Category: Educational


Many people don’t seek the help they need when they’re struggling with depression, anxiety, trouble controlling their anger or going through a rough patch in life and need to talk to someone with a different perspective. And mostly people don’t seek help because they don’t want to seem “crazy”. The kind they show in movies of people hearing voices and seeing things.

The truth is that there are different treatment levels when it comes to mental health. Each level falls into two bigger levels; outpatient and inpatient. Outpatient is when you go to the therapy during the day, then go home. Inpatient means they have to stay in the treatment center for however long is recommended.

After a full evaluation, a licensed professional will recommend the level that would be best beneficial. Someone could start at a lower level and if symptoms don’t improve or get worse, they may need a higher level. Someone could  start at a higher level, and as symptoms improve, they’ll go to a lower level. And sometimes symptoms are so severe, that a person could be forced into a higher level.  Here are the different treatment levels in mental health from lowest to highest. The higher the level, the more severe the symptoms are.

Outpatient Care

Community Based Programs

These are usually free or very low cost support groups such as Grief groups and National Alliance on Mental Illness (NAMI) groups. It offers support and strategies for a successful recovery.

Routine Outpatient Care (ROC)

  • Individual, Family, or Couples Counseling, once a week, 45-60 minute sessions.
  • Medication Management through a Psychiatrist or Nurse Practitioner.
  • Group Therapy once a week, once a month, or a few times a month.

Intensive Outpatient Program (IOP)

  • May include group, individual, and family therapy, more than 45-60 minute sessions.
  • Consists of frequent visits (usually 3-5 days per week) and an average of 3-4 hours of treatment per week for a set period of time (often 4-6 weeks, depending on the program)
  • ƒ Many programs are structured so individuals may work and continue with normal daily routines .

Partial Hospitalization (Partial Program)

  • Consists of frequent visits (usually 3-5 days per week) and an average of 3-4 hours of treatment daily for a set period of time (often 4-6 weeks, depending on the program) ƒ
  • Clients are referred to a partial program when symptoms are not improving or getting worse. The goal is to prevent the client from going into inpatient hospitalization. Or when a client is discharged from inpatient hospitalization, they may be referred to a “step down” partial program.
  • Many programs are structured so individuals may work and continue with normal daily routines ƒsince you attend this program during the day, then go home.

Inpatient Care

Inpatient Acute Care

  • This is where a person stays in the hospital because they need 24-hour care and daily doctor visits to stabilize psychiatric issues.
  • ƒ Recommended for people who aren’t able to care for themselves, or may be a risk to the safety and well-being of themselves or others. Such as someone who is having active suicidal thoughts or attempted suicide.
  • The stay can last for a few days until the person is stabilized.
  • People will attend group therapy and have meetings with a team of professionals, including a psychiatrist.
  • ƒ A family therapy session is important before discharge to discuss aftercare plans.

Inpatient Residential

  • At this level, all available and appropriate outpatient approaches, including intensive outpatient treatment and partial, have been tried first.
  • This level is supposed to be a short-term placement to stabilize the person until they can return home.
  • Primary treatment offered is group, individual, and family therapy in a supportive environment .
  • Should include weekly family therapy when possible.

Psychiatric Hospitals

  • This is the highest level of care and the one we usually see in movies. When people say “I’m not seeing a therapist, I”m not crazy”, they mostly think of this level.
  • Psychiatric hospitals specialize in treating serious mental health disorders, such as Schizophrenia, and severe forms of clinical depression.
  • There are different types of psychiatric hospitals. Some are for short-term stay and focus on people who are low-risk. Others are permanent residency where someone is unable to live on their own due to their mental health illness.


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About the author.

Liza J Alvarado is a professional counselor in private practice. She serves Adolescents, Adults, and Spanish speaking families in the Lehigh Valley, PA area.



There’s a famous experiment by a Japanese researcher named Dr. Masaru Emoto. Dr. Emoto did these experiments where he took water and put either a positive word or a negative word on the slide, put the slides under a microscope and photographed the water as it froze. Dr. Emoto believed that by thinking the positive or negative word, the water would freeze differently because the vibrations (energy)  of the words affect the structure of water.

What do you think happened to the way the water froze? Watch this short video here before continuing to read….

Pretty amazing right? You could do the experiment yourself if you really wanted to. Many people have done a home experiment by using rice. Here’s one home experiment using rice…


Negative thoughts, followed by negative feelings, are a root cause of many problems. Problems such as getting sick, being in an irritable mood for “no reason”, and feeling like you’re making no progress in your life.

Negative thoughts come in the form of complaining, talking bad to yourself, replaying hurtful memories, holding on to grudges, constant worrying, fear, and being mean to others.

So you might be thinking, “Oh my gosh, I think so many negative thoughts! What do I do?!”

It’s okay.  The good news is that one positive thought is stronger than multiple negative thoughts. Just simply start paying attention to your thoughts. When you catch yourself thinking a negative thought, simply try replacing it with a positive thought, or at least think something that makes you feel better.

