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Technology has become integral to our daily lives, from smartphones and laptops to social media and streaming platforms. While these technological advancements have brought many benefits, they also come with a downside: technology overload. This overuse or excessive dependence on technology can have a negative impact on our nervous system. Technology overload can be expressed in many ways, including constantly checking social media, responding to work emails outside work hours, and spending excessive time playing video games. 85% of Us Go Online Daily According to a Pew Research Center survey, 31% of U.S. adults go online “almost constantly.” Overall, 85% of Americans say they go online daily. This figure includes 31% who report going online almost constantly and 48% who say they go online several times a day. The nervous system is highly sensitive to external stimuli, including technology. Overusing technology can overstimulate the nervous system, leading to various adverse effects. As the body's communication network, the nervous system transmits signals between the brain and other body parts. One of the most significant impacts of technology overload on the nervous system is its effect on the brain. How Technology Overload is Manifested Studies have shown that excessive use of technology can alter brain structure and function, leading to changes in neural connectivity and decreased cognitive performance. Additionally, technology overload can disrupt the brain's natural rhythms, leading to sleep disturbances and fatigue. Technology overload can also have a range of adverse effects on our mental health. Using social media, for example, has been linked to increased anxiety, depression, and loneliness. Additionally, the constant stimulation of technology can lead to addiction, making us unable to disconnect from our devices. For example, when we get a notification via text, email, etc., a part of our brain, the nucleus accumbens, is activated—giving us a sense of pleasure. Plus, our adrenaline rises, speeding up the addiction process. Technology overload can also have physical effects—including eye strain, headaches, neck pain, and poor posture. Moreover, excessive use of technology can lead to a sedentary lifestyle, increasing the risk of obesity, heart disease, and other chronic conditions. Finally, technology overload can have social effects, such as decreased communication skills and increased isolation. While technology can connect us to others, it can also create barriers to meaningful human interaction. Developing Strategies As psychologists, it’s important to develop strategies to manage technology use. Setting boundaries can be effective, such as designating certain times for checking social media or email. Practicing mindfulness and unplugging can help reduce dependence on technology. Engaging in offline activities, such as exercise, hobbies, and spending time with friends and family, can reduce their reliance on technology.

Our gut is home to trillions of bacteria, collectively known as the gut microbiota. The gut microbiota can interact with the brain through a variety of pathways. This communication occurs bi-directionally. One of the primary pathways is through the vagus nerve, which connects the gut and the brain. Various neurotransmitters, such as serotonin and dopamine, can enter the bloodstream and reach the brain. The gut microbiota can also interact with the immune system, stimulating the production of cytokines and other immune molecules that can play a role in cognitive function and mental health conditions. Identifying Patterns Attempts to characterize microbiota composition in psychiatric populations have yielded plentiful yet contradictory results. Nevertheless, systematic reviews of individual disorders have identified patterns that may be promising biomarker targets. Despite evidence that probiotic formulations can improve mental health, it was only following advances in DNA/RNA sequencing technologies that the involvement of the gut microbiota in the pathophysiology of psychiatric disorders was recognized. Preclinical studies have consistently demonstrated that fecal microbiota transplants from patients with various psychiatric conditions result in the development of the behavioral and physiological profile of the condition in animal subjects. This suggests that psychiatric disorders may be associated with a distinct pattern of microbial disruptions that could serve as biomarkers. Recent studies have linked these gut bacteria to multiple psychiatric disorders. Researchers conducted a review and meta-analysis of 59 case-control studies to evaluate the specificity and reproducibility of gut microbiota alterations in adults with these disorders and identify potential biomarkers. The study found that alterations in the gut microbiota were linked to depression, bipolar disorder, schizophrenia, and anxiety and suggested that the gut microbiota could indeed serve as a biomarker for diagnosis and treatment. Taking a Holistic Approach Identifying microbial disrupters as a biomarker for psychiatric disorders could pave the way for personalized treatments targeting the gut microbiota. The link between gut microbiota and mental health highlights the importance of a holistic approach to healthcare, where diet and lifestyle interventions are integrated with traditional medical treatments and therapies. Evidence suggests that probiotics have a positive effect on the brain. Probiotics have been linked with stress resilience and can reduce stress-induced physical symptoms and cognitive deficits in adults. Specific prebiotics have also been shown to protect against stress-induced effects on the microbiome and mental health. Overall, the interactions between the gut microbiota and the brain are complex and multifaceted, involving various mechanisms and pathways. The growing body of research in this area suggests that these interactions are important for maintaining overall health and well-being and that gut microbiota disruptions can significantly affect brain function and mental health. Keeping up to date with current developments in microbiome research can help mental health practitioners better understand the brain-gut connection and lead to new therapies that target microbiome composition through diet and pre-and probiotics.

