Meet the Therapist – Becky Lawyer

We are thrilled to welcome Becky Lawyer, LPCC to our team! Becky has 17 years of therapy experience primarily in college settings. We asked Becky a few questions so that our community can get to know her:

Sentier: How did you decide to become a therapist?

Becky: My earliest memory of wanting to be a therapist was during high school after taking a class in psychology. Something about the information I was learning just connected with who I was and am as a person. Since that time, I’ve had no doubts that this would be my career path.

S: Who do you love working with, and what excites you about working with your chosen populations?

B: I love working with teens and college aged clients! As a previous college counselor, I really enjoy working with these clients as they are on a path of discovery of who they are and what they truly want out of life.

S: How would you spend a free day?

B: I enjoy spending time outside and being active. So when I have a free day to myself, you will often find me hiking and sometimes geocaching on the local trails in MN and WI.

S: You’re getting takeout. What’s your meal of choice?

B: This is a hard one with so many great local restaurants to choose from! My first choice would be the roast eggplant pizza from Broders’ Cucina Italiana in Minneapolis. After that option, it would be Thai food, specifically anything with peanut sauce, from one of the great restaurants in Saint Paul!

S: What is your favorite method of self care?

B: I love doing different arts and crafts as part of my self care. As a stained glass artist, you will often find me cutting and breaking glass, or soldering glass together as part of my nightly self care.

S: What are your professional goals for the next year?

B: After leaving a long career working as a therapist in a college counseling center, one of my professional goals for the coming year is getting to know myself as a therapist in private practice. I view myself as a lifelong learner, so I will also be deepening my knowledge of trauma based therapies such as ART.

Read more about Becky here!

Becky currently has openings for individual therapy, EMDR therapy, and workshops for teens and adults. Email ellie@sentiertherapy.com to learn more.

What is play therapy?

Plus a tour of Sentier’s playroom!

Stepping into Sentier Psychotherapy’s playroom is like stepping into a treasure trove of fun. A rack of costumes sits next to a floating shelf filled with dolls which hangs across from a play kitchen set. There’s a bookshelf in the corner with a beanbag chair beside it, shelves holding baskets of legos, building blocks, and yes, a fart sound machine. There’s a tent to crawl in and a velcro dartboard. There are shelves stocked with colored pencils, paintbrushes, coloring books, and board games.

While it has some of the same elements as what you may find in a playroom at school or someone’s home, Sentier’s playroom is set up a little differently. So, what is play therapy? And what are the secrets of the playroom that make it such a fantastic space for children to safely explore their feelings?

What is Play Therapy?

Play therapy is similar to adolescent or adult therapy in that it is an opportunity to process, express, and release thoughts, feelings, or emotions. Kids, though, don’t have as extensive of a vocabulary to express themselves. In play therapy, they can express themselves in a language that they understand–through play! According to the Association for Play Therapy (APT), “play therapy builds on the natural way that children learn about themselves and their relationships in the world around them.”

Why might a child go to Play Therapy?

There are many reasons a child might try child therapy. One of the most common things that brings children to play therapy is difficulties with emotion regulation that keeps them from functioning at school or other environments. Other reasons may include trauma, transition due to divorce or uncoupling, affirmative gender exploration, sibling issues and more.

Bridgett Brye, Sentier’s child therapist, has noticed a trend in her caseload–kids who are adjusting to in-person learning. “I’ve seen a lot of issues with managing big emotions or behaviors in a classroom setting after being at home and missing out on so much of that social development time” she notes.

How does Play Therapy work? The Four Stages of Play Therapy

The first stage of play therapy is to build connection and trust with the child. At the beginning of her clients’ time in play therapy, Brye’s role is almost entirely passive. She lets them explore the playroom without any suggestions or instructions. In allowing the child to guide the play, trust is built and the client can begin to feel comfortable and safe in the space.

Once that trust is built, Bridgett moves on to the second stage, which is to assess the child’s functioning. By observing their play, Brye can begin to understand where the gaps are in a child’s functioning and pick up on themes of play that she may want to address more directly in the therapy. These themes can include power/aggression, control/safety, and family relationships/nurturance.

Once she has a better sense of what the child is needing from therapy, Brye moves on to stage three, which is the introduction of directed play in order to help the child develop coping mechanisms. In most cases she comes to sessions with unique and stimulating activities that engage the client and help them learn about what they’re feeling.

The final stage is termination. From an adult perspective, a child reaching a point where they are stable enough not to be in therapy may seem like a great thing. For the child, though, leaving a setting where they feel safe and comfortable once they start feeling generally more well might feel hurtful. Patience with a child as they transition out of services is key and “with everyone’s efforts, the end of therapy can truly be a celebration of your child’s gains and a genuinely happy and playful event” (APT).

What does Play Therapy look like?

Brye uses both directive and non-directive methods to help children feel, express, and process their emotions.

Non-directive Play Therapy

Non-directive play could look like letting the child know that they are welcome to do what they would like with their time in the playroom. If they venture to the dollhouse, Brye lets the child choose which dolls they want to play with and which doll they want to “be”. This non-directive approach helps children play out things that may have happened or be happening in their worlds. Children tend to reveal their inner turmoil through their play, and child therapists are trained to understand their play.

While she does not instruct the child to do anything, Brye may make clarifying observations about the play to give language to what the child is feeling. Brye remembers a client who was fascinated by the lava lamp and would watch it frequently. Brye verbally observed that it seemed like the client seemed relaxed. The client was pleased to have a new word to label how they were feeling and continued to use the word in different contexts throughout the session. “He knew [the lava lamp] made him feel good but he didn’t know other words that he could use to describe that,” Brye explains. “Reflecting back to them makes them feel understood and expands their emotional awareness, and playing it out helps them feel seen.”

By allowing space for the child to make their own decisions, they can create worlds that both reflect their own and help them imagine what is possible. Maybe the child’s doll family has two moms, or they can explore what feels good to them by dressing up in clothing that may not be typically associated with their sex assigned at birth. Non-directive play helps children build worlds that can clue a child therapist into their strengths, struggles, and areas of growth.

 Directive Play
A non-directive approach doesn’t work for all clients and that is when directive play is more beneficial. Directive activities are introduced by Brye to the child and they work on the activities together during session. For example, incorporating activities that are difficult for the child and working together to complete them can engage and challenge their frustration tolerance. If a child has trouble taking turns, Brye might organize the sessions into 15 minute chunks and alternate between an activity that she chooses and one that the child chooses in order to model patience. For a child who has trouble staying calm, Brye might use part of the session to introduce a method of play that requires slowing down, like building a maze with play doh and using a straw and cotton ball to guide the cotton ball through the maze. How fun, right!?

Brye takes time between sessions to come up with directive activities tailored to each individual client’s developmental level and emotional needs.

 So what’s in the playroom, and why?

“The playroom is filled with intention,” Brye emphasizes. Rather than buying toys of all kinds to stock it with, there are certain staples of child therapy playrooms and they all have specific reasons for being there.

Child Therapy playrooms include both realistic toys (dollhouse, cash register, dolls) and abstract toys (legos, fidgets, play doh). Realistic toys like dolls allow the direct expression of emotions as kids can play out scenes. Toy cars, trucks, and cash registers are also staples of a playroom as they can encourage anxious or cautious children to play “in noncommittal ways without revealing any feelings” (Landreth, 2012, p.161). Moving cars back and forth or organizing play money allow the child to play and move without any pressure to complete a task or play out a specific scenario.

While there are a variety of toys to explore, the playroom isn’t so overwhelmingly crowded that it becomes stressful for clients. A few toy cars to choose from is just as effective if not more than a whole box of them to rummage through. Children who are timid might not have the confidence to dig through a box of stuffed animals or move things around and they should feel like there are less overwhelming options for them to explore as well.

Toys that may appeal more to younger kids are placed lower on the shelves and toys that are more developmentally appropriate for older children are at their eye level. Things like puzzles don’t do as well in playrooms–when one piece goes missing, which is inevitable when it comes to puzzles, it may cause unnecessary frustration (Landreth, 2012, p.170).

One crucial characteristic of the playroom is that it looks exactly the same every time a client comes in for a session. Brye “resets” the playroom after each client, returning toys and materials to their designated spot. The resetting of the playroom provides consistency to kids in a way that they might not experience in other settings. When they enter the playroom, the dollhouses are empty and the dolls are on their shelves, the costumes are hung up, and all toys are back on the shelf. They enter the room as a blank slate that children can build onto.

Another way that a Child Therapy playroom may operate differently than other playrooms is that kiddos don’t need to clean up from their play therapy session. They can if they want to, says Brye, but “this is a different space than home or school and we don’t need to clean up or put away our feelings.”

