Tag: Counseling

A Guide to TeleHealth in Oklahoma

Posted on by Corbin Humble

With the spread of the Coronavirus and it’s impact on the field of counseling, I know many people are scrambling to figure out how to adapt. In order to help my fellow colleagues who may be confused, overwhelmed by technology or just don’t have time to sort through all the new information, I am compiling this straightforward guide to begin doing TeleHealth free, easily and HIPAA compliant. While I don’t claim to be an expert in this field, I do have a little technical knowledge and connections with a lot of smart, informed therapists. This guide is specifically geared towards Oklahoma providers, but will hopefully apply to others as well. I will try to keep this updated as more information comes in. This information is compiled from my own research or gathered from comments from other providers, so use at your own discretion.

Unless otherwise stated, when I refer to TeleHealth I am referring to using HIPAA compliant software to have video and sound communication with a client at a secure site.

While it is in your best interest to follow HIPAA and ethical practices, the Department of Health and Human Services is exercising their discreation not to enforce many of the HIPAA requirements on telehealth and telephonic services during this crisis as explained here.(Thanks to Lee Dodd for that one)

**Updated 3/20/2020 9:35pm**

 

Regarding Insurance

Before getting to the How-To, here is what we know so far about insurance policies on TeleHealth during the Coronavirus Situation. These policies may or may not change when the circumstances change.

Private Pay is ideal in this situation because there are no restrictions other than making sure it is HIPAA compliant. You may want to figure out how to accept credit cards though if you do not already, but that’s another discussion.

HealthChoice has already been confirmed to reimburse TeleHealth in full, prior to the Coronavirus. Their policies can be found here. Just use Place of Service Code 02 and modifier GT* or GO. (*See Tricare/Humana for an explanation)

Optum/United Healthcare have released revised policies allowing TeleHealth during the Coronavirus. Those policies can be found here. It appears they have their own platform and policies, and their reimbursement is uncertain, but they said “You do not need join our virtual visit network in order to be reimbursed for the TeleHealth services you provide our members. Please continue to use standard CPT codes and a Place of Service of 02 for both video-enabled virtual visits and telephonic sessions to indicate the visit was conducted remotely.”

BlueCross/BlueShield OK has given mixed answers about telehealth, but most recent word is that they will be allowing TeleHealth. My good friend Cindy Freeman from the Oklahoma Christian Counseling Center said she spoke to Carol (Lore is out of town) at Blue Cross OK as of late afternoon on 3/17/20 and was told that it is to be billed with an 02 POS code and the usual CPT codes. Their website should be updated in the next day or two.

Tricare/Humana is covering TeleHealth. Reimbursement rates uncertain, but I assume it is the same. Use POS code 02 and a GT modifier*. (Thanks to AJ Brandon for providing the Link to these details) *According to the website, the GT modifier applies to “Synchronus” communication such as video chat, as opposed to something that goes back and forth like texting or messaging. 

Medicare has waived a lot of the restrictions for TeleHealth during this crisis. There are some unique issues and restrictions on this one, so just take a look at this detailed FAQ.  (From the CSWA via Elizabeth Fletcher)

Medicaid is allowing temporary use of telehealth and telephonic visits until April 30th. Use GT* modifier (no apparent indication that the POS code needs to be changed). The details can be found here.

Cigna sent me an email saying they are lifting restrictions on telehealth until May 31st. Use POS 02 and modifier 95. I will update with a link if I get one.

Aetna according to Lacey Leeanne she received an email and confirmed via phone call that Aetna is waiving all copays, coinsurance and deductibles for teletherapy.

Understanding the Issues

From what I have gathered, one of the main keys to using TeleHealth appropriately is choosing the right software. I won’t go into the details, but Skype and Facetime do not apparently pass muster for being HIPAA compliant. The following options have been the main ones I have found for free, unlimited, HIPAA compliant videoconferencing. Many of my colleagues have mentioned zoom, and I found out about the other options from this website.

Zoom (Here is the Link)

VSee (Here is the Link)

Doxy.me (This is the one I am using, found here.)

I found Doxy.me to be everything I needed in a super simple, professional looking package. It allows unlimited one on one videoconferencing for free and your clients can connect with you by following a link you send them, typing in their name and hitting a button. Since I am using this one, I will walk you through the process.

No matter which software you use, make sure to get a BAA printed out. That is what makes it HIPAA compliant. If someone wants to explain what a BAA is an why, feel free to share and I will update this section.

Also, informed consent is an important factor and some providers are creating documentation to address the issues related to TeleHealth. Please scroll to the bottom to see a detailed explanation of this issue from Elizabeth Fletcher and a suggested informed consent form from the American Pyschological Association.

