Family therapy can help to address conflicts in relationships and other disconnects within a group of family members. Sitting in a therapist’s office with your whole family and confronting challenging issues may seem stressful, but there are many potential beneficial outcomes that can be realized from spending that time together.

“The ultimate hope is that families can start functioning in a way that helps each person thrive and feel connected, but also have their own independence and sense of self that fosters safety so that the relationships in the family can continue to grow instead of devolve,” said Elizabeth Earnshaw, a licensed marriage and family therapist and a clinical fellow at the American Association of Marriage and Family Therapy (AAMFT). 

Asking loved ones to start a shared journey into family therapy can be intimidating, but there are plenty of ways for everyone involved to learn valuable lessons and benefit collectively or individually. 

Family therapy is a form of psychotherapy used to treat families as a whole rather than individually, according to an explainer from AAMFT. It’s focused on both the individual’s set of relationships and how a family’s patterns of behavior can affect those individuals. 

Ultimately, family therapy is focused on how different interactions within the family contribute to overarching problems in the unit. According to Earnshaw, when families are together without that third party, they tend to act in the same established patterns of behavior. The therapist can help that interaction change in a way that is more productive.

“There’s another person in the room that can help you articulate yourself in a way that you might not have been able to do before,” Earnshaw said.

A typical family therapy session might focus on what the marriage and family therapy community refer to as “the identified patient,” also known as a black sheep or scapegoat. Families can often put blame on this one person for causing conflicts or chaos.  

“When you move into family therapy, what starts to happen is that we recognize some of the symptoms of that identified patient are based off of symptoms that are showing up in the entire family unit,” Earnshaw said. 

It’s helpful for all members of the family to look at themselves and take responsibility for their role in the dynamic and in the healing.

Back to table of contents.

According to statistics by AAMFT, marriage and family therapists treat over 1.8 million people at any given time.

Family therapy can address events that have transpired in the past, while paving the way for opportunities to construct a new narrative and make healthier choices in the future.  

Addresses intergenerational trauma

Intergenerational trauma is a phenomenon where if someone in the family has experienced a terrifying event, their relatives would also show the same emotional and behavioral reactions to the event similar to the person who experienced it, according to the American Psychological Association. 

“With intergenerational trauma, even though you didn’t like the way a situation made you feel, you also don’t know how to do anything different. So you continue to do the same negative behaviors that generation after generation before you have done,” said Tariiq Walton, a licensed marriage and family therapist in Washington, D.C.

Helps clients move past an individualistic narrative

Earnshaw also noted when a client has their entire family in the room, it allows for everyone to look at each person as a human being with their own challenging experiences rather than going in by themselves and easily demonizing their family members. 

“When you start to hear people’s stories, you can start to create what’s called a coherent narrative, which is a really important piece of trauma treatment that allows you to make sense of the situation through each person’s story,”  Earnshaw said. “It doesn’t mean that you start to think what happened was OK or that it doesn’t matter anymore, but as a family you can start to look at the types of patterns that have been passed down due to trauma and start shifting how you engage and empathize with one another.” 

Gives people space to understand their shared history

For individuals, the benefit of family therapy is that they are allowed more space to talk and be heard. Even if someone doesn’t change, individuals can walk away with a better understanding of what’s going on because they were able to have the conversation and create plans or ideas of how they want to continue to manage their relationships within the family. 

Family therapy might not be for everybody, and that’s OK. Here are some questions people can ask themselves to decide whether family therapy is right for them and their family:

Past Experiences 

Safety/Urgency

Family Dynamics

Personal Goals

“There aren’t a ton of circumstances where it wouldn’t in some way be helpful, even if the outcome might not be what you want it to be,” Earnshaw said. 

Back to table of contents.

When asking a loved one to participate in family therapy, it’s important to be sensitive and mindful of how they might respond because it’s a big step. The reaction may not always be positive. 

“Oftentimes, people don’t see themselves as having a problem. As a family, they’re always looking at that one person who’s the problem,” Walton said. 

However, that “problem person” could be resistant to joining out of fear that others will gang up on them. 

“They get enough of that at home, so they don’t want to sit down with a therapist and allow themselves to be further involved in an oppressive situation,” Walton said. 

Walton and Earnshaw provided the following tips to ask loved ones to join family therapy:

“You want to make sure that each person in the family unit gets to talk about how they feel about how things have been happening in the household, ask questions, discuss specific concerns, and ground it into the greater good so we are happier and get along better,” Earnshaw said. 

Back to table of contents.

In that case, going without the person can help clients process what’s happening within the family dynamic, according to Earnshaw. The therapist could help show what’s going on in the bigger picture, then empower clients to figure out how they want to respond. Whether the family goes without that person, or an individual goes without their family, there are still issues that can be addressed that can make life feel more functional. 

“It’s important not to blame anyone for what’s going on. You’re just expressing how their behavior has impacted you. So when you want to try to convince someone to come into therapy, you do it from a place of understanding and empathy,” Walton said. 

Some reactions to family therapy may come across as angry, defensive or even withdrawn. There are ways to help family members become more open to the idea and to leave the door open for someone to join family therapy at a later time. 

According to Walton and Earnshaw, some ways to respond to common reactions from family include:

Family therapy involves hard work and dedicated effort on everyone’s part, but it can provide worthwhile and long-lasting benefits to the family structure when done correctly. 

“The idea of validating your family’s feelings is, ‘If I truly love and respect you, then I don’t want you to feel that way. I don’t want to be the cause of these kinds of feelings, so maybe there is something for us to work on,’” Walton said. 

Back to table of contents.

But, while artmaking does have therapeutic benefits, it’s important to distinguish it from art therapy. Taking artmaking a step further, art therapy emphasizes processing emotions with a credentialed art therapist through the experience of artmaking.

“I view my role as walking alongside each client to support their individual process and witnessing their artwork is part of that process,” said Lauren Schlenger, an art therapist from Sunstone Counseling in Virginia. “It feels so powerful to be trusted enough to sit with someone while they create and to offer an experience where clients may feel a sense of validation, relief or freedom in the art they make.”

Art therapy can be uniquely tailored to fit the specific experiences of each individual. By participating in the journey of art therapy, clients may be able to better understand themselves in a non-threatening and, sometimes, less invasive way that harnesses their creativity through engaging in emotional processing.