Brye regularly sends requests for materials to Sentier’s team that may not seem like they belong at a therapy clinic but in fact are valuable tools in a playroom. “Does anyone have extra egg cartons?” for example, is a recent text message she sent our team. Egg cartons are great for ripping apart (and many other things!) and bubble wrap, which colleagues save and bring into the office, is a sensory treat for a lot of kids.

When in the playroom, kids are encouraged to be themselves rather than be careful (Landreth, 2012, p.151). The playroom is meant to feel well worn rather than sterile and new.

 Why is play therapy important?

Children play all the time, so what makes play therapy different? Children can’t begin to learn how to function unless they have trust, and a play therapist can be a stable attachment figure that helps facilitate a child’s emotional, social, and mental growth. It allows them to express themselves creatively in a way that makes sense to them. At the end of the day, it helps a child feel seen.

Play therapy may look like just playing, and sometimes it is! But in engaging with a child in their play, a therapist can help foster safety for the child to be themselves. Brye remembers a session where she and the client played hide and seek the whole time. “That is so powerful,” Brye says, “because you are constantly showing that kid that no matter what, you are always showing back up.”

What does Brye like about play therapy? “It’s amazing when you truly let the kid decide what they will do with their hour. The things they absorb in their day to day life that come out in their play and what they say and the questions they ask…it is so powerful and makes me pause,” Brye reflects. “And it’s fun!”


Blog written by Sentier Client Care Coordinator, Ellie Struewing.

What is Sober Curious All About?

Therapists love to ask clients to be open and “curious” about themselves and situations in their lives. It is convenient, then, that there’s a new buzzword in the wellness world: Sober Curious.

What is “Sober Curious”?

Being sober curious means examining one’s alcohol use in order to answer an important question: What is my relationship with alcohol? Sober curiosity is not the same as abstaining from alcohol use in other contexts – during pregnancy or for religious reasons, for example. It is also different than being in active recovery from an alcohol use disorder or addiction. Sober curious folks are eager to challenge their current use patterns and discover how their life feels when they drink less.

Reasons to be Sober Curious

Whether it’s drinking less after a wake up call following an embarrassing moment, or a month-long challenge like Dry January, or cutting back for health reasons, many people are trying drinking less alcohol on for size.

#SoberNotSomber

The reasons people try it are varied, but the result is unanimous: sober curious people seem to be enjoying life more. As Jen Gilhoi, co-founder of the Zero Proof Collective, points out with her hashtag #sobernotsomber, sober does not equal boring. Another sober curious writer backs up this point by saying that drinking less “isn’t about sacrifice – the lucidity I’m able to bring to my important moments now intensifies their brightness and hue.” Having fun without the hangover? That’s enough to pique many people’s interests. What can follow in terms of health benefits makes a lot of people stick with it.

sober not somber

Cutting Back for Health and A Clearer Mind

Alcohol is a chemical that directly affects the brain. According to the National Institute on Alcoholism and Alcohol Abuse (NIAAA), “Alcohol makes it harder for the areas controlling balance, memory, speech, and judgment.” Alcohol also makes the brain process information more slowly, and so brain fog is a major component of a hangover. Emotions can feel closer to the surface and mood swings are also common as people withdraw from alcohol. Cutting back can lead to a clearer mind and better emotional control while drinking and in the day(s) after.

Drinking alcohol is also directly linked to higher incidents of physical health risks including all types of cancer. The National Cancer Institute states that alcohol is a known carcinogen, which can lead to cancer. “Even those who have no more than one drink per day and binge drinkers (those who consume 4 or more drinks for women and 5 or more drinks for men in one sitting) have a modestly increased risk of some cancers.”

The health benefits of sober curiosity do not require being totally dry. People who even just cut back on how much they drink experience improved sleep, energy, skin clarity, and confidence.

Social Norms are Changing While Sober Bars are Popping Up

In the United States, the trend is toward drinking less in all age groups. Forty percent of legal drinkers report drinking less frequently and in lower quantities than they did a year ago. So do college students.

This may be a response to the major increase in sober options popping up. There are more non-alcoholic options available to us than ever, and the “U.S. Sales of non-alcoholic beverages rose 33.2% in the past year, with $331 million in total sales.” Locally, you may notice an increase in alcohol-free options at liquor stores and in specialty NA bottle shops like Marigold. Additionally, we are seeing non-alcoholic or sober bars popping up all over, including Sans Bar, Awake, and Sober Sally’s.

Get Curious

Ready to take a closer look at your own drinking? Great! It can help to keep a journal of your sober curious journey. Try tracking your mood, sleep, and energy levels while you change your drinking behaviors. If you’re already working with a therapist, they can help you explore how it feels to make a change. Again, this is all about exploring your relationship with alcohol and why you choose to drink – or not.

Blog written by Sentier therapist, Sarah Souder-Johnson, MEd, LPCC

My Toddler Tantrums over Everything: What to Do

Nooooo, I don’t wanna!” screams your child at 7:00 am, or in the middle of the grocery store, or while getting ready for bed.

This sort of outburst is a common situation most parents of toddlers must manage a handful of times in a day. In fact, according to Dr. Michael Potegal, Ph.D., a psychologist and associate professor at the University of Minnesota who researches tantrums, roughly 85 percent of 2- and 3-year-olds have tantrums (nytimes.com).

As toddlers develop language skills and learn to communicate their experiences to caregivers, they are also learning how sharing emotions can be a way of getting their needs met. Parents of toddlers who have frequent tantrums may at times feel like screaming from the rooftop: “Help, what do I do?; “Is this normal?”; “Do others think my child is terrible?”; “Am I doing something wrong?”.

There is hope! Paris Goodyear Brown, the creator of TraumaPlay, developed what is referred to as the SOOTHE Skill to help parents approach their child during these difficult times (Goodyear-Brown, 2021).

What is the SOOTHE Skill?

S – Soft tone of voice

Approaching your child with a soft tone of voice and a relaxed face might not be easy when they are in the midst of a temper tantrum, but staying calm and grounded will help them do the same. This allows you to “borrow” your calm body to your child. Breathe and then approach!

O – Organize the child’s experience

As a parent, it may feel like you are living in constant chaos no matter how hard you try. But helping your child organize their internal and external environments can be fun!–no promises here, of course.

Organizing could look like creating a board game for your child to visualize and help them work their way through their morning routine. It could also look like dedicating time with your child to prepare for a new experience so they can feel more organized leading into it. If your child is starting a new sport and appears unsure, have them try on their outfit and wear it around the house or look up fun videos to help explain the rules of the game.

The list of possibilities goes on and on. There is power in predicting and planning with children.

O – Offer choices

Offer choices simply means that you are helping your child feel less overwhelmed by limiting the options. Try using the statement, “You can choose to _____, or I can help you to do it,” or “You can choose to ____, or ____”. Utilize the first statement when trying to build trust with your child and the second statement when trying to encourage your child to choose their own positive outcomes.

T – Touch or togetherness

Physical contact or touch again allows you to “borrow” your regulated body to your child. Just like how adults may sometimes want a hug when they hear sad news, children may also need a comforting touch when they are dysregulated. This might look like placing your hand on your child’s back or asking if they want a hug.

Your child might also display a need for some physical space. You can still provide that sense of support by sitting near your child and letting them know you will be there when they are ready.

H – Hear what the underlying concern is

Hearing the underlying concern or anxiety means trying to look beneath the surface of the “NO!”

Is your child saying no because he is nervous for the task placed before him? Is your child unsure of how to begin? Does your child need choices? Try to understand where your child is at and name that feeling with them.

E – End and Let Go

Finally, end and let go! Once you and your child have weathered the storm, sit with your child and continue to comfort. Read a book together, listen to a soothing song. This is not the time to enforce consequences as your child is likely to become dysregulated again after feeling such intense emotions. Rather, let your child continue to return to their calm state at their own pace.

Don’t forget to breathe along the way, as parental regulation is a critical part of the SOOTHE skill.

toddler temper tantrum

What not to do during a tantrum

Engage, don’t enrage is a catchy phrase to remember in high-stress situations.

Sometimes when we are at our max capacity for dealing with our toddler’s emotions, we fall into the trap that is command and demand (Siegel & Payne Bryson, 2011). We might respond with “I said no!” and expect the child to listen. However, we have just activated our child’s “downstairs brain” which houses his strong emotions and fight or flight responses thereby causing him to experience big emotions again. Instead of a command or demand:

  • Help your child expand their emotional vocabulary by sportscasting using feeling words: “You are mad!” If your child says they are not mad, accept this boundary as they are learning about themselves.
  • Ask your child questions to figure out what made them upset.
  • Work together to brainstorm a solution that appeases you both.
  • Utilize the SOOTHE skills.

