Online Counselling - not just for expats

Author: expatcounsellingnow (Page 1 of 3)

Harry Enfield’s ‘Kevin’ is still relevant today

I have been doing some reflection on my own teens’ behaviour and how it seems to fluctuate with increased contact with their peers. I had a thoroughly self-indulgent re-visit to Kevin and Perry in Harry Enfield’s hilarious take on the teenage years. It was, at the time, described as preposterously exaggerated and extreme. I don’t think it is. I think it’s right on the money, which is why it resonated so strongly and is why they are still being watch on YouTube despite being very dated in some respects. Kevin never had the added hassles of social media to content with, for example, or had to be confined for long periods with his parents (although I would now pay good money to see those episodes!). If you’ve never seen these characters, then I’d recommend the first episode where we see Kevin morph, Jekyll and Hyde-like, into a teenager and the last, where we see him emerge into responsible adulthood (which is admittedly very, very exaggerated for comic effect). The links can be found below.

Looking up the research on teen behaviour and peer influence, I found a wonderful study from 2020 by Block and Heyes, entitled Sharing the load: Contagion and tolerance of mood in social networks. https://doi.org/10.1037/emo0000952

The upshot of their research was that adolescents ‘became reciprocally more similar in mood to their interaction partners’. They adjust their moods to suit the prevailing mood of those around them. The authors also found that this contagion effect was stronger for negative than for positive moods – in other words, teens readily become more low and ‘stroppy’ when around those behaviours. It is probably part of the intricate dance of social acceptance. Interestingly, ‘although one may catch a friend’s bad mood, the friend may feel less negative in the process.’

It doesn’t help that misery is easier to catch than happiness. This is an actual a known fact from the human sciences, supported by numerous studies. At its most basic, this is a throwback to hunter-gatherer times when recognising bad mood meant survival – stay away from angry individuals, recognise the mood arriving etc – whereas good moods, whilst nice, weren’t as immediately threatening or rewarding. This – together with the hormonal turmoil of adolescence – can be a powerful influence on our teens. The WHO identify that half of all mental health issues have their origins by the age of 14. See here for details of that report.

So once again, we are perhaps forced to conclude ‘it’s not their fault’. And whilst we are dealing with a Kevin in the throws of an ‘it’s not BLOODY FAIR’ episode, we can look forward to the beauty and depth which emerges at the other end of the process. (Which may or may not include a willing shopping partner… watch the last episode if you don’t get the reference.)

Kevin becomes a teenager

Kevin grows up   (Bear in mind that this is comedy, as a psychologist I’m not suggesting that having sex helps teens to grow up, far from it!)

Block, P., & Burnett Heyes, S. (2020). Sharing the load: Contagion and tolerance of mood in social networks. Emotion. Advance online publication. https://doi.org/10.1037/emo0000952

Can listening to music improve your well-being?

Can listening to music really make significant (i.e. scientifically verifiable) changes in mood?

In short, yes it can.

There’s much anecdotal evidence for this. Some swear by Mozart for studying effectively, mood music clearly affects temperament in mindfulness meditation, for example. And we are probably all familiar with the adolescent ‘choosing to feel down’ choices of sad songs.

But where is the science on this?

In 2019 a randomised controlled study took two groups of participants in their research on adult ADHD. The first group listened to Mozart’s music (KV 448) for 10 min while the second group remained in a silent room for 10 min (silence group). The researchers assessed subjective arousal and mood in participant before and after the intervention and showed that music listening led to a decrease in negative mood (sadness and hopelessness) in the ADHD group as well as in healthy controls. (Zimmermann et al., 2019)

Listening to music before, during, or after surgery significantly decreased patients’ pain and anxiety and reduced their use of pain medications subsequent to surgery. (Mayor, 2015)

In looked into the effects of music on rats which had been heavily treated with simvastatin ( which is used to lower cholesterol for those diagnosed with high blood cholesterol. It’s also taken to prevent heart disease, including heart attacks and strokes). Rats exposed to music (Mozart’s piano sonata, KV361 in this case) 24 hours before a stress-induing maze exercise showed reduced anxiety levels compared to control groups (da Cruz et al., 2001). Of course, we can’t be certain that this transfers to human experience, but we can hypothesise that it probably would.