Jump to:

The AATA defines art therapy as “an integrative mental health and human services profession that enriches lives through active art-making, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship.”

This form of therapy is a regulated mental health profession facilitated by a credentialed art therapist who is specifically trained to use art interventions and the creative process to work with individuals on their needs or issues that they seek to address. While relaxing and soothing, artmaking for self-care lacks the psychological component connected to a treatment plan or set of goals the art therapist is working on with the client.

“When you’ve created an image or piece of art, you can find meaning through the artmaking process and be better able to tie that into experiences you’ve had,” Schlenger said.

“Art therapy offers a way for someone to express aspects of themselves without relying on words,” said Gretchen Miller, an art therapist in Cleveland and AATA board member. “It transcends verbal language, and for some people that can be very non-threatening and safe because they don’t have to talk about certain experiences or emotions that are very difficult to put into words.”

Return to top

According to Schlenger, an art therapy session may include time for verbal sharing, time for more concentrated artmaking to allow clients to get into the flow of their artmaking process, and then time to verbally process what the artmaking experience was like and what it meant to them.

“My role isn’t to interpret client artwork but rather to encourage clients to share their personal experience and the meaning they made or discovered when creating,” she said. “When processing the artwork, we may also notice and explore elements of the artwork together to uncover how it connects with their thoughts, feelings and experiences.”

Components That Can Be Included in Art Therapy Sessions

AN INITIAL CHECK-IN TO BUILD RAPPORT

An art therapist may ask questions like, “What do you want to talk about in the session?,” “What have you been experiencing this week?” and “Do you have any goals for art therapy that you want to accomplish?” These questions allow the client to reflect on and understand what emotions are present.

AN OPPORTUNITY FOR PLAY AND EXPLORATION WITH DIFFERENT ART MEDIUMS

Art therapy is not constrained to drawing or painting. It can include sewing, knitting, cooking, collaging, creative writing, scrapbooking, digital artmaking, sculpting and photography. Schlenger says having openness is part of the creative process, and clients should engage with different materials that may enable them to better express themselves through art.

INITIATION OF AN ARTMAKING ACTIVITY

According to Schlenger, the art therapist can take a directive approach with clients in a session, suggesting a specific art activity, or a non-directive approach, leaving it up to the client to decide what to make. It depends on whether the client wants structure.

PROCESSING OF EMOTIONS THROUGH MINDFULNESS

Mindfulness is a critical part of art therapy. As clients are creating the art, the art therapist guides them through self-reflection and encourages self-awareness about their feelings. The process allows clients to recognize and identify their feelings, sit with and absorb them, and eventually develop new insight based on observing what they felt.

ACTIVE DISCUSSION WITH THE THERAPIST

A session does not have to be silent during the artmaking process. The importance lies in processing the emotions and connecting that experience to your art. In fact, Schlenger says that talking through emotions out loud throughout the artmaking process can help to increase the comfort within the session.

The goal of the session is to reflect on and understand the art that they have made in order to better understand and manage feelings moving forward.

Return to top

“It can be scary to explore issues about yourself in real life outside the art room, so art therapy offers the opportunity to safely practice things like taking risks through your art,” Miller said.

The experience of art therapy engages clients in the decision-making process, prompting them with questions like what to draw or which colors to use, which in turn enhances their ability to problem solve and apply that knowledge to real life. It can also help clients think through new possibilities and ways of addressing problems, helping them see a future beyond the present moment, which may be clouded by negative emotions.

According to a 2020 article on expressive arts therapy in Psychology Today, the practice can help clients dissociate from anxiety, trauma and fear, supporting emotional self-regulation and better enabling them to respond to stress. Miller teaches her clients specific tools or strategies in the artmaking process that help regulate and express emotions by taking what’s internal and making it visible.

“It’s about taking those emotions building up inside someone and being able to put that out there, which in turn empowers clients to explore that more or do something with that emotion in a way that will lead to growth or resolution,” Miller said.

According to Schlenger, art therapy is also useful in uncovering hidden traumas.

“Sometimes what’s expressed in the art can bring up unconscious feelings,” she said, which clients may need help working up the courage to talk through. “It’s not just the process of creating and talking about it but the process of creating by itself.”

Questions To Consider Before Engaging in Art Therapy

How do you prefer to express your experiences, feelings and thoughts? Miller emphasized that it’s important for people to consider whether it’s easier to express themselves through images or words.

How do you respond to creating art? If you observe yourself experiencing an intense reaction, either negative or positive, during the process of creating art, consider tapping into that reaction with an art therapist.

Do you have a history of pre-verbal trauma? The sensory-based component of art therapy can help you express feelings without words, so you don’t have to rely on speaking and using language if that is too difficult or triggering.

For those who are nervous about seeking art therapy treatment, creating art can still be a form of self-care. Taking a moment for yourself to get out of your head and engage in something that gives you enjoyment can help reduce stress and enhance emotional regulation, Miller pointed out.

“Whether your mind is anxiously wandering about the future or regretfully ruminating on things in the past you can’t change, art is there to slow you down,” she said. “It helps you practice being content with and present in the moment, which demonstrates to you what that feels like and allows you to be able to transfer that to other situations in order to cope.

For those using artmaking as a means to relax, Miller suggests engaging in rhythmic activities, such as doodling, knitting, crocheting or meditative drawing.

“That repetitive pattern of doing that over and over again can help calm your thoughts and re-establish a connection with yourself and your own self-care,” she said.

Return to top

One benefit of art therapy is that clients do not need to be an artist to reap the benefits of artmaking in a therapeutic environment. This can connect well with teens, who are still developing mentally and physically.

“Developmentally, teens are trying to make sense of their own identity and values,” Miller said. “They’re thinking about how they’re feeling in their relationships with peers, family and the world.”

One benefit of art therapy is that clients do not need to be an artist to reap the benefits of artmaking in a therapeutic environment.

According to a study on art therapy for adolescents in the Western Journal of Medicine,  teens and young adults can benefit from art therapy because it’s a non-threatening way to express their inner thoughts and still receive support. Distressed teens may not trust adults in their lives to help them. In cases of abuse, for example, teens may feel embarrassed to reveal details or fear putting themselves at risk. They can use art to express their emotions and feelings visually.