It is important to remember that your child’s brain is experiencing a time of major construction. Our “upstairs brain”, which is not fully developed until we are in our mid-20’s, is where our decision-making, empathy, and ability to control our emotions and body are housed.

Working together with your toddler during difficult times helps them develop and form their upstairs brain. Our brain is a muscle and just like any other muscle, the more we exercise or lift those dreadful weights the stronger our muscles become (Siegel & Payne Bryson, 2011).

It is worth noting that if a child is experiencing excessive tantrums  (five to ten tantrums a day that last longer than 10 minutes resulting in elevated aggression and destruction), parents should consider reaching out for professional help (nytimes.com). Seeking professional help does not mean that you have failed as a parent or admitted defeat!

The SOOTHE skills coupled with the principle engage, don’t enrage may help you as a parent feel like you are heading into a day with your child with flowers as a peace offering rather than geared up from head to toe in clunky and uncomfortable body armor. Remember that your child is learning how to feel feelings and ask for help when they have overwhelming emotions and need parental support with that process to help facilitate the development of emotion regulation and distress tolerance skills.

Did you try the SOOTHE Skill? How did it go for you?

Blog written by Sentier therapist, Bridgett Brye, MSW.

References:

  • Goodyear-Brown, P. (2021). Parents as Partners. The Guilford Press.
  • Siegel, D; Payne Bryson, T. (2011). Whole Brain Child.

How to Give a Compliment that is NOT Related to Appearance

The Problem with Appearance-Based Compliments

It is common to compliment someone’s appearance. Think of how often you are at a social gathering and hear something like, “Oooo you lost weight!”

Even if they are meant to be kind, appearance related comments can be quite harmful. You may be inadvertently complimenting a symptom of a mental health diagnosis (such as an eating disorder) or medical issue, or the impact of grief.

Research shows that people who consistently receive appearance-based compliments begin to see themselves as an object and attach their self worth to their appearance.

A person’s physical appearance is the least interesting thing about them. It is much more meaningful and personal to compliment other aspects of a person.

Examples of compliments that aren’t about appearance:

  1. You light up the room!
  2. I am proud of you for ______
  3. You are easy to talk to.
  4. I admire your ______
  5. Thanks for being there for me.
  6. You are so funny!
  7. You are talented at ______
  8. I feel like I can be myself around you!
  9. I enjoy spending time with you!
  10. You are so creative!

What are your favorite compliments (to give OR receive) that are not related to appearance?

Blog written by Sentier therapist, Andrea Schroeder, MS, LPCC

The Benefits of Using RPGs for Mental Health

What are RPGs?

Role-Playing Games (RPGs) have been around for over 50 years. In essence, they are games in which each player takes on the role of a character. The group of players then work together to tell a story with their characters. Many RPGs also include a Game Master (GM) or Dungeon Master (DM). This is a person who serves as the narrator, moves the story along, and plays all other characters including the monsters and villains. There are many different systems that have their own set of rules. One of the most recognized systems is Dungeons and Dragons.

Due to the potential for fighting and violence, RPGs can be controversial regarding their psychological effect on children. However, research has not been able to show any causal relationship between RPGs and poor mental health or delinquency. We will keep you posted as this research continues. The past decade, however, has started to produce research that shows several positive effects of playing RPGs both in and outside of therapy.

Role-Playing Games as Group Therapy

The most common way that RPGs are used therapeutically is through group therapy. Therapists who facilitate therapeutic RPG groups believe that there is an inherent opportunity in games to allow for skill building and positive social interaction. Skills that are gained can include emotional regulation, frustration tolerance, decision making, and cooperation. The therapist oftentimes takes on the role of the GM, guiding the players into situations that naturally allow them to interact socially and practice different skills.

The therapist also works to ensure safety for all players. The use of safety tools is an important part of therapeutic gaming. Common safety tools include lines, veils, and the X card. Lines are subjects that the player does not want included in the game. For example, racism is oftentimes a line that will not be a part of the game. Veils are subjects that the player doesn’t want included in detail, but can be mentioned or a part of a character’s backstory. For example, a player might not be comfortable with in depth descriptions of head injuries. This means that a character can have a head injury occur, but it will not be described in detail.

The therapist will ask each player if they have any lines or veils before the game starts, but they are free to add them throughout game play as needed. Players do not need to explain their lines and veils in front of the group, although many process these topics with their individual therapist outside of the game play setting.

Can role-playing games really help boost mental health?

The short answer is yes! Here are some of the ways in which RPGs can have a positive impact on mental health:

  • Screen time alternatives- You may have seen the acronym TTRPG. This stands for Table-Top Role Playing Games. TTRPGs allow for interactive game play that doesn’t include staring at a screen!
  • Character distance- When creating a character, people oftentimes put parts of themselves into their character. Even when this is consciously done, it can feel easier to work through these issues and characteristics when we aren’t talking about our real life situations. We can “talk about it” without directly talking about it.
  • Connecting with peers- RPGs can be fun to play with friends AND family! For people who have difficulty making friends, a therapeutic RPG group can give them a safe space to build friendships.
  • Connecting with family- RPGs can also be played as a family, allowing family members to interact in a fun space with less pressure. Many RPGs can be played online, which has been especially important during the pandemic. Online RPGs can also allow people to play with loved ones who they can’t be with in person.
  • Skill building- The skills that can be obtained through playing RPGs are endless! They can include educational skills such as practice in reading or math. They can also include skills in creativity, flexible thinking, social skills, emotional regulation, frustration tolerance, and more.

Where can I find more information?

Non-profit organizations such as The Bodhana Group and Game to Grow have put an extensive amount of time into developing therapeutic gaming techniques and collecting research that has studied the connection between RPGs and mental health. Other organizations like Geek Therapy and CASTT Gamers offer community and resources for therapists, spiritual directors, educators, and other professionals who are interested in the intentional and therapeutic use of RPGs. If you are interested, please check out these great resources!

What could you and your loved ones gain from gaming?

Find information about the Teen Gaming Groups that I facilitate in St. Paul, MN on the Sentier Therapy website.

Blog written by Sentier therapist, Mary Devorak, MS, LMFT.

Misgendering Do’s and Don’ts

Misgendering” is intentionally or unintentionally referring to a person, relating to a person, or using language to describe a person that doesn’t align with their affirmed gender. Referring to someone using their incorrect pronouns is an example of misgendering.

Folks in the LGBTQIA+ community already experience mental health issues at higher rates and not having their correct pronouns used, and by extension not having their gender identity affirmed and encouraged, can have negative impacts on their well-being that contribute to those mental health outcomes.

Even the most well-intentioned friends, family members, colleagues, (and even therapists!) can misgender someone without meaning to and that doesn’t make them a bad person. To be clear, purposefully using incorrect pronouns is highly disrespectful and an active denial of someone’s gender identity.

Oftentimes, however, misgendering is entirely unintentional and the person misgendering does in fact respect and affirm the identity of the person they have accidentally misgendered.

misgendering assumption mistakes

Assumptions about Gender

We have been conditioned to assume the existence of the gender binary and that leads us to make lightning fast assumptions about people at first glance even though someone’s gender should never be assumed.

Even if you understand the harm of that binary and actively work to unlearn it, chances are you are going to use the wrong pronouns when talking to or about someone at some point, whether it’s someone you just met, a friend who recently started using different pronouns, or even a close friend or relative whose pronouns you have known for a long time.

In case you misgender someone either directly or to other people, here are some things to keep in mind:

DO take responsibility but DON’T make it all about you.

The more dysregulation and distress that you display at having misgendered someone, the less space there is for them to feel the impact of what happened and ask for the care that they need in that moment. You may be having strong feelings about what happened such as guilt, embarrassment, or fear, but you can process those later without making them the responsibility of the person you misgendered to deal with in the moment.

DON’T make excuses.

Comments like “I just don’t understand this” or “I’m trying my best but it’s really hard to remember” are dismissive of the impact you’ve made and unhelpful for the person being misgendered to feel safe or comfortable. Resist the urge to become defensive about how you promise you are a good person even though you have just misgendered someone.

DO quickly correct and move on.

Repeatedly apologizing often leads to the person who was hurt by being misgendered to take on the role of caretaker by assuring the person who misgendered them that it’s okay. To avoid that, best reaction to misgendering is often a quick correction. That can sound as simple as “he–I mean she–went to…”

When misgendering someone while in a group or when they are not present, a quick correction is much more respectful than bringing your own feelings into the situation or trying to speak for the person who you have misgendered. If the person is present, this leaves the option for them to clarify more about their pronouns to the group or not to say anything at all depending one what they are comfortable with.

DO repair when needed but DON’T force conversation.

