do have!

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ABOUT THE AUTHOR

MACHAELA RAUSCH- CLIENT LIAISON

Machaela is currently in her second year of the Master of Science in Clinical Counseling program at Central Methodist University (CMU). She is the client liaison for The Counseling Hub where she assists with getting individuals set up with a counselor. She obtained her Bachelor of Arts in Psychology with a minor in Sociology and a minor in Multicultural Studies from the University of Missouri.

 Machaela is currently receiving experience in the Counseling Center at MACC’s Columbia Campus, providing counseling services for students around the topics of identitiy crisis, school-related stressors, depression issues, coping with anxiety, and body image issues. Machaela has attended conferences regarding LGBTQ+ community and currently works for a non profit organization where she provides Applied Behavior Analysis (ABA) Implementing to individuals with developmental delays. Machaela has worked here for three years. Machaela is an active member of the American Counseling Association (ACA).

 Machaela enjoys working with diverse populations and aims to always be open to new learning experiences. Machaela seeks to be a comforting and kind individual for the first contact with The Counseling Hub. Machaela understands the process of getting into therapy can be difficult and aims to provide people with a smooth process.

Goal Setting: the Process of Counseling

Treatment Goals

The first session has passed (here’s what you can expect from it, in case you missed it) and your therapist wants to know what you think the goals of therapy should be. You may think that it’s obvious: to decrease whatever behavior or thoughts you came into therapy for.

Technically, you’re correct. Goals are, in essence, the “end game” of therapy. The purpose of therapeutic goals are to get you to a point where you feel confident that you can live your life the way you want to live it. Treatment goals are a collaboration between you and your therapist. We want you to know that your therapist will want to work on whatever it is you want to work on. There might also be times where your therapist might have ideas of some possibilities to work on. These generally come as a result of sitting with you for prolonged periods and seeking things that you haven’t noticed or realized before. And although you may (or may not) know what it is you want to work on, that may leave you wondering how you’ll get there.

How do I know what my goals should be?

The first thing that’s important in setting up treatment goals is to identify what exactly you want to do. If you are depressed, you may want to feel happier. If you’re fighting with your partner, you may want to figure out how to communicate those feelings. If you feel out of control, you may not recognize that what you want to work on is assertiveness. It may sound simple (it is, but that doesn’t mean it’s easy). However, sometimes we are not sure what we want and we’re especially not sure how to get specific with setting goals.

This is where your therapist comes in. They’re skilled at helping you in recognizing what it is that will be helpful to work. Also, it’s good to remember that your goals are for you. If you are not diggin’ one of your goals, it’s important to share that with you therapist. They can’t know that you are not fully on board if you don’t tell them!

Anywho, identifying your goals means that you’re honest with your therapist and yourself. It means being open to feedback that other significant people around you may have. It also means that you may have to spend some time inspecting what it is that you really want or need from therapy.

How do I get to my “big” goals?

So you’ve identified what it is that you want to work on in therapy. Let’s stick with our example of you want to feel happier. Great goal! That’s not an uncommon goal in therapy. The question, then, is how do you get there? One thing to do is to break the main goal into smaller goals. For instance, you will not (and should not) think that going to a few sessions will instantly make you feel happier all the time. That would be awesome if it did, but in order to achieve your goal of being happier, you may have to set the goal of finding something practical that makes you happy. Small, achievable, things that make you happy on a daily basis may set an overtone of happiness in your life and add considerably to your overarching goal in therapy. As easy as it sounds, you’ll spend more time than you think you will talking this out with your therapist in order to identify how you can make small, measurable goals to achieve your big goal.

An important factor in making small goals is that they must be realistic. For a person who is seeking happiness in their life, feeling happy all the time may not be realistic. Happiness is appropriate for happy times. If a person who is dealing with the death of a loved one expects to be happy all the time, they may be disappointed when they do feel sadness. Realistic goals are goals that are actually attainable. Not only is that helpful for feeling better (actually able to achieve your goals), but even more, being unrealistic is a good way to make yourself feel bad if you don’t meet your goal.

Another important component of goal setting is celebrating the small steps towards the big goal. Sometimes in our journey, healing may seem endless. The big picture may seem impossible and there may be a lot of small goals. Both the big picture goal and the small goals may feel overwhelming. It’s important to celebrate the small successes because that means you are one step closer towards the life that you want to live!

How will I know if I am getting anywhere?