“When I work with teenage clients, there can be that discomfort of going to therapy, but I try to normalize it and talk about it as a healthy way to express yourself,” Schlenger said.

From Miller’s experience, art therapy group work for teens can be highly beneficial because they’re learning how to relate with peers their age. Being in a group with other teens who are also experiencing similar issues can help to create a sense of belonging and support while alleviating isolation.

Miller believes that art therapy can help teens achieve a sense of self-awareness and clarity around their strengths, values and beliefs, which better positions them to understand their struggles and cope.

“Creativity is a huge strength of teens at this time, so they can really tap into the art therapy session with that and explore different things happening in their lives,” Miller said.

Return to top

American Art Therapy Association: An organization that advocates for accessible art therapy and advances art therapy as a regulated mental health profession.

American Art Therapy Association Art Therapist Locator: This is a geographical directory of credentialed art therapists.

Art Therapy Credentials Board:  Provides additional information on credentials.

International Expressive Arts Therapy Association:  An organization that supports art therapists’ work in an inclusive and culturally diverse way.

Art Therapy Without Borders:  An organization that promotes art therapy and art therapy research in mental health, educates others on art therapy and develops art therapy programs.

The Art Therapy Alliance:  An organization that uses social media to promote and advance art therapy and the work of art therapists and seeks to build community.

Remote Art Therapy Resources:  A list of art therapy resources during coronavirus provided by Children’s National Hospital in response to the pandemic.

Art Therapy in Action: Adolescents, AATA: An informational video on the beneficial relationship that adolescents can have with art therapy.

Thirsty For Art:  An art therapist who posts resources on art therapy on Instagram  and YouTube.

Self-Exercises: These videos separate self-guided art therapy exercises by depression,  anxiety,  stress management  and emotional pain/healing.

5 Tips for When You Can’t Draw Your Feelings:  A video on how to work around a creative block.

Resources Folder:  List of resources such as podcasts, books and groups about art therapy and art therapy education.

Return to top

Information on OnlineCounselingPrograms.com is not intended to be a substitute for professional counseling advice. Always consult qualified professionals with any questions you may have about mental and behavioral health-related issues.

Video games can be a pain point for some couples. When one partner spends more time playing virtual football games with their friends rather than engaging with their significant other, that can create tension or resentment. But during a pandemic when people are trying to stay home as much as possible, there are limited options for entertainment and recreation.

Video games, particularly the collaborative ones that allow people to play with family and friends, can be a source of community and social connection during COVID-19 restrictions when people are struggling with mental health problems, said Ryan Hansen, a psychologist at Reset Button Consulting in Columbus, Ohio.

But the pandemic doesn’t give partners a license to ignore their relationships.

“It’s really hard to imagine when you’re playing 20 or 30 hours a week that that isn’t impacting some area of your life,” Hansen said. “If you’re only playing one or two hours a week, you’re probably doing pretty good. It’s just the gray area in the middle that’s a little tricky to sort out.”

For healthy relationships, couples may need to navigate that gray area, which can be more difficult under current circumstances. OnlineCounselingPrograms.com asked professionals in the counseling field to weigh in on how people can manage their gaming hobbies while maintaining healthy relationships.

Lily Lu, LMFT, a behavioral health specialist at Mind Health Services in Los Gatos, California, said some of the couples who come to her for counseling related to video game use already have broken relationships. But many couples still have a chance to heal because they recognize they have just started to grow apart.

According to professionals interviewed, there are a number of warning signs that video games are affecting a relationship.

Video game overuse typically is accompanied by partners’ inability to influence each other around the behavior, resulting in feelings of neglect or insignificance, said Mathew Meyers, LMFT, a therapist and owner at Traverse Counseling and Consulting in Plymouth, Minnesota.

One partner may hesitate to bring up the problem, having lost confidence in how to talk with the other. And the more the couple is unable to thoughtfully discuss and process what is causing strain, “the more the shame-and-blame cycle amps up,” Meyers said.

The gamer may retreat further into video gaming as a means of managing negative feelings about the relationship. In contrast, the partner who does not play video games may concede to avoid drama, which is characteristic of the often overlooked problem of withdrawal from a relationship.

They say to themselves: “I’ve kind of given up, and I’m stonewalling. This is an easy way to kind of manage my hopelessness because I can create some stasis in the relationship,” Meyers explained.

As with many behavioral issues, recognizing video game overuse earlier can help prevent it from developing into a bigger problem. But without strict definitions of what constitutes overuse, it can be difficult to identify if a partner has a problem that needs to be addressed. Standardized screenings do not exist for gaming or digital disorders, and disorders are not recognized the same as other addictions, Hansen said. As a result, concerned individuals should reflect on the level of impairment that gaming may be causing a person and whether it’s affecting their ability to function, he said.

“If this area of your life is eating into other areas of your life, that’s when you start to have a problem,” he said.

To prepare to bring up video game overuse, partners should first recognize that gaming is a culture for some people. Establishing that awareness shows a willingness to understand why gaming has been so important to a person.

“What might seem absolutely ridiculous to you in terms of spending 10 hours a week playing video games is actually considered pretty normal within that culture,” Hansen said. “That doesn’t necessarily mean it’s good or bad, but just that to all of somebody’s friends and the people that they’re hanging out with, it would seem completely normal.”

How partners concerned about video game use approach a conversation about the topic can play an important role in whether they are received openly.

If partners are at an impasse, consider getting professional help. Couples should be open to considering that video game overuse may be a symptom of something else affecting the relationship dynamic and explore that possibility with a professional counselor or therapist

Understanding and compromise can go a long way in preserving couples’ relationships, and that includes video game use. If someone knowingly enters a relationship with a gamer, “asking them to completely give it up would be the same thing as asking an Ohio State football fan to never watch a game again,” Hansen said. “It’s just not going to happen.”

Understand that relationships are about staying connected and video games can provide connections, Hansen said.

“I am always more of a fan of video games that allow people to connect with each other,” he said. “You can overdo it playing Mario Kart, but if you’re playing with your spouse, not so much. If you get into some of these games together, that can lead to a lot of positive experiences.”

