Psychotherapy: Change is coming

IFS therapy is upending the thinking around schizophrenia, depression, OCD, and more

This is an article written by Ben Blum who has it listed on Medium for paid members only. In an effort to protect Mr. Blum’s copy right, I have only included the first few paragraphs of this article on psychotherapy. To read the full article or find more content on psychotherapy, click here. For more about trauma treatment at SkyeHelps, click here.

In May 2014, three days before graduating from college in Massachusetts, Ross Calvert (name changed for privacy), a quiet, artsy guy whose hopeful eyes and side-parted mop lend him some of the cherubic quirkiness of a Wes Anderson protagonisthad a bad acid trip from which his brain somehow failed to come back. His best friend’s face kept looking weird and sinister. Passing strangers seemed to be whispering about his appearance, his mannerisms, his thoughts. Ross managed to keep it more or less together when his family arrived for his graduation, but for the next several months, voices came in and out of his head in a constant swell. One evening, Ross locked himself in the bathroom of the house he shared with friends just outside Boston and refused to come out. After exhausting all other avenues, his friends finally called the police, who broke down the door, hauled Ross out to a squad car, and delivered him to the hospital, where he was stripped of his clothes and belongings, forcibly administered antipsychotic medication, and confined to the psych ward.

The conventional view of psychosis in modern Western medicine is that it is essentially biological in nature. The focus is on rapid diagnosis and medication. Involuntary hospitalization remains common, despite evidence that it can often be avoided through early intervention involving families and psychotherapy. In one small but suggestive study, involuntary hospitalization induced post-traumatic stress disorder in 31% of patients.

“When I first saw Ross, it was almost as if there were a pane of glass between us,” says David Medeiros, the therapist who Ross’s parents brought him to after he got out. “His speech was delayed. And then every time there was another hospitalization, it felt like another glass was put in place.”

In March 2016, two days after yet another hospital release, Ross spiraled into another crisis. Again the police delivered him to the hospital. Again he was confined to the psych ward and forcibly medicated. This time he received a diagnosis of schizophrenia.

It was a devastating blow for Ross, his family, and his therapist. Between 85% and 90% of schizophrenic patients are unemployed in the United States, one of the most difficult places on Earth to live with the diagnosis. In a 1992 World Health Organization study of schizophrenia that continues to spark controversy in the field, patients in developing countries healed and went into remission at significantly higher rates than their counterparts in developed countries like the United States.

The problem is much bigger than schizophrenia. All too often, patients in today’s U.S. mental health system fall into a downward spiral of increasing diagnoses and increasing medication. As journalist Robert Whitaker reported in his controversial classic Anatomy of an Epidemic, the number of people on government disability for mental illness has actually increased since the introduction of Xanax, Prozac, and other drugs that were once billed by pharmaceutical companies as a panacea for mental health. Though psychiatric medications have brought relief to millions of patients, the impact of long-term use of many drugs is only starting to become clear: chemical dependency, mounting side effects, and fundamental changes in the neurochemistry of the brain. For patients with a diagnosis of schizophrenia, the effect is particularly severe. Numerous studies have found that schizophrenics fare worse on long-term antipsychotics, though it remains the standard of care. Ross was teetering on the edge of a long, steep hill that ended in near-total dependency: on daily meds to manage symptoms, on hospitals to arrest full-blown psychotic episodes, and likely on disability checks to provide for a living. (He had already begun the process of applying.)

Medeiros, Ross’s therapist, didn’t want that to happen. He had known Ross since age 11, when his parents had first brought him in for germophobia, and couldn’t help believing that the warm, quirky kid he remembered lay somewhere inside the shell-shocked guy who now showed up each week in his office. But nothing Medeiros had tried seemed to be getting through. Ross kept ending up back in the hospital and coming out even more wary and cut off.

On the day after the 2016 presidential election, terrified by what it meant for the country, Ross slipped into psychosis yet again, wandering into the courthouse downtown and making a scene before the police finally hauled him off to the hospital. This was the fourth hospitalization in two years, and Medeiros was running out of options. At a loss for what else to do, he decided to try something radical: a novel therapeutic model called internal family systems therapy (IFS).

All too often, patients in today’s U.S. mental health system fall into a downward spiral of increasing diagnoses and increasing medication.

IFS had recently been the subject of a lot of chatter in the psychotherapy community. It was based on a novel theory of the mind so profoundly at odds with the biomedical model of mental illness that, if true, called decades of clinical orthodoxy into question. In IFS, mental health symptoms like anxiety, depression, paranoia, and even psychosis were regarded not as impassive biochemical phenomena but as emotional events under the control of unconscious “parts” of the patient — which they could learn to interact with directly.