Step by Step Guide

You and your client will both need a device that has internet access and a video camera and microphone. I also strongly encourage wifi or a wired connection so that you and your clients don’t use too much data. You may also want to consider having the option to plug in your devices so you don’t run out of power. I have found that IPads and IPhones work like a charm.

I broke down every single step, so this may look long, but it should only take about 5 minutes.

First time setup

  1. Go to Doxy.me
  2. Hit the “Get Started – For Free button.”
  3. Click on “I’m a Provider”
  4. Fill out the super short sign up page, check the boxes and hit “Sign Up”
  5. You will be taken to your dashboard. You can explore it and personalize if you want.
  6. Click on the “Account settings” button.
  7. Click on the BAA tab
  8. Fill in all the fields
  9. Hit generate BAA
  10. I advise you to download and print a copy for your records
  11. Hit the Pre-Call Test button at the lower left to make sure all your hardware is set. If there are problems, please contact doxy.me for support because that is beyond the scope of this guide. It worked first time for me.
  12. Hit the Back button on your browser to get back to the dashboard.

To start a videoconference

  1. Sign into your Doxy.me account and you’ll see the main dashboard
  2. Copy the link to invite someone to your waiting room and send the link to your client via text or email.
  3. Wait for your client to follow the link. All they will have to do (aside from any technical difficulties) is to type in their name and hit a button.
  4. Make sure to hit the button to “Turn on webcam” in the top right.
  5. The client should show up in the Patient Queue at the top left. Click on them and hit the button to start chat.
  6. Start doing TeleHealth

 

I hope this allays your fears and gives you everything you need to provide services during this difficult time. I invite my colleagues to comment and share any additional info so I can keep this guide updated and thorough.

Addendum: Informed Consent explanation courtesy of Elizabeth Fletcher.

“Informed consent” is a term used to refer to the ethical obligation therapists have to make sure that every part of our practice that affects patients is explained to them in language they can understand, and that they agree to it in writing only once they understand exactly what they’re agreeing to.

This is to make sure that no one who engages in psychotherapy experiences something that feels like a violation of consent, something that they didn’t expect or agree to experience, or any form of exploitation at all.

Trust is an essential part of the therapeutic relationship. The therapist is in a position of power and authority, and we have a lot of rules and guidelines that are designed to protect patients from even accidental abuses of that power. For example, if a therapist suddenly told a patient that they weren’t going to accept credit cards anymore, only cash, effective immediately, the patient might not realize that they have a right to know about changes like that ahead of time, and that it might be unethical or even illegal for their therapist to make such a change. The patient, concerned about having an interruption in their therapy, might think they have no choice but to agree right then and there. This would be an abuse of power by the therapist, and a violation of our obligation to obtain informed consent for our practices.

Instead, a therapist could provide a letter about their decision to stop accepting card payments at least a month in the future, their reasons for not accepting card payments, and some options to help patients with that transition. The therapist could then give each patient an opportunity to discuss the change in policy with the therapist and either give written consent or begin termination of the therapy with referrals to other providers. This would be abiding by the ethical obligation of informed consent.

So right now, as many providers are being proactive about protecting their patients’ and their own health and safety by not meeting in person, it is necessary for us to provide each patient with an opportunity to engage in informed consent. We will discuss the benefits and risks of telemental health and videoconferencing with patients before patients decide whether this is something they feel okay doing, or if they’d rather have a referral to a provider who is providing in-person sessions.

 

INFORMED CONSENT CHECKLIST FOR TELEPSYCHOLOGICAL SERVICES (From the American Psychological Association)

 

Prior to starting video-conferencing services, we discussed and agreed to the following:
· There are potential benefits and risks of video-conferencing (e.g. limits to patient confidentiality) that differ from in-person sessions.
· Confidentiality still applies for telepsychology services, and nobody will record the session without the permission from the others person(s).
· We agree to use the video-conferencing platform selected for our virtual sessions, and the psychologist will explain how to use it.
· You need to use a webcam or smartphone during the session.
· It is important to be in a quiet, private space that is free of distractions (including cell phone or other devices) during the session.
· It is important to use a secure internet connection rather than public/free Wi-Fi.
· It is important to be on time. If you need to cancel or change your tele-appointment, you must notify the psychologist in advance by phone or email.
· We need a back-up plan (e.g., phone number where you can be reached) to restart the session or to reschedule it, in the event of technical problems.
· We need a safety plan that includes at least one emergency contact and the closest ER to your location, in the event of a crisis situation.
· If you are not an adult, we need the permission of your parent or legal guardian (and their contact information) for you to participate in telepsychology sessions.
· You should confirm with your insurance company that the video sessions will be reimbursed; if they are not reimbursed, you are responsible for full payment.
· As your psychologist, I may determine that due to certain circumstances, telepsychology is no longer appropriate and that we should resume our sessions in-person.
Psychologist Name / Signature:
Patient Name:
Signature of Patient/Patient’s Legal Representative:
Date:

 

 

Feelings are Real but not Reality (Feelings Part 1)

Posted on by Corbin Humble

I remember watching the original Star Trek when I was a child and taking note of how often Spock and Kirk would debate logic versus emotions. In retrospect, I think they did a good job of valuing both. Inspired by those debates, the young counselor in me came up with this theory.

 

What if emotions are like a super fast computer that quickly evaluates a situation based on past experience and generalizations to warn us of danger or problems?

 

Have you ever felt angry before you even knew why you were angry, only later to process that someone had violated your boundaries or undermined your security? Have you ever felt uneasy or anxious about a situation only later to recognize all the clues and warning signs?

Anger, fear, frustration, worry, etc. come on quickly and the unpleasantness motivates us to change our behavior. They can serve as excellent warning signs and indicators that we need to take a situation seriously.

 

The problem is, because this survival mechanism needs to process things so quickly, our emotions are based on generalizations, assumptions and past experiences, which are prone to error. For example, when you have all those odd physical reactions to public speaking, it is because your body reacts to the anxiety of being judged, the same way it would react to prepare to run from a lion. It is a protective mechanism that we regard new situations and people with hesitation and care, but to the extreme this becomes racism and seclusion.

And while our logic is certainly still prone to errors, given more time we can usually discern better what is right and true and what was just a false alarm or poor judgment.

Feelings are just another way to get information about the world, but just like sight or hearing, they can be impaired or faulty. I like to think of feelings as warning lights on a car dashboard. They are indications that something might be wrong. They should be respected, not ignored. But there have been times that I had a low tire warning light, checked all my tires with a gauge to find they are fine and later found out that the pressure sensor was broken. It feels a bit odd to drive around with that warning light on afterward, but I know why it is on and that things are ok.

Society appears to be doing a better job lately of recognizing that feelings need to be validated. Too many people have been hurt and told they were wrong to be upset. And too many people have ignored their feelings when they shouldn’t. Furthermore, depression, anxiety and many other mental health issues are invisible illnesses where people appear to be fine from the outside, but have a very real internal experience of pain and distress. Consider that if someone has tinnitus and experiences painful ringing in their ears, but there is no external sound, their pain is still real. It is largely ineffective or counterproductive to tell someone their experiences are not real.

But, it is an opposite and equally problematic extreme to confuse validating a person’s experiences with saying that those experiences are reality. It is a delicate balance for both those experiencing painful emotions and those caring for such people. But it is good to first validate that feelings are real, and painful, and distressing, and confusing. People are not crazy for being angry, or scared, or stuck.

But then no one should stay at this point too long. Feelings are real, but not reality. Just because you feel scared does not mean you should run. Just because you feel hurt does not mean anyone did you wrong. Just because you feel hopeless, worthless or a failure does not mean you are.

When actions are based on feelings all kinds of things go wrong. Half my blogs are basically getting at this point. I plan to write Feelings Part 2 soon as an example of this. And many of my clients, especially people who struggle with bipolar disorder, are basically just trying to learn how to stop letting their emotions be in control of their lives because of the ongoing problems this causes.

On the other hand, many people have tried to be Spock and be purely logical, and that usually fails or has its own problems, because our emotions are valuable and a crucial part of our existence. Often the best parts of our existence come from emotions. When we are in touch with reality, including the painful parts, life becomes so much more vibrant and rewarding. I think the balance is to learn how to use feelings as clues to navigate our lives, but not let them be in charge of steering the ship.

And as many people say, the longest distance in the world is between the head and the heart. It is a very difficult challenge to act based on your will, rather than you feelings, but it is a challenge worth accepting. At the end of the day, it is not what you feel, but what you do that matters.

On the bright side, most people find that once they realize they do not have to act based on feelings, they start to do things differently, challenge their reality and have new experiences. And, as I said at the beginning, since feelings are largely based on experiences, new experiences are often the best way to eventually change our feelings.

Lock and Key Dating

Posted on by Corbin Humble

Dating is rough for a lot of people. I am no exception. There is so much stress, drama and awkwardness. And a lot of that stress we bring on ourselves due to our own expectations, values and assumptions. One of those assumptions that complicates dating is based on an otherwise very useful rational thought:

“If something is not working, then you need to change what you are doing.”