You’ve been working hard in therapy, but is it really working? Some days it feels like it, others it doesn’t. In order to tell if you’re making progress, goals must be evaluated. You won’t know how you’re doing if you don’t step back and review your work. Evaluation may look different for different people. It may also look different depending on what your goal is. Some individuals may look at their progress and need tangible evidence, such as, a count of how many times they did a certain behavior in a day. Other’s may seek feedback from important individuals they may be struggling with such as asking a spouse their perception. Yet others may self-reflect. Whatever method you choose, it is important to share your evaluation with your therapist and then shift into maintaining the goals/changes in your life.

What if my goals are not going anywhere?

Your evaluation of your goals should, and will, inform the process of therapy. Something important to remember is that treatment goals are for you. You and your therapist may discover that work you’re doing with your goals isn’t working. If what you’re doing is not working, you can redefine what it is that you want from your goal and how you will get there. It may be as simple as adjusting one of the smaller goals to help your big goal. Some goals may get marked off the list as you progress through therapy, while others may trigger an entirely new goal. It’s also possible (maybe even probable) that goals will evolve with you in a cycle of self-improvement.

How will I know when I am done?

Knowing you are done with a goal might be obvious or subtle. If you and your counselor are evaluating your goals frequently, then it maybe easier to tell when you have reached a goal than if you are not evaluating frequently. It may also be important to remember that sometimes we’re never fully “done.” Goals are great when you can say, “I completed this!” but oftentimes when people are under pressure they may revert to old patterns of behavior or thoughts. That is okay. Really. The beauty of therapy is that your therapist is there to help you if you need them. Just because you may have met a goal once, doesn’t mean it’s a forever change. It means it’s a change that you’ve successfully made and now know you can make when you slip up into old habits. You will likely need to intermittingly practice a goal that has been met once already. That’s expected!

When do I start?

Typically, goals should be set during some of the first few sessions. A general rule of thumb is that goals should be set in writing with a clear process by the third session. However, a lot of therapists will want to know what goals you want to work on by the end of the first session. Goals are a very important part of therapy. Without setting goals, you (and your therapist) are likely to feel lost and unproductive (think of floating in water with no island in mind- where would you even start swimming?!).

A recap of what goals should look like is: they should inform the therapy process; be a collaboration between you and your therapist; have smaller, measurable goals; be frequently evaluated; and, can be modified whenever they are not working. Goals are for you. Our team is just here to help you out along the way! Happy goal setting!

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About the Author

Molly Lyons- Counseling Intern

Molly is currently in her final year of the Master of Science in Clinical Counseling at Central Methodist University (CMU) and is a student intern at The Counseling Hub and Boone County Mental Health Coalition, where she will assess and provide mental health interventions and resources for individuals and groups in Boone County schools. She obtained her Bachelor of Science in General Psychology with a minor in Child Development from Central Methodist University directly before enrolling in the counseling program. Prior to pursuing her counseling degree, Molly received an Associates of Science in Early Childhood Education from Moberly Area Community College. 

Molly has experience in the Counseling Center at MACC's Columbia campus, providing counseling services for students around the topics of identity crises, school-related stressors, depression issues, and coping with anxiety. Molly has co-facilitated Safe Zone trainings which introduce its members to the LGBTQ+ community terminology and basic information. Molly has also completed on online course in LGBTQ+ Counseling Competencies (College and Career Readiness) through the American Counseling Association (ACA). Molly is an active member of both the ACA and the Association for Multicultural Counseling and Development (AMCD).

Molly enjoys working with diverse populations and seeks to always be open to new learning experiences. She works best with individuals who are trying to discover who they are and how they relate to their world, as well as others in their world. Molly believes that a person’s external factors can provide both barriers and resources towards growth and that one must discover these in order to thrive.

Clearing Up the Process: The Intake Session

You’ve done it! You’ve signed up for therapy and are awaiting the next chapter of your story to begin. You may have been to therapy before (or maybe you haven’t), but either way, it can be nerve wracking. Finding someone you fit with and (generally) it being someone you have never met can be daunting.

What should you wear? What should you say? Should you cry at the first session? How much do you really want to tell your therapist? What if you don’t like your therapist?

These questions are ones that people may ask themselves before their first session. The first session is unlike the following sessions, and therefore it can feel like a strange encounter. The first session is known in the “counseling world” as the intake session. The purpose of the intake session is for the therapist and you to create the most whole and accurate picture of you as possible. In other words, this is a time where your therapist goes over all there is to know (as if that’s possible in one session) about you to help gather a picture to help you both out. One way in which your therapist gets to know you is through the use of forms. There are probably going to be a lot of forms you must fill out. These could include informed consent, intake forms, release of information, questionnaires, and so on.