Partners have to work together so their relationship can succeed, he said. Just having conversations about the issue prioritizes the relationship, which helps build trust and allows for grace. The next step would be to implement strategies that help the couple manage the effects of use on their relationship.

“Partners may not be able to change their partners,” Lu said. “However, partners may share their concerns and model good behavior and habits.”

Information on OnlineCounselingPrograms.com is not intended to be a substitute for professional counseling advice. Always consult your qualified professionals with any questions you may have about behavior-related issues.

Are you interested in pursuing an education in counseling, but need flexibility when pursuing a master’s degree? Learn more about what an online master’s in marriage and family therapy can offer.

A common piece of advice for family gatherings is simply to say, “no politics.” Bringing up hot-button issues at a party can cause emotional turmoil when people have different deeply held stances. Many people believe that avoiding these conversations keeps the peace.

But for those in marginalized and underrepresented groups, avoiding politics is often not an option because these “political” issues affect their everyday lives. Many within the civil and human rights arenas have argued that claiming neutrality is a privilege and getting to choose whether to talk about politics is a luxury.

As communities around the nation work to confront racism, police brutality and the racial and ethnic health disparities underscored by COVID-19, more friends and families are being forced to engage in discussions that challenge their personal and political beliefs and require them to reflect on how their “politics” impact the lives of others.

Approaching these conversations with discernment that acknowledges existing family dynamics and your personal sense of self and safety is important. Below, find common questions about engaging in politics with family members in a healthy, respectful way, including how to end a discussion that becomes disrespectful or too damaging to continue. While this experience will be different for families with different personal histories and cultural backgrounds, the advice below can offer a starting point for productive conversations.

Family relationships differ from friendships in one essential respect: people cannot choose their family of origin. In friendships, people gravitate toward those with similar values and views, according to Karl Pillemer, PhD, author of the forthcoming book Faultlines: Fractured Families and How to Mend Them.

“It’s a principle of like attracts like, and [we] tend to feel closer to people who share our basic values,” said Pillemer. “That fact is also true in families.”

However, if two people in a friendship develop different views, they generally are not under an obligation to maintain the relationship. Separating from a family can be much more complicated, awkward and painful.

“But in general, you are with your family members, so you may be stuck with these people,” said Pillemer. You may also have a history of shared positive memories that makes cleanly exiting the relationship hard.

Vickey Maclin, MA, PsyD, counsels adolescents struggling with this dynamic and often reminds clients of the deep, underlying concern that exists in many—though not all—families.

“They care deeply for you, and for some kids, that’s something to buy into,” said Maclin. “But as is typical of adolescents, they just think their parents are idiots.”

This push-and-pull dynamic of both loving and frustrating each other can apply to family members of all ages, further complicating discussions in the political arena.

Many people believe their upbringing and lived experiences solely influence their political beliefs. However, these factors only partially explain our political identities, says John Hibbing, MA, PhD, a political scientist at the University of Nebraska–Lincoln. In his research, Hibbing explores the psychological differences between conservative and liberal Americans.

“We have this sense that those views that our parents have passed along are supplemented by those, you know, from a clergy member or a trusted relative, a close friend. But we sort those through own our view of the world,” he said on the NPR podcast “Hidden Brain” in an episode about the psychology of political identities.

According to Hibbing, conservatives tend to prefer things that convey comfort and predictability—meat and potatoes on the table, organized workspaces and poetry that rhymes. Liberals, on the other hand, appear more willing to experiment. His past research indicates that liberal Americans tend to prefer food from different cultures, have less tidy living spaces, and feel more comfortable with free verse poetry.

“The point of this research isn’t to stereotype liberals and conservatives but to show that our political choices flow from deeply ingrained psychological differences,” said Shankar Vedantam, host of “Hidden Brain.”

Therefore, interacting with relatives who hold an opposing view may be as much a matter of biology as upbringing and environment.

The point of this research isn’t to stereotype liberals and conservatives but to show that our political choices flow from deeply ingrained psychological differences.

Still, Maclin affirms that culture and the family system do shape political views.

“My personal navigation with families around generational and intergenerational issues really has a lot to do with the sensitivity of the culture of the people that I’m working with,” she said.

Having a holistic view of the reasons behind people’s perspectives is helpful to bear in mind before entering politically charged situations.

Maclin advises clients preparing for family gatherings to reflect on their own values and how they relate to those of their family members.

Reflecting on these can help build your sense of self, so that a relative’s disagreement will be less devastating to you.

“The ideal way to approach it is to have this strong and stable sense of self that allows you to express your views without becoming infuriated or disappointed if others don’t agree with them,” said Pillemer.

Have a strategy for responding to political conversations at family gatherings and other events. While these topics are important, keep in mind that some relatives may not be ready for open, respectful dialogue. Use discretion in deciding which conversations to focus on.

Ask yourself if dialogue with a family member is likely to change their opinion. Would the debate be enjoyable, safe and edifying? If so, Pillemer advises following the same guidelines of respectful dialogue as in any conversation. Ask if the person is interested in your opinion, talk about the reasons behind your feelings, and share heartfelt stories.

However, if pursuing this particular conversation will only lead to further conflict and loss of connection, reconsider. Reply with, “I do not share your opinion, but I prefer not to discuss politics at family gatherings,” or something similar. Your energy may be better spent continuing the discussion with other family members or in other spaces.

Standing up to relatives who express views that deny the dignity of others can be intimidating—but may also be vital.

“If someone is routinely expressing white supremacist views, for example, it may not be possible to continue the relationship if the views are so offensive,” said Pillemer.

A mental health professional can offer support in evaluating the relationship and taking healthy next steps. Depending on your sense of safety in the environment, “standing up” can take various forms. You might counter the individual’s views in the moment, or you could write a personal note later (not a public post on social media).

If a conversation becomes overly heated or harmful, politely but firmly decline to continue. You could say, “I just don’t want to be engaged in these kinds of conversations because it doesn’t get us anywhere.”

If someone continues to press the issue, do not engage. If you are asked for your political opinion, you could explain that you do not think your perspective would be valued or accepted.