The Mental Health Connection Remember to adjust your clocks. Daylight Savings Time begins Sunday, March 12th. We set our clocks ahead an hour—giving us an extra hour of light. Many of us feel that when it's dark (whether it's 4:30 P.M. or 7:30 P.M.), it signals that the day is over—time to have dinner and get ready for bed. When it stays light outside until 7 or 8 P.M., we have more energy and motivation to do something more before the day ends. What will you do with the extra hour of daylight? Do you know a licensed mental health professional that could benefit from what Help Therapy offers? We have put a hold on onboarding new providers, but we are once more accepting applications. Let them know. They can contact us here. Annette Conway, PsyD CEO and President Help Therapy March is National Self-Harm, Brain Injury, and National Developmental Disabilities Awareness Month National Self-Harm Awareness People of different age groups, from a variety of backgrounds, ethnicities, and cultures engage in self-harm—referred to as non-suicidal self-injury (NSSI). Yet research around NSSI is generally lacking, especially concerning different cultures, identities, and races. Learn more here. Brain Injury Awareness Approximately 3 million people in the U.S. sustain traumatic brain injuries each year. Most people are at a loss about how to be around these injured people, which is part of the reason why Brain Injury Awareness month was created. Learn more here. National Developmental Disabilities Awareness Many different impairments are included in this broad term and thereby include many people. These disabilities include physical, learning, language or behavior areas and include: Autism spectrum disorders Attention deficit/hyperactivity disorder Learning disabilities Hearing loss Vision impairment Learn more here. Solutions to Common Medical Billing Challenges Facing Mental Healthcare Providers Many therapists consider dealing with billing challenges to be an ongoing part of being a mental healthcare professional. Some common billing challenges include: Insurance coverage limitations: Many insurance plans have limitations or exclusions for mental health services, making it difficult for mental healthcare providers to get paid for their services. For example, some plans may only cover a certain number of visits per year or require pre-authorization for specific treatments. Complex coding requirements: Mental health conditions often require detailed documentation and coding, which can be time-consuming and require specialized training. If a wrong code is submitted, it can lead to rejected claims and delayed payments. High denial rates: Insurance companies frequently deny claims for various reasons, including missing or incomplete documentation, disputes over the medical necessity and, of course, incorrect codes. Billing errors: Mistakes in billing, such as incorrect billing codes or missing information, can lead to delayed payments or even legal and regulatory issues. Mental healthcare providers may need a billing specialist to ensure their claims are accurate and compliant. Unpaid patient balances: Some patients may struggle to pay their bills in full or on time. This can be time-consuming and impact their cash flow. As a mental healthcare provider, you want to spend your time helping patients rather than dealing with insurance and billing. Here are some tips that mental healthcare providers can use to overcome the challenges associated with mental healthcare billing: Verify insurance coverage: Before providing any services, it's essential to verify the patient's insurance coverage and benefits to ensure that you can bill appropriately. Train yourself or your staff on coding and documentation, or hire a billing specialist. Monitor and track claims closely: Keep a close eye on your claims to ensure they are being processed correctly and to catch any errors or issues before they become larger problems. Implement patient payment policies: To help manage patient balances, it's essential to have clear policies in place for collecting payments. Consider offering payment plans or financing options to help make it easier for patients to pay their bills, and make sure that your staff is trained to handle billing and payment inquiries professionally and respectfully. Partner with Help Therapy. As a Help Therapy provider, you can simplify your practice by having us take care of your medical billing and more. Learn more here. How to Support a Friend or Family Member Suffering with a Mental Health Condition An estimated 26% of Americans ages 18 and older—about 1 in 4—suffer from a mental health disorder in any given year. Many people suffer from more than one disorder. For example, depression often co-occurs with anxiety disorders and substance use. When a friend or family member is dealing with a mental health condition, it can be challenging for them and those around them. Supporting a friend or family member is crucial to help them in their journey toward recovery. Here are some ways you can support your loved one: Educate Yourself About Their Condition Learning about your friend or family member's condition, including its symptoms, causes, and treatments is essential. Educating yourself can help you understand what they are going through and how to support them better. Listen without Judgment When a loved one opens up to you about their illness, listen without judgment. It’s essential to create a safe and supportive environment. Avoid giving unsolicited advice. Let them know you are there to support them. Help with Daily Tasks People with a mental health illness may find it challenging to perform daily activities like cooking, cleaning, or shopping. Offer to help them with these tasks to ease their burden. You can also accompany them to appointments or support groups. Small gestures like these can make a significant difference in their life. [READ MORE] This Month’s Tip Improve Your Mood and Reduce Depression with Exercise Here are 7 types of exercise and movement that can help relieve the symptoms of depression and improve your mood. Cardiovascular Exercise: Activities like running, cycling, and swimming Walking: Walking at any speed, especially in nature Resistance Training: Building strength by lifting weights, using resistance bands or other equipment Yoga and Tai Chi: Both of these practices incorporate physical postures , breathing exercises, and mindfulness Pilates: Pilates focuses on core strength and posture with or without the use of equipment Dancing: Dancing is a fun and social way to exercise Team Sports: Sports like baseball, basketball and tennis provide social support and a sense of belonging. Events National Careers Week March 6-11, 2023 See AD for more information. International Women’s Day March 8, 2023 See IWD for more information. Sleep Awareness Week March 12-18, 2023 See NSF for more information. World Sleep Day March 17, 2023 See World Sleep for more information. National Drug and Alcohol Facts Week March 20-26, 2023 See NIH for more information. International Day for the Elimination of Racial Discrimination March 21, 2023 See UNESCO for more information. World Down Syndrome Day March 21, 2023 See DSI for more information. National Autism Awareness Week March 27- April 2, 2023 See NAS for more information. World Bipolar Day March 30, 2023 See IBPF for more information. International Transgender Day of Visibility March 31, 2023 See NT for more information. Partner with us! Are you a psychologist, LCSW or LMFT? We’re always looking for exceptional mental healthcare providers. Visit helptherapy.com for more information and fill out the quick and easy application. Do you have something to share?We’d love to hear about your successes and accomplishments! Have you: Written an article? Given a presentation? Have a client success story? Contact us at info@helptherapy.com.

An estimated 26% of Americans ages 18 and older—about 1 in 4—suffer from a mental health disorder in any given year. Many people suffer from more than one disorder. For example, depression often co-occurs with anxiety disorders and substance use. When a friend or family member is dealing with a mental health condition, it can be challenging for them and those around them. Supporting a friend or family member is crucial to help them in their journey toward recovery. Here are some ways you can support your loved one: Educate Yourself About Their Condition Learning about your friend or family member's condition, including its symptoms, causes, and treatments is essential. Educating yourself can help you understand what they are going through and how to support them better. Listen without Judgment When a loved one opens up to you about their illness, listen without judgment. It can be difficult for them to share such personal information, so it’s essential to create a safe and supportive environment. Avoid giving unsolicited advice. Instead, validate their feelings, and let them know you are there to support them. Help with Daily Tasks People with a mental health illness may find it challenging to perform daily activities like cooking, cleaning, or grocery shopping. Offer to help them with these tasks to ease their burden. You can also accompany them to appointments or support groups. Small gestures like these can make a significant difference in their life. Send a Care Package Put together a care package filled with items that will bring joy and comfort to your loved one. Plan a Fun Activity Doing something fun together can provide a distraction from their mental health struggles and create positive memories. Just be sure to consider any limitations their condition may present to make it enjoyable, not stressful. Encourage Treatment Like other illnesses, mental health conditions often don’t improve without treatment. But not all treatments work for everyone. Finding the right treatment that works for your loved one may take time. Often, treatment integrates several components, such as talk therapy, lifestyle changes and medication. Encourage them to seek professional help and support them through their journey. Take Care of Yourself Supporting a friend or family member with a mental health condition can be emotionally and physically draining. We can quickly put our needs aside while focusing on helping our loved one. But we all need to practice self-care. If you feel overwhelmed or stressed, remember you can talk to a mental health professional too. Be Patient and Understanding Mental health conditions can be unpredictable, and recovery is not linear. Your loved one may have good days and bad days, and it is essential to be patient and understanding. Avoid judging them for their struggles and celebrate their small victories. The most important thing you can do to support a friend or family member with a mental health condition is to show them that you care and are there for them.