Over time, it’ll be much easier to think good thoughts until it becomes a habit and thinking any kind of negative thought doesn’t feel right to you anymore. Even being around negative people will be irritating for you.


“The greatest discovery of all time is that a person can change his future by merely changing his attitude.”

~ Oprah Winfrey


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About the author.

Liza J Alvarado is a professional counselor in private practice. She serves Adolescents, Adults, and Spanish speaking families in the Lehigh Valley, PA area.


Fun and Interesting Psychology Facts

Knowing random facts, although sometimes useless, nonetheless are interesting. Here are some facts about psychology that may explain some of your own behaviors, or that of the people you live with.

  • We are an average of the people we spend the most time with. Spend time with positive people, and you’ll become more positive. Spend time around negative people, and you’ll become more negative.
  • It’s possible to die from a broken heart. It’s called Stress Cardiomyopathy.
  • We can’t always trust what we think we see. Test yourself by watching this video.
  • We can only remember 3-4 (plus or minus 2) things at the same time. Example, we remember a phone number as xxx-xxxx instead of xxxxxxx.
  • Your favorite song is most likely associated with an emotional event.
  • When you remember something, you’re actually remembering the last time you remembered it, rather than the event itself.
  • 18-33-year-olds are the most stressed out people.
  • People become happier the more money they make. Until they reach  $75,000 a year. After that their happiness stays about the same.
  • Money does not change people. It just makes them more of what they already are.
  • Spending money on experiences rather than objects makes you happier.
  • Research shows that it’s better to compliment people on their actions/character instead of labeling it. For example, instead of telling a kid “you’re so smart, good job”, say “wow you worked really hard on that project, good job”
  • Music could change your attitude and outlook on things.
  • Meditation and prayer can lower stress.
  • There’s a phobia of loosing your cell phone. It’s called Nomophobia.

About the author.

Liza J Alvarado is a professional counselor in private practice. She serves adolescents,  adults, and Spanish speaking families in Lehigh Valley, PA.



Developmental Stages In Our Life

According to psychologist Erik Erikson (1960’s), there are 8 psychological stages that we all go through in our life. Understanding these stages helps you understand what you and the people around you are going through.

According to the theory, when you complete each stage successfully, you develop a healthy personality and develop psychological strength.

But if you don’t pass through a stage successfully, you may develop an unhealthy sense of self and trouble with the stages that follow. However, you can work on resolving that stage successfully later in your life, through counseling for example.

According to psychologist Erik Erikson, the following are the 8 developmental stages.

Trust vs Mistrust

This stage is from Birth to about 1 1/2-years-old. This is where we learn if our world is trustworthy or not. If a baby cries because he’s hungry and his mom feeds him, he learns that his needs can be met. If he cries and his needs are not met, he learns that this world is not trustworthy. Infants that are severely neglected actually stop crying after a while because he learns that his needs are not going to be met.

Successful completion of this stage teaches us hope that our needs will be met. If this stage is not completed successfully, the child learns that the world is unpredictable and has a sense of mistrust. This could turn into anxiety later on.

Autonomy vs Shame and Doubt

1 1/2-3-years-old. At this stage the child is learning that they can be more independent. If you’ve ever been around a 2-year-old, you that that their favorite words are “mine” and “me do it”.

If children in this stage are encouraged and supported in being more independent, they become more confident and secure.

But if children are criticized or not given the opportunity to assert themselves, they begin to feel inadequate in their ability to survive, and may then become overly dependent upon others, lack self confidence and feel a sense of shame or doubt in their own abilities.

Initiative vs Guilt

Age 3-5, kids begin to be more assertive. During this stage the primary feature involves the child regularly interacting with other children at school. Playing is how they learn in this stage, not only learning cognitive skills but interpersonal skills as well. At this stage kids ask a lot of questions.

If a child is supported and is allowed to explore, they learn to show initiative.  If not, they can develop a sense of guilt.

Industry vs Inferiority

5-12-years-old. It is at this stage that the child’s friends will start to have more importance and will become a major source of the child’s self esteem. Kids now feel the need to win approval from others and begin to develop a sense of pride in their accomplishments.

If they’re enforced in taking initiative, they feel confident. If not, they can develop a sense of inferiority.

Identity vs Role Confusion

Oh the wonderful teen years. From 12-18-years-old, at this stage, teens are trying to figure out the big question, “Who am I ?” Kids change clothes styles, listen to different types of music, and want to explore different activities and jobs. This can be a very confusing time since there are so many changes going on at the same time; socially, physically, and emotionally.

Allowing teens to explore what they’re interested in helps them figure out what they want when they get older. Of course, they still need boundaries from parents.

Parents should talk to them as a person, not talk at them. Explain that what they’re going through is normal, and this will help them outgrow this stage in a healthy way.

Successful completion of this stage will give the teen a better sense of who they are as a person. What their own views of life are.