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Informed Consent

This is the most important document that you want to read with a careful eye. We aren’t trying to slide anything past you, but we really want you to know what it says. An informed consent is super important to not only the therapist, but for you as well.

Essentially, the document lays out the framework for the legal and logistical parts of therapy. The informed consent will likely be packed with information such as social media policies, mandated reporting laws, what will happen to your file if your therapist expires, payment arrangements, cancellation policies, confidentiality statements, and anything else that your therapist may think is important.

Intake Forms

This is likely to be the form that takes you and your therapist the most time to digest. The purpose of the intake form is to get as much information as possible about you that could inform the therapeutic process. For our team, the intake is online so you can take your time thinking of the answers! Then, we go over it together.

So many different domains are associated with mental health therefore your intake form is probably going to be longer than any other form you must fill out. Most of the time the form will begin with questions to gather basic information; What’s your name? Where do you live? What is your birthday? How do you identify your gender? Race or ethnicity? Therapists know that age, gender, and ethnicity can influence certain disorders differently than persons of differing age, gender, and ethnicity. Also, in the first part of the intake, you will find questions that inquire about work, living arrangements, and education. Our mental health can negatively influence these areas of our lives and it is good to know if these areas are ones that can be positively influenced by therapy. The next sections are not necessarily in this particular order; however, they are all generally included in the intake forms.

Relationships are invaluable as social supports during times when you may feel like you are not feeling like you. Your intake form will want to know about all the types of relationships you have had since you were a child. Did you have supportive parents or siblings? If not, who were your role models? Do you have friends that you can talk to when you are feeling down? Do you have a significant other? If so, do you feel happy with that relationship? Do you have a relationship with spiritual or religious beliefs? All these various relationships can be important when discussing what supports you when you are not in the therapy office.

Being honest with your therapist is crucial. Therapists know how difficult it can be to talk about hard things you may have experienced (i.e., neglect, childhood abuse, family or parent substance abuse, couples conflict), but they also know how much of a need it is and relief it feels to get it off your chest. Although that doesn’t all (i.e. getting it out) come within the first session, we are prepping for the opportunity ahead of you!

There will be questions about previous therapy. Your therapist will want to know if you have been in therapy before. Did someone refer you to therapy? Were you ever hospitalized for psychiatric purposes? Do you take any psychotropic medications? If so, what are they? Most likely, your therapist will inquire what you liked and disliked about previous therapists and what previous goals were. Your therapist may also want to know what you expect from your new therapy. How long should it last? What do you want to see change from the beginning to the conclusion of therapy? Last, your therapist will want to know in your own words why you are coming in. What exactly is happening so that you sought out therapy? Knowing what you have accomplished in previous work and what you expect from current therapy will inform your therapists approach.

Typically, towards the end of the intake form, your therapist will want to know if there is anything else that you want them to know about you. This is a great opportunity for you to expound on any of the answers your previously provided. Also, towards the end of the form, your counselor will ask you to write your strengths. You are so strong and have come so far in life! Your therapist will want to know how you have made life work and then help you find even more strengths within yourself.

Release of information

Although release of information may not be discussed in every intake session, it is good to know about.

A release of information is a form that allows your therapist to speak with other professionals you may visit. In the therapy world when many professionals come together to help the health and well-being of an individual it is called collaborative care. Your therapist may ask you if you would like your other health-care professionals to be able to communicate with them. Collaborating with other professionals can enhance the effectiveness of therapy in many ways. Therapists often spend more time with clients than other health professionals. Because of this inequal amount of time, therapists can act as an advocate for their client if there are any concerns.

If you agree to a collaborative care approach, you will be signing a release of information. On a release of information form there should be specific information; who can the therapist speak with, when the form will expire, and what you can do if you decide to retract the form. As mentioned previously though, it might not be discussed in session because it might not be of interest to you. This is not required.

Questionnaires

Not as if you have had enough papers to fill out, your therapist may ask you to fill out some questionnaires. These questionnaires may be completed at different time intervals such as weekly, monthly, or every three months. Questionnaires serve a purpose, but the purpose may vary.

