Beyond the Sessions is answering YOUR parenting questions! In this episode Dr. Emily Upshur and I talk about…
- What are the advantages of telehealth appointments and the ability to do virtual sessions from anywhere.
- Do the full range of emotions and subtle nuances get lost when you’re talking through a screen? (Spoiler: Our brains fill in so much it often feels like we’re in the same room.)
- What to consider to determine if virtual therapy may not be the best option for you.
- The different levels of interventions and the types of support that can match up with each.
- If you are doing virtual therapy, how to maximize the experience and specific strategies to implement to make your sessions most effective.
- What is the difference between therapy and mental health coaching and what are the different rules for each based on the state you live in.
REFERENCES AND RELATED RESOURCES:
👉🏻 If you’re interested in exploring our therapy and coaching support services, feel free to reach out to us at Upshur Bren Psychology Group for a free 15-minute consultation so we can suggest a treatment plan for your unique needs.
ADDITIONAL PODCAST EPISODES YOU MAY LIKE:
🎧 Listen to my podcast episode about newborn sleep with Greer Kirshenbaum
🎧 Listen to my podcast episode about going back to work after maternity leave with Lauren Smith Brody
LEARN MORE ABOUT US:
- Learn more about Dr. Sarah Bren on her website and by following @drsarahbren on Instagram
- Learn more about Dr. Emily Upshur on to her website
Click here to read the full transcript
Dr. Sarah (00:02):
Ever wonder what psychologists moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard, because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.
(00:41):
Hello everyone. Welcome to another episode of Beyond the Sessions segment here on the securely attached podcast. Emily Upshur, thanks for joining us.
Dr. Emily (00:54):
Always a pleasure.
Dr. Sarah (00:56):
We have a question and I am glad that you are here to talk about this because I know you have a lot of feelings about the different ways of access points for therapy for new moms, but okay, here is her question. Hello. I’m a new mom and honestly, everything feels so overwhelming right now. I’ve never been in therapy before, but I’m considering seeing a therapist virtually that feels like the most accessible option for me with a baby at home. But since I’ve never done this before, I’m wondering if you think it’s better to see a therapist in person. I know this is a little off topic, but I’d love to hear an episode where you share your thoughts on this. So first of all, I would definitely say this is not off topic. I feel like this is right on topic. We love talking about maternal mental health and supporting the health of the whole family, and if the mother is not feeling like she’s getting her mental health needs supported, it’s going to impact the health of the family system as a whole. So I think it’s very on topic. So I’m glad you wrote this question in. Thank you.
Dr. Emily (01:59):
And it’s a good question that I think we’re all sort of really exploring now as we come out of only virtual things and things are going back to more in person from years of covid, which just can I start a new relationship with a therapist online via teletherapy? And I would always encourage saying yes. The short answer is yes. I think it’s the job of the therapist to determine if that’s the right fit for you to be very transparent. We want to make sure that that is the appropriate setting for you. But for a lot of you, I think the answer is yes, and I think that that’s a great place to start. And the silver lining for me of the burgeoning teletherapy is giving very busy, very legitimately watered down moms access with less transportation, less demand on their time, and still allowing them to be able to have the space to have a little bit of time carved out for themselves.
Dr. Sarah (02:58):
Yeah, childcare. You don’t need to have someone to watch your baby so that you can leave, go drive to therapy, do therapy, drive home, and then resume childcare obligations. I think that just being able to do virtual sessions from a childcare perspective alone is a huge access expander. It’s funny though, I dunno, Emily, I’m curious what your experience was with this because before everything went virtual in Covid, I had not done teletherapy. I was a therapy had always been my experience of doing therapy and practicing therapy had always been in person and I remember having these conversations before covid with my colleagues being like, I would never do teletherapy. So much would be lost. It can’t be done. And almost even, and I say this having taken healthy dose of humble pie, but at the time I almost looked down on it, I was like, that’s a lesser form of delivering this type of therapy. And I will say to be very explicit, having then gone through along with all the rest of us, the whole wide world basically of moving everything virtual because of that initial lockdown and then the pandemic and I was so amazed actually at how much did not get lost through the screens and I was actually kind of impressed with almost our brain’s ability to fill in the gaps. I do almost all my sessions virtually still because I do see so many parents who really want the convenience of teletherapy and I often will forget that we are not in the room together. My brain just fills in the gaps and there’s still so much body language and facial expression and nonverbal communication that’s happening through the screen that I didn’t think that that could be possible.
Dr. Emily (05:07):
Yeah.
Dr. Sarah (05:07):
And I’ve always been very amazed at how deep of a connection I still am able to have with my clients who I work with virtually
Dr. Emily (05:17):
Definitely to this I definitely had done prior to to Covid, the thing we were allowed to do was phone sessions. I don’t know if you remember
Dr. Sarah (05:29):
This. Yes. Oh, I remember doing phone sessions. I hated phone sessions.