The Mental Health Connection It’s February—the month of hearts, flowers and chocolate. As mental healthcare providers, we need to be aware of the impact of Valentine’s Day on our patients—especially those with relationship issues and depression. It can be a time of romance and love for some, but many see it as a time to emphasize how lonely or alone they are. In fact, relationship issues are among the significant causes of suicide. Children who commit suicide often experience relationship issues with family members, while adolescents' problems with romantic partners are often the cause of suicide. It’s appropriate that February is International Boost Self-Esteem Month and Teen Dating Violence Awareness and Prevention Month. Read more below. Annette Conway, PsyD CEO and President Help Therapy February is International Boost Self-Esteem Month and Teen Dating Violence Awareness and Prevention Month Mental Wellness Month International Boost Self-Esteem Month February is the designated time of year to focus on believing in and appreciating ourselves more. When we have high self-esteem and learn to love ourselves, we can better help and support others and ourselves. Here are a few ways to boost your self-esteem. Teen Dating Violence Awareness and Prevention Month This observance aims to break the cycle of violence by providing support and services to victims and their families. The Family Violence Prevention and Services Program is working to bring visibility to this issue by hosting social media events and webinars throughout the month. Learn more here. Is Telehealth Therapy Replacing In-Person Therapy? A study published in JAMA Health Forum, based on data for more than 5.1 million adults with private health insurance, found that the use of telehealth for common mental health issues increased 16 to 20 times during the first year of the pandemic. The study also found that telehealth usage increased the most for anxiety disorders and the least for bipolar disorder. Receiving counseling and treatment via telehealth can positively and negatively impact mental health patients. On the positive side, telehealth can increase access to care for patients in remote or underserved areas. It can allow for more flexible scheduling and can save patients time. On the negative side, the lack of in-person interaction can make it harder for patients to form a relationship with their therapist—which is particularly important in building trust. Overall, telehealth may be effective for specific patient populations and conditions, but it is not the best option in all cases. In-person therapy sessions may be a better option in certain situations. Some examples include: When a patient is experiencing a severe mental health crisis When a patient does not have access to reliable technology When a patient has difficulty communicating verbally due to a language barrier or hearing or speech impairment It's important that patients and their mental health providers discuss the pros and cons of telehealth and determine the best course of action for individual treatment. Therapists have 3 Practice Options—Is Partnering with Help Therapy the Smart Choice? As a therapist, you have options for the type of practice you want. #1 The Pros and Cons of Solo Private Practice Solo private practice has the benefits of: Being in control of every detail of your business Setting your own rates and keeping all you make Starting at a low cost and growing at your own pace But it also: Requires business savvy Can be isolating Carries greater risk #2 The Pros and Cons of Group Practice The pros include: No self-marketing needed No business savvy required Built-in support However, the cons are: Lower pay Determining your pay rate and taking up to 40% Less control Which may include scheduling and patients Higher likelihood of burnout [READ MORE] This Month’s Tip How to Celebrate Valentine's Day Without a Sweetheart If you expect to be alone on Valentine’s Day, you may tell yourself it’s no big deal. But inside, you may feel left out or lonely. Not to worry. You don’t need to spend Valentine’s Day alone. Think about who’s important in your life and who fills your heart with love— your pet? Valentine's Day is the opportunity to spend quality time with your pets and create special memories. It's also a good excuse to spoil your pets with things they love, such as spending time with you. Spend Valentine's Day with your pets and participate in activities together to celebrate the holiday. Here are a few ideas: Arrange a professional photo shoot Commission a professional pet portrait Make pet-friendly Valentine’s treats Create a new game Go on an adventure What you do with your beloved pet is less important than the simple fact that you spend quality time together. Valentine’s Day is all about celebrating love. So why not celebrate it with the pet you love? Events National School Counseling Week February 06-10, 2023 See ASCA for more information. National Make-a-Friend Day February 11, 2023 See National Today for more information. Random Acts of Kindness Week February 14-20, 2023 See National Today for more information. National Eating Disorder Week February 27-March 5, 2023 See NEDA for more information. Partner with us! Are you a psychologist, LCSW or LMFT? We’re always looking for exceptional mental healthcare providers. Visit helptherapy.com for more information and fill out the quick and easy application. Do you have something to share?We’d love to hear about your successes and accomplishments! Have you: Written an article? Given a presentation? Have a client success story? Contact us at info@helptherapy.com.

As a therapist, you have options for the type of practice you want. #1 The Pros and Cons of Solo Private Practice Solo private practice has the benefits of: Being in control of every detail of your business Setting your own rates and keeping all you make Starting at a low cost and growing at your own pace But it also: Requires business savvy Can be isolating Carries greater risk #2 The Pros and Cons of Group Practice The pros include: No self-marketing needed No business savvy required Built-in support However, the cons are: Lower pay Determining your pay rate and taking up to 40% Less control Which may include scheduling and patients Higher likelihood of burnout When considering a group practice or online platform, there are numerous sites offering different types of services and specialties. Each has its own pay structure (some taking as much as 40% of the session rate) and requirements, including the number of years of professional experience and a full-time commitment. Here are a few examples: ReGain focuses solely on relationships and couple therapy. Brightside focuses on anxiety and depression. Betterhelp requires three years of professional experience. Amwell offers only video chats that typically last less than 10 minutes. Talkspace Network Clinicians must work five days and 40 hours per week with a minimum caseload of 80 clients. But there is a third option for therapists—more of a hybrid. Option #3 Help Therapy—The Ultimate Resource for Therapist Involvement ​Help Therapy is a resource for therapists that delivers high-quality care solutions to meet the changing needs of therapists and patients. We partner with independent practitioners who want to maintain their independence and support them in their private practices. Help Therapy provides intensive marketing strategies, patient referrals, scheduling assistance, claims-filing and billing support. We also offer flexible scheduling options and transparent, cost-efficient services with 82% reimbursement for providers. Help Therapy therapists earn 50-100% more than with other companies. Help Therapy also assists with credentialing with Medicare, Triwest Alliance, Magellan Healthcare, and more. Therapists have the option to provide in-person or telehealth visits—or a combination of both. Our goal is to allow mental healthcare providers to grow their own independent and successful practice. In Summary When considering joining a group practice, it’s essential to find out the specifics of the work environment and the salary structure. What’s important to you? How much control do you have over your practice? What support services do they provide? How much does the company take, and how much do you actually keep? If you want to learn more about what Help Therapy offers therapists, visit us here.