First, to get a baseline. For therapists, they cannot know where to go if they don’t know where you are. A baseline is an understanding of where you currently are so that your therapist can help you move to where you want to be.

Second, questionnaires can potentially help identify what it is that you are experiencing. Sometimes it is hard to tell whether or not it’s anxiety, depression, obsessions, and so forth. Tentatively identifying what you are experiencing helps inform treatment.

Last, questionnaires can identify when you may need immediate help. It can be very uncomfortable to talk about thoughts of suicide or homicide, but it’s important to talk about it. Research has consistently backed up that directly questioning is the best way to help an individual who is at an extreme end of harming self or others. When you indicate that those thoughts are present, it’s important that your therapist can help you right away.

So now… Let’s talk about it!

So, you have filled out the mountains of forms. You are ready to go in and spill your guts to your therapist. Before you do, it is important to know that the first session will mostly be information gathering. This will not be a normal therapy session. I repeat: this will not be a normal therapy session. This session is to gather more information from you, really a sense of who you are (and for you to meet and get a sense of your therapist), provide you an opportunity to elaborate on any of your answers on your intake form. During this session you may often feel the need to focus on the critical aspects that drew you to therapy; but, as urgent as those feel, you probably won’t get the chance to talk about them in depth. Not that your therapist doesn’t want to hear about the things you’re coming in for! They totally do (or should if they are a good fit).

They are also tasked with getting the biggest view of you as possible, that way they can pinpoint how to move forward and help you find what works for you. If you come in and talk about your problem before your therapist can fully understand you as a person, they may not be able to provide you the most individualized help. The intake session can feel like a weird encounter. You may hear your therapist say, “That sounds really important, and I want to come back to that, but for now, I need to know…” You are also welcome to say, “I know that we have to get through all this stuff, but I want to make sure we talk about…” That way your therapist knows that a specific topic is very important to you.

In summary, there are a lot of forms. These forms give your therapist a clear understanding of who you are so that both of you can make the most informed decisions as possible. You need to carefully read through the informed consent document and decide if there are any release of information forms you would like to fill out. Also, be prepared for more questions as your therapist may want to use a questionnaire. Finally, be prepared to talk about all the forms. The intake session can be quite nerve wracking, but hopefully, you will have a positive experience and you are able to begin your journey towards health!

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About The Author

Molly Lyons- Counseling Intern

Molly is currently in her final year of the Master of Science in Clinical Counseling at Central Methodist University (CMU) and is a student intern at The Counseling Hub and Boone County Mental Health Coalition, where she will assess and provide mental health interventions and resources for individuals and groups in Boone County schools. She obtained her Bachelor of Science in General Psychology with a minor in Child Development from Central Methodist University directly before enrolling in the counseling program. Prior to pursuing her counseling degree, Molly received an Associates of Science in Early Childhood Education from Moberly Area Community College. 

Molly has experience in the Counseling Center at MACC's Columbia campus, providing counseling services for students around the topics of identity crises, school-related stressors, depression issues, and coping with anxiety. Molly has co-facilitated Safe Zone trainings which introduce its members to the LGBTQ+ community terminology and basic information. Molly has also completed on online course in LGBTQ+ Counseling Competencies (College and Career Readiness) through the American Counseling Association (ACA). Molly is an active member of both the ACA and the Association for Multicultural Counseling and Development (AMCD).

Molly enjoys working with diverse populations and seeks to always be open to new learning experiences. She works best with individuals who are trying to discover who they are and how they relate to their world, as well as others in their world. Molly believes that a person’s external factors can provide both barriers and resources towards growth and that one must discover these in order to thrive.

How to Build Confidence

How to Build Confidence

Individual Counseling | Columbia, Mo

Does this scenario sound familiar? 

You're laying in bed, scrolling through your feed, and you think to yourself, "Man, I must be doing something wrong. Everybody looks like they live this awesome life and I'm a mess." You see a classmate or coworker rocking those jeans that you could never pull off. You see the silky-smooth face of another while constantly checking the mirror to make sure those zits are well concealed. You see Dr. What’sHisFace graduating from med school, while you're struggling to finish one semester in college. In short, you see the happiness of others all around you.

Are you comparing yourself to others while you scroll?

Do you see how it impacts you?

Do you think about the benefit and cost of doing so?!

Our current social environment (including media) is a breeding ground for low confidence.

Yes, obviously, people have varying levels of confidence. Some people are more confident than others, some people are less confident than others, and you're feeling down on yourself right now about your own levels of confidence (otherwise why would you be reading this). 