Trial and error for short. If we want something to work, then we keep trying until we make it work. This results in persistence, problem solving, adaptability and a whole host of useful character traits. It is the way we should approach most problems in our lives. However, I find that this attitude is often a cause of problems when it comes to dating and relationships.

Now, please bear in mind that like most pieces of wisdom, this one is not a 100% rule, but just a part of the puzzle to keep in mind. Of course relationships take work, persistence and adaptability. However, my point here is that people get so focused on making relationships work they sometimes forget to ask if they should be making it work. A sign of healthy relationships is that they make you a better person. But if you have to change or hide fundamental aspects of who you are, then maybe you are not in the right relationship.

Let me just go ahead and share my experience. I was a nerdy teen in the 90’s before sci-fi and video games were as mainstream as they are now. Back then, “nerd” and “geek” used to be far more of an insult than a description of your taste in media. I was also distinctly under the impression that most girls did not like those things at all. It doesn’t matter if that belief was right or wrong, it still limited me. And so I thought, if I want to find a girlfriend, then I need to hide those things about me to improve my chances of finding a girl. Sure, writing about those assumptions and conclusions now sounds ridiculous, but it seemed so rational at the time. I wanted to broaden my appeal to have better odds at success, so I hid what I thought was undesirable. I think that is a common attitude.

And then one day, I went on a trip to California and spent a few days with my female, adult cousin and her family. While I was there, they showed me their board game closet. I perused their sci-fi movies and heard stories about their weekly Dungeons and Dragons games with friends. This was the first time I realized that there were girls out there who not only put up with those hobbies, but loved them just as much as guys did. And that completely changed the way I thought about dating.

Before, I had thought that finding a girlfriend was like most problems in the world. Make changes to increase your chance of success. But now I realized that dating was like a lock and a key. If the key does not fit in the lock, it does not mean there is something wrong with the key and you need to change the key. That key just does not fit with that lock. I did not need to change myself to fit with what I assumed most girls wanted, I needed to unabashedly put myself out there, making clear what I liked and what I valued. Even if it turns off 99% of the people, it will attract the 1% that I fit with best. This was not an odds game, this was a matching game.

In fact, there more clear you are about who you are, the faster and easier the process will be. We mistake rejection in relationships to mean that something is wrong with us, when in reality it is just the process of elimination to find the right fit. Again, to clarify, if you are cruel, paranoid, have trust issues or other baggage, we all need to continually work on self-improvement. But if you are worried that your desire for a serious relationship, your religion, your politics, your values or your interests will turn people off, then realize, it only turns off the people who are not right for you.

At the end of the day, what almost everyone truly is looking for is a relationship with someone who knows the real you, intimately, good and bad, and loves you anyway. You won’t find that by changing who you are.

Humor

Posted on by Corbin Humble

Humor is one of those things like music or nature that has an inexplicable, yet very real effect on our well being. I tried to find the source of the quote, “laughter is the best medicine,” but it seems to predate people taking credit for things. It is a piece of wisdom that may even predate language….and now I’m just imagining caveman humor.

And of course it is important in the counseling process. It is a little delicate, because no one wants to be laughed at when they share intimate details of their lives, but at just the right time, it can be enormously helpful to have a good laugh when you’re hurting. Sometimes you just have to laugh to keep from crying, and sometimes you have to laugh at yourself so you don’t take yourself too seriously.

Several clients have told me that they were glad I had a good sense of humor because they can’t connect with people who don’t “get” them.

I think trying to describe a sense of humor is a pretty ambiguous and difficult task, so I won’t try too hard. Just know that I don’t take myself too seriously, I don’t take your problems lightly and I don’t mind a little dark humor.

Oh, and here is a joke that I made up while I was on hold with an insurance company for 2 hours:

How many customer service representatives does it take to screw in a lightbulb?

Just one…

“Your lightbulb is very important to us and will be screwed in by the next available representative.”

 

Lastly, here is one of my favorite comic strips about mental health professionals:

Words vs Consequences – The Two Bosses Analogy

Posted on by Corbin Humble

Allow me to share some of the parenting observations I have accumulated over the past decade. 

Parents are usually concerned primarily with their children’s obedience and respect.

How do I get them to behave?

Why don’t they respect me?