Dr. Emily (05:32):
I actually didn’t mind phone sessions. It’s funny, my experience was more aligned with the experience you’re describing now, which is, but I never started a relationship on the phone, for example. I think that makes a big difference and that’s something I would, A couple of things you said. I just want to note for anybody who’s considering doing this, which is I think some of the important things are really protecting that time with your therapist. So if you’re feeling like, oh, I can’t do this virtually because I’m very distracted or I am running around or I find that I’m not sitting down even talking on the phone without a visual, if I’m just really not able to be present in that moment, I think that is something to think about. Right? To me that is one of the barriers is really taking a deep look and saying, am I really getting as much out of this as I can by giving myself a private place with space and time and sitting down?
(06:31):
But I do think if you are able to do that, you’re right. A surprisingly close connected ability to be with somebody and be able to work together on very vulnerable and sort of supportive topics is very accessible. And I think that really is important. And I think another piece that I always want to chime in, this happens a lot in my practice, which is I also think there’s different types of interventions and different levels of therapy. So I have moms where I see weekly or parents that I see weekly and we really do virtual sessions all the time. I have parents I just do phone sessions with, I have parents that I see quarterly and they’re like, it’s time for my tuneup. I need a little tuneup.
Dr. Sarah (07:23):
But those parents that you see quarterly, did you start off seeing them quarterly or did you start off seeing them weekly or every other week and then move to quarterly as a maintenance mode?
Dr. Emily (07:32):
I mean that’s the more common thing, but I will say that as I’ve become just even more seasoned and there will be people that I think need a little less, they have a little bit of a different discreet need or question or even a mini crisis. It seems like an overdramatic representation of it, but I do think that think of it more as consult. I think of it more as contained, how can I help you in this moment?
Dr. Sarah (08:05):
Which we do. I mean if you think about it, Emily, that makes me think of when we see parents, because we see a lot of parents at our practice at I’m sure brand psychology group. We see a lot of parents who are, I am pregnant, maybe I do or I am worried that maybe I have a history of some mental health challenges in the past and I want to make sure I’m kind of heading it off at the past. Or I’m just really want to get my ducks in a row before I have this child and I want to have a preemptive mental health check-in before I move into that postpartum phase where I might be more vulnerable to, for whatever reason, any genetic preloading or psychiatric history of having maybe vulnerability to a perinatal mood anxiety disorder that I want to have a check-in with the therapist to just do a diagnostic eval and make sure that we’re looking good and we have a plan set up should I, after having this baby experience postpartum depression or it’s a one off, maybe two off thing.
Dr. Emily (09:06):
And a person so that when you’re in that vulnerable place, it’s not the first time you’re meeting someone. Right. I think that that’s a relationship just as in even one session creates a relationship with
Dr. Sarah (09:17):
Somebody. Yes. Which we do. That makes sense. I see what you mean by that. I’m also thinking too, you said something that I feel like I also want to circle back and point out. You were saying if you’re going to do virtual, you want to double check and make sure, am I in a private space? Am I going to be relatively distraction free? Can I get into a flow easily? One, I would add to that if we’re talking, if you want to do teletherapy, how to absolutely get the most out of it, and this is a thing I see a lot as a bit of a roadblock to getting the most out of it is one thing because teletherapy allows for us to kind of zip in and zip out of therapy is that we sometimes just switch into our therapy mode and then switch out of our therapy mode and then we can sometimes inadvertently kind of cut off the half life that therapy can have for us. So you viewed a 45 minute therapy session.
(10:20):
It’s not 45 minutes, right? It’s then I leave the session and I’m thinking about it and I’m integrating and I am sort of reflecting and there is an effect, we’ll call it a halflife that ripples past the 45 minutes. And the longer you can get that half life to last, the more bang for your buck you are going to get, the more useful, the faster the outcome’s going to come that you’re desiring. So what I often will say to clients who I’m seeing virtually and kind of if I see ’em in person too, I want to increase their reflection of the work that we did in that session well beyond the therapy session, but especially virtually. I think it lends itself to this. It’s like if you have a 45 minute therapy session booked with me, I will encourage you to book it as an hour in your calendar and then spend that last 15 minutes that you might otherwise have spent commuting or transitioning out of therapy to transition out of therapy in a really mindful way.
(11:22):
Like write down a few things you want to remember or just sit and reflect on how it felt to go over what we went over or think about looking out forward to the rest of your week. How do you want to take some of these things with you and apply them to your life? Because one of the risks of a teletherapy session is if I have a back, I go straight from therapy to a meeting with my boss or I have to rush over to pick up my kid in Carline or whatever. I am going to interrupt that reflective integration that we want to occur after a therapy session and you might not come back to it. It might kind of just disappear. And so that would be something I think if you want to get the most out of a teletherapy session would be to have a buffer after it and even maybe a little bit of a buffer before it so you can not be rushing into the session and then have to transition into that kind of head space in the first five, 10 minutes of the session.