And sure, compliments from others can help. However, no one will compliment you enough to make you feel better about your insecurities.

Let me repeat so those in the back can hear.

NO ONE CAN COMPLIMENT YOU ENOUGH TO MAKE YOU FEEL BETTER ABOUT YOUR INSECURITIES.

Confidence is a gift only you can give yourself. What we want for you to do is to engage in some self-assessments and realize that you have qualities and knowledge that others can appreciate. All of us (yes, all of us) can be secure in the situation that we are in. Nobody is stopping you from being confident in yourself. And we're going to help. Here are tried and true ways of building your confidence.

Build Healthy Relationships

It’s uncomfortable at first, but push yourself to form healthy relationships. I know, I know. This is a topic our individual counseling and couples counseling highly focuses on, but it is sooo important.

Having meaningful people around you that are honest and caring can help you to feel better about yourself. Not only will they build you up, but they'll push you to stand up for yourself (which will, in turn, build your confidence). Listen to your trusted friends when they tell you that your new haircut looks fly as hell (just kidding, but not really).

(And Then Change Body Language)

Then take that fresh new haircut out into the world and show it off!! There is nothing wrong with embracing things, such as a new haircut, that make you feel GOOD. Why? Because we are talking about healthy things and healthy relationships. 

It might be extremely uncomfortable, but that strut you have going on is actually proven to increase your confidence! In other words, it's not just all in your head.

And then it becomes a fantastic feedback loop - building relationships will help generate some confidence, which you'll feed into by "acting as if," which will actually solidify for you, and then this will further that social circle you have because people are drawn to those that seem like they know what’s going on. Phew! 

Act "As If" Until You Reach "Is"

I can’t tell you how many times I’ve been drawn to a person simply because they were so confident in themselves.Maybe this is what you see in Dr.What'sHisFace and your friend rocking their jeans. You see them either "acting as if" or they have reached that level of confidence! I wanted to know what made them so confident. This resulted in meaningful conversations that let me know that this person is normal, yet interesting as hell. I then realized that I know some stuff. Not a lot, but some. I thought to myself that I could hold myself differently and walk as if I have it figured out. When asked if I know what’s going on, I answer confidently and honestly. Why would I be ashamed if I didn’t know the answer to their question? 

Not knowing the answer is part of life!! No one knows everything and that is completely fine. Remain confident with the knowledge that you possess. With confidence, you gain resiliency to failures and can move forward with the knowledge that your failures provide. Every success and failure can be used as a learning experience and your confidence can help you avoid dwelling on the failures and propel you to use this newfound information.

Learning comes with a sense of accomplishment. Use that shit!! You’re learning, and you feel good about it!! Don’t sweep it under the rug and act like it’s no big deal. Allow yourself to celebrate this. You don’t necessarily have to throw a party but embrace the fact that you are learning things and have more to provide others.

Be Confident In Your Work

Confidence is especially helpful in the workplace. The supervisor/ supervisee relationship is one that you need to respect. However, honesty is a great policy. Honesty that is accompanied with confidence is even better. If you have a lot on your plate, you should communicate that with confidence, or a strong statement, in order to avoid getting overwhelmed and not completing the tasks the best you can. We are so used to being the society so proud of how hard we work. What good is that work if you aren't confident or putting in 100% effort? Using confidence to fuel your ability to set boundaries is one of the main reasons confidence is so important. People with low self-esteem tend to desire to please others. This can be alright; however, it should not be the only reason to gain confidence.

This low self-worth that many people deal with causes more than being taken advantage of. We begin to struggle to express ourselves effectively and remain quiet when we find a problem with the way we are being treated. Remaining quiet and hoping that nobody will take advantage of you is not the best way to handle this situation. Express yourself! State the way you feel and your thoughts on the situation. If you know how to handle a situation, then utilize that knowledge to express yourself effectively. You may not think you’re being confident but if you state something that you know is a fact, people will listen. Whether you viewed this statement as being confident or not, utilizing this form of communication can help you to gain traction in your search for confidence. The reaction of others can tell you everything. When someone hears you say something and listens, it feels good. Imagine being able to do this across the board.

Many people don’t feel heard and this is typically the case for people with low confidence and low self-worth. Trust in yourself and believe that what you are saying is important. The same is true for your feelings. Feelings are not a sign of weakness. Feel free to express them. This is one area that you will not be wrong in. Nobody can tell YOU how YOU feel.

