Category: <span>Therapy</span>

A Therapist's point of view: THE STIGMA OF MENTAL HEALTH

A stigma is when there’s disgrace or shame around a certain circumstance, quality or person. Some examples of stigmas people have are, having certain physical disabilities, certain diseases such as HIV/AIDS, sexual orientation, ethnicity and certain religions, to name a few. One of the biggest stigmas people have is dealing with mental health.

Now, this is just my opinion, but I think the biggest reason for the stigma of mental health is due to ignorance. Ignorance is simply lack of knowledge. We’re going into 2017 and people are still not properly educated on what mental health or treatment for mental disorders is.

We’re not taught in school about maintaining good mental health or improving our emotional intelligence. Emotional intelligence is the capacity to be aware of, control, and express one’s emotions, and to handle interpersonal relationships judiciously and with empathy.

The little bit that we are shown about mental health is usually in movies and TV shows. Typically the picture they portray is of a character who hears voices, hallucinates, has severe mood swings or kills people. So the image of mental health we get is of someone being “out of their mind”

It’s no wonder that so many people are hesitant to seek help, out of fear that they’ll seem crazy.

Some mental health diagnosis are more debilitating than others, such as Schizophrenia or Severe Autism. With these disorders, it is believed that there is something neurological or developmentally wrong. There are many people that from a young age showed symptoms of these disorders. Is that their fault?

 Why is it that we don’t look at Type 2 Diabetes (a purely preventable disease by exercising, not smoking, and maintaining a healthy diet) with stigma? But when it comes to mental disorders, something that they didn’t create because it was either genetic or caused by difficult circumstances in their life, we want to look at it with shame?


The short answer is, because it affects everything in your life.

The way that you talk to yourself, how you treat others and the way you behave affects everything else in your life; such as relationships, vocation, and health.You can be the most talented person in your industry, be with your ideal man/woman, make lots of money, but if your mentality is not healthy, you won’t be able to truly enjoy those things, or even worse, mess it all up.

Let me ask you this. Why is it important to maintain good physical health? Why maintain a healthy diet, move your body regularly and drink plenty of water? To have a healthy body of course.

So what is wrong with learning to control your emotions and behaviors? To understand your patterns of thinking and do something to change it? To practice relaxation techniques, learn to improve your mood and practice self-reflection? Well, nothing is wrong with that. Maintaining good mental health is a priority in order to live a healthy, satisfying, happy life. That’s because everything in life comes down to our mentality.



You can learn on your own by reading or watching self-help materials. Here’s a great article on how to improve your emotional intelligence. 

Learning from your mistakes will naturally help you grow as well. Or if you’re lucky enough to have someone in your life that is emotionally healthy, they can be a great teacher. But one of the best ways for you to learn how to control those emotions is through outpatient therapy. I look at therapy as “school for your emotions”

You can read about the different levels of therapy here.

Seeking outside help with something you’re struggling with or want to improve is actually a sign of a mature person.

If you’re having suicidal thoughts, going to the hospital and getting help is a sign of health and maturity.

Not that people who don’t seek help are immature and unhealthy. Instead, the misinformation they’ve been given keeps them away from getting the help they want and need. If more people understood how therapy works, more people would get the help they need. And when they get help, other areas of their life also improve.

My hope is that one day talking about taking care of your mind, practicing good mental health, and seeking help and guidance is embraced and accepted.


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.



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.


3 Side Effects of Therapy That No One Talks About.

The benefits of getting professional counseling are pretty known. Some benefits are learning to stand up for yourself, lowering symptoms of depression and anxiety, better handling your anger, increasing your self-esteem and improving your relationships.

But therapy also has other side effects that people don’t really talk about. Here are three of the most common ones.

Some of your relationships might end.

It’s very common for friendships or romantic relationships to have problems or even end after starting therapy. Just because you are working on yourself and growing as a person, it doesn’t mean that everyone around you is as well. As you work on yourself, you’ll start to see things that you didn’t notice before, such as how immature or negative certain people are.

Of course not all relationships are affected in a negative way. Just know that as you change the way you look at things, things around you are going to change.

After some therapy sessions, you may experience intense negative feelings.

Talking about uncomfortable things will bring up feelings that you’ve been ignoring. You were pushing certain feelings down  for a reason…because they made you feel like crap.  Why do you think people talk about changing but not many people are willing to do what it takes? Nobody wants to voluntarily feel bad.

As bad as it may feel, it’s part of changing. I like to use the analogy of washing a dirty pot. At first it gets really dirty as the grease and stuck on food comes off. But as you keep rinsing it, it gets cleaner and cleaner. As you work on changing negative feelings, there will be a point where it gets “dirty”. But don’t give up, it does get better.

You may be given the wrong diagnosis.

When you use your health insurance for therapy, you must be given a diagnosis. Diagnosis are given by assessing history and symptoms. A correct diagnosis rules out any physical reasons for problems, such as making sure thyroid levels are normal.

Because there is no brain scan or blood test that tell us what the diagnosis is, we only go by what is being reported. A correct diagnosis will look at the whole picture of your life; health, history, recent changes, etc. and not just a snap shot. When unsure, we are trained to give the least harmful diagnosis.