The Mental Health Connection Happy 2023! We look forward to working in partnership with you to help more people in need. Sometimes we are among these people. In an effort to help others, we may not make our own wellness a priority. It’s important to be mindful of our mental health and practice daily self-care. You can discover how you’re taking care of your mental health in This Month’s Tip below. The new year is filled with possibilities as well as change, like the multitude of new laws governing health care services in California this year and bills still in legislation. Welcome the new year and embrace the possibilities. As author Alex Morritt points out, “New Year — a new chapter, new verse, or just the same old story? Ultimately we write it. The choice is ours.” Annette Conway, PsyD CEO Help Therapy January is Mental Wellness Month and National Mentoring Month Mental Wellness Month We usually are filled with festive cheer while celebrating the holidays. Yet, for many, these events are the predecessors of struggles about to come. The rates of seasonal depression, loneliness, and post-celebration blues are at an all-time high following New Year’s Eve. Mental wellness month is celebrated every January as a reminder to take better care of our mental health. We should all work to release stress, find more joy and improve our relationships. National Mentoring Month January is designated a time to celebrate the power of supportive and meaningful mentor relationships. With the start of a new year comes opportunities to share our knowledge and experiences to help others fulfill their dreams through being a mentor. Misconceptions About Pre-Surgical Evaluations An individual’s mental health has an impact on their physical health. For example, most patients have an emotional response to the idea of undergoing surgery. Fear, sadness, anxiety and depression are not uncommon. Yet the patient may not be aware of these emotions and the effect their mental state can have on them or on the outcome of the surgery. Many people think pre-surgical psychological assessments are done to disqualify them from surgery. Actually, these evaluations are an important part of the surgical process and help to ensure that individuals are able to not only undergo the surgery safely but also be prepared to do what’s necessary to recover effectively from the surgery. Mental health professionals should make sure to address these misconceptions with the patient in order to get the most accurate assessment. During the evaluation, patients can discuss their concerns and expectations and ask questions. Many individuals undergoing surgery will find their lifestyle will change significantly—temporarily or permanently. Knowing what will or may change and accepting these outcomes is very stressful. This is why it’s crucial for individuals to be honest and thorough about their current emotional state and mental health history. The patient and the mental health professional work together to ensure the individual is mentally, as well as physically, prepared for the surgery, is willing and able to follow the post-op instructions and will likely experience a positive outcome. The mental health professional helps identify the individual's strengths and any risk factors that may impede successful recovery. Then, the patient and mental health practitioner can work together on any areas that may benefit from additional support after the surgery. Some of these areas may include emotional and psychological reactions to the surgery, working with caregivers or following post-surgery instructions. Recovery support can be invaluable. Having someone supportive to confide in after the surgery can make a dramatic difference in recovery. Discussing any challenges the individual faces along the way and working out solutions can significantly improve post-surgery results—physically and psychologically. This Month’s Tip Tips to Strengthen Your Mental Health Since January is Mental Wellness Month, it’s fitting to look at ways to enhance our own mental wellness in the new year. Practice self-acceptance and self-care: Engage in meaningful activities that bring you joy. Seek calm and relaxing experiences. Read more here. Be mindful and grateful: Bring your attention to the present moment and what you are doing and thinking. If you happen to have a negative outlook, stop and be grateful for what you have. Practicing gratitude regularly can help you see things more positively and help you through challenges. Leave work at work: Whatever happened at work, take a deep breath and let it go (at least until you are back at work). Appreciate the positives in your day. Then turn your attention to home and focus on relaxing. Eat for health: Eat lots of veggies and other healthful foods. A nutritious diet can improve mental and physical health. Get quality sleep: Get 7 to 9 hours of restful sleep each night. Avoid caffeine after lunchtime and electronic devices a few hours before bedtime. Get moving: Find a few activities or exercises you enjoy and get your body moving for at least 30 minutes daily. Exercise can help lift your mood and lessen symptoms. Mental health professionals should also make sure to address these misconceptions with the patient in order to get the most accurate assessment. Ask for help when you need it: Reach out to family, friends, co-workers, or other resources who can support you. Talk with a mental health professional if you need a safe and non-judgmental person to help you work through your challenges. Burnout in Mental Health Professionals Burnout is an occupational condition that has physical and emotional consequences for an individual. But these consequences affect more than the particular individual. For psychiatrists, psychologists and other mental health professionals, this condition can adversely affect their patients and their treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) published a brief addressing burnout in mental health professionals. It states in this publication that an estimated 50% of mental health care providers report feeling burnt out due to: High levels of stress Low salaries Perceived lack of career advancement opportunities Increased caseloads “The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” - Rachel Naomi Remen To understand burnout as it relates to mental health professionals, we need to know how it’s defined and what causes it. [READ MORE] Events No Name-Calling Week January 11-21, 2023 See National Today for more information. National Fun at Work Day January 27, 2023 See National Today for more information. Partner with us! Are you a psychologist, LCSW or LMFT? We’re always looking for exceptional mental healthcare providers. Visit helptherapy.com for more information and fill out the quick and easy application. Do you have something to share?We’d love to hear about your successes and accomplishments! Have you: Written an article? Given a presentation? Have a client success story? Contact us at info@helptherapy.com.