Setting boundaries was mentioned previously, but this is one of the best ways to protect yourself and increase/utilize your confidence. Most people form relationships with others and find out that some of these relationships are not healthy. This is okay, and we don’t need to cut ties with everybody. However, we can certainly develop boundaries to protect ourselves from being dragged down.

These boundaries can help to increase your confidence by limiting the amount of negative feedback you are receiving. It can prevent insecure people from causing you to question yourself and encourage you to surround yourself with like-minded and confident people who will encourage you to become a better version of yourself. Nobody has the right push you around. Unfortunately, many of these people who decide what’s best for you are the people that should be encouraging you in your search for what’s best. They have this idea that they know what is best for you and this could be due to your lack of confidence in the past. While utilizing confidence, you can tell them that what they are doing is not helpful. This doesn’t have to be a hateful conversation. Remain confident and tell them how you really want things to be. You have given them a choice. They can respect your wishes and remain an important and trusted person in your life. If they decide that they still know you better than you know yourself, healthy boundaries may be required. This doesn’t mean cut out people in your life. This just means limiting the amount of an influence these people have on your actions and your feelings.

Allow yourself to learn from many different avenues. A lot of self-help strategies sound very corny. That doesn’t mean they don’t work! Reassure yourself that what you are happy doing is the right thing for you to do. Many people use confidence to put themselves in positions to succeed. While many people measure success by their monetary income, this is not the only route of happiness. Enjoy what you do, and you will constantly learn and increase your confidence in any given subject. Use that confidence to better yourself. Give yourself a pep talk every morning and know that you have every reason to be confident in yourself. This healthy state of mind will transfer to other areas of your life. Use this as fuel to take better care of your physical self. Use this as fuel to take better care of your mental self. Allow yourself to speak with a counselor and don’t be afraid to rent a self-help book from the library (Barnes and Noble has an entire section dedicated to it). Enjoy more time on your favorite trail to increase your physical health and blow off steam that could translate to better mental health. This will all help increase your confidence in yourself. Develop a routine and begin to grow accustomed this routine. As you develop your new “normal”, your confidence will grow. You will feel better about yourself and begin to see that you’re in control.

This realization of the amount of power you possess can transform the way you approach your life. The more you feel better about yourself, the more you will strive to attain more confidence. The change in other’s behavior around you will have you noticing that others are taking you seriously. This is a great feeling.

Have I struck a chord with anyone or am I just rambling? Hopefully someone has found reason in their life to be confident. We all have a reason, however, sometimes it can be difficult to find a place to start. That is perfectly fine!! Start slow and assess your interests. Find what you enjoy and find what you are good at. Remain open to new ideas and allow yourself to believe that you are better at some things than others. This is probably the truth. We all have qualities that make us better at some things than others.

With all of this confidence talk, I want to encourage everyone to remain humble. Confidence is not an excuse to blow off others or treat others with disrespect if they are wrong. Confidence is believing in yourself and trusting that you are doing what is necessary to better yourself. At times, confidence can be gained from helping others. Be confident, not cocky, and be willing to share your knowledge. Believe in yourself and treat others with respect. That is a very broad and simple idea, but the point is very simple. Be good to other people and utilize your confidence to better your situation. Others will begin to believe in you and your boundaries will help to provide you with the most ideal situation to grow your confidence. You deserve to feel better about yourself. Once again, be selfish periodically and know that the best person to care for you is you.

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About the Author

Tim Fitzpatrick | The Counseling Hub in Columbia, Mo

Tim is a provisional counselor with The Counseling Hub, a counseling practice in Columbia, Mo that focuses on meaningful connection between self, partners, and others. Tim enjoys working with both adolescents and adults on issues regarding making major life changes or transitions, enhancing and building meaningful relationships, wanting to build confidence, wanting to grow self-esteem, anxiety, depression, experiencing an inability to enjoy life, and feeling as though they are being taken advantage of. Tim is an active member of the American Counseling Association, the national counseling association for the United States.

Tim earned his Master's of Science in Clinical Counseling from Central Methodist University. He is currently a Provisional Licensed Professional Counselor in the state of Missouri and has presented and written on topics including the influence of parental support on depressive symptoms, ethical practice, and the development of adults based on marital status.