These are two of the most common and central issues I see parents trying to manage. And from this point, a very common relationship dynamic occurs. Parents tend to use their words to manage behavior and their consequences to build respect. Perhaps this cycle seems familiar…

Ask the child to do something. Tell the child to do something. Ask them why they didn’t do it. Yell. Complain. Argue. Nag. Threaten. Beg. Guilt trip. Etc. Then, after there is so many hurt feelings and regrets for hurtful things said, you feel guilty and let them off easy, mend fences with a treat or don’t even follow through with a consequence.

“What can I say or do to get through that thick skull of theirs and make them listen?” “Why do I have to yell at them before they will obey?”

Wouldn’t it be great if there was some magic phrase to get the light bulb to turn on and your child to respond, “Oh! You’re right mom. You’re just trying to do what is best for me. I’m sorry I didn’t get it and you really do love me. I’ll cooperate and everything will be easier from now on.” If only.

Ideally, it should be as simple as telling them something and them obeying. In a well running relationship, that is how most things work. But when it doesn’t work that way, we think we need to step it up and figure out the magic words to get cooperation. And when you try harder and harder to use your words to get obedience, you tend to do more and more damage in the process. It is like trying to get a seed to grow by digging it up and squeezing it. Sure, you might get a reaction, but that is not going to thrive.

And then, when you try to repair the relationship or make sure the child still likes you, you decide to give them things, not to punish them or to cut that 2 week grounding back to 2 days. “I’m sorry I yelled at you. I don’t want us to fight. Let’s go to the mall and look at that new Iphone you wanted.” I see a lot of parents that really struggle to apply consequences when they feel guilty.

So, that is the common dynamic. Use words to try to manage behavior and consequences to manage relationship/respect. But consider what that would look like if you had boss that did that…

Imagine a bad boss who comes in and just complains about all the things that aren’t done right. “Why is this so sloppy?” “You need an attitude adjustment.” “You guys need to work harder.” “What’s your problem?”

People tend to protect their ego from criticism by discrediting the source of the criticism.

That means, if someone is yelling at you, there is a part of you trying to knock them down a few pegs so their criticism doesn’t hurt as much. You may be thinking about that nagging boss, “Well, you’re never here. You don’t know how hard we work. I’ve seen all the stuff you do wrong. How dare you criticize me.” So, when people use their words excessively to control behavior, it tends to breed disrespect and hurts relationships.

Now, if that same bad boss never actually punishes anyone or enforces rules, but rather tries to enact casual Fridays and bring treats to make the employees like them, does that actually work? No. You just learn the boss won’t really do anything and you simply take advantage of their gifts without developing any respect.

Now, let’s flip the script. Imagine a good boss who uses their words to build relationships and consequences to deal with behavior.

This boss comes in and encourages you and points out what you do right. “Hey, I noticed how you put up with that angry customer with grace and tact.” “I know I can always count on you.” “You have such a great attitude, we’re lucky to have you.” If a boss was sincerely encouraging and really appreciated you, would you be more willing to go the extra mile when they said, “Hey, can you come in on Saturday? I know it’s no fun, but I need someone I can trust to do this for me.”

And if that same boss had to address a problem and said, “I do need to mention the issue of getting to work late. That’s your responsibility and if you are signed up to open, we will have to start docking your pay for being late.” If you were late again and got your pay docked, would you really be that mad at the boss? No, they told you what would happen and they followed through. Now that you know they are serious, maybe you’ll try harder next time. 

Which boss would would you respect more? Which boss would you cooperate with more?

Let me tell you that after visiting with easily over 100 kids in my experience, they almost never complain about punishments. Usually they know what they did. What kids say over and over again is, “Why do they have to yell at me?” Truth is, any open mindedness to change usually shuts off when the volume starts to go up. The yelling, the lectures, the nagging and the criticism usually do not convey any new information to the child, but it does affect them. They hate it. Sometimes they try to act like it doesn’t bother them, but it does. And if we’re being honest, this is why parents use it…because it gets a reaction. Punishments often seem ineffective, but you can find a hot button topic to get a reaction. And this feels like an accomplishment. But it is not accomplishing what you want. Sure, they might obey just to shut you up, but that wins the battle and loses the war.

Do you want to get them to pick up the socks off the floor today even if it means they don’t tell you about their depression tomorrow?

What did you win if they turned down the music only to stew on how you don’t care that they had a horrible day and needed something to cope?

And if your make them so miserable that they make good decisions while you are around, will they still do those things when they are on their own?

 

I used the seed analogy earlier. Using words to control behavior is like squeezing a seed. It gets an immediate reaction that does not thrive. Consequences on the other hand are like pouring the water on a seed that is buried. Just because it doesn’t seem to make a difference now does not mean that it is not working. Create an environment that encourages growth. Create consequences that make good decisions the better option and give your child time to figure that out. 

