Tag Archive - private practice

The Journey Continues…A Stage Along the Way

November 5, 2009 in Marriage-Family, Ministry-Theology, Therapy-Psychology with 7 Comments

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[image by Maria Keay]

For those who choose to take the journey, it is lifelong. The longer the journey, the more nuances it takes on and the more it opens up to broader experiences. Yet, a journey must progress step by step. So it is with our spiritual journey. (pp. xvii, The Critical Journey: Stages in the Life of Faith by Janet O. Hagberg and Robert A. Guelich).

I have been meditating on Exodus 17:1 for a good eight years now. The idea of journeying from “place to place” or from “stage to stage” as some translations state has always captivated me.

In fact….it brings me a sense of peace and comfort knowing that I am not expected to journey from A to Z (a one chance shot to move from beginning to end, or to have life figured all out), but rather God moves me from place to place as desired. Where I am now is not my final stage in the journey, but rather one step along a path that will continue to guide me throughout my lifetime. Sometimes the stage may require a lengthy stay, and at other times it may be a quick stop. But each stage is designed to equip and prepare me for whatever step lays next. Whether I move forward, backward or lateral…that does not matter. What matters is that stages are just steps along the way in our larger journey. Or in our larger story as Donald Miller would say.

Why all this talk about stages and journey?

Because after seven months in one stage, I am moving on to the next, and I thought I might share what I have learned, and hopefully you may glean some nuggets for your own journey.

In March of 2008 I decided to leave PCEC so that I could move into my own private practice. And now after seven months in my private practice I am moving on again. This time to HopeWorks in Plano, TX. There are several reasons for this, but one thing my wife and I decided early on was that whether or not I stayed in private practice, it was that risk/step to private practice that moved us out of situation we felt stuck in, and into a new breadth of opportunities, as well as new opportunities for discernment.

Why Am I Moving On?

  1. I have learned that I enjoy working more in a collaborative group environment.  Being my own boss was great, but it was also lonely at times.  Being in a group setting allows me to still be my own boss, but in a supportive environment.


  2. Part of the journey has been learning what I am good at, and what I am not so good at.  As well as learning what skills I want to strengthen, and which skills aren’t as strong, nor should be spent inordinate amount of time working on.  What I learned was that though I can do all my own administration (I am pretty organized), I didn’t thrive on doing Quickbooks, scheduling, bills, etc.  In fact, it zapped my energy for much needed areas that I should be devoting my time to (i.e. therapy itself, study, marketing, etc.).  Now I’m in a setting where people who are gifted with billing, scheduling, payments, etc. will take care of all that for me, and I can focus on what I think I do best.  Working with people in a therapeutic setting, as well as providing education for churches, speaking and writing.


  3. I’ve learned that to become the best therapist I need to become it will require that I give all my energy to that.  (A minimum of 10,000 hours according to Malcolm Gladwell in Outliers).  This new setting allows me to do that, while still allowing me to do the other things I love as I mentioned above (speaking, teaching, writing).


  4. This situation I think allows me to set better boundaries and take better care of my family.  I’m no longer thinking about all the bills and paperwork when I go home at night, because someone does that for me.  I found that because of that I’m more attentive to my wife and daughter.  And shouldn’t I be practicing that if I’m going to be telling couples and families they need to be doing the same thing?


  5. I really do get the best of both worlds: I’m still my own boss, set my own schedule, building what is essentially my own practice/clientele, but in a group setting under the auspice of HopeWorks.  I love it.

I am already seeing new clients at HopeWorks, but will also continue to see current clients in my private practice until the end of January. I would appreciate your prayers…as well as any referrals to me, or any opportunities you may have for me to speak, teach, or write.

So I feel very blessed and content believing that this is what stage God has me in along my journey. And even though at times I feel like I should be farther along, or because at times I feel like a failure because I moved on to a new place in seven months…I’m at peace knowing that life is full of nuances, and to fully live life we must be prepared to move where God leads us…even if it’s not what we had expected. My father and I were discussing a while back that the longer we live life, the more we realize that God provides us with opportunities in areas that we have never expected or envisioned if it were left up to our own making.

So a key to our journey…to writing our story well, is to be open for God to lead you in those unexpected ways.

Can you share an example of the stage you feel God has you in now and how you got there?

Has God ever brought you to a stage totally unexpected from what you had planned?

33% OFF Online Therapy Till January 1, 2010

September 24, 2009 in Marriage-Family, Ministry-Theology, Technology-Social Media, Therapy-Psychology with 0 Comments

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[image by oddsock]


I’ve been talking a lot about online therapy on this blog, and now it’s time to make you a GREAT offer!

