Celebrating 5,000 Followers: Giveaway Alert!

On Monday, something pretty cool happened: my Twitter following hit an arbitrary numerical milestone! Hooray! Can you believe 5,000 people saw what I had to say and thought, “I want more of that in my life”?

Screen shots are forever

I created my Twitter account to promote this blog, and I created this blog to help people. At first, it was to help other therapists struggling to find kid-friendly telehealth interventions, but it has since expanded into mental health education for the general public. There is so much stigma around mental health, and there is so much misinformation in the media. I want to provide accurate, helpful information that you don’t need graduate training to understand. I want people to be able to advocate for themselves and make informed decisions about their own treatment.

Anyone can create a free blog and start posting things. Without readers, I’m just screaming into the void here. You all gave me feedback on what information is helpful, and you shared what I wrote so that more people actually saw that. For all of this, I am so grateful!

How do you express gratitude? By giving away free stuff! I’m going to use an app to randomly choose ten followers. Five will receive a printable copy of It’s About To Get Real Unprofessional, and five will get a personalized Cameo-style video of Armani telling them they are great. Armani will accept requests for custom messages, but he reserves the right to say things at his own discretion.

Since winners will be chosen randomly from my followers, everyone who follows me is automatically entered to win! If I notify you that you won, and that reminds you that you actually never want to hear from me again, I’ll pick new winners until there are 10.

I’m also going to give away one autographed and inscribed copy of Armani Doesn’t Feel Well. Because of shipping and stuff, you have to be in the United States to win this one. Please fill out the submission form below to enter, and I will again choose a winner at random. I will inform the winner via email so that you don’t have to give me your contact information unless you win.

I will select winners the weekend of October 9.

When I started this blog, it was a big day if 10 people wanted to hear what I had to say. A bit over a year later, here we are. Thank you so much!

My Experience with the Therapist Phone Scam

This morning, the San Francisco Chronicle published an article about a phone scam that has been targeting therapists. The article is paywalled, so here are the bullet points:

  • Therapist gets a phone call from someone claiming to be law enforcement
  • Caller states the therapist failed to appear for a subpoena and now has a warrant out for their arrest
  • Caller states that the therapist must pay bail over the phone via gift cards or they will be arrested
Photo by Mikhail Nilov on Pexels.com

Since I received one of these calls over a year ago, I wanted to share my experience so that others know what red flags to look for. Getting a call from someone claiming to be with the police can be terrifying, and it is hard to keep your rational brain going when you are scared.

This scam has been going around for a while. I first heard about it almost two years ago in a Facebook group for therapists – therapists with profiles on Psychology Today were being targeted with these calls.

I am not on Psychology Today, but a few months later, I received a voicemail from a man claiming to be a lieutenant sheriff in a county close to mine. The message stated that he needed to speak to me about an “urgent legal matter” that was “not an emergency.”

First things first: before returning a call from someone claiming to be an authority, Google them. Nothing came up when I searched this man’s name, which was telling. I also searched the phone number, which came up as Kentucky. Why would a sheriff in South Dakota call from a Kentucky number? Short answer: they wouldn’t.

I returned the call because I was suspicious but wanted to cover myself on the tiny chance that this was legitimate. He verified my name, title, and the address of my office (all available online – my Sioux Falls Psychological profile is the top Google result for Amy Marschall, that same information is on this website, and I am listed on several “Find a therapist near you”-type sites).

Then he told me, “On [date], you signed a subpoena to appear at [courthouse] yesterday, and you didn’t show up.” This is when I knew for certain it was a scam because on the date he stated, I had worked from home and not been in the office at all.

He started talking about warrants, and I interrupted him to tell him I had worked from home that day, so it was impossible that I had signed a subpoena. I then asked why he was calling from a Kentucky number, to which he said it was his personal cell phone number.

Me: “Right, because law enforcement officers want people they arrest to have their personal contact information.” (That made him mad.) “Listen, ‘lieutenant,’ since you’re legitimately with the sheriff’s office, I’m sure you know there’s a scam going around targeting therapists and telling us we have warrants out for missing subpoenas that don’t actually exist. I’m going to hang up and call the department directly, and if they can verify your story, I’ll call you back.”

He tried to give me the phone number to his “direct supervisor,” and I told him the phone number was actually available on the sheriff’s department website, which somehow had no mention of him as an employee. To further cover my a**, I did call the sheriff’s department, who confirmed he didn’t exist in their system.