If it’s not completed successfully, the teen will grown confused about who they are as a person and what their own values are. They easily follow or fall for other people’s  opinions and views since they don’t have a strong sense of their own.

Intimacy vs Isolation

18-40-years-old. This is where young adults start to focus on relationships. Dating and finding a life partner is the major focus. Also, figuring out what career you want to be in is another focus.

Successful completion of this stage will allow a person to feel intimate with others. While it may cause a feeling of isolation if it’s not.

Generativity vs Stagnation

40-65-years-old. During middle adult hood, career is the focus. The goal is to be more stable in your relationships and careers. We start to give back to society and share our wisdom with others.

If this stage is not successfully completed, a person might feel stagnant, as if they haven’t accomplished anything in their life.

Ego Integrity vs Despair

65-years-old and up. This is thought to be the final stage where we look back at our lives and reflect. If you feel accomplished and good about your life, you get a sense of integrity, proud of all that you’ve done. But if you look back with regret, it may cause you to feel despair.

These stages  explained here are very general, but hopefully it’ll give you a better understanding of the different stages we go through. Of course a lot of factors go into whether or not the stages are completed successfully or not, such as personality, environment, and cultural influences.

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About the author.

Liza J Alvarado is a professional counselor in private practice. She serves Adolescents, young adults, and Spanish speaking families in Lehigh Valley, PA.



Psychiatrist, Psychologist, Counselor?

What’s the difference between a Psychiatrist, Psychologist, Counselor, and Social Worker? Psychology is the study of the human mind and behavior. It’s used in so many fields such as Advertising, Sales, Education, and most notably, in the human services field. But unless you have some form of training, it can be confusing knowing what each role does.  Here is a quick explanation of the different titles in Psychology when it comes to the human services field.


A Psychiatrist is a medical doctor who prescribes  medications for mental health. Only they, or a nurse practitioner, can prescribe medications. They go to medical school and study mental health disorders (diagnosis) and learn which medications are used to treat people. When you see a Psychiatrists for the first time, they’ll give you  an evaluation, which is a bunch of questions about your family history, health history, and symptoms. You then  get a mental health diagnosis and depending on the doctor’s recommendations, they may also give you a script. They should give you a script for blood work to rule out any medical conditions that can affect your emotions and behaviors. For example, if your thyroid levels are too high or too low, you can have symptoms of Depression, mood swings, and Anxiety. Remember, there is no blood test to look for psychological diagnosis.

After that, you typically see them once a month or once every other month, for 15 minutes to see if the medications are decreasing symptoms or if they should adjust the dosage or prescribe something else.

A Psychologist is a doctor because they have a doctorate degree, (PhD or PsyD) but they are not medical doctors so they can not prescribe medications. Psychologist are trained to provide psychotherapy and to administer tests such as IQ tests, personality tests, test for learning disabilities, and other tests.

A lot of Psychologists work in schools, counseling centers, and courts.

Psychotherapist, or Licensed Professional Counselors (LPC), have a masters degree, although some Psychologist are also LPCs because they took the state exam. LPC’s study clinical and counseling psychology and are trained to give Psychiatric evaluations, diagnose, and provide therapy. Total training takes at minimum, 8 years. 4 years of college, 2 years of graduate school, and 2 years post masters training. After the 8 years, they can now take the state license exam. Every state is different, so some require more or less time of training.

If you don’t want medications and just want therapy to help you with a problem your facing, such as feeling depressed, anxious, cutting, Eating Disorders, etc. these are the guys you would want to see because all of their training is in the therapy process.

Licensed Marriage and Family Therapists (LMFT) are the same as LPC, except that their training focuses on Marriage and Families. If you want to see a couples therapist, or want family therapy, these are the guys you want since all of their training is in this area. Although a Psychologist or LPC would also have training in this area because the license board requires it, it’s not specialized training.

Social Workers may provide  counseling, but they are trained in helping people and families function the best way possible in their environment. They’re not too concerned in figuring out why you keep doing what you’re doing and how to stop it. Instead, they’re concerned with your safety and what help do you need right NOW. Social workers can work with Child Services Agencies, at hospitals, prisons, and schools.

Licensed Clinical Social Workers (LCSW) provide psychotherapy. Health insurances will only pay if you’re seeing a licensed clinical social worker, not a non licensed clinical social worker. LCSW’s train in helping people and families to function the best way possible in their environment, plus some courses on the therapy process. LCSW’s license requirements are very similar to LPC’s.


I know it can be confusing but it comes down to the training of the clinician. If you only want medication, you’d see a psychiatrist. If you don’t want medications and want to learn skills to know how to deal with things, you’d see a LPC, LCSW or Psychologist. If you want to go to couples therapy, you would want to see a LMFT.  If you need a test to see if you have a learning disability or custody evaluations, you’d see a Psychologist.


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About Liza J Alvarado, MS, LPC

Liza J Alvarado is a professional counselor in private practice. She serves Adolescents, young adults, and Spanish speaking families in the Bethlehem, PA area.


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