Another interesting study in 2020 considered the effects of music on pregnant women. Their research concluded that ‘Music combination between murotal and music kitaro has a significant effect on reducing anxiety of third trimester pregnant women.’ (Sumaningsih et al., 2020)

Another recent study specifically researching undergraduates’ responses to music listening found that music provided regulation in preparation for stressful events and that music listening increases mindfulness following a stressor. (Groarke et al., 2019)

This is a far from comprehensive review of the current literature, just 5 studies. There are hundreds. The renowned neurologist Dr. Michael Schneck has shown that classical music helps relieve anxiety. Other studies have found that it also increases blood flow by 26%, laughter by 16% and relaxation by 11%.

How does the science translate actions you can take to reduce anxiety and stress?

We know that connecting with other people who are going through the same things we are – think support groups – is a very effective way to get over any mental health challenge. Similarly, sad and melancholic music can achieve the same thing. Sad music validates our own emotions of sorrow, grief or loneliness and permits us to feel them more fully.

You can try simple experiments yourself, with your own choices of music, journalling your responses and finding your own very personal cocktail for well-being. Sitting and intentionally listening to music can be a powerful way of re-centering yourself and connecting to the present moment.

Why not build ten minutes of music into your daily routines and see what happens?

 

References

da Cruz, J. G. P., Dal Magro, D. D., de Lima, D. D., & da Cruz, J. N. (2001). The Power of Classic Music to Reduce Anxiety in Rats Treated with Simvastatin. Basic and Clinical Neuroscience, 2(4), 5–11. Iran University of Medical Sciences.

Groarke, J. M., Groarke, A., Hogan, M. J., Costello, L., & Lynch, D. (2019). Does Listening to Music Regulate Negative Affect in a Stressful Situation? Examining the Effects of Self‐Selected and Researcher‐Selected Music Using Both Silent and Active Controls. Applied Psychology: Health and Well-Being. https://doi.org/10.1111/aphw.12185

Mayor, S. (2015). Listening to music helps reduce pain and anxiety after surgery, review shows: BMJ, h4398. https://doi.org/10.1136/bmj.h4398

Sumaningsih, R. `, Rahayu, T. P., & Santosa, B. J. (2020). Effects of Classical Music, Natural and Murottal Music on Fetal Well-Being. Health Notions, 4(7), 222–225. https://doi.org/10.33846/hn40704

Zimmermann, M. B., Diers, K., Strunz, L., Scherbaum, N., & Mette, C. (2019). Listening to Mozart Improves Current Mood in Adult ADHD – A Randomized Controlled Pilot Study. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01104

Is the news bad for you?

Back in March, on another blog, I wrote that I was done with the news. I was aware that even reading tweets about UK politics, US elections and the aftermath, Afghanistan…(the list is endless), left me feeling anxious, frustrated, impotent. So I stopped. My mood and sense of self improved dramatically.

So it worked for me. Later, whilst counselling with Bob who suffers from PTSD (clearly not his real name, though he has given me permission to share the essence of the story) I shared my experience. And he bought into it wholesale. No more TV news. No more Twitter or Facebook on his phone. He even asked colleagues to avoid the subject around him and found himself instead discussing family, hobbies and reading with them. He changed a lifelong habit of listening the radio in favour of curated playlists (a later post will address music and wellbeing). And the reported drop in anxiety and negative self-talk was impressive.

Photo by Austin Distel on Unsplash

So much for anecdotal evidence

So I began to wonder what research was out there on the subject. Perhaps not surprisingly most recent research relates specifically to anxiety and COVID19 news. In a 2021 paper, Jain found that, ‘High levels of news exposure led to lower levels of trust that led to low satisfaction and happiness.’ Stainback et al (2020) reported, from a survey of over 11,500 participants, ‘that greater COVID-19 media consumption is associated with greater psychological distress and that approximately two thirds of this effect operates indirectly through increased perceptions of COVID-19 threats.’ Neill et al. (2021) conclude that ‘Evidence suggests that frequent media exposure is related to a higher prevalence of mental health problems, especially anxiety and depression.’ Similar research produces similar results for other specific news events as well as for the more generalised consumption of news (Holman et al., 2019; Thompson et al., 2017; Thompson et al., 2019).

