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Sep 28

When Your Therapist Is Only a Click Away

By Dr. Jack Singer | Blog , Counseling

Excerpted from New York Times

Skype Counseling For Depression, Anxiety, Anger Management, Divorce Recovery, Infidelity/Affair, Athletic Performance with Dr. Jack Singer.Mary Smith headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype application on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Smith, a 33-year-old high school teacher, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer!”

And, she added, “I even e-mailed him that I was panicked about a first date, and he wrote back and said we could do a 20-minute mini-session.”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype has made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly.

“In three years, this will take off like a rocket,” said Eric A. Harris, a lawyer and psychologist who consults with the American Psychological Association Insurance Trust. “Everyone will have real-time audiovisual availability. There will be a group of true believers who will think that being in a room with a client is special and you can’t replicate that by remote involvement. But a lot of people, especially younger clinicians, will feel there is no basis for thinking this. Still, appropriate professional standards will have to be followed.”

The pragmatic benefits are obvious. “No parking necessary!” touts one online therapist. Some therapists charge less for sessions since they, too, can do it from home, saving on gas and office rent. Blizzards, broken legs and business trips no longer cancel appointments. The anxiety of shrink-less August could be, dare one say … curable?

Ms. Smith came to the approach through geographical necessity. When her therapist moved, she was apprehensive about transferring to the other psychologist in her small town,  who would certainly know her prominent ex-boyfriend. So her therapist referred her to another doctor, whose practice was a day’s drive away. But he was willing to use Skype with long-distance patients. She was game.

Now she prefers these sessions to the old-fashioned kind.

But does knowing that your therapist is just a phone tap or mouse click away create a 21st-century version of shrink-neediness?

“There’s that comfort of carrying your doctor around with you like a security blanket,” Ms. Smith acknowledged. “But,” she added, “because he’s more accessible, I feel like I need him less.”

The technology does have its speed bumps. Online treatment upends a basic element of therapeutic connection: eye contact.

Patient and therapist typically look at each other’s faces on a computer screen. But in many setups, the camera is perched atop a monitor. Their gazes are then off-kilter.

“So patients can think you’re not looking them in the eye,” said Lynn Bufka, a staff psychologist with the American Psychological Association. “You need to acknowledge that upfront to the patient, or the provider has to be trained to look at the camera instead of the screen.”

The quirkiness of Internet connections can also be an impediment. “You have to prepare vulnerable people for the possibility that just when they are saying something that’s difficult, the screen can go blank,” said DeeAnna Merz Nagel, a psychotherapist licensed in New Jersey and New York. “So I always say, ‘I will never disconnect from you online on purpose.’ You make arrangements ahead of time to call each other if that happens.”

Research on the effectiveness of on-line therapy shows the same effects, essentially, as in person therapy, so the practicality of on-line therapy outweighs the few negative issues, such as not sitting in front of the client and seeing his/her body language, eye contact, etc.  In addition, I am able to Skype with clients who are on vacation in other locals, and with athletes, who are out of town performing in major events and want to touch base with me before or after their events.  In short, I have found using Skype has grown my practice and dramatically increased my access to clients.

Dr. Jack Singer offers Skype Therapy with clients all over California.  For more information, contact Dr. Jack at (800) 497-9880.

Free 20 Minute Telephone Consultation with Psychologist Dr. Jack Singer

Aug 12

Stressful Childhoods can Have Lasting Impacts

By Dr. Jack Singer | Blog , General

Did you know that childhood stress can affect your health later in life? And not in a positive way!

Stressful Childhoods Can Having Lasting Health ImpactsMuch research has shown that the turmoil of such dramatic events as abuse and divorce can have a lifelong impact on youngsters.  In fact, the impact of divorce can be so deleterious that many mental health professionals advocate staying together regardless of how bad the marriage is, if there are children involved.  Indeed, in our society we have a large percentage of “marriages of convenience,” where couples remain married long after the closeness has dissolved away.

Research on the impact of psychological stress on ones’ health as appeared  across the board for decades.  Psychological stress has been linked with increased risk for cardio-vascular disease, autoimmune disorders, infectious disease, and of course, mental illness.

When one is stressed, they turn on the fight or flight response, which prepares the body to overcome or to avoid danger.  Since this system was developed in us to turn on rarely, repeated activation of this system (because of the stressors we face each day) causes wear and tear on the body, eventually leading to illness.

We now know that children raised with harsh or cold parenting are at greater risk for heart disease, cancer, chronic lung disease and skeletal fractures in adulthood than children whose parents were warm and nurturing.

Moreover, we now know that as adults, people who had harsher parenting tend to develop more cortisol (the stress hormone) to normal stressors.  This impacts their sleep and health.

The key seems to be to make certain that you provide a warm and nurturing parenting environment for your children.  Although this is obvious to most, what wasn’t known was how dramatic and long term the health consequences would be for those who were raised under more harsh and cold parenting.

Free 20 Minute Telephone Consultation with Psychologist Dr. Jack Singer

I am also available for phone consultations with athletes around the U.S. and in-person visits with athletes in Southern California.

Jack N. Singer, Ph.D.
Certified and Licensed Sport and Clinical Psychologist
Diplomate, National Institute of Sports Professionals, Division of Psychologists
Diplomate, American Academy of Behavioral Medicine
Certified Hypnotherapist, American Academy of Clinical Hypnosis