If you are not 100% sure, you can ask other follow up questions, such as “What case is this regarding?” Therapists get subpoenaed to testify about clients. While I would not give a client’s name or information, someone following up about a missed subpoena should know what case they are calling about. Know also that the police typically do not call to give a heads up before arresting someone.

Scammers have a script that they know tends to work. They use fear and your desire to do the right thing to manipulate you into thinking you need to comply with them. Take a breath, remain clam, and trust your gut about the red flags. It will be okay.

Telehealth Activity: Zoom Buddha Board

One thing from my in-person office that I have not been able to replicate in telehealth sessions has been my Buddha Board. (You can see a demonstration of the Buddha Board here.)

Photo by Zaksheuskaya on Pexels.com

When I use art in therapy, I encourage clients to focus on the experience of creating rather than on the final product. The Buddha Board helps them let go of this because the final product disappears before their eyes. Knowing the drawing will disappear also lowers inhibitions – they feel free to draw something that might seem weird or outrageous because it is not permanent.

You can implement something similar with a white board, but something about the drawing vanishing on its own is so freeing for a lot of kids. They don’t have to wipe it away when they are done because it happens on its own.

Recently, Zoom added a “vanishing pen” feature that is the closest I have found to a virtual Buddha Board. Here’s a demonstration of what it looks like:

Vanishing Pen Demonstration

For this to work, the client needs to be on a laptop, and you have to be using Zoom as your telehealth platform. Have the client share the white board screen, select annotate, select spotlight, and select vanishing pen.

Whatever they draw will disappear! Of course, you cannot save the drawing for future review, but a lot of kids really need that added layer of confidentiality when the drawing disappears.

What therapy activities would you like to see developed for telehealth? Tell me, and I will try to make it happen.

The Weekly Mews with Armani

Welcome back, friends! I apologize for the technical issues lately – I usually upload the photos for Armani’s mewsletter using the app on my phone, but that has been glitching on me (it is likely a Code-18 error, unfortunately). So I’m going to try transferring the photos to my laptop and uploading them that way. It’s an extra step that will hopefully Amy-proof the process.

Armani!

Armani has so many updates! First, his pawtograph stamp came, so you can buy a special, signed copy of his book on Etsy, and he will even inscribe it for you! He is so excited to help more kids by sharing his story.

He is so proud of himself!

In other news, our veterinarian quit, so Armani’s care is being transferred to a new provider. He’s nervous about meeting a different vet, but we will make sure they do just as good of a job taking care of him.

His latest blood sample had that clotting issue again, which the new vet reassured us is just bad luck and not a sign that something bigger is wrong. (This is what the last vet said too, and my husband said it checks out.) They aren’t sure about doing another draw, since he hates having them and it has not given us good information. Our choices now are to try the Libre again or just keep him on the low insulin dose and continue to monitor him for symptoms.

Armani and Vera reading together

I’d rather not put him through more invasive procedures that he hates if it is not going to help him, but it makes me nervous to not have the information. He has been doing so well and has been climbing and jumping, still not as high as before he got sick, but he seems happy.

If anyone has the answers, please let me know. We will keep taking care of him the best we can.

Telehealth Activity: 8 Ball Pool

When I interned in a residential setting, a lot of kids bonded and had great therapeutic moments around a pool table. We could play teams with a group or have a casual one-on-one game while talking about a larger issue. A pool table is something that I never thought would be practical for my therapy practice because of space constrictions, but once again, telehealth has shown me that nothing is impossible!

Photo by Tomaz Barcellos on Pexels.com

I use this version of 8 Ball Billiards for telehealth. Pull up the website, choose human versus human, and share your screen. Take turns with screen control to play with your client. They can use any device with a mouse or touch screen for this activity, though I have found that phone screens are challenging due to the small size.

The goal of using pool in the residential program was to give the kids something to do with their bodies while we talked. It gave them the opportunity to relax enough to explore deeper issues. You can get a similar effect with telehealth pool, though there is less body work due to the nature of the virtual game.

Telehealth pool works focus, planning, problem solving, and of course frustration tolerance. It requires taking turns, and since the rules are coded in, following instructions. Sometimes there are no good shots, so you have to decide which option is best when what you really want is not available. Plus, it’s a lot of fun!

Play interventions for telehealth are endless!