If you know your family members will “look at you cross-eyed and think you’re crazy” for expressing your views, said Maclin, try telling them so.

Sarah Stewart Holland and Beth A. Silvers, co-hosts of the podcast “Pantsuit Politics,” suggest trying, “Thank you for talking to me about this. I have reached the point where I’m not up for any more today. I would love to do this again.”

Consider the factors that have shaped other family members’ political identities.

Ask yourself where their beliefs may have originated and why they express them over and over. Maclin asks clients, “Is there some place where you can develop a sense of compassion for them, for who they are, for how they have given and invested in your life and for how they feel about you?”

Reflect on why the family member’s disagreement bothers you personally, beyond political or moral reasons.

According to Pillemer, it could be a form of identity threat to you if someone you respect and admire begins espousing offensive or opposing views. A counselor or therapist can be a helpful sounding board in this process.

Work on accepting that the other person is likely not going to change, especially if the argument has become heated.

“We [usually] aren’t talking about a meaningful, reasonable exchange of ideas. We’re talking about people with extremely hard positions yelling about it,” said Pillemer.

Recognize that people don’t change their minds through argument—but do not be discouraged.

“We don’t ever argue somebody into our way of thinking,” said Maclin. Be especially wary of political conversations on social media platforms. “It’s just not a likely venue where anyone’s ever going to change their mind,” said Pillemer. Speaking out against views that dehumanize or degrade others is still progress, even if the other person does not change their mind.

Speaking about white allyship on the podcast “Pantsuit Politics,” Dr. David Campt highlights how engaging in conversations with relatives can be part of long-term anti-racism work.

“On the one hand, we need a certain sense of urgency. On the other hand, we need to have a long-run point of view,” he said. “So, that means if you have a super racist Uncle Tony, and you have more of a kind-of racist Aunt Edna, as you try to learn these techniques you might first focus on Edna before you move to Tony—because you need to practice, and it’s a lifelong thing anyway. You’ll get around to Tony.”

There is a difference between peaceful discourse and argument, and it is possible to have civil discussions about different opinions in a productive, informative way. However, when things become heated, it may be best to calmly shut things down. Again, Maclin cautions that arguing rarely, if ever, changes minds.

“Really, that has to come from within a person,” she said. “But if people are willing to sit down and listen, engage in, and hear from another’s perspective, then I think movement can happen toward change.”

While avoiding and redirecting an unproductive conversation can feel like giving up, consider focusing your energy to create change elsewhere. These efforts can help shape politics for generations to come.

Contact your elected officials 

Call their office or write a letter or email to share your perspective and advocate for the issues that matter to you.

Learn about the voting laws in your state

Before the election, find out how to register, where your polling place will be and what identification you will need. Also check to see if your state offers early voting.

Attend town hall meetings

Your local officials and Congressional representatives may hold free public town hall meetings. Sign up for your representatives’ email lists and bring questions.

Make a donation

Offering financial support is a meaningful way to build up candidates, organizations and movements that make a difference. Charity Watch and Charity Navigator can help you make thoughtful giving decisions.

Do you have a professional interest in working with families to navigate challenging conversations? Learn more about what a master’s in marriage and family therapy can offer.

When the coronavirus pandemic forced the world to go virtual, it disrupted life’s many systems—mental health care being one of them. But for Patricia Tucker, a licensed clinical social worker, meeting with her clients continued as usual. From her home in central Pennsylvania, Tucker primarily sees her clients virtually through Skype. She’s used to adjusting where she sits for her online sessions and avoiding things like poor lighting or being near a sliding door. She’s learned exactly how to assess facial expressions and body language through a screen. Although her work hasn’t changed much because of the crisis, the pandemic has taught Tucker how vital telemental health services are during this uncertain time.

“Nothing’s perfect, but the value virtual therapy offers outweighs the obstacles you’d have to overcome,” Tucker said.

Virtual therapy, also known as online counseling or telemental health care, can help people get the support they need if they are unable to meet in person. As long as the client has an internet connection, this form of mental health care can be provided through text, phone or video conferencing, offering people who want to start or continue therapy an avenue to receive these services while in quarantine.

Telemental health care has proven to be an effective alternative to conventional care. According to the American Telemedicine Association, the benefits of virtual counseling include:

“As therapists, we want to work around our clients,” Tucker said. “Virtual therapy gives us the flexibility to always be connected.”

However, there are limitations.

“Not everyone is a good fit for telemental health, such as if they have severe symptoms that require a higher level of care,” said Zeyad Layous, a clinical psychologist based in northern Virginia.

Layous pointed out that mental health practitioners are hardwired to pick up on other people’s emotions through micro-expressions in their faces, which can be easier in face-to-face meetings.

“Energy changes in the room when someone’s upset,” he said.

Tucker agrees that being able to see the client’s face is important, which is why she encourages virtual counseling to be performed via video conferencing.

“If I was just talking on the phone and someone was being dishonest, I would miss something,” she said. “It could have revealed something we could have really worked on. So, to me, including the face has to be a part of the session.”

Technical issues, such as screen freezes and connection disruptions, can also take getting used to.

“There’s a new flow in virtual conversation that shifts because you’re operating through a digital space where you say something that’s being transported, and there’s a delay,” Layous said. “You have to be more mindful of the session’s flows.”

Are you interested in seeking online counseling or virtual therapy, but don’t know what to expect? OnlineCounselingPrograms.com asked experts to share their tips on how to get started using this growing field of mental health care.

10 Tips for Clients Starting Online Counseling

---

Research your potential therapist’s background and expertise to ensure they will fit your needs.

Make sure the therapist is licensed in your state.

Don’t expect to be comfortable right away. Layous said to work through three to five sessions before making a decision on whether to continue. “It takes time to build a solid relationship,” he said.

If you are continuing with your current therapist, address your goals and concerns about online counseling or virtual therapy directly with them.

Consider a phone call meeting to ease into the virtual sessions. Some people may feel anxious about being seen on camera at first.

Consider a phone call meeting to ease into the virtual sessions. Some people may feel anxious about being seen on camera at first.

Be in an emotionally safe place that allows you to feel comfortable being vulnerable. In some cases, sitting in a parked car in the driveway could be beneficial if there’s a lack of privacy at home.