Burnout is an occupational condition that has physical and emotional consequences for an individual. But these consequences affect more than the particular individual. For psychiatrists, psychologists and other mental health professionals, this condition can adversely affect their patients and their treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) published a brief addressing burnout in mental health professionals. It states in this publication that an estimated 50% of mental health care providers report feeling burnt out due to: High levels of stress Low salaries Perceived lack of career advancement opportunities Increased caseloads “The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” - Rachel Naomi Remen To understand burnout as it relates to mental health professionals, we need to know how it’s defined and what causes it. Burnout has 3 dimensions 1. Emotional Exhaustion Exposure to the emotional stress and trauma of others 2. Depersonalization or Cynicism A detached or dehumanized attitude towards clients, as they are seen as a source of stress and anxiety 3. Feelings of Inefficacy A decline in professional self-esteem and negative self-evaluation of their work performance Burnout also has 6 key drivers 1. Workload Unmanageable workload or time pressure 2. Control Lack of influence over work environment and resources 3. Reward Insufficient or inconsistent recognition 4. Community Lack of support among coworkers 5. Fairness Inequitable procedures or policies 6. Values Dissonance between personal and organizational values Mental health care providers often have little time for breaks between appointments and are unable to emotionally refuel after client sessions. This can lead to empathy fatigue and emotional exhaustion. Some signs and symptoms of burnout include: Changes in mood (such as lack of motivation, anger, anxiety, hopelessness and irritability) Lack of concentration and forgetfulness Problems sleeping Procrastination Physical changes (such as loss of appetite and headaches) Withdrawal from relationships and responsibilities If these symptoms seem familiar, it’s time for an intervention. Prevention is the focus if none or a few of these symptoms are present. Prevention and intervention First, know and respect your limitations as a psychiatrist, psychologist or other mental health practitioner. Next, practice self-care regularly. You need to be your best self to help others successfully. Finally, don’t let your ego get in the way of asking for help. Find social support and seek professional guidance from a fellow mental health professional. In terms of organizational intervention, research shows these actions have considerable promise for reducing mental health professionals' burnout. This requires identifying the areas that need improvement, creating a plan to address these areas and implementing the solutions. It’s important to note that some factors of burnout, such as workload, may seem to be about only caseload, but other aspects may be involved that stem from more extensive professional requirements, such as the paperwork necessary for insurance reimbursement. Mental health professionals are capable of assessing what needs to change in their work life. The challenge is to take their own advice gracefully. Help Therapy strives to support mental health professionals with their administrative burdens so they can focus on taking care of both their patients and themselves.

The Mental Health Connection We want to express our sincere appreciation for your support and for making 2022 a success. Anything is possible when we work together. Let’s keep this in mind as we plan for the coming year. May the holiday season fill your home with joy, your heart with love, and your life with laughter. Happy Holidays, Annette Conway, PsyD CEO Help Therapy December is National Stress-Free Family Holidays Month We see the holidays as anything but stress-free. Our “to-do” list explodes, time moves faster, and family obligations and traditions loom. While completely “stress-free” may not be attainable, we can enjoy this festive season more by managing our expectations and stress. If some of the old holiday traditions aren’t making you happy and causing stress, it’s time to try something different. The key is to take some control over the holidays instead of letting them control you. Don’t do something just because you always do, like sending holiday cards to every acquaintance, long-lost friend and out-of-touch family member, baking seven varieties of cookies for your neighbors, spending the entire day planning and preparing a holiday meal, inviting your in-laws to stay at your house the week before Christmas, etc. If you’re not enjoying the activity, ask yourself how important it is to the overall holiday, then spend less time on it, schedule another time after the holidays, find an alternative or give it up altogether. You do have a choice. 4 Easy Self-Esteem Boosting Activities People with high self-esteem are happier, more confident, and generally feel good about themselves. We sometimes can’t help but compare ourselves to others and the “ideal.” This leaves us open to self-criticism and decreased self-esteem. We can find ways to nurture our self-esteem. Below are three activities that can help. Build a list of Positive Qualities When feeling down or disappointed in ourselves, it’s often difficult to think positive thoughts about ourselves. It’s helpful to have a list of our positive qualities to lift our mood. Start by writing down your positive characteristics on small pieces of paper (bonus points if you use a variety of colors preferred). Fold each piece and put them in a decorative container. Before bed, first thing in the morning and anytime you need a boost of confidence, select one or more pieces of paper and appreciate the quality you possess. Text 3 Awesome People When was the last time you told someone how awesome they are and how much you appreciate them? Boosting someone else's confidence can, in turn, boost our own. Acknowledge others We all like to feel seen. When we are acknowledged, it gives us a feeling of acceptance and inclusion. Next time you see a stranger, give them a smile and a nod of acknowledgment instead of just walking past. We get the added benefit of the mood boost smiling gives us, too. Show Kindness The holiday season is a special time of year when we feel more compassion for others—both those we know and those we don’t. Being kind to others reflects kindness back to ourselves. It helps increase our feelings of self-worth and brings a sense of joy and connection with others. Here are some ideas to get you started: Send a card to a friend you’ve lost contact with and express your desire to keep in touch. Buy a meal for a homeless person you pass on the street. Use your skills to offer free professional services to a nonprofit. Bake holiday treats for your neighbors. Get together with friends, coworkers, or family to clean up a local park or beach. Compliment a stranger. Foster a pet. Offer to take a photo of a couple struggling to take a selfie. Offer a person behind you in line to go before you. Tell a family member you love them. Help a child with homework or a project. Say “thank you.” We all have the power to enhance our self-worth. You don’t need to change who you are, but you may need help believing and remembering how amazing you are. Practice makes perfect. The Brain Energy Theory of Mental Illness Many factors can play a role in mental illness. Genetics, stress, trauma, and substance abuse are often identified as the source or contributing factors to mental health conditions. But some researchers are looking deeper and searching for a root cause of mental illness. Researchers are discovering it may be all about mitochondria and their effect on metabolism. The Powerhouse of Energy Mitochondria are often referred to as the powerhouse of the cell. Mitochondria are crucial for energy production in the form of adenosine triphosphate (ATP). The mitochondria in our cells regulate or influence: Neurotransmitters, such as serotonin, dopamine, and GABA Hormones, such as cortisol, estrogen, testosterone, and progesterone Gene expression Inflammation Enhancing mitochondrial functioning may be an effective way of treating mental illness, solely or in