Depending on the situation, you may need to take a longer moment to apologize. If you sense that the person is feeling hurt and needs support, find a moment alone to validate their reaction and feelings about the situation, let them know that you care about them and their gender identity, and ask if there is anything they need or if there is anything you can do to help them feel more comfortable either in that moment or in the future.

That being said, don’t force this conversation as the person may not want to talk about it further and they don’t owe you a bigger conversation about their gender identity or pronouns.

DO be mindful of the person’s comfort level with conversation around pronouns.

Continuing to talk about and apologize for what happened, either to the person you misgendered or to the person/people you misgendered them to, may bring more attention to the situation than the person who was misgendered feels comfortable with. Be aware that someone’s pronouns may be a topic that they don’t want to be discussed openly unless they are bringing it up themselves.

DO ask people’s pronouns when you’re unsure.

You should never assume someone’s gender identity or pronouns and asking them directly when you meet them is a great way to avoid misgendering them in the future.

There may be a tendency to defer to gender-neutral pronouns (they/them) when talking to or about someone who’s pronouns you are unsure of. Sometimes this is perfectly fine and the person can correct you if needed. Other times it may cause hurt if the person does not identify with they/them pronouns.

Some folks would rather be misgendered with gender-neutral pronouns (they/them) than gendered pronouns (he/him, she/her) but others don’t appreciate others using gender neutral pronouns for them if it’s not how they identify.

Regardless of whether they don’t mind the mistake or have a strong negative reaction, the important thing is to repair if needed and listen deeply to the person when they tell you their pronouns to avoid making a mistake in the future.

In conclusion, there is no one way to respond to misgendering. Reading the situation will allow you to decide the best course of action for responding and repairing.

It is important not to let the fear of making mistakes like misgendering stop you from interacting with, working with, or engaging with people. You will probably misgender someone at some point that is okay. Your responsibility isn’t to be perfect, but to help the person feel respected, even when mistakes happen.

Respecting people’s gender identity is more than just saying their correct pronouns out loud. It’s about internalizing what they mean and taking the time to see and appreciate the person for who they are.

What gets in the way of you responding in one of the “right” ways when you misgender someone?

Blog written by Ellie Struewing, Client Care Coordinator at Sentier Psychotherapy.

My Teen Has No Friends

In life, human friendships are filled with joys and pitfalls. Most of us can probably even remember a time when we got into a fight with our friends in grade school, leaving us feeling lonely, sad, frustrated or any other mix of emotions. These emotions can become even more amplified if we are a parent watching our teen navigate the high and lows of friendship.

There are numerous factors that filter into how our teens maintain their friendships. First, our teenage years are a time for trying out different identities which means it can become normal for teens to experience a change in friend groups. It also should be noted that in the age of technology it has become easier for teens to connect more easily virtually than in person. The pandemic has unfortunately contributed to this as this was how our teens interacted with their peers for roughly one year of their schooling experience. Adjusting to being back in person has brought to light the effects of this as teens are reporting a struggle with relearning how to interact in person without having a computer in front of them as a barrier. On the same note, online groups can be a place of positive support and allow teens to establish to people who share similar interests that might not be in their everyday social circles.

Help! My teenager has no friends

While it is important to remember and respect the independence and autonomy of our teens it can be helpful to parents to have some ideas of how best to support our teens during these sometimes difficult time in our development:

  • Encourage your teen to join a club (at your local community center or through their school). This is a great and fun way for your teen to engage with peers of close age who share a similar interest. Let’s also be honest, this can be a sneaky way to get your teen out of the house!
  • Help your teen highlight their strengths! Helping your teen identify and highlight their own strengths helps them boost their confidence. Having an increase in confidence is a must, especially when our teen years are usually focused on their underlying worries and fears of what our peers might think of us.
  • Attend local events (within their interest). Have your teen create a list of a couple local events, the Events page on Facebook is a great source. Offer to help your teen coordinate transportation, if needed, and encourage your teen to reach out to a peer to attend the event with.
  • Talk with your teen and learn more about why they might be struggling with their peers. Your teen might have some underlying anxieties contributing to their external appearance of distancing themselves from their peers. Talking with your teen can help them identify cognitive distortions and highlight positive reframes when approaching a social situation.

What have you done to support your teen during times when they wanted more friendships?

Blog written by Sentier therapist, Bridgett Brye, MSW

Meet the Therapist

Mary Devorak (she/they) joined the clinical staff at Sentier in July, 2022. Mary enjoys working with adolescents and their families as well as young adults in therapy. They are also passionate about leading group therapy and finding ways to connect with clients through their love of gaming. They are also a master gamer.

Sentier: How did you decide to become a therapist?
Mary: After seeing so many of my neurodivergent family and friends have negative experiences with therapy, I decided to become a therapist who celebrates and affirms each person’s identity.

S: Who do you love working with, and what excites you about working with your chosen populations?
M: I love working with neurodivergent people and nerds! It’s so rewarding to see them open up and embrace the parts of them that make them unique.

S: How would you spend a free day?
M: I would play some kind of game – usually a video game or table top role playing game with my family and friends.

S: You’re getting takeout. What’s your meal of choice?
M: Pizza!

S: What is your favorite method of self care?
M: Playing games and spending time with my cats are my favorite methods of self care.

S: What are your professional goals for the next year?
M: I plan to finish certification in brainspotting, so that I have a body-based tool to help work through trauma. I’m also excited to get multiple therapeutic gaming groups started at Sentier.

To schedule an individual or family therapy Meet & Greet or group intake with Mary, contact our Client Care Coordinator: ellie@sentiertherapy.com


Blog written by Sentier therapist, Mary Devorak, M.S., LMFT

Are My Thoughts Facts?

Thoughts play a very powerful role in our self concept and the way we feel. Cognitive distortions – or thinking errors – can occur when the thoughts we have about ourselves, other people, or situations do not match reality. Thinking errors usually first develop out of adverse situations that feel threatening and then often stick around to become automatic thoughts. These faulty patterns of thinking easily become repetitive and can get us caught in thinking loops or ruminations.

When automatic thoughts are also negative, they cause high anxiety, low sef esteem, difficulty trusting others, trouble in relationships, and under-performance in our work. Therefore, it is important to challenge automatic negative thoughts and irrational thinking errors in order to have a healthier mentality and feel better about ourselves and various situations.

Please note: It is normal and healthy to have some negative thoughts. The goal is not to eliminate cognitive discomfort. The goal is to be fair and rational so that you can acknowledge when a situation is not ok but avoid exaggerating it in your mind or slipping into a state of aimless rumination.

Cognitive restructuring is the umbrella term for identifying and then challenging automatic negative thoughts. Here are a few strategies from Cognitive Behavioral Therapy (CBT) that may be helpful in this process.

  1. Record Your Thoughts. Automatic thoughts occur almost as reflexes and can be hard to even notice until we feel awful in our emotions and bodies. That is why it’s helpful to talk about it with another person and/or write thoughts down in order to sort through what is really going on in your mind. A thought record is a simple way to identify and then move toward challenging thinking errors.
    1. Parse through your thoughts by writing down everything you are thinking, one thought per line. (It might be a lot.)
    2. Put a star next to the thought(s) you believe are automatic negative thoughts or thinking errors.
    3. Note the date, time of day, and situation/place
    4. Note any physical sensations, emotions, and behavioral changes taking place when the thought occurs.
  2. Socratic Questioning. Once a thinking error has been identified, the distortion can be called into question.
    1. Ask yourself the following questions about the distressing thought:
      1. Do I have evidence for this thought?
      2. Do I have evidence against this thought?
      3. Would a rational person believe this thought to be true?
      4. Would I say this out loud to another person about myself?
      5. Would I say this to another person about them?
    2. Rewrite the thought..
      1. Rewrite the thought using words that are rational and evidence-based.
  3. Decatastrophizing. This one is pretty simple and especially effective for worry-based thoughts. Simply ask and answer this question: “What is the worst thing that could happen?” over and over until you get to the end of your worry. You will likely notice the fact that even the worst-case scenario is a. Unlikely, and b. Manageable, even if it is scary or uncomfortable. Then you can use step “b” from above to rewrite the thought based on rationale and evidence instead of a worst-case scenario worry.
  4. Adopt Flexible Thinking. Thinking errors occur when we adopt a rigid way of thinking. The flipside is to stretch ourselves to see things from a different – or opposite – point of view. One way to reduce anxiety is to stop looking at the thought in a black and white way and, instead, to consider the entire spectrum of options and possibilities. In order to be cognitively flexible, avoid using words like “always”, “never”, “should”, and “must” to describe yourself, situations, or people in your mind.