Bad is stronger than good

Whilst the Hollywood culture teaches us that good prevails, in fact it’s bad news that intrigues and draws us in. This goes back to hunter-gather times when your entire world was the 30 or 40 people you knew and gossip was a means of survival. Knowing who did what to whom, who could be trusted etc, was crucial. Fast forward to 24/7 news coverage and this evolutionary survival trait backfires on itself. News outlets claim that the increasingly negative bent of the news is consumer driven. Trussler & Soroka (2014) concur – in their randomised controlled lab study ‘regardless of what participants say, they exhibit a preference for negative news content.’ More generally, we are programmed to pay more attention to ‘bad’ – again, back to our hunter-gathering roots, ‘good’ could mean an extra meal, ‘bad’ probably meant death. (A study into psychological preference found that ‘Bad impressions and bad stereotypes are quicker to form and more resistant to disconfirmation than good ones.’ (Baumeister et al., 2001))

How to avoid the ‘news blues’

‘Numerous studies have shown that too much negative news can affect your mental health, promoting anxiety and depression, and even acute stress reactions in some extreme cases,’ says David Mischoulon, MD, PhD, Director of the Depression Clinical and Research Program at Massachusetts General Hospital.

He suggests some tactics to protect mental health and avoid ‘news blues’.

Like dieting, think smaller portions. Some news is good, being aware of whats going on the world is good. Too much of the same diet however, is bad. Limit your news exposure to certain periods of time during the day and avoid ‘catching up’ just before sleep.

Self-monitor. If a news item is making you feel agitated, turn it off. Walk away. Breathe. Do something else and return to it late if you feel you need to.

Don’t watch the same news over and over again. News channels recycle their stories, producing ‘updates’ hourly or more often throughout the day. Usually nothing has changed, except one more ‘commentator’ adds their own opinion. News becomes views about news and spirals off into infinite regress.

If you can, take a day off now and then. A whole day. The world won’t stop just because you aren’t watching it. Take some time to watch yourself.

Reference

“How to Avoid the ‘News Blues’ While Still Staying Connected to the World: Limiting your news consumption and being more selective about your news sources can help.” Mind, Mood & Memory, vol. 17, no. 9, Sept. 2021, p. 3. 

Academic References

Baumeister, R. F., Bratslavsky, E., Finkenauer, C., & Vohs, K. D. (2001). Bad is stronger than good. Review of General Psychology, 5(4), 323–370. https://doi.org/10.1037//1089-2680.5.4.323

Holman, E. A., Garfin, D. R., Lubens, P., & Silver, R. C. (2019). Media Exposure to Collective Trauma, Mental Health, and Functioning: Does It Matter What You See? Clinical Psychological Science, 8(1), 111–124. https://doi.org/10.1177/2167702619858300

Jain, P. (2021). The COVID-19 Pandemic and Positive Psychology: The Role of News and Trust in News on Mental Health and Well-Being. Journal of Health Communication, 26(5), 317–327. https://doi.org/10.1080/10810730.2021.1946219

Neill, R. D., Blair, C., Best, P., McGlinchey, E., & Armour, C. (2021). Media consumption and mental health during COVID-19 lockdown: a UK cross-sectional study across England, Wales, Scotland and Northern Ireland. Journal of Public Health. https://doi.org/10.1007/s10389-021-01506-0

Stainback, K., Hearne, B. N., & Trieu, M. M. (2020). COVID-19 and the 24/7 News Cycle: Does COVID-19 News Exposure Affect Mental Health? Socius: Sociological Research for a Dynamic World, 6, 237802312096933. https://doi.org/10.1177/2378023120969339

Thompson, R. R., Garfin, D. R., Holman, E. A., & Silver, R. C. (2017). Distress, Worry, and Functioning Following a Global Health Crisis: A National Study of Americans’ Responses to Ebola. Clinical Psychological Science, 5(3), 513–521. https://doi.org/10.1177/2167702617692030

Thompson, R. R., Jones, N. M., Holman, E. A., & Silver, R. C. (2019). Media exposure to mass violence events can fuel a cycle of distress. Science Advances, 5(4), eaav3502. https://doi.org/10.1126/sciadv.aav3502

Trussler, M., & Soroka, S. (2014). Consumer Demand for Cynical and Negative News Frames. The International Journal of Press/Politics, 19(3), 360–379. https://doi.org/10.1177/1940161214524832

Can you eat your way out of depression?

