What to do when mental health treatment isn’t working?

What to do when mental health treatment isn’t working?

Has it been months since you started therapy, yet you don’t see any positive results? Are you having a hard time opening up to your therapist? Have you been missing too many of your appointments lately and unable to commit to your therapy? Do you fear being judged by your therapist? Do you feel as if your therapist is unable to reason with you? Do you feel more confused, stuck, angry, in a state of paradox after a session with your therapist? If you are familiar with these situations, perhaps your therapy hasn’t worked as effectively as you had anticipated. Fear not because you are not alone in this dilemma. 

Often at times, more serious mental illnesses, such as PTSD or schizophrenia require more than just a few appointments to a psychologist/psychiatrist. Say, for instance, you had asthma and your first medication didn’t work out, do you give up easily and let your lungs hold you back from enjoying a nice stroll in a park with your child? No, right? You don’t do the same with therapy either. If your therapy has failed you, you should explore other options before quitting or changing the therapist.

First and foremost, you must speak to your therapist regarding your feelings about the ongoing therapy. There are different types of medicines for different medical conditions. Similarly, PTSD will not be treated in the same manner as an eating disorder. Talking to your therapist may help him/her change the course of therapy and opt for one that is more suitable to you. 

You can always book an appointment with another mental health expert. When visiting a new therapist, do not forget to take along a list of queries on your first session. It will be a great start if the therapist transmits confidence and he is willing to address all your questions openly.

You may also want to try other kinds of therapy along with your traditional talk therapy. You may want to go for dance therapy or art therapy to help you relax and declutter your mind. These kinds of therapies are often more stimulating and require greater engagement than going to a psychologist and talking about feelings.

Moreover, you can consult with a nutritionist or a wellness coach to help you bring lifestyle changes, for instance in your diet, sleeping schedule, planning out your days, meditation, or other physical activities you normally partake in. 

Therapy issues may be resolved if you change your approach regarding therapy. This means that you may have to change the timings, days, or frequency of your therapy. You may be unable to commit to therapy because you have been worried about household chores or may not have slept well through the night which can deter an effective conversation with your therapist. Once you change your therapy routine, the process continues the same as before. 

If your notice that your therapy isn’t working, it is a cue that an intervention is obligatory. It is paramount to not hold back on voicing your concerns if you want to get better. Thus, you should be honest about who you are and what kind of help you think works best for you.

 

By: Rabeea Shakeel

 

 

 

 

Efforts to be made for suicide prevention in Pakistan

Efforts to be made for suicide prevention in Pakistan

We all know the unfortunate stigma that exists around mental health in our society, so it comes as no surprise that the topic of suicide is even more hushed and overlooked. Because of this most of us don’t realize how big this problem actually is in our country and how it’s taking away thousands of lives annually, especially during recent years. Suicide rates are reported to be higher in younger unmarried adults under the ages of 30 and more common in women, with the most recurring reasons being domestic and relationship problems. Covid-19 has just made matters worse, with a total of 29 cases reported since January 2020. Among these, 12 suicides were committed due to financial/economic issues faced by the victims as a result of the pandemic, as well as due to the fear of being infected.

We can clearly see what a big threat this is to our society but what measures can be taken to prevent these deaths from happening? Suicide prevention requires a multi-sectoral approach. Depression is related to more than 90% of suicides in Pakistan, with almost 34% of the population suffering from common psychiatric disorders.  This is something that needs to be tackled at the local level. Mental wellness and suicide prevention services need to be incorporated into primary health care (PHC) systems. Since the government-funded PHC units in Pakistan are largely inefficient, the best solution is to involve counselors, therapists, and other mental health care professionals to establish community mental health programs, keeping the costs as low as possible to ensure affordability.  

One of the most important predictors of potential suicide is a prior history of direct self-harm (DSH), therefore, it is critical to effectively detect early signs of possible future attempts, such as acts like cutting. At least 10-20 DSH actions are predicted to occur before any suicide is attempted. According to current estimates, over 100,000 DSH acts occur in Pakistan each year. The underlying psychological problems should be discussed in addition to the medical treatment of DSH. To make this possible, the decriminalization of DSH acts is essential so people aren’t afraid to seek help. Any DSH individual, regardless of how harmless the act seems to be, should undergo a psychiatric evaluation. Furthermore, suicide reduction can be greatly helped by properly educating the emergency department staff.

As seen in developed countries like the USA, suicide prevention hotlines and crisis intervention centers play an integral part in helping out and stopping people who are on the verge of suicide. Some hotlines already exist for this purpose and offer free counseling like Umang hotline, White Ribbon Pakistan, Madadgaar National Helpline, Rozan Youth Helpline, etc. However, more services like these are urgently needed in Pakistan, which are both prompt and effective. Alongside this, programs should also be introduced at the school level, as recommended by WHO’s Suicide Prevention Strategies, to minimize the occurrence of suicide among younger individuals. These include healthy decision-making, social skills development, self-esteem improvement, and crisis control.