How many times have you made the same bad decision over and over and dealt with the consequences before you finally decided it was not worth it and made a change? I think most people who consider that question honestly will realize that sometimes it takes many times before we learn our lesson, but when we do, it is real change. That has to be the attitude with consequences. Don’t expect immediate results, just create situations that make good decisions worthwhile and give the child time to accept that change. You don’t have to win today.

So, which kind of parent do you want to be?

Thought Stopping and the River Analogy

Posted on by Corbin Humble

Most people struggle with recurrent negative thinking patterns that they feel they simply cannot stop. Anxiety, worry, self-loathing and even anger are usually just the same thoughts over and over without any resolution. I think we have all had those nights when we could not sleep because we could not turn our brain off. I think we usually keep thinking the thoughts because we keep expecting to somehow solve the unsolvable problem and that will lead to relief. But you know from experience that those thoughts just make you miserable and do not make anything better. Almost everyone I see at some point asks me how to stop those thoughts, and when they do, I explain the process like this…

 

Something I think every single person has done at some point, but we never really talk about, is stand in a steamy bathroom and watch water condense on the tile, glass or mirror. We watch curiously as one drop eventually gets so big that it cannot hang there anymore, so it begins rolling downward, leaving a meandering path behind it. And the next drop to come along, which was making its own path, will follow the first path when they collide. You can even take your finger and draw a diagonal line that future drops will follow. This phenomenon is the same process that creates rivers. Trickles run into streams, that run into rivers and into bigger rivers, carving out deeper ruts all along the way. The Grand Canyon was created by this process.

The way your brain works is very similar. You have probably seen images on TV or in movies of electrical impulses shooting through chains of neurons in the brain. When you have a thought, there is a chain reaction of electrical impulses along a series of brain cells. When you use the same series of cells over and over again, the brain wraps that chain in what is called a Myelin Sheath. Basically, it is an insulator that creates an information super highway. It is why toddlers wobble around when they learn to walk, but now you can walk without even thinking about it. It also explains why past hurts that you have dwelt on or critical thoughts you have told your self repeatedly can now be triggered so easily. Anything vaguely reminiscent of the originating situation almost instantly leads to the same emotional reaction.

So, again, how do you stop this process?

Well, let me ask you, how would you change the course of a river?

 

If you took a moment to consider that question, almost everyone says something along the lines of, “Dig a new path,” and/or “Block off the old river.” That’s right. You have to stop the water going down the old path and dig a new path. I’m pretty sure you have never been tasked with changing the course of a river before, but yet you knew how to do it. Why? Because it is simple. But would it be easy? Heck no. That is a lot of back breaking work. It is simple, but not easy. You know how to do it, you just have to do the work. Changing your thinking patterns is the same way.

And consider the river again. When you start digging a new path, will that make much of a difference? No. And will the first few sandbags in the old river slow it down any? No. There is likely to be no noticeable change at first. But, if you keep at it, slowly but surely, that old path will start to dry up. And as more and more water goes down the new path, it starts to do the work for you deepening the rut. After a while, that is the new normal.

When it comes to thought stopping, you have one big advantage to start. You have been down that old path of thinking many times. It is familiar and you know where it leads. It leads to stress, worry, depression and misery. By now, you should be an expert on knowing when you are about to go down that negative thinking path. If you do not want to feel those things, then you need to:

  1. Recognize the pattern is about to start.
  2. Remind yourself of how it will make you feel and that you do not want to go there.
  3. Tell yourself to stop and go a different way.
  4. Choose to think the alternative thoughts that lead to hope, empowerment, forgiveness or freedom.

For many people, a big part of counseling is finding, processing and applying these healthy alternative thoughts. You can’t just expect to stop negative thinking and be ok. The wave of emotion will always wash over you. You need a healthy alternative. Just for a few examples:

  • Instead of “I can’t let them treat me this way,” you decide, “This isn’t worth the fight.” or “Just because they are hurting me, doesn’t me I have to let them.”
  • Instead of “Why try? I’m a failure,” you remember, “Failure is an event, not a person,” or “I can’t succeed if I don’t try. At worst, I’ll learn something in the process.”
  • Instead of “I’ll never find anyone who loves me,” you tell yourself, ” I may not have found that special someone yet, but I have the courage to keep putting myself out there until I do and I’m proud that I have too much self respect to settle.”

Everyone is different, so your new healthy thoughts will be based on your unique values and personality. And even if you do learn and practice them, it is to be expected that you will stumble frequently until you make those your new normal. That’s ok. It is simple, but not easy. But it can be done with work, guidance and time.