Test the software beforehand to make sure it works and verify your counselor or therapist’s contact information.

Place your screen on a stable surface to avoid excessive movement that could be distracting.

Focus your camera so it’s pointing from the top of your head down. This will allow you to see your therapist face-to-face.

Amwell: directory for licensed therapists who are on call to provide treatment.

BetterHelp: e-counseling platform that connects clients to psychologists, therapists, social workers and counselors.

Black Virtual Therapist Network, Black Emotional and Mental Health Collective: online directory of black licensed therapists.

Doctor On Demand: hub that allows clients to schedule virtual appointments with psychiatrists and therapists and receive a free mental health assessment.

“Find a Teletherapist,” Psychology Today: comprehensive directory for virtual therapists.

MDLive Therapy: resource that can connect clients with licensed therapists via phone or video.

National Crisis Text Line: mental health text line connecting anyone to a crisis counselor 24/7.

TalkSpace: service that allows clients to connect with therapists via text, audio and video messages, with the option for live video sessions

Virtual Therapist Network: teletherapy platform for therapists, counselors and life coaches to meet with clients online to provide secure telemental health services.

7 Cups of Tea: platform connecting anyone to volunteer listeners as well as licensed therapists for emotional support.

Are you interested in supporting people through mental and emotional challenges? Learn how to become a mental health counselor.

“Whether people have a lot of money or people have no money, money is a really stressful thing in our lives,” said Maureen Kelley, a Denver-based financial therapist and founder of MADRE (Money, Assets and Durable Relationships). “This crisis we’re working [with], dealing with and living with now, it just accentuated it. And the fear and the panic around this is exponential.”

Financial, physical, mental and emotional health are all intertwined.

“We can’t just assume that it’s only financial stress,” said Alex Melkumian, Psy.D., LMFT, founder of the Financial Psychology Center in Los Angeles. “It’s also psychological stress, emotional stress [and] the stress that compounds our concern about our physical well-being.”

Fear and panic associated with stress can trigger the fight, flight or freeze response. Melkumian explained that we react to stress because our emotional brain, or limbic system, can take over and cloud our ability to make rational decisions.

Financial, physical, mental and emotional health are all intertwined.

“And that’s when you see the really negative response to the stress, which can be overthinking, a lot of anxiety, worry, sadness and despair,” he said.

Studies have shown that financial stress can lead to a range of physical and psychological complications. Depression, anxiety and poor work performance are among the possible psychological effects of financial stress (PDF, 254 KB). The physical health complications of financial stress  can include cardiovascular disease, increased mortality, inflammation, hypertension, diabetes and digestion problems.

Long-term financial stress can also negatively affect immune response.

“When we’re stressed—chronically stressed—that stress response takes away from our immune system functioning,” Melkumian said. “We’re actually reducing our ability to cope with the virus.”

Kelley has seen an uptick in fear and panic among her clients. And although she believes the economy will bounce back, the lingering question for many people is when that will happen.

“There’s a lot of uncertainty with this,” she said. “People are losing their jobs, their hours are cut, retirement portfolios have been decimated. These fears are very real for us as a country.”

Rather than becoming paralyzed by fear and making irrational decisions, Kelly says that it’s important to learn how to manage fear, stress and anxiety.

“Look at the small things that are in your control right now around spending and know that this will pass,” she said.

OnlineCounselingPrograms.com asked a number of experts in the realm of financial counseling and coaching for tips on how to manage financial stress during crises.

Practice mindfulness

---

Become more aware of how you are feeling and identify the root of those feelings in order to move away from a panicked state.

Financial coach Jenn Steliga  explained that it’s important to get comfortable being uncomfortable.

“The more we push our feelings away or ignore them, research actually shows that they grow and get out of control,” she said. “Then, we’re in a position where our emotions are controlling us.”

Simple mindfulness practices can help ease anxiety. Steliga said that if you notice you are feeling anxious, stop and ask yourself something simple.

“Sounds very silly,” she said, “but if you can say, ‘Where are my feet?’ you bring focus to something.”

Melkumian also suggested making time for short, incremental meditation sessions for a few minutes throughout the day to alleviate the buildup of stress.

Talk about money

---

“Money is still the last taboo in our culture,” Kelley said. “Nobody likes to talk about it. It’s uncomfortable. People don’t know how to talk about it.”

Money can be difficult to discuss because it is often surrounded by feelings of shame, guilt and embarrassment. Those feelings can be heightened in a crisis. Kelley encouraged people to find a safe space to talk about money with a friend, family member, financial advisor or therapist.

“Often when you’re just able to verbalize it or share it with someone else, that in itself relieves a lot of stress,” Kelley said.

Make a financial plan

---

Free budgeting apps can help families create and track budgets

“A budget is not just tracking their expenses,” Steliga said. “It’s spending every dollar on paper on purpose, before they ever hand it out to anyone at all.”

For those facing true financial hardship, it’s best to prioritize spending on basic needs including housing, utilities, food and transportation. Kelley suggested cutting down on nonessential spending and “really looking at what are the things that I can control in my spending and what are the things that are not essential that I can cut out.”

When it comes to shopping, shop intentionally, Steliga added. Take stock of products you have in your house; then, make a shopping list and stick to it.

Don’t focus on getting out of debt during a crisis

---

After meeting your basic needs, including bills and legal obligations, make your minimum payments on loans and credit lines but don’t worry about paying off debt.

“A lot of people would say, ‘Hurry up and get out of debt,’ which is a really big misconception,” said Wendy Wright, LMFT, a financial therapist  based in Denver. She encourages clients to build savings while paying down debt.

It can be tempting to take on more debt when money is tight during a crisis, but try to minimize new debt. Don’t let short-term panic dictate long-term financial decisions.

Save money when you can

---

Wright suggested tracking how much money is required to meet basic obligations and then putting extra funds in a savings account for a set period of time. She encouraged using a timeline of three months and revisiting the situation after that time has passed. Having a set window to focus on saving can help reduce anxiety.

“Our brains like a beginning and an end,” Wright said.

Financial stress from the coronavirus outbreak can compound general stress surrounding the pandemic. It can also exacerbate pre-existing mental health issues, such as anxiety or depression.