Sleep Hygiene: Creating Routines

I wrote last week about the factors that contribute to quality sleep hygiene. Specifically, I talked about creating routines around when you go to sleep and when you wake up – as I mentioned, there is no one-size-fits-all approach to sleep hygiene, and the most important factor is determining what works best for you, the individual.

Photo by Ketut Subiyanto on Pexels.com

There are some general tips to consider, of course, such as:

  1. The light from screens can make your brain think it is daytime, so turning on the blue light filter after about 6pm can help your sleep-wake cycle.
  2. As much as possible, going to bed and waking up around the same time helps your body know when it is time to rest and when it is time to be awake.
  3. Your brain can associate certain things with bed time, so having a routine can help you get restful sleep.

So, what goes into a healthy sleep routine? Again, the specifics need to be whatever works best for you, but general guidelines include:

  1. Light. Do you sleep best in complete darkness, or does that bring up some anxiety? Having a small light in your room can be relaxing. Notice how you feel with different options, and do what works best for you.
  2. Sound. Do you need complete silence? Do you prefer background white noise? Some people have trouble turning their brain off, so a guided meditation or even a familiar television show or podcast distracts their brain enough to get rest. As I mentioned, screens can make your brain think it’s daytime, so turning the device away so you are listening but not watching can aid with sleep. For guided meditations, my personal favorites are from The Honest Guys on YouTube.
  3. Smell. If you are someone who is sensitive to smells, you can use a diffuser or pillow spray. Your brain can tie the scent to your bedtime routine and help you recognize that it is time to rest.
  4. Ritual. A good sleep routine is about 30 minutes of consistent behavior done before going to bed. If you find that bathing relaxes you, bathe at night. This routine can also include reading something relaxing, drinking (un-caffeinated) tea, journaling, meditating, or any activity that brings your heart rate down and makes you feel relaxed.

It can be helpful to deliberately and mindfully document your preferred sleep routine to help you practice. After a few weeks of consistency, you can start to see better quality sleep.

Of course, bring any concerns about your sleep to your primary doctor as well.

App Review: Move Mood

From the awesome people who brought you Calm Harm and Combined Minds comes another amazing mental health app: Move Mood.

“Low mood and depression weigh you down. Instead, engage, initiate, and activate. Build your power to lift this weight.

Move Mood was developed for people with depression or other mood issues, but I think it could be helpful for anyone who has trouble doing The Thing. (The Thing is what I refer to as any activity that is important and helpful, but our brains do not want to let us do it for whatever reason. People with anxiety, ADHD, or many other diagnoses also struggle to do The Thing.)

Helping people get themselves to do The Thing is sometimes referred to as behavioral activation. Basically, this app helps you take steps to trick your brain into doing things that make you healthier and are associated with better mood.

“Now choose a companion to work with you and to help motivate you.”

After you give the app your name, you get to pick an adorable avatar to help you in your journey. There are shapes, characters, and critters to choose from, and you can go back and change it if you want to. After trying some different options out, mine is now a fox.

Setting some tasks

The app prompts you to choose three tasks to work towards. I found it difficult to decide what my top priorities were in each category, but I see the benefit of limiting the number of goals so that the user does not get overwhelmed.

You are prompted to choose a “routine task,” a “necessary task,” and an “enjoyable task.” There is overlap for the different kinds of tasks, so you can decide which things are enjoyable for you versus necessary. Options for tasks are presented based on what you indicate is your priority, with options like “managing my mental health” and “improving my physical well-being.” You can also create your own task, so it is fully customizable.

Customize Task

I told the app that I want to walk a short distance every day to improve my mental and physical well-being. The app prompted me to create a series of very specific steps that go into this task. These kinds of specific steps help if the task seems overwhelming (for example, some people have a hard time showering because the act of bathing has so many smaller steps) or they have trouble knowing where to start.

The app then notifies you at a pre-selected time to cue you to do The Thing.

Although Move Mood markets itself specifically for depression, I think this app is very helpful for someone who wants to form better habits, with a little virtual accountability and planning. It follows a lot of steps I have used with clients in sessions for behavioral activation and does so in a non-threatening and fun way.

Making Therapeutic Moments: Adds

I wrote before about what makes an activity therapeutic, using the premise that an attentive and creative therapist can get therapeutic benefit out of almost anything with the right attitude. In my telehealth and kids training, I say: “It is not my job to do a specific therapeutic activity; rather, my job is to take what happens naturally in the session and make that activity therapeutic.

Although I sometimes want to explore a specific skill or activity with a child, I am constantly surprised by how easy it is to pull a child’s treatment goals into whatever happens in the session.