We know diet is important, but increasingly research is showing that specific foods, in specific combinations, have a measurable effect on mental health.

Let’s be clear, a lot of studies show correlation, not causality. But the evidence is mounting.

Multiple studies point to a strong correlation between decreased serotonin and the food we eat. Another way of considering this is that we can eat foods to boost serotonin and possibly effect our mood.

Photo by Pablo Merchán Montes on Unsplash

Francis et al. (2019) found that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression. Firth et al. (2019) conclude their systematic review of 16 peer-reviewed studies including over 45000 participants saying, ‘Dietary interventions hold promise as a novel intervention for reducing symptoms of depression across the population.’

A minor bit of the science

Tryptophan is an amino acid known to increase serotonin production in the brain. Serotonin is a mood stabilizing neurotransmitter – its the one targetted by the group of antidepressants called SSRIs. They essentially block the brain’s natural process of sweeping up unused serotonin so that it hangs around in the brain for longer, aiding synapses in firing their messages across the gaps between brain cells. So eating foods with high tryptophan levels should, in theory, boost serotonin production. It’s not that simple, of course. There’s a blood/brain barrier to overcome, which limits what can cross from your bloodstream directly into the brain. It appears, though, that eating complex carbs together with high tryptophan content foods helps the amino acid to make it’s way to the brain and rev up serotonin production.

Complex carbs would be fruits and vegatables. So that bit’s easy. High tryptophan content foods include nuts and seeds, particularly pumpkin seeds and chia seeds which have a higher content and are more easily accessible than tryptophan contained in meat and dairy products. Dark chocolate and bananas are also good options. So that bit’s actually easy too.

Don’t take my word for it and gorge yourself on pumpkins seeds as a self-medication for depression – that’s not what this post is about! It’s food for thought though. Check out the academic references, talk to your doctor, do your own research.

It’s certainly no surprise that healthy foods effect your mental state as well as your physical. And it’s probably not unconnected that many people suffering from depression have a very poor diet, which becomes a vicious circle of cause and effect.

I hope that this brief post has been interesting and prompted you to find out more yourself.

The research

Adan, R. A. H., van der Beek, E. M., Buitelaar, J. K., Cryan, J. F., Hebebrand, J., Higgs, S., Schellekens, H., & Dickson, S. L. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European Neuropsychopharmacology, 29(12), 1321–1332. https://doi.org/10.1016/j.euroneuro.2019.10.011

Firth, J., Marx, W., Dash, S., Carney, R., Teasdale, S. B., Solmi, M., Stubbs, B., Schuch, F. B., Carvalho, A. F., Jacka, F., & Sarris, J. (2019). The Effects of Dietary Improvement on Symptoms of Depression and Anxiety. Psychosomatic Medicine, 81(3), 265–280. https://doi.org/10.1097/psy.0000000000000673

Francis, H. M., Stevenson, R. J., Chambers, J. R., Gupta, D., Newey, B., & Lim, C. K. (2019). A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial. PLOS ONE, 14(10), e0222768. https://doi.org/10.1371/journal.pone.0222768

Counselling the Counsellor

I just completed my M.Sc. Psychology degree with a year-long research project entitled:

Counselling the counsellor – a phenomenological analysis of how Professional International School Counsellors view their own wellbeing

It was a rewarding and eye-opening process.

Here is the abstract from that report, outlining the approach and the findings:

“This study is concerned with Professional International School Counsellors and their wellbeing. The primary objective of this study was to investigate how Professional International School Counsellors maintained their wellbeing within the context of the school they worked in and the wider international environment. The research used Interpretive Phenomenological Analysis applied to semi-structured interviews, allowing for wide-ranging discussion and follow-up questions exploring issues arising from initial responses. Eight participants were selected for the research, drawn from social media advertisements within international school counsellor groups. The analysis revealed three themes: workload and role definition, the nature of support available and maintaining a balanced lifestyle. The results of the study showed that Professional International School Counsellors often have ill-defined roles and incomplete or non-existent job descriptions, leading to role confusion and work overload. The results also established that personal relationships were a key factor in counsellors’ wellbeing, together with professional online support. A third finding was the effectiveness of routine physical exercise and mindfulness activities on maintaining counsellor wellbeing. In conclusion, the study suggests that specific and systematic provision should be in place for supporting counsellors’ wellbeing within international schools, which should include independent clinical supervision.”