 

Nerd Cred

Posted on by Corbin Humble

While this may not matter to some people, many of my clients have been surprised and delighted to find out that in addition to being an educated professional and good listener, I am also a very well rounded nerd. You’d be surprised how many people have benefited from my ability to make analogies of how their favorite television show applies to their current struggles.

If I haven’t personally seen a show or played a game, then chances are I have talked to someone who has and learned about it second hand. For some people, this factor makes me more relatable and sometimes just a friendly talk about common interests helps build a level of comfort that contributes to the counseling process.

So, I can’t think of any better way to establish my nerd credibility than to share a list of some of the tv shows and games that I have watched and played, most of them in their entirety. Don’t judge me. I do read a book on occasion.

In no particular order, I have watched the full series or am up to date on the following shows:

Firefly, Doctor Who (starting with the 9th doctor), Sherlock, Buffy, Angel, Xena, Heroes, Supernatural, Arrow, Flash, IZombie, Agents of SHIELD, Star Trek (every episode, spinoff and movie except for Enterprise), the IT Crowd, the Office, Walking Dead, Person of Interest, Daredevil, Bones, Blacklist, Gotham, the Expanse, and Colony. I’m sure there are many more that I am not thinking of, are much older or that I have watched portions of. If you include all the shows I watched on Nick at Nite as a kid, then my knowledge goes all the way back to Dick Van Dyke and the Andy Griffith Show.

Also, I have been gaming since the MacPlus to present day, so I have played or know about most video games. Most kids are surprised to learn that I play Minecraft with my daughter, know who PewDiePie is, got to legendary arena in Clash Royale and made gold nova rank in CS:Go. When teens tell me that some of their closest friends are on Xbox live, I don’t argue with them because I know that you don’t have to ever meet someone in person for them to talk with you for an hour online about how your day went.

I also know my way around a computer and have done my own programming work on several games, so I know what people are talking about when they discuss their job as a programmer or dream to be a game maker one day.

I may not have ever dressed up for a convention, but I have been to a few ComicCons and had the pleasure of meeting quite a few interesting people. I know there is no real accomplishment in paying to have a picture taken with a celebrity, but it was super cool that one time when Milo Ventimiglia remembered my name.

Some of my favorite past times also tend to be a bit more on the fringe. For instance, I own my own paintball gun, have two bookshelves full of board games, hold annual charity Poker tournaments at my home and I was on the starting line of the Baylor Ultimate Frisbee team.

Lastly, I have seen my share of movies. I often find movies can be exceptional opportunities to get a feel of what other life experiences might feel like, even though I know they are just recreations. My best friend and I are currently working on an ever growing list of movies we feel contribute to the understanding of the human experience and make us better so that we can try to get our kids to watch them all some day. For your benefit, I’ll try to keep it updated Here. Sometimes movies can be excellent therapy.

My wife and I with Norman Reedus and Michael Rooker.

My Spirituality

Posted on by Corbin Humble

First off, let me say that I have effectively worked with clients who describe themselves as Atheist, Agnostic, New Age, Muslim, Jew, Wiccan or even Satanist without ever having any apparent conflicts or negative feedback due to my spiritual beliefs. Along the same lines, I have had many clients from the LGBT community who have achieved their counseling goals with me and never encountered a problem.

That being said, I am a lifelong Christian. Nothing has had a bigger impact on my personality than my ever deepening understanding of God’s word and the life to which he has called me. My beliefs have taught me humility, because I fall short of His standard. Recognizing my own need for forgiveness and my humanity has taught me to give that same level of grace, understanding and patience to others. My faith has taught me hope and a value for everyone, even though we do not deserve it. I take to heart the call to be non-judgmental and loving to everyone I meet. I know we are all a work in progress and we should help each other along without worry of how far along we may think we may be compared to another.

I am a fan of the quote by Corrie Ten Boom, “God has no grandchildren,” which is to say, despite being raised Christian, I have had those long dark nights where I truly considered the reality of my beliefs and come out on the other side more secure in them. This allows me to be present and non-confrontational with others because I do not feel the compulsion to convince other people of my beliefs in order to reassure myself.

With my Christian clients, the shared beliefs are often an amazing source of empowerment that I try to incorporate on a person to person basis. For some people, a single Bible verse will be far more convincing than a dozen psychological research studies. And I have seen people use their beliefs to find amazing strength to continue fighting when most would give up. Regardless of specific religion, I encourage anyone to use their particular faith to inspire them to make changes. But I do so carefully, as I know some people may not be active or may not feel good enough about their spirituality, even if they do profess a certain faith.