From now until January 1, 2010, I will be offering online therapy at 33% reduced rate. So instead of $75, you only pay $50.

If you, or someone you know is interested in this offer, please contact me.

Breakthrough: An Online Platform for Therapy

September 16, 2009 in Marriage-Family, Technology-Social Media, Therapy-Psychology with 1 Comment

58916v2-max-250x250-1The world of online therapy is emerging quickly and there are a lot of tools out there to make this easier, and most importantly, secure. The AAMFT which I am a member of recently sent us out emails about a service they endorse, Therapy Hosting. This is just one of many, and even I at one point last year was in conversation with a technology company about creating an online tool for therapy that I had outlined.

Yesterday I was watching TechCrunch, TC50, and the presentation by Breakthrough.

One thing that stood out to me was this exchange of Q & A:

TO: How do you get therapists to participate?

A: We have a log of providers who are interested.

TO: How do you qualify them?

A: We only get licenses medical therapists and make sure to authenticate all professionals.

In the emerging online world of counseling and therapy it can be quite difficult to authenticate people’s credentials, while many are just plain practicing without credentials. So it will be interesting to see how this does.

I’m going to test out this tool for a little bit and blog about it some more.

For a more in-depth analysis of the company and tool, check out the post, TC50: Have You Considered Tele-Psychiatry? Schedule a Session with Breakthrough.

Is Your Addiction to Technology Transforming Your Life

August 25, 2009 in Marriage-Family, Technology-Social Media, Therapy-Psychology with 17 Comments

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[image by David R. Carroll]

Do you remember what life was like before your cell phone, or before you had an internet connection in your house? It seems like such a long time ago. We even wonder at times how we could have lived life without them. The scary thing is that it wasn’t that long ago, yet in several short years these technological tools have rewired the way we interact, communicate and relate.

I sent my first email message in college, probably around January of 1994. It was so slow going through at the time that it didn’t even really seem worth sending another. I bought my first cell phone in 1998. I think it had only like 150 minutes per month on it which was enough because there were very few people I could call at that time who had a cell phone. In 2005 I put internet in our new house after we got married, which was really the first time I had had internet in my home before. Now I wonder how I got anything done. These personal discoveries encompass a time of around the last 4—15 years, yet at 34 I sometimes wonder how I lived without them.

What at one point were things that I felt like I could not live without, I’ve been contemplating if they are worth living with? Or if I even tried to live without them, would that even be possible. You see, I’m starting to wonder if I’m addicted to my technology. I’m not the first to wonder this question but I have been thinking about it a lot more this week as news on the opening of reSTART Internet Addiction Recovery Program near Seattle, WA has been widely discussed online. Ben Parr wrote an article on Mashable where he stated:

“It’s getting tougher and tougher to argue that there is no such thing as Internet Addiction Disorder, especially if you watched the CNN video above. The sad truth is that it’s possible to become addicted to just about anything, and that the web (and World of Warcraft) has sucked many people in so deep that they ignore social interactions and forget real-world obligations.

Does a rehab center for extreme cases make sense? Yes, especially if reSTART can provide scientific proof of success in breaking the addictions of its patients. Still, rehab doesn’t work for all drug addicts, and it probably won’t work for all Internet addicts. And unlike drug addiction, you can’t simply avoid and abstain from using the web; it’s too central to our economy, our work, our education, and our lives to be ignored.”

In case you were curious, here are the “signs and symptoms” of technology addiction:
Here is what to look for (3-4 yes responses suggest abuse; 5 or more suggest addiction)
Increasing amounts of time spent on computer and internet activities

  • Failed attempts to control behavior
  • Heightened sense of euphoria while involved in computer and internet activities
  • Craving more time on the computer and internet
  • Neglecting friends and family
  • Feeling restless when not engaged in the activity
  • Being dishonest with others
  • Computer use interfering with job/school performance
  • Feeling guilty, ashamed, anxious, or depressed as a result of behavior
  • Changes in sleep patterns
  • Physical changes such as weight gain or loss, backaches, headaches, carpal tunnel syndrome
  • Withdrawing from other pleasurable activities

And if you still aren’t sure, you can take the Are you addicted? survey.