Sometimes, the mere awareness of a thinking error or automatic negative thought is enough to eliminate it. Other distortions are more deeply ingrained, requiring extra work. Keep at it – it’s worth the work to dig out from under thinking errors and find a more rational, truthful version of the way you talk to and think about yourself.

Simply put: Don’t trust everything you think.

Blog written by Sentier therapist, Sarah Souder Johnson, MEd, LPCC

How To Make Peace with Food

Many people struggle with their relationship with food or their body image. Right now there are endless ads about getting a “beach body” or social media influencers showing what they eat in a day, which can really make people feel terrible about themselves and think they need to change the way they look. You are enough just the way you are! A lot of people have felt pressure to diet from messages they’ve gotten from friends, family, society, and sometimes doctors. Diets are not long-lasting for weight loss and can be gateways to eating disorders. The “anti-diet,” Intuitive Eating, is actually the way to make peace with food once and for all.

make peace with food

Here is an overview of the 10 principles of Intuitive Eating:

  1. Reject the Diet MentalityDiets do not work long-term. People will inevitably gain the weight back at some point, if not end up at a heavier weight than they were prior to starting the diet. When people gain weight back, they often feel like a failure or like they do not have willpower, when in reality it has nothing to do with lack of willpower. When people diet, they end up in a state of deprivation and the body has many natural biological mechanisms to help you in this state. Your body cannot tell the difference between you choosing to restrict calories or there being an extreme scarcity of food.
  2. Honor your HungerYour body gives you signals when it is hungry. Listening to your body when it gives these signals is important. If you do not listen to them, you will become excessively hungry and could overeat. Your body gives other signals, such as telling you when you have to go to the bathroom. You wouldn’t ignore those signals, so why ignore hunger cues?
  3. Make Peace with FoodGive yourself permission to eat any foods. Having foods that are “off limits” leads to cravings and when you finally cave in to cravings you will feel out of control because your body does not know when you will be able to have this food again. If the food is always available your body does not need to binge on this food.
  4. Challenge the Food PoliceThe food police is the negative self-talk you have about foods being “good” or “bad” or even you being “good” or “bad” for what you’ve eaten or how much. All food is guilt free because food is not a moral issue! It can take practice to “talk back” to these messages, but it is possible.
  5. Discover the Satisfaction FactorEating can be an experience that brings joy if you allow it. Eating what you really want in a pleasant environment can be a truly pleasurable experience.
  6. Feel Your FullnessBe mindful while you are eating and honor when you feel full. Some people were taught they have to finish what is on their plate or they eat until they are uncomfortably full. Listen to your body.
  7. Cope with Your Emotions with KindnessSome people use food as a way to cope with emotions. This may soothe emotions in the short term, though it does not fix problems and can make people feel worse in the long run. Instead, find effective coping strategies that don’t lead to you feeling worse.
  8. Respect Your BodyThere is body diversity in the world. Some people live in bigger bodies and some people live in smaller bodies. No matter your body size, your body deserves respect. You don’t necessarily have to love your body to respect it.
  9. Movement-Feel the DifferenceLots of people exercise for the purpose of losing weight but this creates a negative association with exercise when your body is not changing in the ways you want. Instead, change your mindset about movement. Focus on how it decreases stress, helps you feel more energized, builds strength, etc. When movement is no longer tied to losing weight, it is more fun and enjoyable.
  10. Honor Your Health with Gentle NutritionMake food choices that make your body feel good. You do not have to follow rigid food rules in order to be healthy. One meal or snack will not make or break you.This has just been a quick overview of intuitive eating. If you would like to learn more about it, I recommend the following books:

    Intuitive Eating: A Revolutionary Anti-Diet Approach, 4th ed.

    The Intuitive Eating Workbook for Teens: A Non-Diet, Body Positive Approach to Building a Healthy Relationship with Food

    If you need support around your relationship with food or body image, make an appointment with a therapist who is knowledgeable about eating disorders and intuitive eating.

Blog written by Sentier Psychotherapy Therapist, Andrea Schroeder, MS, LPCC.

What is a Zine?

Every time someone asks me this question, I find myself tripping over my words to try and arrange a coherent answer.

While there is no singular definition of a zine,  I like to think of zines as small book-like or magazine-like containers for expression of all kinds. Terms like DIY, self-published, non-commercial, easily reproduced, small batch, and hyper-local are often descriptors of a zine and many zines are hand folded or bound. 

Zines can be made in large batches or be one of a kind. Some are sold and others are handed out for free or traded. Some zines are submission-based and others are made by one person. Zines can include writing, photographs, artwork, poetry, collage, and more. 

Zines are an outlet for self expression and artistic passion as well as a form of insider communication and a way to critique capitalistic and elitist systems within the hierarchical world of mainstream media. Their DIY nature makes zines a relatively accessible form of artistic and personal expression–all it takes to create one is a single piece of paper and a pen or pencil. Add a photocopier and that zine can reach the hands of many many people, all without relying on formal publishing networks. 

As The Bindery puts it, zines are “a glorious mash-up of art, letters, story and emotion; just like the brains, hands and hearts of those who produce them.”

Still confused? Me too!

Maybe parsing apart a definition of a zine is a fool’s errand, but historical context helps crystalize  the timeless power of zines.

how to make a zine

A brief history zines in the United States:

 

  • The term “zine” was first utilized in the 1930s and 40s by fans of science fiction writing. These superfans created “fan magazines” to connect with other fans and share their writing, analyses, and artwork. The term “fan magazine” was shortened to “fanzine” and then again to “zine.” 
  • Zine culture grew significantly alongside the DIY punk music scene of the 1970s and 80s.  Zines were often cheaply distributed or traded and they traveled with touring bands all across the country. DIY punk culture was highly informed and motivated by a pushback against mainstream corporate elitism and zines from this era included writings and art that echoed that anger towards capitalism, sexism, racism, and more. Punk zines “represented the aesthetic and ideals of an entire subculture, a condensed version of this cultural revolt against authoritarianism.”
  • Just as with any other movement, the punk movement is not without flaws and has been critiqued for its overwhelmingly white middle class representation. Pushback against that emerged in the form of subcultures within the movement that aimed to elevate the experiences of marginalized groups within the punk scene, and one of the ways that those movements grew was through the distribution of zines. For example, Queercore was a subculture that critiqued homophobia in the punk spaces as well as more widely in cultural and movement spaces. Queercore zines were one of the main forms used to spread the ideas and beliefs of the movement. riot grrrl brought attention to the overwhelming dominance of white male influence in punk spaces. riot grrrl zines spread feminist ideologies and shared artists, musicians, and fans’ personal experiences of sexism in the music industry. Both of these movements used zines to encourage discussion and share experiences about topics that would be considered taboo or risque in other publishing contexts. 
  • A more recent theme in contemporary zine making is prisoners rights. In these zines, compilations of political essays, works by scholars and activists, and writings by people who are incarcerated critique the prison industrial complex and make accessible theories and writings of prison abolition and broader radical social change that are often gatekept within the academic world.

what is a zine examples

Zines are for everyone. 

There is no way to make one, and there is no right or wrong thing to make one about. They can be hyperpersonal or broadly relatable. They can fit in the palm of your hand or take up an entire table. They can fold like a book or unravel like an accordion. 

Making zines can be an act of resistance and an act of love. They can also be a slow Saturday morning activity with a few friends or a Tuesday night alone with some music or a T.V show. Zines can be created in order to spread far and wide, or shared with one or two people, or with nobody at all.

For me, zines are a way to release something that I am holding–not necessarily release it forever, and not necessarily in a way that fixes or solves something. They are a way to take something in my heart or head and hold it in my hands. 

They can help me unravel grief, and visualize love, and arrange something when so much of the world around me is out of my control. They can also be about absolutely nothing. When I sit down to create a zine, they include not only the pages that I end up with, but all of the emotions and interactions that went into creating it, which is why I particularly love creating in community with others. 

Sometimes they take weeks and months to write and arrange, but more often, the one-page zines that I create emerge from just one sitting and a burst of silly creative energy. Zines don’t have to be sold or distributed, and most of mine end up somewhere on my desk.

You don’t need to consider yourself an artist or a writer to make a zine. All you need is to sit down and do it. 

So, how can you start your zine collection?

  • Zinefests are gatherings of zinesters (zine-makers) and artists and a beautiful space to sell and collect zines as well as meet other artists and zine-lovers. (Check out the Twin Cities Zine fest!) 
  • Zines are also often found in independent and radical bookstores like Boneshaker and Moon Palace which are both located in Minneapolis. 
  • There are also extensive online archives of zines. 
  • Zine Workshops at Sentier Psychotherapy

Want to try it yourself?

Like zines themselves, the zine shops that I facilitate at Sentier Psychotherapy are also for anyone and everyone. For those that are new to zine-making, there will be a demonstration of one of the simplest and most popular zine making techniques, one that uses one sheet of paper with four folds and one cut–that’s it!