If you are interested in finding out more about clinical supervision, you can do so here.

Complementary Online Counselling for schools

A proposal

About me

I have taught internationally for over 25 years, in eight countries, on three continents. In the last ten years or so of that time, I was a school counsellor. I have post-graduate Diplomas in Counselling and Cognitive Behavioural Counselling and am currently completing my final thesis for my second Masters, an M.Sc. Psychology with the University of Derby, in the UK.


As a seasoned School Counsellor, I can offer pastoral and academic counselling to middle and high school students, either taking individual referrals from School Counsellors, where the families would pay for counselling, or through a more systematic arrangement with a particular school, which would retain my services for an academic year, paying consultancy fees.


This arrangement works for smaller schools, where there is no resident counsellor or perhaps only one for the whole school, where even brief counselling may be a difficult timetabling option. It also works for larger schools with counselling departments, where counsellors see that a longer, one-on-one counselling arrangement would best suit a student.


Counselling takes place via a secure end-to-end encrypted video chatroom. An option exists for students to engage in text-based counselling.


Please contact me for rates, using the contact page on this site.

Scott Langston, MA, Dip.Coun.
www.expatcounsellingnow.com


Online counselling


What the research says:


There is a growing bank of research looking at the effectiveness of online counselling, particularly in the education sector. Alleman (2002) concludes that, whilst regulatory concerns certainly exist and ethics requirements will be paramount, “therapy can be done online, that it can be done ethically, and … online services might not be a serious threat to face-to-face therapy.”
Chardon, Bagraith & King (2011) suggest that there is evidence that online counselling might dive less deeply into action planning and goal exploration for clients – however, there is no suggestion that this must be the case. As online counselling develops, so too do the skills of the practitioners. Particularly for a counsellor operating within the parameters of Cognitive Behavioural Therapy, there is no reason for the interaction to be any less deep or meaningful. Indeed research is showing that teenagers in particular are more, not less, likely to engage in counselling online. Lunt (2004), in the relatively early days of online interactions, identified what would come as no surprise to most working school counsellors: students expressed an unwillingness to engage with their school counsellor, perceiving them to have too close a relationship to other teachers and possibly to their parents. They were more likely to pursue online counselling disconnected from their school. They also reacted positively to counselling out of the normal hours of the school day, citing the relaxed home environment, greater nexus of control and lack of stigma when peers are unaware of the counselling.


Another research paper, from Glasheen, Shochet & Campbell (2016), concludes that “students experiencing psychological distress had a preference for online counselling. If students did use online counselling it was more likely they would discuss sensitive topics rather than for career issues.” These finding are not surprising and schools would do well to consider the addition of an online element to particularly their pastoral counselling services. In many schools the school counsellor has a large case-load of students, and academic counselling takes precedence. It can be difficult to commit to a longer-term counselling arrangement, nor is that always appropriate in a school setting. Having a reliable online referral outlet would be a valuable tool in a school’s well-being toolkit, particularly for those International Schools in locations where local services might be poor, non-existent, or simply not available in English. Glasheen et al. (2016) conclude that “online counselling provides a less threatening way of approaching help” and that “online counselling may assist some of those students who have, up until now, been reticent to access the services of the school counsellor.” In an earlier paper, Glasheen et al. reported that most school counsellors were conditionally in favour of offering online counselling in a school setting and were open to pursuing further training to enable them to provide online counselling effectively (Glasheen, Shochet & Campbell 2013).


In a separate qualitative study into adolescents’ motives for choosing online counselling, King, R., Bambling, M., Lloyd, C., Gomurra, R., Smith, S., Reid, W. & Wegner, K. (2006), revealed “that factors such as privacy and lack of emotional exposure attracted adolescents to online environment.” The report also concluded that web-based counselling services would become an increasingly important part of student well-being services.