The following strategies can help mitigate financial stress when paired with other mental health concerns in a crisis.

Creating and maintaining a schedule can provide structure for people who are home-schooling or caring for their children while dealing with struggles like job loss and financial insecurity. Schedules set boundaries and can help people avoid unhealthy coping mechanisms like binge-watching television, drinking too much or online shopping.

“Within that schedule, give yourself very specific time to job search and to get yourself on a budget,” Steliga said. “Be very specific.”

Rather than committing to looking for jobs without a real plan in place, Steliga suggested telling yourself, “I will job search for 30 minutes tomorrow morning at 9 a.m. at my kitchen table with my coffee while my kids are doing homework.”

Eat well, exercise, and try to avoid round-the-clock binge-watching. Avoid heavy social media use and excessive news consumption.

“Do the things that bring you into a good place so that you can continue to make good choices,” Steliga said.

People are being asked to make important decisions while dealing with fatigue. Wright said that “pacing yourself, building a routine [and] sticking to your routine as much as possible” can help create a sense of steadiness during uncertain times. That can also include maintaining previously established mental health interventions.

She also said that it’s important to remember everybody is doing the best they can.

Crises can bring a heavy sense of loss. Identifying the stage of grief that you’re experiencing (denial, anger, bargaining, depression or acceptance) can help you build connections with others. People experience grief at different rates, so naming which stage you are in can allow you relate to people in different stages.

Melkumian also encouraged “scheduled worry sessions”—actually set aside 5 to 10 minutes during the day where you allow yourself to worry. The paradoxical intervention helps contain anxiety.

“You get your worries out for 10 minutes, but then the rest of the day you’re worry free,” he said.

Although worrisome thoughts may still arise throughout the day, it’s up to you to guard your own mental well-being and protect yourself from those automatic thoughts, Melkumian said.

Staying connected in times of crisis is vital.

Seek financial advice from people who are grounded. Look for support from friends, family members and counselors who are financially stable. And if you are unable to see your regular counselor, look into telehealth options.

These resources can help alleviate financial and other stress related to the coronavirus outbreak.

This article is for informational purposes only. Reach out to a financial professional before making any important financial decisions. If you are experiencing mental health issues related to financial concerns, consult a mental health professional.

Are you interested in supporting people through mental and emotional challenges? Learn more about how to become a counselor.

“People might wonder, ‘How’s a therapist supposed to guide me through something I feel so hopeless about?’” said Dr. Margaret Rutherford, counselor and author of “Perfectly Hidden Depression.” “But a therapist isn’t going to solve your problem. A therapist is going to help you get back in touch with your own strength.”

The need for counseling or therapy may be difficult to identify, because mental distress looks and feels different from person to person. Symptoms that signal it’s time to seek therapy can change as people age. It is also not required to observe or feel any of these symptoms before seeking help; help is available to anyone regardless of their personal experiences.

Romantic breakups, parenting struggles and career burnout might seem like typical stressors for the average person. But these events can lead to unhealthy coping mechanisms, like trouble eating and sleeping, emotional outbursts, social anxiety or isolation that need professional attention.

Both therapists and counselors can provide mental health care for someone in need. Licensed professional counselors can diagnose and help treat mental or emotional disorders. Licensed therapists address clinical mental health needs with holistic approaches.

Seeing a professional therapist or counselor can provide a consistent source of support on an interpersonal level. Whether the visit occurs in person or online, clients will receive emotional help, fill their knowledge gaps about mental health, and establish new patterns of behavior by learning behavioral skills that last a lifetime.

While every counseling session is tailored to the individual’s needs after evaluation, counselors can provide a range of benefits to their clients.

“When things are spinning out of control, people come in to get a hold of their lives,” Rutherford said. “But a therapist is going to have you unpack the source of your shame and perfectionism first, before you can address the issue of control.”

Anyone can see a counselor even if they haven’t experienced an identifiable trauma or developed a mental illness. However, it’s common for adults to brush off feelings of stress or not take their symptoms seriously.

Rutherford compared the process of identifying mental health concerns to that of physical health concerns.

“If one of your children came up to you with a cut on their arm, would you say, ‘Just be glad it’s not broken?’” she said. “No. You’d immediately do something about it.”

Some behavioral patterns or emotional symptoms  are a more classic indication that someone needs help, according to the National Alliance on Mental Illness. These signs look different across the lifespan.

Symptoms may be masked by perfectionism, overachievement, denial or extroversion.

“People with perfectionism have a hard time seeing their problems because their lives look so good to others,” Rutherford said.

Across all age groups, a mere desire to seek help from a professional or trusted confidante is enough reason to look for a counselor.

Friends and loved ones will often see the signs before a person recognizes a need in their own life. In fact, almost 1 in 5 people who have seen a counselor said they found a provider through a recommendation from a friend or family member. Thoughtful, compassionate encouragement can help a person pursue professional care in a safe way.

“No matter your age, watching someone else struggle is difficult,” Rutherford said. “Talk to them about how it impacts you as a starting point.”

While children and teens may be subject to their parents’ and guardians’ decisions about pursuing mental health care, adults may struggle with the stigma related to seeing a counselor or asking for help, especially when faced with losing independence as they age. To address stigma with compassion, Rutherford identified several ways to support someone who needs help.

Search online for a counselor in your area at any of the following sites:

If you are interested in a career in mental health counseling, learn more about how to become a mental health counselor.

Teen dating violence is a form of intimate partner violence that occurs between teenagers of all genders who engage in romantic relationships. TDV can take place in person, over the phone or online, similar to bullying.

THE TWO MAIN TYPES OF TDV INCLUDE:

The Youth Risk Behavior Surveillance System collected data about physical and sexual dating violence among high school students in relationships in 2017. Overall, about 8% of high school students in relationships experienced physical dating violence, while the overall prevalence of having experienced sexual violence ranged from 7.7% to 18.5%. Female students and lesbian, gay and bisexual (LGB) students were among the groups most at risk.

Go to the bottom of this page for a tabular version of data on teen dating violence among high school students.

TDV, or even the threat of violence, can significantly alter a person’s feelings of safety and self-security, even when the threats aren’t visible to peers or caregivers.