Change, Part 3 - Making a Change

Let the work begin! Well, that may sound a little over ambitious. Start with the small things to get going. It’s a difficult process and this is supposed to make you feel better, not overwhelmed. Try different things and see how that feels. There is no need to implement a large change to start. This can lead to getting overwhelmed with the changes. When change seems to difficult to do on your own, seeking counseling here at The Counseling Hub in Columbia, Missouri can be helpful.  We need to feel comfortable with these changes. Allow yourself to experience your feelings and evaluate the way you feel following the implementation of these changes.

Keep in mind that this is for you. People will probably notice that you are doing something a little differently. That is not a bad thing! If they say something to you about it, own it. I’ve experienced situations where people say something to me, which follows with me shutting down the change I was starting to make. Why would we give someone this power? A simple reply expressing that you are trying something new will suffice. You don’t need to explain yourself. You don’t need to justify yourself.

One of the most helpful things about making a change is to examine changes on a larger scale. Everyone is trying to change. Whether they are trying to lose weight or trying increase their knowledge in a certain subject, changes are always being sought. This is the easiest way to normalize the difficulty of change. If you struggle, continue to try. You wouldn’t be the first to struggle, and you certainly won’t be the last. This is normal and change is difficult.

Suppose a gain in confidence would make you happier. You make the decision to allow yourself to set expectations a little higher and no longer allow people to treat you like you don’t matter. Great!!

You walk into work and have a lot of deadlines that are creeping up. However, you also have coworkers who assume you will do their tasks as well. Would it be rude to tell a coworker that you will not be able to make copies for them while they are on lunch? Given that this person is not in a position to be ordering you to do things for them, this would not be rude at all! You are allowed to put your task before others. Simply express that and this could prevent you from being taken advantage of in the future. You are not there to make friends and make others happy. We all have things to do and sometimes you may rub others the wrong way when they assumed something about you that is incorrect.

This will lead to uncomfortable situations (trust me, it will). This discomfort will only last a couple days and soon people will learn that you also have boundaries similar to everyone else. As long as you know the environment, then you should be fine. Try to refrain doing this to your direct superiors at work as this could cause issues (DISCLAIMER!!) and utilize these skills for the meaningless busy work that is handed to you by people who are too lazy to do it themselves.

How free will you feel? Will the anxiety of deadlines approaching while you are doing meaningless work (for others) be reduced? Allow yourself to set boundaries and know that certain stressors could dissipate. Your mental health is so important, and this will have a direct effect. Enjoy it! Happiness is the ultimate goal and it truly is a great feeling.

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Change, Part 2 - Preparing for a Change

Change can be intimidating. Change is difficult. Luckily, we can prepare for this change. Nobody can be expected to change without a little preparation. There’s a high chance this change will be difficult if this stress and anxiety has been part of your life for a while. Take a deep breath and remember that this is for you. This is only the preparation.

So you need to make a change….. This is difficult. You need to do some prep work. This is similar to reading the instructions before you put together a shelf. Do I have the necessary tools? Are all the parts accounted for?

This is where we typically get in our own way. I don’t think I’m alone in this thinking process. We know the change but we want to ensure that we make this change when we are fully ready. However, we struggle to identify when that time is. You can spend time identifying the ways that you handle your stress and anxiety and discover what the causes are. Write them down if you need to.

I feel overwhelmed when I am trying to find my favorite soup and there are others in the aisle.

I feel stressed when I am given a deadline at work that I was not expecting.

Identifying these feelings can help you to understand what stands in the way of making that needed change in your life and of happiness. Don’t get overwhelmed with making the change. Let’s think about how we can better position our self to make this change effectively. Feeling anxious is awful but there is typically a reason for it. Process through the series of events that lead to this.

Were you anxious because you felt that people were looking at what you chose to wear? Are you happy with what you are wearing? If not, why are you wearing it? Did you have enough time to review your options in the morning? Would an extra fifteen minutes in the morning help you feel more comfortable throughout the day? That seems like an easy change to make. Right now, this is more about being self-aware than it is about changing behavior. We should be able to figure out how we end up in situations that bring us unwanted feelings.

If we can’t figure it out, could we pay more attention to our needs? There is no need to view this as selfish behavior. Think of it as self-care! Most of us could use a little more than we are currently providing ourselves.

As stated previously, change is difficult. Don’t let this difficulty intimidate you! You’ve prepared, and you understand that this is an investment in yourself. It’s similar to making sure you don’t spend too much on a gift but having much more freedom with your money when buying for yourself. This change can be life changing and the preparation is just as important. Prepare correctly and this change will feel natural.