My own experience as a counsellor suggests that students are reluctant to miss lessons during the school day to see a counsellor, are reluctant to have their peers aware that they are seeing a counsellor, are reluctant to open up to a counsellor they perceive as a friend or colleague of their regular teachers and are reluctant to discuss personal issues with a counsellor who they see as one face of the school and who may have interactions with their parents. Whilst ethical concerns, particularly with regard to confidentiality, need addressing clearly and upfront with students and families, I have every confidence in the online model supplementing what schools are currently able to offer.


Online counselling can often be the bridge, or stepping stone, towards face-to-face counselling. Certainly the initial contact through texting can build student confidence fairly quickly, to a point where the video chat feature becomes less threatening. By extension, it is then more likely that the student will engage with more traditional direct face-to-face counselling when required.


References
Alleman, J. R., (2002) Online counseling: The Internet and mental health treatment. Psychotherapy: Theory, Research, Practice, Training, Vol 39(2), Sum 2002, 199-209
Chardon, L., Bagraith, K. S. & King, R. J. (2011) Counseling activity in single-session online counseling with adolescents: An adherence study, Psychotherapy Research, 21:5, 583-592,  DOI: 10.1080/10503307.2011.592550
Glasheen, K.J., Shochet, I & Campbell, M.A. (2014) Opportunities and Challenges: School Guidance Counsellors’ Perceptions of Counselling Students Online Journal of Psychologists and Counsellors in Schools Volume 23 Issue 2 https://doi.org/10.1017/jgc.2013.15
Glasheen, K.J., Shochet, I & Campbell, M.A. (2016) Online counselling in secondary schools: would students seek help by this medium?, British Journal of Guidance & Counselling,  (44:1), 108-122, DOI: 10.1080/03069885.2015.1017805
King, R., Bambling, M., Lloyd, C., Gomurra, R., Smith, S., Reid, W. & Wegner, K. (2006) Online counselling: The motives and experiences of young people who choose the Internet instead of face to face or telephone counselling Counselling and Psychotherapy Research, September 2006; 6(3): 169174 https://doi.org/10.1080/14733140600848179
Lunt, P.T. (2004) Adolescents’ Willingness to Utilize Online Counseling Virginia Tech. (2004) Retrieved from: http://hdl.handle.net/10919/26643

The power of gratitude

Gratitude, or being thankful, seems to have become a wellbeing buzzword. Searching the terms will find thousands of articles like this one, championing the real power that gratitude can have in your day-to-day wellbeing.

You’d be forgiven for being skeptical.

But here’s the thing. As a society, we used to practice gratitude in a big way. And as an increasingly secular society we still can, and perhaps should.

Throughout much of our history, we’ve been religious beings, with a capital R. Motivations have evolved over time, but essentially this was in response to a threatening world and ignorance of natural processes. Scared of the storm? Take solace in the all-powerful entity to protect you. And when you have survived, thank him (it’s usually him, isn’t it?) Even at its most banal, the brief ‘Thank you Lord for the food we are about it eat’ is an expression of gratitude and thanks.

But it’s thanks to something exterior. Gratitude expressed to another. An acknowledgement that the locus of control is outside of us, in the hands of the other.

There’s another way.

We can simply be thankful. Literally, full of thanks. We can be grateful. Full of gratitude. The Latin roots of the word can be expressed as having appreciation and expressing thankfulness. And whilst we tend to associate that with the other, having done something for us, we can just sit with the feeling of gratitude in quietude and simply be. You can be grateful for a sunny day, a meal, being free from pain – the list is endless. It is a way of recognising the good, and celebrating it.

You can try a simple and free gratitude mediation here.

If you would like to know more about the fascinating scientific research behind gratitude, you can begin here.

One increasingly popular way of focusing on gratitude daily, and expressing it, is to keep a gratitude journal. Find 3 things a day for which you are grateful. There are numerous examples online to guide you in this process. Writing them done strengthens their influence and solidifies the positive effects of expressing gratitude. (Emmons & McCullough, 2003).

Here are some interesting links to explore this further:

Gratitude meditation

How to start a gratitude practice

The power of gratitude

Thanks for reading.

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