Each workshop has a theme but these are loose and all participants are welcome to create whatever they feel. Sentier will provide all of the supplies–books, magazines, paper, glue,  etc.– so that participants can collage mini-zines. 

Come ready to write, collage, and create in community about whatever is calling to you and see what emerges. To read more about the upcoming workshops, visit Sentier’s website. If you have questions or would like to register, please email ellie@sentiertherapy.com

The cost of the workshop, including all materials, is $25 with sliding scale fees available. Sentier Psychotherapy is located in St. Paul and the room where workshops are held is located up one flight of steps. 

Please note that these workshops are artist led and not therapy groups. 

Go to eleanorstruewing.com to see more of Ellie’s artwork, including their zines. 

 

My Teen is Depressed

Since the onset of the pandemic, mental health concerns, including depression have risen globally. It makes sense that this is the case. Events that people look forward to have been canceled, people are isolated, and there is uncertainty about when the pandemic will end, creating a perfect storm for depression to manifest. Not to mention depressive symptoms that existed before the pandemic.

If your teen is depressed, that is completely understandable.

talking to your teen about depression

What can you do as a parent?

It is really important that you find a way to be a support person for your teen. You can show them by saying validating statements. Validating statements acknowledge that someone else’s feelings make sense. Some examples include:

  • “I can tell that this is a really hard time for you.”
  • “You are not alone.”
  • “I’m sorry it is so difficult right now.”
  • “I understand you are feeling depressed.”

Validating statements help teens (adults and children too) feel seen, heard, understood and they strengthen relationships.

Here are some examples of invalidating statements (these are the types of statements to avoid):

  • “Why are you depressed, you have such a good life, you have no reason to feel that way.”
  • “I had it way worse when I was a kid.”
  • “Just be happy.”
  • “You are just being dramatic.”

A lot of times people are inadvertently invalidating. Some invalidating statements are really well-meaning. For example, telling someone to focus on the positive may genuinely be trying to help someone feel better. However, it could also convey that they SHOULDN’T feel the way that they do. We want to be compassionate and let teens know that how they are feeling is okay.

You can let your teen know that they can always come to talk to you about feeling depressed/sad/down. It is okay if your teen declines this. Pressing your teen to talk when they do not want to will not build trust or strengthen the relationship. Your teen will likely open up more over time as they see that you are a safe, trustworthy, validating person to go to.

Sometimes with depression, people have suicidal thoughts. This of course is very scary as a parent. If you have concerns for your teen’s safety, you can call a teen crisis line at 310-855-4673 or bring them directly to the emergency room.

At Sentier, we have multiple therapists who specialize in working with teens. If you think your teen needs additional support, please reach out today!

Blog written by Sentier therapist, Andrea Schroeder.

My Teen Won’t Go to School – Part One

You wake up on a cold, Monday morning to the annoying sound of your alarm and struggle to drag yourself from your bed. The temptation to resist is strong but you finally get out of bed to start your day and deal with the next battle… making sure your teen is up and ready for school. You walk into your teen’s room and are immediately greeted with a groan of disgust. After numerous attempts and even the potential yelling match, you admit defeat and walk away. You are left with a mix of emotions and think to yourself yet again, why won’t my teen just go to school?

teenager school attendance

what do you do when your teenager starts missing school?

School refusal isn’t a new problem, but has noticeably become a bigger issue due to the pandemic. Refusal rates are estimated to be 15% to 20% higher than previous pre pandemic rates of 1 to 5% of students. The pandemic has created a rollercoaster of ups and downs in schools. One week students are in-person and the next they are back to sitting in front of a computer and talking to their friends through a screen. Peer relationships are important in helping teens develop their social skills, problem solving skills and discovering their sense of self. Being distanced from their friends can cause your teen to feel lonely and isolated.

However, school refusal cannot just be credited to the pandemic. On a daily basis teens are learning to manage and navigate school workloads, extracurricular activities, and peer relationships. Dealing with this can feel immensely unbearable to teens as their problem solving skills have not fully developed.

Some other factors that lead to school refusal or absenteeism include: anxiety, friendships or bullying, family struggles and difficulties with classroom learning.

student school attendance

How can you help your teen?

  • Talk with your teen: Express interest and empathy in the struggles they are experiencing. Ask them if there is anything you can do at home to help with these feelings. Let your teen know they are heard! (Remember, some issues might seem small but can feel overwhelming large to your teen)
  • Connect with their teacher: Reach out to their teacher and see if there is a way to get your teen some help with managing their struggles in the classroom. (You can even include your teen in this conversation so they can feel like they have a voice. Teachers spend a significant amount of time with your kid and might have insights into their classroom struggles that you don’t.
  • Limit electronics: Removing video games, cell phones or other electronics can let your teens know it isn’t a fun, free day off. Holding firm limits during regular school hours takes away the temptation for them to stay home curled up in their bed scrolling through social media or trying to pass the next level in their video game. Electronics might only be adding to your teen’s stress, especially if bullying is happening.
  • Brainstorm fun mid week activities: Schedule fun activities to help keep your teen feeling connected with others and give them something to look forward to. Get creative and keep it simple. Have your teen pick a place to eat/order take out, plan a movie or game night, etc.

What tip will you try to help make that school struggle a little bit easier?

Blog written by Sentier therapist Bridgett Brye, MSW, LGSW

What your Sentier therapist does behind the scenes

teen counseling saint paul

Sentier Therapy at work and play

You park the car, enter the building, and open the door to the waiting room, where you are met with the calming whir of white noise machines.

Maybe you browse through a National Geographic or scroll through Instagram while you wait for your therapist, or maybe you make a cup of coffee or hot chocolate to sip on during your session.

Eventually, you walk into your therapist’s office and sink into the comfy chair of your choice.

Or, alternatively, you open your laptop, click the Doxy link, and wait for the ding that means your therapist is ready to begin.

What you may not realize once you leave the building or close the laptop is just how much your therapist is doing outside of your sessions. Here are just a few things that are part of your Sentier therapist’s job that you may not know about:

  • Therapists complete a case note for each and every therapy session they do in order to monitor their clients’ progress and keep track of what is covered in sessions. If you’ve noticed your therapist writing or typing during a session, they were probably adding to the session’s case note. These aren’t extensive reports but rather a quick summary of what happened during the session. What was discussed and what topics did the client bring up? What was the client’s mood and demeanor? What changes occurred between this session and the last? What sorts of activities or exercises were done during the session? Was any homework or practice assigned for next time?
  • Every day, each of the therapists at Sentier updates a massive spreadsheet with 18 tabs outlining everything from therapist availability for new clients to new client inquiries to important dates for the team to remember. Each time someone inquires about therapy at Sentier, it is carefully logged in this spreadsheet. The date and times of Sentier’s groups are outlined months in advance. The list goes on and on! This spreadsheet is a puzzle that keeps the clinic running smoothly and therapists maintaining each piece of it is crucial to the success of the clinic.
  • Sentier is an out-of-network clinic which means that therapists submit claims for some clients sessions to insurance providers. By doing this step for our clients, we are trying to make it easier for folks to get reimbursed if possible. Submitting to insurance also means that therapists work with clients to troubleshoot with insurance companies if issues with claims or reimbursement arise.
  • Therapists also monitor their sliding scale availability. By logging what sliding scale fees they have offered to clients, they are able to keep track of what they can offer to future individual and group clients.
  • Your therapist also updates their waiting list, reaching out to people when availability opens up and communicating frequently with clients about scheduling. Therapy is in high demand, and keeping these waiting lists organized and updated is an important part of your therapist’s job.
  • Sarah trains the team on HIPAA (Health Insurance Portability and Accountability Act) guidelines that keep your private health information safe.
  • Andrea is the resident expert on Sentier’s Electronic Health Record (EHR). She fields your therapist’s questions about the software and updates a manual that therapists often refer to when they need help.
  • Once a month, Sentier therapists gather in the Group Room of our office. We each do a brief check in, updating the team on both our personal and professional lives, and each share something we are grateful for, all while munching on breakfast provided by a rotating member of the team. These gratitudes are recorded in a journal so that your therapist can look back on them whenever they want. The team goes over big and small changes that may have come up in the past month, perhaps about our EHR or how our COVID policies continue to evolve. Therapists bring questions to the team about their approaches to client care and receive feedback and advice on how to proceed.