Medeiros had only been undergoing IFS training for a year and didn’t feel ready to do more than some preliminary exploratory work with Ross. But he had some idea who could help: Richard C. Schwartz, PhD, the developer of the therapy, whom Medeiros had had the good fortune to meet in person back in June 2016. When Schwartz appeared on the lineup for a trauma conference in Chicago, Medeiros signed up with the hope of speaking to him again. Nearly holding his breath with anxiety, Medeiros found an opportune moment to seek Schwartz out and explain Ross’s case. Schwartz listened intently.

“Why don’t you bring him to Boston to see me?” Schwartz said.

Click here to read the rest of this article on how IFS is changing psychotherapy. Click here to set up a psychotherapy appointment with a SkyeHelps Trauma Counselor.

“The opposite of addiction isn’t sobriety – it’s connection” ~ Johann Hari

Many people struggle with substance addiction ranging from substances like alcohol, nicotine, caffeine, illicit drugs, and prescribed medications. Many people also struggle with behavioral addiction which can look like over-involvement with activities like gambling, sex, eating, spending, relationships, exercise, gaming, etc. 

If you are interested in finding a supportive environment to talk about your own relationship with addiction and find tools to help you in your recovery, SkyeHelps Counseling & Wellness hosts a free SMART group. Our licensed clinicians have a passion for addictions treatment and facilitate this SMART Recovery group online and in-person free-of-charge every Wednesday at 7 PM. 

What is SMART?

SMART is a nonprofit program founded in 1994 that hosts addiction recovery groups facilitated by trained volunteers. These meetings take place virtually and in-person all over the county. 

SMART stands for Self-Management and Recovery Training. This program teaches tools that are meant to help you build awareness of how your own thoughts, emotions, and beliefs affect your addiction and your recovery. SMART emphasizes the importance of building problem-solving skills and learning different ways to understand your addiction and recovery. 

This approach to addiction recovery support follows a 4-step program:

  1. Enhance and maintain motivation to abstain
  2. Cope with urges
  3. Manage thoughts, feelings, and behaviors
  4. Balance momentary and enduring satisfactions

SMART groups are for adults 18+ interested in what abstinence from addiction might look like for them. If the idea of lifelong sobriety sounds scary to you, that’s okay. SMART Recovery recognizes your personal choice in addiction recovery and welcomes you to join our meetings wherever you are in your journey with addiction. SMART’s focus during group meetings is to foster an environment of support and motivation to pursue abstinence. 

SMART believes regardless of where you are in your relationship with addiction, you are valued and welcome. SMART is the largest alternative to Alcoholics Anonymous, and is different from Alcoholics Anonymous (AA) in that SMART emphasizes individual choice and self-empowerment. SkyeHelps’ SMART group is also lead by clinical mental health counselors. SMART is unlike in AA in that spirituality/religion are not aspects of the program. 

SMART encourages attendees to explore options that feel right to them, as many SMART participants attend AA and SMART meetings together. Active participation in meetings is encouraged and also entirely optional. 

What You Can Expect from this SMART Group:

Connection with other members, two addictions-trained facilitators, and a supportive and welcoming environment. No matter where you are in your journey with addiction or how you feel about your current relationship with addiction, you are welcome to join us for SMART Wednesdays 7pm – 8:30 pm at 72 Public Square N Suite B, Dahlonega, GA, online by following this link.

SMART Recovery - Life beyond addiction
SMART Recovery – Life beyond addiction

Why We’re Hosting SMART 

Our intention is to offer our clinical skills as mental health therapists to help you find and develop your own wants and goals for your relationship with addiction. We intend to offer you a space to explore your own habits and thoughts while building and offering connection with other group members. We intend to offer our curiosity, our compassion, and our knowledge of addiction and the SMART approach/tools for addiction recovery. We hope the best for you wherever you are in your journey and we are excited to meet you.
Ours is the only in-person SMART meeting located in North Georgia. If you’d like to see other options for SMART meetings including online, check out this online roster of other available SMART meetings! If you’d like to learn more about SMART, check out their website here.

Online Trauma Therapy is Effective

Online EMDR Therapy

SkyeHelps Counseling & Wellness offers in-person and online trauma therapy. This article will present three recent studies that show that online trauma therapy is effective, and is as effective as in-person PTSD treatment utilizing EMDR.

