Tag Archives: therapy

Is Online Counseling Safe and Effective?

It can be. Here’s what you need to know:

Telecounseling, using the telephone to conduct legitimate counseling sessions with licensed therapists, has been occurring for close to 50 years.  Telemedicine is what they call it when doctors and other healthcare providers provide services via telephone and Internet video connection. Now, it is a common practice, a clinical mode that is studied and taught to doctors and therapists, and in many cases, covered by health insurance.

As an older Licensed Mental Health Counselor, a boomer, I have been slow to accept the rapid advance of our culture into the digital age. I was even slow to accept the idea of distance counseling via telephone, without the eyeball-to-eyeball and close-up intimacy of live personal human contact. But circumstances forced the issue, with established clients sometimes homebound, and more and more people living an hour or more away who wanted to work with me. I found that counseling over the phone worked quite well, and actually had some distinct advantages over in-person sessions. No travel time, for one thing. It’s also convenient with less stress for busy people and those uncomfortable with going to a “shrink’s” office.

Today, telecounseling is routine and accepted, and the issues that were raised as potential problems, like privacy, confidentiality, compliance with the HIPPA laws, protection of personal health information and your most guarded secrets, have been answered with services that use technology and accreditation to insure those things. Counseling via phone or video calling, if done appropriately, can be as safe and effective in many cases as in-person counseling.

The same rules apply as with any healthcare services you seek. You need to make sure you are dealing with a licensed health professional in your state. You need to check what the counselor presents in their website or other public information to see if they might be a good fit. You need to be willing to invest in at least one session to see if the fit feels right. Also, you need to be prepared to try a different counselor if your first choice doesn’t feel right.

When COVID-19 hit early this year, telecounseling was a godsend. So many people needed help to cope, and distance counseling was perfect to meet the needs for social distancing and stay-at-home protocols.

Right at that time, I noticed a lot of advertising on NPR by BetterHelp, an Internet company that promised connection with licensed counselors through your computer, tablet or smartphone. I did a little checking and found they offered access to a professional counselor 24/7 via text (the counselor would respond within 24 hours if not sooner), for $40 per week and up, depending on how much service you wanted, and you could also arrange phone or video sessions.

I balked at the idea of counseling via text or chatting. I had a lot of experience as a user of social media, and I’m certain that real counseling or therapy cannot occur with texting or chatting. However, I have also served as a mental health expert in media where “ask the expert” questions were invited, and I would provide information that was very helpful to people. It was kind of like a “Dear Abby” column and it turned out to be very helpful to the people who wrote in. In fact, lots of people get lots of help with personal problems with therapeutic ideas and information they glean from books and other quality sources. That could not be called counseling, but it is in fact referred to as “bibliotherapy” when a counselor gives you a book to read. So, while it’s not counseling, communicating with a professional counselor with questions, issues and problems can be quite helpful. As one of the “Ask the Expert” experts when answering a message from those writing in about a problem, I’d sometimes suggest, after answering their question, that they connect with a professional for real counseling if it seemed like it was what they needed. As it turns out, I believe that’s what happens when you connect with a counselor at BetterHelp.

While I was spurred to write this article by BetterHelp’s community outreach, I don’t want to give the impression that I am endorsing them. I don’t know anymore about them than you’d know by reading what they say at their website. If you are interested in looking into online counseling, I’d suggest you do what I did and Google it. You’ll get pages of things to look at and there are some good articles to read from good sources like Psychology Today and The New York Times.

One thing I’ll heartily endorse is the experience of working with a counselor. I think it’s something everyone should do. Of course, it’s my life’s work, so you’d expect that I believe in the value of it. And I think it has value even if you don’t have a terribly troubling problem, like my specialty, infuriatingly stubborn weight control. In fact, talking to anyone rather than keeping everything inside is usually helpful. Sometimes though, if the person is not a professional, they can do more harm than good. It’s better to talk with someone who knows the right things to say and how to avoid making things worse.

Talk to a counselor, it’ll do you good.

Can a Drug or Surgery Solve Your Weight Problem?

Successful Weight Loss
(Published first in The Huffington Post)

In a word, no. Can they help? Perhaps.

Last month I wrote an article that spoke somewhat favorably of the new weight loss drug, Saxenda. I said it was perhaps the most important weight loss medication ever developed.

Wow! Did I get lambasted! I got all sorts of email blasting me for going over to the dark side and becoming a drug pusher and lackey of Big Pharma. I even got an email from my favorite professor of counseling at the University of Massachusetts, now friend, Allen Ivey, Ph.D. Besides being a friend, he is a big shot in the counseling field, the father of Microcounseling and developer of “active listening”. He said he was “sad” to see that I seemed to be pushing drugs. He is the last person on earth that I would want to be mistaken about my views on the solution to obesity. We’ve since gotten that misunderstanding corrected, but I want to make sure it is clear with everyone who reads my blogs.

I am still the world’s staunchest advocate of the behavioral therapy I teach to reverse the condition of obesity. It works -like a miracle, some say. But not 100% of the time. For some, it is not enough.

After 30 years successfully helping people to lose weight permanently, I am convinced that a percentage of the population is dealing with a physiological condition that creates more persistent and intense degrees of craving and compulsion than the rest of us have to deal with. My approach teaches people how to overcome the habits and feelings that make them overweight but sometimes those cravings and compulsions are so strong that nothing on God’s natural earth will quiet them.

If you’ve ever had a blister on your foot or a pebble in your shoe, you’ll remember that your brain is getting the message loud and clear that you need to relieve that pressure and you need to relieve it right now. You will feel the drive to relieve it until you do. It won’t go away until you do whatever it takes. There is no “will-powering” it away. Something is going on in the body, physiologically and chemically, that is triggering a response in your brain that will bother you until you satisfy it. It isn’t exactly the same with the food cravings that some have, but it gives you an idea of what some people are dealing with. Hold your breath for as long as you can and see how powerful the urge to breathe becomes. This is the kind of relentless drive that a small percentage of the population is fighting in their attempts to stop eating too much.

For them, some sort of intervention or tool that would make it easier for them to eat less would be a Godsend. Then, perhaps what they learn in a good behavioral approach would be enough. Self-programming and cognitive techniques like I teach work like magic for many people, but they would be so much more productive for these folks with eating hyperdrive if we could reduce that drive, which the pharmaceuticals can do. Or in the case of surgery, an additional tool to use behaviorally.

Make no mistake about it, drugs or surgery will not by themselves solve your weight problem. To solve your weight problem, you need to make a permanent change in your behavior, made possible with behavioral therapy, taught in my book and by my therapists. Success comes with learning how to eat what you like in ways that keep you at your desired weight and it becoming habitual and a new “normal” for you. Now, with these new medical interventions, success may be possible even for those who have suffered from an abnormally intensive eating drive. Weight loss drugs or surgery may now enable them to overcome the obstacles that prevented them from being able to make those behavioral changes.