A few other things you might not know about what goes on at Sentier when you’re not in session:

  • Megan can tell who is coming to hang out in her office before they arrive based on their footsteps and her door is always open for a chat or a question.
  • Mailboxes fill with paperwork, and then are emptied, and then fill again, and sometimes chocolate or other treats appear in them from the Sunshine Committee. The Sunshine Committee is in charge of birthday gifts, handwritten messages of support and encouragement for therapists, and other random offerings that make our team a family.
  • Ashley provides the team with an endless supply of fidgets and help with the printer when it inevitably decides to stop working.
  • The thermostat is adjusted often, as half the therapists are always shivering and the other half are too warm.
  • Andrea keeps the kitchen stocked with sweet snacks.
  • Your therapists ponder the temperature of the lighting in the waiting rooms—too bright? Too warm?—and discuss how the furniture is arranged.
  • Jenga, Sentier’s therapy dog, plops down at your therapist’s feet between sessions and looks expectantly at them for pets, love, and apple cores, his tail eternally wagging.

These little things make all of the difference in the way daily life is shaped here at Sentier.

At Sentier, we’re lucky. Having such a small group of therapists allows the team to get to know each other and develop a flow so that we can all help one another be successful.

These personal moments that your therapists share help them maintain the momentum to get all of the other things done. It is a privilege to work with our clients and with one another, and we help each other out so that we can better help you.

Blog written by Client Care Coordinator, Ellie Struewing.

DBT Therapy – What Is It? (Part 2)

See our first blog about DBT: “DBT Therapy: What is it?” to learn about types of concerns that DBT can help relieve. 

So, what else is there to know about DBT?

DBT has four modules: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. 

DBT Mindfulness

Mindfulness skills teach people how to live in the present moment. Wouldn’t it be so great to spend time with friends and fully enjoy that time together, rather than thinking about all the chores you have to do once you get home? You may be thinking, “What if doing chores is awful? I don’t want to do that!” Even when your present moment is unpleasant, it is beneficial to be present in it because if you are aware of what is going on, you are better able to decide how to proceed.

DBT Distress Tolerance

Distress tolerance skills help you avoid acting on impulses. A lot of times, impulses that people have might feel good in the short term, but end up having negative consequences in the long term. These can include drug or alcohol use, self harm, and disordered eating. Distress tolerance skills help you find effective ways to manage negative emotions in the moment  in a way that doesn’t leave you feeling worse later. 

DBT Emotion Regulation

Emotion regulation skills help individuals have more control over their emotions. This module includes tips for improving your emotions in the short term by doing activities you enjoy, but it also helps you have more stable moods over time by helping you examine your sleeping habits, eating habits, and other factors. 

DBT Interpersonal Effectiveness

The Interpersonal Effectiveness module includes skills for everything relationships. People often struggle with assertiveness skills and communicating effectively (especially in the Midwest). Have you ever avoided a hard conversation? Do you find yourself saying yes to favor after favor when you really don’t have the capacity to take something else on? Or do you struggle with getting your own needs met because you are too afraid to ask for what you need? Skills in this module help you ask for what you want and need in such a way that makes the other person more likely to say yes and without getting defensive as well as respect your “no”. With these skills, you can ask for something and say no to something all while maintaining your relationships and your own self respect. Sounds pretty good, right?

Why DBT Is Useful

As you can see, DBT skills can be useful for just about anybody! At Sentier, we offer a Teen DBT Skills Group and a Young Adult DBT Skills group. Each of these groups is 10 weeks long and teaches some of the skills from each of the modules. I like to say we go through the “Greatest Hits” of the skills. New groups are offered quarterly. 

What module sounds most helpful to you?

 

SPACE Treatment: How Parents Can Support Your Child or Teen with Anxiety

You cut your evening short because your child won’t fall asleep without you in bed with them.

You order for your adolescent at a restaurant when they turn away from the server.

You tie your child’s shoes every morning because they claim they “can’t do it right.”

You often cancel plans to attend events as a family because your teen feels uncomfortable in new places.

Do any of those sound familiar to you? If so, you may be stuck in unhealthy patterns due to child or adolescent anxiety and parental accommodation.

It is common for parents and caregivers who are stuck in these patterns to feel overwhelmed with what may appear to be child misbehavior. The truth is, no one is to blame and everyone is responsible for making changes to get unstuck and move forward in healthier ways. A therapeutic intervention used for getting unstuck is called SPACE: Supportive Parenting for Anxious Childhood Emotions. SPACE treatment may be helpful to your family if you find yourself changing plans or noticing that your child’s anxiety interferes with day to day functioning.

From www.spacetreatment.net:

SPACE is a parent-based program for children and adolescents with anxiety, OCD, and related disorders.” It is also appropriate for concerns such as separation anxiety, social anxiety, fears and phobias, and selective mutism. SPACE Treatment is unique in that, although the interventions are intended to treat the child’s anxiety, the adults are the ones attending therapy sessions, gaining new tools, and making strategic changes to their own behaviors.

When parents accommodate anxiety to help their child (or themselves) feel better in the moment, it actually upholds the symptoms and increases anxiety over time. SPACE is a collaborative process between the therapist and caregiver with the basic recipe of learning: 1. To respond more supportively to your anxious child, and 2. To reduce the accommodations you have been making for the child’s symptoms. Caregivers who participate in the SPACE treatment protocol report increased family satisfaction, decreased anxiety in the household, and increased confidence in both child and parent.

For more information about the SPACE treatment protocol, check out this video:

At Sentier, Sarah Souder Johnson is available to deliver SPACE to families who are eager to reduce the systemic effects of anxiety in their household.

What Does Grief Look Like?

The Parts of Grief We Do Not Expect and Do Not Talk About

I am a Covid Widow. I lost my partner of nineteen years at the very beginning of the pandemic before we knew what Covid was, and before it was being diagnosed. We do not have an official diagnosis of Covid as the cause of death for my partner, however, all of the signs and symptoms and her cause of death point to Covid as the cause.

Since losing my late wife, I have become a non-consensual expert on Grief. Not only do I sit in and process my own grief, but I now have a collection of widow friends (we call ourselves “the weeping”) that I have formed a deep and intimate relationship with over these past eighteen months. Having a community of people who know what it is like to be a griever is a game-changer in being able to sit with and process grief. My weeping and baking bread are probably the two things that have made it possible to continue to exist in space with folks.

This blog isn’t necessarily about me and my experience with grief and it’s not about all of the usual mainstream conversations around grief, either. This blog is about the unspoken pieces of grief and the things that crept up or surprised us Weeping Widows while going through our Journeys.

grief is normal

First off…

Grief is not a horizontal line, and it’s not even a circle. Grief is like an ocean. Some days you have giant capsize your boat waves, and sometimes you just have little laps on the shore.

Grief has a starting point but never an end point. I think this is one of the hardest things to learn when going through the process. So many folks ask me when grief will end. I am the forever optimist and I want to say that it will end soon or someday, but the realist in me (and the griever) has to say unfortunately, never. Grief stays with you. At first it’s really intense and ever-present. As it continues to flow through you (and as you continue to process along your journey) it evolves. It still can be intense and ever-present, but hopefully those days get further apart and don’t linger as long as they did in the beginning.

Grieving is unpredictable and pops up in strange ways during the most inconvenient times. It can be a song or a smell, a bird or a flower, or something you didn’t know was going to bring on strong feelings. When talking with my widow friends, we all agree that those “surprise griefs” are the worst. Surprise griefs are the moments that show up when you least expect them; you have no idea where they came from. These are moments in grief that you can’t prepare for.

I asked my widow friends what were the things that surprised them the most after they lost their person, and here are their responses:

The build-up is always worse than the day…

The buildups to the big anniversary milestones (birthdays, hospitalizations, etc.) are hard and painful. We spend so much time and brainpower thinking about all the things that are, were, or what could be. We are also just anxious about how it’s going to be on the actual day. I have had 18 months worth of anniversaries and this statement is always true: The build-up has always been worse than the actual day. When the day comes, it might be sad, but it is never as tragically sad as we prepared for.

Those who you thought would stick around don’t, and those you didn’t think would stick around, will.

Is very interesting to see who stays after a significant loss. Everyone shows up obviously for the first two weeks to a month after the death, and then the world tapers off and gets back doing their thing. At this point, we as grievers are left feeling very lonely. Many of the people that I thought would hang around and be supportive did not support me, and I was constantly surprised by who was able to lean in and stay present even after that first month.

Grief math or “Widow Math” as I call it.

This is the subconscious need to countdown until the next significant event. How many days until the next anniversary? how many days has it been since the first anniversary? how many days until I’m older than they were ever going to be again? That constant counting of time is our brains trying to keep us connected to the human we lost, and also breaking down forever into measurable moments. It is not an anxiety easing process or technique. In fact, grief math is incredibly difficult and intrusive for most folx.

It’s really hard to be around people who don’t also experience grief.