We generally see three distinct categories of trauma:

  • Singular/Acute Trauma – a one time event such as a car wreck, assault, or accidental injury;
  • Complex/Chronic Trauma – a series of traumatic events or one traumatic event that has a years-long cascading effect; and
  • Developmental Trauma – interpersonal danger, maltreatment, and inadequate caregiving occurring in childhood that affects a person’s sense of self and safety.

Trauma treatment counseling for PTSD takes a multidimensional approach by a skilled counseling clinician that includes Eye Movement Desensitization and Reprocessing (EMDR), Internal Family Systems Therapy (IFS), Accelerated Resolution Therapy (ART), and Somatic Therapies. These PTSD counseling treatments have traditionally been administered in-person, but since the pandemic, more data on the efficacy of online trauma counseling treatment for PTSD has come available. This article will review three of the most recent published papers about EMDR counseling for PTSD delivered via online telehealth to help us answer the question, “can you trust online trauma therapy?

The first paper addressing online PTSD counseling, published by Morris, et al., reported results on a 3-year pilot study to determine if EMDR counseling reduced trauma symptom severity. The study started with in-person PTSD counseling treatment in 2018 and continued through the first part of the pandemic utilizing an online virtual counseling platform. They concluded “No significant differences were found between the online or face-to-face modes of delivery, suggesting both options are effective.”[1] This study can helptrauma counselors feel confident that the EMDR method works online and in-person, and even in the face of interruptions to in-person PTSD counseling care, online PTSD counseling treatment may continue with no significant difference in efficacy. Online trauma therapy is effective.

The second paper addressing online PTSD counseling treatment is a medical chart review by Liou, et al. (2022) published in Telemedicine and e-Health that found “both in-person and virtual EMDR led to significantly improved GAD-7 scores.”[2]  GAD-7 is the Generalized Anxiety Disorder assessment that rates a person’s subjective experience of anxiety with final scores ranging from 0-21. The review concluded that EMDR counseling for PTSD delivered either in-person or online resulted in significant decreases in anxiety. This analysis helps boost clinical confidence that providing online EMDR via telehealth can reduce patients’ anxiety as effectively as face-to-face EMDR counseling for PTSD. Online trauma therapy is effective.

The last paper addressing online PTSD counseling modalities utilizing EMDR was published in 2023 by Farrell, et al., which reported “a large treatment effect in the treatment of trauma and adverse memories, including co-morbid symptoms” utilizing “group EMDR therapy delivered remotely as video-conference psychotherapy (VCP).”[3] This trial, which included 85 frontline and emergency workers during the primary pandemic lockdown periods between July 2020 – March 2022, bolsters the conclusions of the previous two papers and presents deductions that virtual online EMDR counseling for PTSD is also effective for groups and not just in individual treatment. Online trauma therapy is effective.

Our understanding of how trauma affects the brain and body has increased and effective modalities have been tested and approved for treatment, such as EMDR, which created the need for accessible, ethical, and effective virtual trauma counseling. Online therapy adds another dimension that allows more PTSD patients access to care by qualified EMDR psychotherapists and counselors. SkyeHelps’ counselors are informed, trained, and certified in these trauma treatment approaches and telehealth.

If you, or someone you love, is suffering from singular, complex, or developmental trauma, has been diagnosed with PTSD, or just curious about EMDR, please reach out for help. There are excellent and effective PTSD counseling treatments and PTSD counselors available in-person and online. You can be confident that online trauma therapy is effective, and is as effective as in-person counseling.

[1] Morris, H., Hatzikiriakidis, K., Dwyer, J., Lewis, C., Halfpenny, N., Miller, R., & Skouteris, H. (2022). Early intervention for residential out-of-home care staff using eye movement desensitization and reprocessing (EMDR). Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication.

[2] Liou, H., Lane, C., Huang, C., Mooadam, M., Joseph, M., & Hecker Du Val, J. (2022) Eye Movement Desensitization and Reprocessing in a Primary Care Setting: Assessing Utility and Comparing Efficacy of Virtual Versus In-Person Methods. Telemedicine and e-Health, 1359-1366.

[3] Farrell, D., Moran, J., Zat, Z., Miller, P. W.., Knibbs, L., Papanikolopoulos, …Kiernan, M. D. (2023). Group early intervention eye movement desensitization and reprocessing therapy as a video-conference psychotherapy with frontline/emergency workers in response to the COVID-19 pandemic in the treatment of post-traumatic stress disorder and moral injury-An RCT study. Frontiers in Psychology, 14, 1664-1078. Retrieved from