conjunction with other therapies. Several studies have found a relationship between mitochondrial dysfunction and mental health disorders, such as bipolar disorder and depression. Impairments in energy production are found in these disorders. A better knowledge of mitochondrial physiology and pathophysiology might allow for developing new effective therapies to treat these specific mitochondrial impairments. This could be especially beneficial for treatment-resistant patients. In line with this theory, Christopher M. Palmer, M.D., in his recent book, Brain Energy, maintains that all mental health disorders are metabolic disorders of the brain. [READ MORE] Get Kids Away from their Electronic Devices this Holiday Season There’s more to life than video games, movies and social media. When children are on holiday break, persuading them to put down their phones and tablets can be challenging. There are plenty of indoor and outdoor activities for kids of all ages to do alone, with a friend or as a family. The trick is to find a few your kids will be more interested in than their iPhones. Holiday shows and festivals offer festive entertainment for the whole family. Indoor and outdoor seasonal and year-round activities can be discovered or re-discovered. Arts and crafts supply stores, like Michaels, offer DIY kits for boys and girls of all ages. Here are a few activities to keep your kids focused on something other than their electronic devices. Holiday festivals Holiday parades Holiday light displays Ice skating Indoor or outdoor Zoos Aquariums Museums Amusement Parks Sports Arts and crafts kits Painting or drawing Knitting or sewing Model Building Jewelry making Puzzles and games Board games Card games Jigsaw puzzles Painting projects Bedroom walls Furniture Shelves Picture frames Baking cookies or making snacks There’s no shortage of activities for kids to do on their holiday break. The trick is to find a few your kids will be more interested in than their iPhones. Easy No-Bake Holiday Treats Cheesecake Stuffed Strawberry Santas From: MOMables.com Prep Time: 10 minutes Total Time: 20 minutes Pecan Pie Bites From: MOMables.com Prep Time: 15 minutes Total Time: 15 minutes Events World Aids Day December 1, 2022 See Worlds Aids Day for more information. International Day of Persons with Disabilities December 3, 2022 See United Nations for more information. Human Rights Day December 10, 2022 See United Nations for more information. Partner with us! Are you a psychologist, LCSW or LMFT? We’re always looking for exceptional mental healthcare providers. Visit helptherapy.com for more information and fill out the quick and easy application. Do you have something to share?We’d love to hear about your successes and accomplishments! Have you: Written an article? Given a presentation? Have a client success story? Contact us at info@helptherapy.com.

People with high self-esteem are happier, more confident, and generally feel good about themselves. We sometimes can’t help but compare ourselves to others and the “ideal.” This leaves us open to self-criticism and decreased self-esteem. We can find ways to nurture our self-esteem. Below are three activities that can help. 1. Build a list of Positive Qualities When feeling down or disappointed in ourselves, it’s often difficult to think positive thoughts about ourselves. It’s helpful to have a list of our positive qualities to lift our mood. Start by writing down your positive characteristics on small pieces of paper (bonus points if you use a variety of colors preferred). Fold each piece and put them in a decorative container. Before bed, first thing in the morning and anytime you need a boost of confidence, select one or more pieces of paper and appreciate the quality you possess. 2. Text 3 Awesome People When was the last time you told someone how awesome they are and how much you appreciate them? Boosting someone else's confidence can, in turn, boost our own. 3. Acknowledge others We all like to feel seen. When we are acknowledged, it gives us a feeling of acceptance and inclusion. Next time you see a stranger, give them a smile and a nod of acknowledgment instead of just walking past. We get the added benefit of the mood boost smiling gives us, too. 4. Show Kindness The holiday season is a special time of year when we feel more compassion for others—both those we know and those we don’t. Being kind to others reflects kindness back to ourselves. It helps increase our feelings of self-worth and brings a sense of joy and connection with others. Here are some ideas to get you started: Send a card to a friend you’ve lost contact with and express your desire to keep in touch. Buy a meal for a homeless person you pass on the street. Use your skills to offer free professional services to a nonprofit. Bake holiday treats for your neighbors. Get together with friends, coworkers, or family to clean up a local park or beach. Compliment a stranger. Foster a pet. Offer to take a photo of a couple struggling to take a selfie. Offer a person behind you in line to go before you. Tell a family member you love them. Help a child with homework or a project. Say “thank you.” We all have the power to enhance our self-worth. You don’t need to change who you are, but you may need help believing and remembering how amazing you are. Practice makes perfect.

Many factors can play a role in mental illness. Genetics, stress, trauma, and substance abuse are often identified as the source or contributing factors to mental health conditions. But some researchers are looking deeper and searching for a root cause of mental illness. Researchers are discovering it may be all about mitochondria and their effect on metabolism. The Powerhouse of Energy Mitochondria are often referred to as the powerhouse of the cell. Mitochondria are crucial for energy production in the form of adenosine triphosphate (ATP). The mitochondria in our cells regulate or influence: Neurotransmitters, such as serotonin, dopamine, and GABA Hormones, such as cortisol, estrogen, testosterone, and progesterone Gene expression Inflammation Enhancing mitochondrial functioning may be an effective way of treating mental illness, solely or in conjunction with other therapies. Several studies have found a relationship between mitochondrial dysfunction and mental health disorders, such as bipolar disorder and depression. Impairments in energy production are found in these disorders. A better knowledge of mitochondrial physiology and pathophysiology might allow for developing new effective therapies to treat these specific mitochondrial impairments. This could be especially beneficial for treatment-resistant patients. In line with this theory, Christopher M. Palmer, M.D., in his recent book, Brain Energy, maintains that all mental health disorders are metabolic disorders of the brain. Metabolic Treatments According to this brain energy theory, metabolic treatments may lead to better outcomes than traditional treatment plans and pharmaceuticals. Understanding the intricacies of metabolic science as it relates to brain energy can lead to new mainstream treatments, such as strict dietary protocols to treat disorders like schizophrenia and alcoholism. In studying this correlation, research shows that some patients with schizophrenia have actually experienced remission of symptoms by restoring their brain energy metabolism and no longer need antipsychotic medications. This successful treatment is credited in part to adhering to a strict Ketogenic diet. When following a ketogenic diet, the brain switches from glucose to ketones for energy as fats are substituted for carbs. Energy production is kept stable with higher mitochondria efficiency. Getting to the root cause of illness and not just treating symptoms can be a life-changing treatment plan for those suffering from mental health conditions. If the cause of a mental health issue is found to be related to brain energy, lifestyle changes may be the place to start. Changes in lifestyle factors such as diet, exercise, stress reduction, sleep management, and reducing exposure to environmental toxins may effectively treat mental health disorders better than traditional approaches for many people. Taking this approach empowers patients and gives them more control over their healing journey.