Working With Addicts
For about a year in 2006 and 2007 I spent time working with addicts at a community mental health clinic in Los Angeles. The addictions were primarily related to substance abuse (drugs and alcohol) and I did everything that I could do to better understand the world of addictions. I took classes, I went to some Alcoholics Anonymous and Overeaters Anonymous groups, and I co-facilitated a 12 Steps group for 9 months a group that was mandatory for individuals if they wanted to stay out of jail. From that time a few of observations have really stuck out to me in regards to addiction:

  1. Compulsions
  2. Rationalizing behavior/choices
  3. Re-arranges, transforms relationships Continue Reading…

Some Practical Tips for Dealing with Depression

July 30, 2009 in Marriage-Family, Therapy-Psychology with 1 Comment

If you haven’t noticed yet, I have been covering the topic of depression quite a bit the last couple of weeks. This is going to be the last post on this topic for a while, but I wanted to leave you with an article that I thought had some great practical tips, and coping skills for dealing with depression.

Check out the article here, and if you have any questions, please feel free to contact me.

Leading on Empty

July 29, 2009 in Marriage-Family, Therapy-Psychology with 0 Comments

Recently I have been very intrigued by the topic of burnout and depression in ministry, and I have been writing on the topic mainly because it seems to not only be so prevalent, but it’s rarely talked about.  In fact, I would say that the symptoms (burnout and depression) are often a result of a lack of boundaries, and a mentality that says do more and more in ministry…as if that equates to godliness.

There are lots of great resources out there, and some pastors are beginning to approach the subject and write about how burnout and depression has affected not only the ministries they are involved in, but everyone around them. In fact…

I think openly discussing and seeking help for burnout and depression is innovative…

because so few are doing it, that to broach the subject puts you ahead of the curve in this area of thinking and praxis.

Recently I read the book Leading on Empty: Refilling Your Tank and Renewing Your Passion by Wayne Cordeiro, who is the Senior Pastor of New Hope Christian Fellowship in Honolulu, Hawaii. Wayne’s book is a great read, and it’s not only very authentic, vulnerable and insightful, but he provides some great steps and resources for those who may be suffering through burnout and depression. Wayne says:

We don’t forget that we are Christians. We forget that we are human, and that one oversight alone can debilitate the potential of our future.

It arrived without warning, like an uninvited guest. Decisions that were once simple now refused solution, and I found myself dodging anything that asked for my emotional input. My once stalwart faith was left fragile; I avoided whatever required my action.

It was a balmy California evening. I had gone for a jog before I was to speak at a leadership conference. I still can’t recall how I got there, but I found myself sitting on a curb, weeping uncontrollably. I couldn’t tell if it took place suddenly or gradually, but I knew something had broken inside. I remember lifting my trembling hands and asking out loud, ‘What in the world is happening to me?’

I had been leading on empty.

This is such an important topic, and I think one that needs to be talked about more in church ministry, especially among leaders. But it must not only be talked about, but action must be taken to move leaders to a more healthy place of leadership.

If Christian leaders do not model a healthy life, then what exactly are they modeling?

Wayne helps leaders assess what burnout and failure looks like, but he also provides a roadmap for how they can get back on track. His seven hard lessons seem obvious, but unfortunately they don’t become obvious except in hindsight for many of us.

Wayne also does a great job of talking about some actions that one can take such as sabbaticals, and he provides some important resources (counseling centers, camps, retreats, books, etc.) for leaders to access.

I think if more leaders would read this book, and learn some important lessons ahead of time, as well as possibly finding a partner in their own burnout (such as Wayne), then they will find themselves in a much more healthy leadership position than before.

Depression and Burnout: Anne Jackson Interview, Part 2

July 28, 2009 in Marriage-Family, Therapy-Psychology with 0 Comments

Yesterday I posted the first of two interviews I did with Anne Jackson back in January of 2009. Check out part of the interview below, and read the rest of it here.

From your own perspective, what is at the root behind the stigma of counseling and therapy in the Church? What would you say to Christians who think that we should not take medications for depression and anxiety?

It has always been difficult for me to say I needed to be in counseling to the extent I was, or to say that I have been on a myriad of anti-depressants or anti-anxiety medicine because I’ve heard countless times people question my salvation or my authority to work out God’s calling in my life. Most people think that something is wrong with my spiritual walk if I have to use these “crutches.” I think that the people who are judgmental about these things live in a bubble that desperately needs to be popped. That means they have stayed safe and comfortable their whole life…and there is nothing about Christianity or redemption that is safe or comfortable.