By effectively implementing these measures, Pakistan will be able to get this societal problem under control and see a huge decline in national suicide numbers.

 

By Rabeya Hayat

Assertive Training in CBT

Assertive Training in CBT

Assertiveness training is a type of behavior therapy that is the basis on increasing assertiveness & self-reliant behavior in individuals and it’s guiding a more confident & effective communication skill. Assertiveness training places highlighting on respecting the desire and needs of both parties in an effective conversational exchange in both verbal and nonverbal assertive behavior.

Individuals to express feelings directly, calmly, and honestly, and to stand up for themselves without unhealthy anxiety, while at once taking into account the personal rights of both parties. In short, the main objective of assertiveness training is to help individuals react productively to challenging interactions in their day-to-day life. It can be applied to many different social situations.

Self-confidence is an important part of assertiveness, Your rights, thoughts, emotions, requirements, and wants are just as important as everyone else’s, but not more important than anyone else’s. Assertiveness is based on stability. It requires being straightforward about your desires and needs. One of the main advantages of being assertive is that it can help you to become more self-confident, as you obtain a better understanding of who you are and the value that you offer. To be more assertive, you need to gain a good acceptance of yourself, as well as a strong belief in your basic value and your value to your organization and team.

This self-belief is the basis of self-confidence and an assertive attitude. It will help you to concede that you deserve to be treated with dignity and respect. That will give you the confidence to stick up for your rights and protect your boundaries. Assertiveness training can be an effective treatment for specific conditions, such as mental health issues like depression, social anxiety, and problems resulting from unexpressed anger.

Assertive training in CBT

Cognitive Behavior Therapy is a type of treatment that is based strongly on research findings. These approaches support people in achieving certain changes or goals.

Changes or goals might require:

  • A method of acting
  • A method of emotions
  • A method of thought process
  • A method of dealing with physical or medical problems

Assertiveness plays a major role in Cognitive behavior therapy. Basically Cognitive behavior therapy motive helps to reduce negative thoughts and turns into a positive way, also it works on our emotions, increases motivation level, manages their life values with emotional intelligence.

Cognitive behavior therapy plays an important part in improving any aspect of our lives that’s why therapist gives importance in their treatment plans. It makes therapy more effective and understandable. With all these characteristics of Cognitive behavior therapy when we add on assertiveness in our therapy that will more effective and helps to a speedy recovery to our client. Because Therapists help clients understand what assertiveness is and how to act assertively may be helpful. Unreliable or unproductive behavior and beliefs about assertiveness are discussed. Once clients recognize the importance of assertive behavior for their situation, therapists help them develop more assertive behaviors.

Written by:

Hira Saeed

Clinical Psychologist

Consult A Psychologist

Brief Cognitive Behavior Therapy for Anger Management

Brief Cognitive Behavior Therapy for Anger Management

Anger is the emotion & everyone does experience it in life. Some people can manage it with the use of different strategies & it can be out of bounds for someone. There are so many triggers in our daily life which bother us and we lose our temper. Meanwhile, a person can experience uncontrollable anger that often escalates, especially when the provocation is minor. In that situation, anger is not a normal emotion but a major problem.

It increases due to how we interpret and react to certain situations. Our interpretation and reaction to a situation can depend on lots of factors in our lives. Like:

At that point when anger affects a person’s daily life & relationship whether with family or with regard to work; it may make a person feel helpless. In these situations, a person can get help from a mental health professional to boost life in a healthy way.
According to mental health professionals, there are so many techniques that can be used to control anger. But Cognitive Behavioral Therapy (CBT) works well compared to others because CBT works on anger in all the different ways.
Anger is a mixture of what we feel and how we react. Actually feeling is the reason to generate our thoughts and our reaction is related to this thought process. It is a triangle process & that’s how our brain functions naturally. CBT works on our cognition and behaviors at the same time. Here we need to understand that anger is a normal emotion. It is a natural human feeling – it’s how you use it and express it that counts. Healthy anger is a kind of energy, motivating you to speak up, stand up for yourself or get people together to make changes for a better life.

Brief Cognitive behavioral therapy for Anger management:

Brief CBT treatment has proven to be the most highly effective anger management therapy. CBT has been studied more than other psychotherapies, and have proven to be effective for many issues. In as little as 8-12 weeks, many techniques have shown promising results. Cognitive restructuring techniques, problem-solving, relaxation training, communication skills, and combinations of these all techniques have reduced both the experience of anger and many of the associated behaviors. It is a helpful way to conceptualize how beliefs and interpretations are involved in emotional episodes. The ABC model of CBT has the core component to be used in any of anger management training.

“A” stands for activating triggers or events, “B” stands for our Beliefs, and “C” stands for Consequences or reasoning.