The Mental Health Connection We all have much to be thankful for. I am grateful to each and every one of you for partnering with Help Therapy and making mental health care services more accessible to more people. But it’s not just one day a year we should express gratitude. Gratitude helps us connect to something larger than ourselves. In the process of expressing gratitude for the tangible and intangible things we have received—whether large or small—we can recognize that the source of that goodness lies at least partially outside of ourselves. Feeling grateful can rewire our brains to be more in the present. Consistently expressing gratitude and giving thanks can help us manage negative emotions, stress and anxiety. Thanksgiving is the perfect time to start a daily gratitude practice and continue it throughout the year. We also want to congratulate the Navy Seal Foundation for organizing another successful Whole Warrior Health Impact Forum! Help Therapy was again an exhibitor. It was a wonderful opportunity to meet and network with other resources that provide services for military members and their families. We will send you a reminder of the next Impact Forum date during the summer of 2023. We have received a lot of questions about whether we do medication management. The answer is YES, Help Therapy has Nurse Practitioners who do medication management. And there is availability for patients with Medicare, TriWest, TRICARE, BCBS, Optum/UHC and private pay. Wishing you all a Happy Thanksgiving. Annette Conway, PsyD CEO and President Help Therapy Inflation and Holiday Giving Many Americans are under a lot of stress caused by the rise in inflation rates. Statistics reported by Statista show why. Monthly Inflation rates from January 2020-September 2022: Lowest inflation: April 2020 0.3% Highest inflation: June 2022 9.1% Last reported inflation: September 2022 8.2% A Harris Poll reported Inflation as a source of stress for an overwhelming 83% of Americans. While 69% cited the economy and 66% cited money as significant sources of stress. More than half of adults who reported money as a significant source of stress stated money was a cause of disagreements or tension in their family. What’s more, inflation rates are devastatingly affecting an astonishing number of Americans—over half a million people are homeless. It might be surprising and dismaying to find that one-third of those are families. The top causes are lack of affordable housing, unemployment, poverty, and low wages. As Black Friday and the holidays approach, we may want to consider these facts when thinking about gift-giving. How many people on your list do you struggle to find a suitable gift for? How often do you just purchase something because you don’t know what type of gift to give? Instead of wasting money on more and more material things your family and friends don’t need, you can give a gift that also helps people (or animals) in need. There are an endless number of possibilities. One idea is to donate to a charity on a friend’s behalf. Think of your friend’s interests and passions. If they love children, contribute to an organization that helps support children in need, such as Covenant House, Children’s Defense Fund or Save The Children. Donate to a conservation organization, such as The Nature Conservancy, if they are environmentally conscious. Animal shelters and wildlife conservation programs like the World Wildlife Fund (WWF) may be perfect for animal lovers. If money is tight, consider volunteering for a non-profit of interest to you and your gift recipient instead of donating money. You can volunteer on their behalf or make it an activity you do together. Don’t be tempted by Black Friday “deals.” Reflect upon the true meaning of the holidays and how you can help support others with your gifts. Uncertainty, Disillusionment and Their Impact on Mental Health The last few years have been challenging for everyone. As more time passes, the continued uncertainty of the future, combined with the disillusionment surrounding the political environment, is affecting the mental health of many. A Harris Poll survey reported the majority of adults are unsettled by government and political actions, apprehensive about inflation levels, and distressed by boundless violence. The poll also found respondents hold a pessimistic view of the future. Over 60% disagreed with these statements: “I feel our country is on the path to being stronger than ever.” “Our children are going to inherit a better world than we did.” More than 75% of respondents said the future of our nation is a significant source of stress in their lives. And almost 70% said the current political climate is a significant source of stress in their lives. The stress caused by this uncertainty, disillusionment and fear plays a toll on mental health. This stress and pessimistic view of the future leads many Americans to consider moving to another country. Over 50% of Americans aged 18-44 said the state of this country has made them consider moving to another country. And 59% of LGBTQIA+ said the same. Stress and Health Consequences Over 75% of people polled said that stress had impacted their health. They reported headaches, fatigue, nervousness, anxiety, sadness and depression. Those with higher stress levels were more likely than those with a lower average stress level to report experiencing these symptoms. What’s more, over 70% also reported other impacts on their mental health, including feeling overwhelmed, changes in sleep and constant worrying. These changes in mental health have caused 15% of these people to turn to alcohol and drugs. [READ MORE] Top 10 Thanksgiving Favorites If you’re wondering what to serve for Thanksgiving dinner—stick with tradition or try something new—you may want to consider some of the dishes voted in the top 10 by a Ranker opinion poll. Including a few of these favorites will help ensure your Thanksgiving’s a hit. Here’s a list of the top 10 in descending order: 10. Green beans 9. Buttermilk biscuits 8. Cranberry Sauce 7. Green bean casserole 6. Crescent rolls 5. Mac n’ cheese 4. Bread 3. Gravy 2. Stuffing 1. Mashed potatoes You probably noticed this is a carb-loaded list. That’s no surprise, as most of us love our comfort food. But you may be surprised to see turkey and pumpkin pie—two Thanksgiving icons—don’t rank anywhere on this list! According to this poll, serving some form of bread and green beans will probably make your guests happy. And don’t forget the mashed potatoes. If you don’t know if some of your guests have any food sensitivities (no dairy, no gluten, etc.) or follow a specific dietary plan (vegan, keto, etc.), it’s best to find out before you plan your menu. Don’t assume that your guests will (or should) overlook their food sensitivities or choices just because it’s