Depression and Burnout: Anne Jackson Interview, Part 1

July 27, 2009 in Marriage-Family, Therapy-Psychology with 1 Comment

I had the privilege of interviewing Anne Jackson back in January 2009 on the topic of depression and burnout, especially as it relates to ministry and the church. Since I have been writing about depression over the last week I wanted to link again to her interview. Here is a piece of the interview below, but check out the full post here.

One of the reasons I wanted to interview you as you know, is that not many Christians are forthright on the topic of depression, anxiety and what I would describe as adjustment disorders….so why did you decide to be more vulnerable about this issue in such a public forum such as your blog and book?

I remember feeling so alone as I struggled with anxiety and depression…especially in the church world. I would go to services at my church or even as I would hang out with other staff members, it seemed like everyone was so happy and put together.

Those issues became so bad, I had to take a three week leave of absence from work where I started some medication and went to see a counselor. Talking about it with her made me feel so free. Go figure…the truth will set you free…that sounds familiar, doesn’t it?

As I began to share what was really going on with my friends and coworkers, many times those same people would share with me their own struggles with anxiety, depression or other issues.

I realize when other people share their struggles with me, it builds an instant bridge of trust. I know I can talk with them because they’ve walked in my shoes. It also makes a “me too” moment. I think it was Rob Bell who said the words “me too” are the two most comforting words in the English language.

Again, just starting that conversation and allowing others the permission to share knowing they will be welcomed with grace and trust and love – unconditionally, is why I am so passionate about talking about these things.

Depression: Discernment in Pastoral Caregiving

July 25, 2009 in Ministry-Theology, Therapy-Psychology with 4 Comments

Discernment
As we talk and think about the issue of depression in ministry one of the most important factors that we have in helping us determine what exactly we are dealing with is discernment.

the quality of being able to grasp and comprehend what is obscure

Discerning what type of help a person needs can be tricky. Should they see a therapist? A psychiatrist? Both? Is a recommendation for meds necessary? Are we dealing with depression, melancholy, burning out, etc? Maybe it’s all, maybe it’s some, maybe it’s none. But the act of discernment is a process and often involves multiple people helping one through their difficult journey.

In the book Depression and Hope: New Insights for Pastoral Counseling (which I mention quite a bit, is a great resource, and which I will reference and quote from heavily in this post), Howard W. Stone says:

Depression disturbs one’s most important relationships; for melancholics this may mean family members or close friends. For the mystic or hermit monk, and indeed for all faithful Christians, that most important relationship is with God. When people feel the absence of God, when they doubt, when religious ritual and service lose meaning, their experiences are very similar to the symptoms of depression.

Pastoral caregivers listen in a certain way to the words of those who are disconsolate, a way that is distinct from other helping professionals. To clergy and other professionals in ministry, despair, suffering, struggle, and adversity are laden with spiritual import, because reflection on the experience of melancholy and spiritual desolation can bring depth and meaning to those who are trying to be faithful to the call of Christ (Stone, 21).

When dealing with issues of such vital importance, you can see why discernment is key.  In fact, I would say that it’s quite rare for most people entering into ministry to have a decent understanding of mental health issues and the role of the pastor in pastoral caregiving.

In his book Stone talks about four experiences that “compare strongly to depression: the dark night of the soul, ‘accidie’, desolations, and Martin Luther’s understanding of ‘Anfechtungen’”. Fascinating stuff! Let me just mention them briefly here:

Continue Reading…

Depression: Christians and Medication

July 24, 2009 in Ministry-Theology, Therapy-Psychology with 10 Comments

“you may have questions about whether Christians should take this or that. You get in that state, I assure you, you will take rat dung.” Pastor Tommy Nelson on his depression

Why the Stigma?
Let me start this post by saying this. When it comes to the issue of taking medication for depression…there are some Christians who believe in it, and those that do not.

I believe in them. And I’m not trying to convince you otherwise. That will require circumstances, experiences convincing beyond my control.

I have worked long enough in the ministry and therapeutic setting to see the amazing and beneficial results that they have had in the lives of the co-workers, students and clients that I have journeyed through life with.

I believe God has given scientists/doctors/researchers amazing minds to create some medications that can help.

As one friend says, “If someone is diabetic, they are going to take insulin…aren’t they?”

Or I tell my friends, “If you have a heart condition, you are going to the cardiologist, right?”

So what’s the stigma around mental health and medications in the Christian life? I’m not completely sure. There is some disconnect it seems. Or rather than disconnect, there is some inconsistency in how we pick and choose what areas of our lives we seek help on, and what areas we think we should be able to pick ourselves up by our own bootstraps.

Continue Reading…
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