The real question many may be asking is, “Do you push your beliefs on others?” Some people may even think that I should feel obligated to share the good news that has had such a life changing impact for me. Honestly, I reconsider this position often. Especially for those young men that lack a healthy father figure when I have experienced a trans-formative relationship with a Heavenly Father. But, I always find that I come back to keeping my faith to myself in session, unless a client specifically works toward spiritual things.

Firstly, counselors are ethically prohibited from using our position to coerce our clients. I suppose that I consider being a counselor to be a noble responsibility that I have been entrusted with by the State of Oklahoma and an arrangement entered into with my clients. As such, I think the most pressing deciding factor is that I feel as if I have promised that I will not abuse my position to change people to be what I think they should be.

Secondly, my style of counseling is all about respecting people and working toward their goals, not my own. If someone brings up concerns that they feel their spiritual life is lacking, then I am more than happy to help them work toward that, whatever it may be, but it won’t be my suggestion. I am also very comfortable being present with differing opinions or even admitting the extent of what I do not know.

Lastly, I suppose I justify my decision, after much prayer and Bible Study, that it is up to God to call people to him. Some people are called to evangelism. Some may argue that all Christians are. But I believe I am called to be a counselor. I love people by helping them work on their desires. I want to see people get healthier. I want to respect them without needing to add a caveat that I do not approve of some such behavior. In the end, I figure that if I can help a person solve all their apparent problems, it may just reveal a God shaped hole in their heart.

Person Centered Therapy

Posted on by Corbin Humble

Every counselor has different styles, theories and approaches to the counseling process. 

Some will analyze your dreams, some aim to dig up past trauma, some give you homework assignments, some try to trick you into getting better, some give lots of advice and others just silently take notes and make diagnoses.

Different people need different counselors. My style is not for everyone. If I am not the right counselor for you, then I will gladly make referrals so you can find the help you need. This is about you, not my ego.

While I may incorporate useful tools, skills and ideas of various counseling theories, the foundation of my approach is called Person Centered Therapy. What that means is that I believe the people who come visit me are intelligent human beings who just want to make their life better. You are the expert on you. I believe my number one priority is to create an environment where you can process your issues at your pace towards your goals.

If I can be genuine, respectful and understanding then I believe a comfort and rapport will develop that allows you to share more freely. Research has shown that these qualities of a counselor are far more important than any technique. If you know that I am not going to make you feel bad, share your secrets or get you in trouble, then I believe trust will develop. Just the process of putting words to what is going on in your head and your heart requires you to sort it for yourself in order to explain it to me, and this is one of the simplest and most beneficial parts of counseling as you gain a better understanding of yourself through the conversation. Of course, I will ask the necessary tough questions at the right times and try to share the skills, wisdom and perspectives that I have to give, but my priority is helping you figure things out for yourself.

Everyone is different, so I do not have a formula or set structure for how therapy will proceed. I believe whatever we talk about it what we need to talk about. If you got an F in history class, I wouldn’t ask what your problem is, I would discuss what you want to discuss. And what do you know…if you want to discuss the people messing with you in history class, I bet solving that problem helps those grades. Sometimes counseling can be very difficult, just like physical therapy involves pain as you increase your ability to function. But if at any point you just want to change the subject and talk about movies, then that is what we will do, because respecting you means respecting your pace. And I believe that respect builds trust so you will feel comfortable going further next time.

I also try to avoid giving advice. I’m human and I will fail, but aiming for it helps me find a good balance. If I tell you what I think you need to do, then you may reluctantly go try it, but it probably won’t work if you don’t buy into it, so then you’ll fail and just think I’m an idiot. But if through the course of a conversation, you slowly come to accept that you need to do that thing you already knew you needed to do, then when you are ready you will pursue your solution. And chances are it will work because it was your idea based on your knowledge of yourself and your commitment to succeed. Then I’ll gladly give you a high-five as you proudly tell me how you solved your own problem. 

I believe it is my job to put myself out of a job. I want to help you get to the point that you do not need me.

In short, my style is very non-directive and laid back. Some people need structure and pressure. If so, we can find you a referral. But many people find that this style is exactly what they need. I can’t always explain why it works, but it truly does. Of the people who like my style and were willing to engage in the process for more than 3 visits, 90% received some benefit, while 68% made good or excellent progress. And when I say excellent progress, I am thinking of the people who started off struggling to make it through the day and ended feeling confident, capable and eager for the challenges ahead.

If this sounds like what you want, then please Contact me to discuss setting up an appointment.