Basically Anger management through CBT can help you control your anger in three ways;
You can learn on the scientific basis of anger management techniques that prevent an anger episode from appearing in the first place, reduce the intensity and manage the length of your anger episodes once they occur, and help you to act positively & effectively even when you are angry, instead of shooting yourself and make a situation worse. You can learn how to change your thinking, feelings, and behaviors with Cognitive Behavioral Therapy techniques that have empirical support.

Written by:

Hira Saeed

Clinical Psychologist

Consult A Psychologist

PSYCHOLOGICAL PERSPECTIVE ON CORONA PREVENTION

PSYCHOLOGICAL PERSPECTIVE ON CORONA PREVENTION

As we all know that we are facing corona pandemic in the history of mankind, for the very first time. It is caused by a virus COVID -19. As the name implies, it was first appeared in the last month of 2019, in the city of Wuhan, China. Up till now millions of people are affected, thousand died, all around the world and the numbers are still increasing. No vaccine is invented yet, to prevent it from affecting mankind. The only factor which is considered fruitful is to adopt preventive measures against the deadly virus. Scientists around the world, and the technologically advanced countries, seem to be kneeling before this tiny virus. It cannot be seen with the naked eye. Thousands of people are being affected on a daily basis. Once it goes down in the respiratory tract through the T-Zone of the human face, it plays havoc in the respiratory system of human beings. All the small bronchioles of lungs are choked down, in a very short time, making it difficult for the affected person to breathe. Giving oxygen to the patient becomes vital. But as the number of patients is doubling, after every passing moment we are observing a marked shortage of equipment and ventilators. Every passing moment there is an increase in the death toll, which is a very frightening and alarming situation for every single person on this earth.

This pandemic not only effecting mankind physically but also playing havoc on mental health

Round the globe. People are getting anxious, nervous, fearful and obsessive regarding the dos and don’ts of the current situation. With every passing day, it is becoming the need of the hour, to take care of people’s mental wellbeing along with physical health. More and more people are contacting mental health professionals to combat fear and anxieties related to coronavirus. Now the responsibility falls on the shoulders of Psychologists and counselors to address corona related obsessions, stress, anxiety, and even depression. On the individual level and for the physical precautions we must take measures like staying home more. Gloves, sanitizers, and masks should be used, when going out becomes necessary. Gatherings must be avoided. Social distancing should be observed. Washing hands with soapy water should be done, frequently. Keeping the house and kitchen neat and tidy and preparing homemade food is the best option. If we find any signs like dry cough high and persistent fever, body aches and pain, difficulty in breathing, then we must report to the authorities.

All the above measures should be taken for physical wellbeing. Apart from these precautions, it is very necessary to keep focusing on our psychological health and mental wellbeing as well. While taking physical health into consideration, people become very obsessed and they constantly worry. Too, many worries about the pandemics make them stressed out. They continuously watch the updates on the coronavirus. Overloading of Information about the pandemic is affecting our mental health. In this regard, the proper measure becomes necessary for our mental and psychological health. The foremost strategy is to limit our exposure to corona related news. Adopting hobbies like book reading, article writing, painting, sketching can be a good stress releaser. Even talking to old friends online is helpful. In order to combat anxiety meditation, exercising regularly, mindfulness therapy and deep breathing are very beneficial for our mental health. We must keep a check on our thoughts. We must review and revise our thought patterns. Whatever and whenever a negative thought appears in our mind, we must replace it with a positive one. Like for example ‘why all this happening to me ‘can be replaced by ‘everyone around the world is suffering, it’s not just specifically me. And everything will come to normal, one day.’ In this regard journal writing is helpful. It can be done to keep a record of handwashing frequency. Like washing hands for 20 seconds is enough, rather washing for 15 minutes or more. In this way, we can help worry not to convert into a handwashing obsession. A little anxiety is necessary for the sake of prevention, but to anxiety, much can convert into a disorder. With little effort, we can keep our life in order. By adopting healthy habits, we can combat the psychological stress created by the pandemic and live a physically healthy and mentally stable life.

Written By: Bushra Askari
Psychologist & Counselor

Psychological Recommendations – In the light of COVID-19 Threat

Psychological Recommendations – In the light of COVID-19 Threat

 

  1. Isolate yourself from news about the virus. (Everything we need to know, we already know).
  2. Don’t look for additional information on the Internet, it would weaken your mental state.
  3. Avoid sending fatalistic messages. Some people don’t have the same mental strength as you (Instead of helping, you could activate pathologies such as depression).
  4. Maintain discipline in the home by washing your hands, putting up a sign or alarm for everyone in the house.
  5. Your positive mood will help protect your immune system, while negative thoughts have been shown to depress your immune system and make it weak against viruses.
  6. Most importantly, firmly believe that this will pass and that the universe is in the hands of God. He is a God of love and not of punishment.

May Allah bless you all!

Stay Home – Stay Safe
Stay Psychologically Wise
Written By:
Zooni Ashfaq
Clinical Psychologist
Islamic International University Islamabad

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