This one surprised me. I am a people person and I love to be with people. I now find it hard to be around people who don’t know what it’s like to experience grief on a cellular level the way I have. I’ve asked a lot of widows about this, and this is something that they feel as well. It is a common theme. We tend to lean into each other and into our network because it’s a lot easier to be around people who get it than it is to explain it.
You see grief and death everywhere.

Until becoming a widow, I never realized every show has a character who deals with some sort of significant loss. Many shows have widowers or widdudes as we call them in the Widow’s Club. You can’t help but see those characters differently after joining the Widow Club/Grief Club. Or maybe you didn’t even notice that character at first, and then that’s all you can see.

The body remembers before your brain will.

There is something to be said about the body keeping score. We hold trauma in our bodies, and our body then reacts in somatic ways. My body told me an anniversary was coming up before the calendar did. It was shocking to make the connection between the physical pain and the proximity of the anniversary. Grief does not just hurt emotionally, it hurts physically, as well.

minnesota counseling can help

What is the takeaway from all of this?

If you are a griever:

Find a community. Find people who know what it’s like to experience what you have experienced. A community will give you common language, and most importantly connection. Grief is such an isolating experience that creates such big internal and external spaces of loneliness. Most people need to have people around them in order to get through, and out to the other side of those dark spaces. Remember that you’re not alone. There are so many of us out there. Just come find us.

If you’re not a griever:

Don’t forget about your friends who have lost humans. Be patient with them, as they may not be the same person they were before the loss. Allow people to grow into their new selves as they work on figuring out who they are becoming after their loss.

Don’t take silence personally. If your grieving friend withdraws, it is not about you. It is most likely because they needed to go inward and do some work.

Be there for them when they return with open arms, and not with judgment. Remember, they are different now.

Trust your grieving friend when they share things with you about their experiences. If you don’t understand why they are doing a certain thing or you don’t agree with the choices they are making, ask them about it. They may be doing things a certain way because they have to protect themselves or because they may be dealing with other people’s grief. They have to be a certain way in the world right now in order to keep themselves safe.

Do your best not to put your own grief onto the person who is grieving. If your friend loses a parent or a partner, going to your friend and talking about how sad you are and leaning into them to help you process your feelings of grief and loss may be incredibly overwhelming to that individual. If you’re able to take your feelings and process them with somebody else who is not as close to the loss, that is going to be more beneficial to your grieving friend. Grievers do not have the emotional space to hold grief for other grievers the way that other grievers need. This is not Universal for everybody but in general it’s very hard for those who are in it to be there for others.

One important thing to remember is that we will all be Grievers one day.

Unfortunately, death and loss are inevitable and every person will experience some sort of significant loss. As a culture (in North America), we are generally not great about talking about death. Death is scary, so it is avoided. But it is a thing that happens. The more we can all remember that we will all be grievers one day, the easier it will be for us to lean into that experience and to feel what we need to feel and process what we need to process.

You cannot bypass grief, you cannot avoid the loss, and grief can never be outrun. The only thing you can do is go through, feel it, process it, and even eventually embrace it. It is not scary, it is just beautifully sad.

What has helped you in your grief?

Blog written by Sentier therapist, Ashley Groshek, LMFT

How to Nurture your Teenager

How to Nurture your Teenager During Conflict

My Teenager Hates Me – Part 2

Being a parent is challenging. One day you have a beautiful baby who is the center of your universe, and then your baby grows into a teenager who you might not recognize. You may be asking yourself, “where did this argumentative young person come from?” Many parents of teens come into our office feeling hopeless. Parents are unsure if they did something wrong, and feel that they can’t understand their teen.

Well, good news! Teenagers are designed to oppose their parents. Adolescence is all about teenagers finding their identity (separating from their parents) which leads them to challenge the main source of authority, their parents.

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Teenage years are filled with extreme highs and lows. This highly emotionally charged period of life is coupled by developmental changes and growth, surging hormones, and societal pressures. Teens are trying to navigate the waters of their new body, new feelings and emotions they have on things they thought they once understood.

Five things a parent can do to help their teen through this time:

  • GUIDANCE
    All teens need guidance. Their inability to consider consequences and fully engage in future thinking, means they need their parents to do that for them. Part of a parent’s job is to keep their teen safe from harm and guide them to become the best person they can be. To be clear, we are not recommending that you helicopter. Ask your teen questions, let them make mistakes, talk with them a lot (note: do not lecture them) and you are on your way to properly guiding them!
  • PERSPECTIVE
    Keep perspective. This too shall pass. The attitude your teen is presenting (and their need to challenge you) will subside. Don’t let these battles become wars, find ways to keep perspective on the situation, and soon their emotions will fade. Find out what is important to your teen and learn how to negotiate so you can support them in the independence but also keep them safe. Get external support if you need it.
  • VALIDATE
    Validate your teenager’s emotions and let them know that you hear them and care about how they feel. Most teens don’t like to hear you say that you “get it,” so drop that if it is an irritation to your teen. Although these emotions may not make sense to you, there is merit to your teen’s feelings and validating the feelings allows the teenager to feel that you care for them.
  • LOVE
    This goes without saying, but love your teen unconditionally. Although they may scream, “I hate you!” and respond with one or two-word responses, know in your heart that they need you and love you too. Sometimes expressing this is difficult (if your teen is really argumentative) but try to get past your hurt and continue to communicate your love to them. Again, get external support if you need it.
  • CALM
    Your teen needs you to be the adult. If your teen is irrational and yells, things will only get worse if you start to act the same way. Be aware of how you respond, how your physical posture (non-verbals) comes across, and what the tone of your voice communicates. If you feel that you are unable to stay calm, state that you will continue this conversation later and walk away until you are able to manage your emotions properly. If this dynamic is not pretty and tends to not resolve itself well with you and your teen, either your and/or your teen might need help with emotion regulation skills.

Good luck, parents! Let us know how things go!

This blog was written by Rachel Samuelson and Megan Sigmon-Olsen, M.S.W., LICSW

How to Sleep Better

Help me Sleep!

How well do you sleep?  If you are like most teens and college students, then probably not too well. Most people between the ages of 14 and 24 have demanding school, work, and activity schedules that favor the Night Owl lifestyle with hopes of “catching up” on the weekends. Additionally, the biological clock naturally shifts forward in adolescence, which means that adolescents experience a surge in energy in the evening while rising in the morning is more difficult. As many as 75% of college students report difficulty falling asleep, excessive sleepiness during the day, or sleep disturbances. Many of these students report that emotional and academic stress worsen their sleep problems, which can in turn increase the stress, which then leads to more sleepless nights. If this sounds familiar to you, there are ways to reduce your stress by improving your sleep.

Healthy Sleep Habits
If you have difficulty getting enough sleep or feeling rested, try some of these tips to develop healthy sleep habits:

  • Develop a bedtime routine and use this routine consistently. Following the same ritual before bed and having a consistent bed time (including weekends) can create and improve the consistency of your sleep patterns.
  • Make room in your schedule for 7-9 hours of sleep. This is the average amount of sleep an adolescent/college student needs, which is often far less than the schedule allows.
  • This is where naps come in! Naps late in the day are not very helpful, but a 30-minute nap before mid-afternoon can do wonders.
  • Only use your bed for sleep and the activities that promote sleepy time, such as reading and journaling on paper. If you avoid watching tv, doing homework, or playing on your phone in your bed, you train your brain to know that bed = winding down.
  • Exercise for 30 minutes per day on most days. Not only does exercise help you sleep more soundly, but it will also keep you more alert throughout the day.
  • If you lay in bed for 20 minutes trying to fall asleep, just go ahead and get out of bed. Sometimes the anxiety over not being able to fall asleep complicates the problem and makes it even more difficult. Get out of bed and do something mundane like fold laundry or clean your room before trying the routine again.
  • We recommend this chart as a way to track your patterns and get a baseline on your current sleep habits.A young woman is sleeping in a bed with a cat next to her

When to See a Doctor
If the tips listed above don’t do the trick or if you experience any of the following symptoms, schedule an appointment with your family doctor or with a sleep specialist:

  • You gasp, choke, or stop breathing during sleep. If you have a bed partner or roommate, ask that person if they have observed any of these behaviors in you while you sleep.
  • You fall asleep at inappropriate times, such as while eating, talking, or walking.
  • You feel excessively sleepy during the day and the tips above don’t seem to help.

Need a Laugh?
Hear comedian Mike Burbiglia’s recounting of his own experience with sleep disorders. But remember that even though his stories are amusing, sleep disorders can be extremely serious and should definitely be checked out by a doctor.

How Sleep Savvy are You?
Test your knowledge about sleep by reading the National Sleep Foundation list of common myths.

Blog written by Sarah Souder Johnson, MEd, LPCC