If you’re given the wrong diagnosis you can start wrongly identifying with it which can be harmful. For example, being diagnosed with Bipolar Disorder when your thyroid was not normal or birth control pills had your hormones all over the place. Then blaming your actions on you “being bipolar”.


These “warnings” are part of the informed consent when you first start therapy.  Just reading these side effects can make therapy seem scary, and sometimes it is. But the benefits of therapy out weight the side effects. Make sure you discuss some of these concerns with  your therapist.


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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.



5 Myths about Counseling

Myths about Counseling. psychology


What many people think they know about psychotherapy usually comes from movies and TV shows. If you think what you see on TV is what therapy is, think again. You must be an informed consumer when looking to start therapy. There are a lot of myths out there, but what follows are the 5 I hear most often.

  1. Depression and other mental health diagnosis are caused by a chemical imbalance.

This is a debate among us in the field. Truth is that yes there are hormones and neurotransmitters in our body that have to do with regulating mood and energy. For example, Serotonin is a neurotransmitter that boosts our mood. We release Serotonin when we exercise. Anti-depressant drugs are believed to increase Serotonin levels.

The problem is that these neurotransmitters are not measured when giving clients a mental health diagnosis. There is no machine that scans your brain or a blood test that can measure these chemicals. When doctors give scripts for blood work, it is to make sure that there is nothing else wrong physically, such as a Thyroid problem, which will affect your mood.

Diagnoses are given by symptoms. We follow the Diagnostic and Statistical Manual (DSM) which tells us the criteria for each diagnosis depending on the symptoms that the client is reporting. Therefore, if you are diagnosed with Anxiety or Depression, you have symptoms of Anxiety or symptoms of Depression; it is not something you “have”, not something you “catch” like a cold. The goal is that once you learn how to better cope, the symptoms would decrease. Remember, it is normal to feel anxious, sad, scared, etc. It’s called being human. It is only a problem when it affects your day to day life such as having problems with school, work, relationships, and/or your health.


  1. You’re “crazy” or something is wrong with you if you see a therapist.

As mentioned in #1, diagnoses are given by the symptoms reported. When giving a diagnosis, we have to look at the whole picture as well. For example, if you’re going through a bad divorce or someone close to you just died, feeling depressed is a normal reaction to the situation. It doesn’t mean you HAVE Depression. You have SYMPTOMS of Depression. You just had a big loss; of course you’re going to feel sad. Not looking at the whole picture is taking things out of context.

I’ve seen this when working with younger kids. Parents or teachers are complaining that the child can’t focus, doesn’t stay still, and is defiant. Then when we look at the bigger picture we find out that the child’s home life is unstable, or he’s going to school hungry because there’s not a lot of food at home, or that he is a witness to domestic violence. It’s very important to always look at the whole picture.

Furthermore, seeking therapy is a sign of maturity and health. Some of the most successful people in life have reported that they have or are seeing a therapist because they see the value and how it makes them great at what they do.

Finally, there are different levels in therapy. Outpatient therapy, the type of therapy I practice, is one of the lower levels. Clients come either once a week or once every other week. This level is more appropriate for people who are NOT hallucinating, homicidal, or a danger to themselves. Individuals who are a danger to others or themselves, or their symptoms are so bad that they can’t go to school or work, need a higher level of care. This could be in a hospital setting, or a form of outpatient, such as partial program, where they get several hours of therapy per week.


   3.  Some techniques, such as CBT, REM, or Biofeedback, are better than others.

There are a lot of techniques that therapists learn in graduate school and post-graduate training. And most of those techniques are backed up by extensive research. Some techniques are still being studied to see how effective they are. However, there is also A LOT of research that has shown that what really matters in therapy are not the techniques used, but the relationship between client and therapist. You can look up some studies by doing a Google Scholar search.

The most important thing is that you find a therapist that you feel comfortable with. See my post on 5 tips when seeking psychotherapy HERE

Think about it, you could have a therapist that uses a technique that is effective, but if you don’t click with that therapist, the technique doesn’t matter.


  1. Therapists get paid  just to listen to people vent.

Therapists do need to know what brings you to therapy and know your background information. But that’s a starting point to know how to help you. Typically during sessions, there will be an interactive dialogue and sometimes you practice certain techniques, other times the therapist may suggest homework such as techniques to practice at home. They may help you look at things differently in order to come up with solutions to a problem.

You have to be active in your treatment to see some progress. Sometimes it’s gradual, and sometimes people see changes right away. Everyone’s situation is different.

A therapist can only provide resources, suggest different things to try, but in the end they can’t make you DO anything. You have to put some work into it as well. And this all entails a lot more than just listening to people talk.

  1. I have to talk about my childhood.

You might explore childhood events that had an impact in your life. But it really depends on the reason for seeking therapy. If you have a pattern of being in unhealthy relationships, for example,  it makes sense to explore childhood events, as we learn about relationships from our first teachers, our parents. Also, we can predict future behaviors by looking at past behaviors. It’s important to know if you have a pattern of negative thinking or being that is contributing to problems. Exploring and working on this can help you change those behaviors.

However, if you are seeking therapy because you’re having trouble adjusting to graduating from high school or college, you might just focus on the problem at hand. Many therapist will focus on solutions to the current problem, not childhood issues.


I hope that some of these myths were cleared up. Ultimately, therapy is a process and you have to judge it from your own experience. I hope that you find the right therapist for you along your journey in personal development.

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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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