(12:27):
But before the session starts, can I get into a quiet place? Can I take some grounding breaths? Can I kind of just go inward and orient myself to what do I want to talk about? What do I want to get out of this session before it even starts? So five minutes before a session and five to 10 to even 15 minutes after a session, bookend that, buffer it, protect that space so you can get the most out of not only the therapy session, but then extend the half-life of the benefit of that session to be as long as you can make it. That is one way to get the, this is not an answer to this person’s question, but a question I get a lot, which is, how do I get the most out of therapy because it’s an investment and it’s a time and a financial investment and I want to make sure I’m getting the most I possibly can out of it. That is one way to definitely do that.
Dr. Emily (13:13):
And I think at the same time, I also want to emphasize that the same thing I said about my quarterly check-ins, which is you might just pop in for a handful of session by initiating a therapeutic relationship or initiating therapy, parent coaching, any of these options. You’re not necessarily saying, I commit to weekly sessions for eternity. I think it’s really important to say to exactly your point, Sarah, to compliment that a little say, I think I could give six weeks to really have a little bit of that buffer, a little bit of that space really commit. And that’s okay. I just want people to know that a lot of therapists will meet you where you are. And that’s a really important piece of this is that we don’t want to limit access based on your capacity. If it’s too hard, you have a school transition coming up, one of your kids is at camp, maybe you have a few weeks go for it.
(14:17):
Then you have a therapeutic relationship with someone that you can do booster sessions with that you could recommit to weekly therapy with at a later time. But I do love to take the pressure off of it because I think that there’s a lot of different ways of accessing and utilizing, and it’s certainly something we do a lot, which is we’re going to, to the best that we can, to the extent that that’s the right treatment course, an appropriate treatment course for you, that we will meet you where you are and try to be as flexible as we can with how you access the service.
Dr. Sarah (14:50):
Yeah. Another thing, so I don’t know where this mom is located, but something to consider if you’re looking to do teletherapy, a lot of people don’t know this and it can be kind of confusing, but typically if you want to see a therapist for therapy, that person needs to be licensed in the state in which you are receiving the therapy. So just because we can zoom in from anywhere across the country doesn’t mean that if I’m only licensed in New York, I can’t do therapy with someone who’s living in Wisconsin, which I think is less understood and something to consider. And also that’s the difference between therapy and coaching. So therapy can only be, therapy is like you give someone a clinical diagnosis and you treat a diagnosed mental health concern. Coaching does not provide a diagnosis and does not treat anything diagnosable. It’s about building skills and working towards a goal. So you can do parent coaching with someone who’s not licensed in your state because parent coaching doesn’t require a license therapy. If you had postpartum depression and you wanted to be treated for that, you need to be looking to work with a therapist who’s licensed in the state that you are in, which is just a consideration that I feel like people should know about.
Dr. Emily (16:13):
I think that’s a really good point, right? Because I think we get a lot of inquiries either from parents who are looking for parent coaching or parents who really just want to work with us and who are looking for therapy, and we sort of have to suss that out. But I’d say ask us that’s the best way to do it. Or ask anybody, I think that anybody you’re looking to work with, because I think that there are ways to be able to support you and different parts of what you’re looking for. If you’re looking for more psychiatric help, there’s a treatment for that. And whether or not the state you’re in or those little things will come up, but we can help. But people like us, we would help you find the right place to be if parent coaching is the right, which often is right. Parent coaching or support or just coaching in general. That’s also something we’re able to provide. And again, as Sarah noted, it’s a little bit less diagnostically based, but there’s a lot of things we can offer for skills and goals and coping strategies that can really help you meet, get some of the needs needed that you’re looking for when you’re reaching out for these things.
Dr. Sarah (17:24):
And I mean, again, this mom isn’t saying exactly what she is looking for. I think she’s looking more for support for herself, but we get a lot of requests from parents who are looking for support and just strategies to understand my kids’ overwhelming behaviors or emotions. And that really squarely falls, in my opinion, into parent coaching because we’re not diagnosing the child or the parent, but we are giving them strategies for better understanding the underlying drives behind the behavior. So that gives them more strategies for responding in a different way or setting for success.
Dr. Emily (18:07):
Yeah. And I think what else falls into that category is strategies for us as parents to manage our relationships with our children and our families. I think that still falls in a coaching mentality, and that is a valuable resource for a lot of families.
Dr. Sarah (18:27):
I hope we answered this mom’s question, and I think I’m just really grateful that she’s taking this time to actually tend to herself. I think that’s really, really important. And it’s undervalued, I think, or maybe not undervalued, but it’s under prioritized. I think as moms, we probably all know that it’s important to take care of our mental health, but we just drop our stuff to the bottom of the list. And so for a person who’s never done this before and is now with a new baby, just feeling like I’m going to put my needs first.
Dr. Emily (19:04):
Yeah.
Dr. Sarah (19:05):
That’s huge. So bravo.
Dr. Emily (19:07):
Love that. Yeah, definitely. If we can increase that access for parents, that is awesome. I’m all for it, and we’re here to help with that.
Dr. Sarah (19:16):Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.