Something that has been a surprising opportunity for therapeutic moments in telehealth sessions has been adds. Yes, advertisements. Hear me out.

Photo by Negative Space on Pexels.com

Some of the websites I use for telehealth activities have advertisements. Understandable – this blog has advertisements because we all have bills. I use AdBlock to minimize this on my end, but some sites have a workaround for this, and sometimes my client does not have an add blocker.

Most people do not like adds. They make us wait for the thing we actually want and are annoying and frustrating. When an add pops up in a telehealth session, I cue the client to check in with their body and emotions. I validate that feeling and take a moment to practice being patient. Sometimes, we will do a quick breathing exercise or body scan to regulate while we are waiting.

Who would have thought adds would be therapeutic? These opportunities are everywhere in the session, waiting for us to discover them.

What Contributes to Sleep Hygiene?

Two weeks ago, I introduced the topic of sleep hygiene on this blog. Sleep is vital to our survival as well as both physical and mental health, but so many of us have trouble falling asleep, staying asleep, or achieving high-quality rest.

Today, let’s look at what factors contribute to good sleep hygiene.

Photo by Samson Katt on Pexels.com

The tricky thing about sleep hygiene is that there is not one ideal routine that works for everyone. Below are factors that contribute to sleep hygiene, and each individual has to explore and determine what is the best fit for them.

  1. Schedule: Your schedule refers to when you sleep and wake up. Generally, we get the best quality sleep when we go to sleep and wake up around the same time each day, but this is more easily said than done! I for one enjoy sleeping in on the weekends. Not to mention, many people work rotating shifts and might have different demands on their time. Having consistency when you are able can improve your quality of sleep, and making gradual adjustments can help you feel more alert when you wake up.
  2. Habits: In this context, habits are the things you do throughout your day that contribute to your quality of sleep. For example, I have a habit of drinking coffee every day. For some, drinking coffee after a certain time makes it more difficult for them to fall asleep, so a good sleep hygiene habit might be to discontinue coffee before 3pm. Be mindful of the habits that contribute to better or worse sleep.
  3. Sleep Space: Your sleep space is…the space where you sleep. Your brain associates different spaces with what you do in those areas, which is why work-life balance can be extra challenging if you work from home. If possible, avoid non-sleep activities where you sleep. This will help your brain understand that being in that space means it’s time for sleep. Be mindful of the type of lighting, sounds, and even smells that you find relaxing and restful, and try to incorporate those into your sleep space.
  4. Routine: Routines are like vegetables: you might not like them, but they are good for you. When it comes to sleep hygiene, it can be handy to have two 30-minute routines in your day: the 30 minutes before you go to sleep, and the 30 minutes right after you wake up. Having consistent routines around these times cues your brain that it’s time to sleep and time to be awake. There unfortunately is not one ideal routine, since we each have unique needs and preferences, but discovering what helps you can improve both your quality of sleep and how you feel while you are awake!

Throughout this series, I will explore a bit more what each of these aspects of sleep hygiene looks like and how to determine your own needs. As always, consult your care team about what is best for you.

Do you have specific questions about sleep? Let me know, and I will try to answer them.

App Review: Mindfulness

It’s that time of week again, the time when I tell you what to download onto your smart phones and tablets next! I worry a bit about the day when I run out of apps to review, but I keep hearing about new ones. If you can dream it, there’s an app.

Today’s app is called Mindfulness (or Mindfulness Coach). Guess what it teaches you about.

Welcome to Mindfulness Coach! This app is designed to help you learn everything you need to start practicing mindfulness.

“Mindfulness” simply refers to the practice of being aware and in tune. This can mean being aware of/in tune with what is going on with your body or the environment around you. It can involve noticing positive or negative sensations, but the aim is to observe rather than judge.

The goal of this app is to teach basic mindfulness skills and educate about the role of mindfulness in mental health.

Level One

The app teaches you about mindfulness, what it means to be mindful, and how to track your progress in your own mindfulness practice. It uses a levels system based on what you have previously learned, which is great little dopamine rush when you advance to the next level.

Mindfulness practice

Speaking of dopamine, the app gives you a mindfulness tree, which grows and flourishes as you do your practice. What a cute reward for attending to your mental health!

Build Expertise

There are many different options for learning more about mindfulness and practicing different exercises so that all users can find what works best for them. This app is straightforward, easy to use, and has great reinforcement for making those healthy choices.