Thanksgiving. If you’re looking for some new recipes that are vegan, gluten-free and dairy-free, take a look at these recipes: Balsamic Roasted Vegetables From Just What We Eat Ingredients 2 bell peppers, cut into 2” chunks 2 zucchini, cut into 1/2” thick half circles 1 red onion, cut into 2” wedges 8 oz mushrooms, cut in half 3 cups Brussels sprouts, trimmed and cut in half 1/4 cup olive oil 1/8 cup balsamic vinegar 1 tsp thyme 1/2 tsp salt How to Make Preheat the oven to 375°F. Chop vegetables and place them in a large food storage bag. Add olive oil, balsamic vinegar, thyme, and salt to the bag and seal the bag tightly, letting out as much air as possible. Shake the bag to coat the vegetables evenly. Optionally, let the vegetables marinate in the refrigerator for a couple of hours. Pour the vegetables onto a cookie sheet and arrange them into a single layer. Bake for 30-35 minutes until the vegetables have started to brown and are fork-tender. Vegan Sweet Potato Casserole with Pecan Crumble From Bakerita Ingredients For the Sweet Potato Mash About 3 lbs. sweet potatoes, peeled and cubed 2 ” flax eggs” ⅓ cup coconut sugar ¼ cup vegan butter 1 teaspoon vanilla extract ½ teaspoon salt For the Pecan Topping 1 cup chopped pecans 1 cup almond or oat flour ¼ cup coconut sugar ½ cup (1 stick) vegan butter, softened and cut into cubes ¼ teaspoon cinnamon, optional Pinch of salt How to Make For the Sweet Potato Mash Add sweet potatoes to a large pot and barely cover them with water. Bring to a boil and simmer until fork-tender, about 20 to 30 minutes, depending on the size of your cut potatoes. Once they’re tender, drain the potatoes and put them in a large mixing bowl. Let cool slightly, and then mash the potatoes. Add the flax eggs, coconut sugar, vegan butter, vanilla extract, and salt. Stir until well combined, mashed to your liking, and the butter has fully melted and incorporated. Spread the sweet potato mash into a lightly greased casserole 8” x 11” dish or one of similar dimensions. Set aside and prepare the pecan crumble topping. For the Pecan Topping In a mixing bowl, combine the pecans, flour, coconut sugar, vegan butter, cinnamon, and salt. Mix together until well combined and crumbly. If it doesn’t seem crumbly enough, place it in the refrigerator for about 10 minutes to firm up the butter. Sprinkle evenly on top of the sweet potato mash. Bake at 350°F for 30 minutes until the top is crispy and browned. If you find yourself eating alone on Thanksgiving, you can choose to have a traditional Thanksgiving dinner or celebrate your own way with a few of your favorite foods—even if they’re pizza and brownies! If you have leftovers, you can put them in the freezer to enjoy another day. Medicare Enrollment Medicare Fall Enrollment began October 15 and runs through December 7. This is the time Medicare recipients can change from Medicare Original to Medicare Advantage plans, or Advantage plans to Medicare Original, and also change prescription plans. Beware of marketing pitches that offer Advantage manage care plans with low or zero premiums. In general, Medicare managed care plans require individuals to go through their limited network of health providers, can get hit with unexpected co-pays and deductibles, receive denials for services deemed not medically unnecessary, and often requires referrals from a PCP to see a specialist. Researching options and considering the consequences to changing plans is recommended; otherwise Medicare recipients will be re-enrolled in their current plan the first of the year. November is Adoption Awareness Month This month's particular focus is the adoption of children currently in foster care. It’s estimated that 407,000 children are now in foster care, with 60,000 here in California. As we give thanks this month, we think of the foster care children waiting for their forever families. The U.S. is making progress in placing foster children with families, particularly relatives, as opposed to group homes or institutions. But much more work is needed. Consider these statistics for children in foster care in California: Only 45% of children in the California foster care system will be adopted Less than half of all foster youth graduate high school 75% of young women in foster care report at least one pregnancy by age 21 Half of youth who have aged out of foster care end up homeless or incarcerated Events International Stress Awareness Day November 2, 2022 See ReThink for more information. International Stress Awareness Week November 7-11, 2022 See ISMA for more information. Hunger and Homelessness Awareness Week November 12-20, 2022 See HHWEEK for more information. World Kindness Day November 13, 2022 See National Today for more information International Day for Tolerance November 16, 2022 See UN for more information. International Survivors of Suicide Day November 19, 2022 See ASFP for more information.Giving TuesdayNovember 29, 2022 See Giving Tuesday for more information “Life doesn’t make any sense without interdependence. We need each other, and the sooner we learn that, the better for us all." - Erik Erikson Recap of the 2022 Whole Warrior Health Impact Forum Congratulations to the Navy Seal Foundation for organizing another successful Whole Warrior Health Impact Forum! The sixth annual Forum informed the audience on the most relevant and cutting-edge issues affecting the medical and behavioral well-being of military members, their families, and medical personnel. The Forum also addressed statistics about the increasing number of service members with complex mental and behavioral health challenges, and the demand for therapists who provide evidenced-based practices in their psychological treatment. The three-day agenda included topics such as “Achieving More Happiness, Improve Well-Being, and Optimizing Performance”, “The Mismatch Between the Warrior Mindset and the Powerlessness Mindset: What Traditional Addiction Treatment Gets Wrong for Naval Special Warfare”, “Psychedelic-Assisted Psychotherapy for Psychiatric Illness”, and “Common Sense Approaches to Suicide Risk”. The conference also included parking, lunches, receptions, and 12.5 CECs at no cost. Help Therapy was again an exhibitor. It was a wonderful opportunity to meet and network with other resources that provide services for military members and their families. We will send a reminder of the next Impact Forum date during the summer of 2023. Partner with us! Are you a psychologist, LCSW or LMFT? We’re always looking for exceptional mental healthcare providers. Visit helptherapy.com for more information and fill out the quick and easy application. Do you have something to share?We’d love to hear about your successes and accomplishments! Have you: Written an article? Given a presentation? Have a client success story? Contact us at info@helptherapy.com.