THE CDC NOTES THAT LESS VISIBLE FORMS OF TDV INCLUDE:

For all types of intimate partner violence, the CDC estimates that 26% of women and 15% of men who experienced contact sexual violence, physical violence, and/or stalking by an intimate partner first did so before the age of 18.

What Are the Signs of Teen Dating Violence?

Alarming behaviors can begin between the ages of 12 and 18. Some relationship red flags that could be a cause for concern include:

• Breaking up and getting back together repeatedly over short periods of time
• Frequently fighting or arguing in public, in private or online
• Excessive jealousy and insecurity from either partner
• Invasions of privacy such as reading through text messages, social media accounts or personal devices
• Controlling and threatening behavior
• Taunting or teasing in a bullying mannerat school or via social media accounts
• Consistent monitoring or checking in on each other’s locations, friends or plans
• Restricting time spent with friends or extracurricular activities
• Temperamental or explosive discussions, including false accusations

These types of behaviors may be modeled to teens or adolescents by their parents, characters in entertainment media or even peers at school. It’s important for school staff to monitor this behavior, while also looking for risk factors that make students more likely to experience intimate partner violence, which can include:

• Significant age differences between partners
• Decreased attachment to caregivers or parents
• Increased association with peers who exhibit violent or risky behaviors such as substance use
• Cohabitation with an intimate partner before the age of 18
• Engaging in sexual activity before the age of 16
• Exposure to traumatic life events or domestic violence at home

Addressing TDV as early as possible can help promote healthy relationships in adulthood and prevent negative outcomes.

---

What Are the Consequences of Teen Dating Violence?

The CDC reports that teen dating violence has been shown to produce the following long-term and long-lasting effects for those who experience it:

• Poor school performance
• Drug and alcohol abuse
• Development of eating disorders
• Depression
• Suicidal intent

Adolescents who experience TDV during high school are at a higher risk for mistreatment during college. Intimate partner violence is also associated with the development and worsening of mental health conditions  that include post-traumatic stress disorder, anxiety, obsessive-compulsive disorders, substance abuse and severe and persistent mental illnesses.

Under Title IX of the Education Amendments of 1972 (PDF, 589 KB), sexual violence is a form of sexual harassment. Any school that receives federal funding must respond to all instances of TDV or risk being subject to lawsuits.

SCHOOLS BECOME LIABLE FOR THE TEEN DATING CONFLICT INCIDENTS WHEN THE:

The Office for Civil Rights requires by law that school administrators — including school counselors — respond and report in an effective manner, immediately upon knowledge of an incident. Some states have mandatory reporting laws that require the involvement of law enforcement or child protection agencies.

Regardless of legal obligations, documentation should always be prompt, thorough and impartial.

For reported incidences, a school counselor’s role involves working with administration to minimize additional trauma from investigation. While every student has a right to confidentiality, a school counselor must weigh the request of confidentiality with the seriousness of the allegation, age of the student, number of other complaints against the harasser and the alleged harasser’s right to receive this information. If there is an insistence on confidentiality, the school could seek other steps to limit the effects of the harassment and seek preventive measures.

Regardless of legal obligations, documentation should always be prompt, thorough and impartial.

According to a model policy created for schools in the District of Columbia by Break the Cycle, some ways that school counselors and other staff can protect the confidentiality of students (PDF, 621 KB) include:

In 2012, the American Academy of Pediatrics conducted a national assessment of school counselors’ perceptions on teen dating violence. School counselors identified themselves as the main school-associated personnel to assist survivors of TDV. Their roles include identifying and supporting students who have experienced TDV, developing and implementing appropriate dating abuse policies, training other personnel and encouraging students to report.

But as Break the Cycle points out, many students do not seek help because of mistrust of adults and professionals. In addition to reassuring students about confidentiality through the measures outlined above, school counselors should explain to students how they can help. The D.C. model policy highlights the ways school counselors and other staff can assist students:

Navigating a sensitive conversation is an important part of an effective intervention and can establish a trusted relationship with a student when they’re ready to seek help.

Tips for School Staff Intervening With Teen Dating Violence

• Reflect on personal values regarding relationships and consider personal biases that might not be relevant to the student’s experience.
• Establish a safe space to talk, so the student knows they’re entitled to confidentiality.
• Offer to assist with a problem instead of trying to solve it for the student.
• Use age-appropriate and relevant examples of healthy relationship dynamics.
• Give undivided attention and actively listen to the student’s concerns.
• Remind the student they are not alone and offer additional resources for help.

For more tips, consider this conversation guide on healthy relationships from Break the Cycle (PDF, 776 KB).

Promoting healthy partnerships can also play an important role in TDV prevention. The Dating Matters training module created by the CDC encourages schools counselors and staff to highlight characteristics of strong, safe relationships (PDF, 476 KB).

Characteristics of a Healthy Relationship

• Partners are free to be individuals and enjoy activities and interests apart.
• There is a mutual respect for boundaries and privacy.
• Partners listen to each other and understand each other’s values.
• Interactions are rooted in respect and encouragement.
• There is an understanding that disagreements will happen.
• Partners express themselves honestly and respectfully.
• Both partners feel equal in the relationship.
• The relationship is fun and enjoyable.

School counselors and other staff can also model healthy behaviors when it comes to handling emotions and interacting with peers or students. Dating Matters module encourages school staff to consider promoting the following strategies for emotional self-regulation:

By actively pursuing new strategies to help students recover from traumatic relationships and prevent them from falling into new ones, counselors and other school staff can create a safer, more nurturing school environment that lets every student succeed. Peers can also intervene and protect students who may be victimized by a partner. Break the Cycle offers a number of steps to help friends who say they are being abused.

How to Support a Friend Experiencing Teen Dating Violence

1. Initiate a conversation by sharing that you may have noticed concerning behaviors. Ask them how these behaviors make them feel.
2. Offer support without judgement. Your friends may not recognize behaviors as problematic. Some supportive phrases include:
   1. What do you need?
   2. Thank you for trusting me.
   3. You deserve to be treated with respect.
   4. It’s not your fault.
3. Keep the door open for them to ask for help, even if they don’t initially respond to your concerns how you would like them to.
4. Get help from professionals, like school counselors, if you feel your friend is in danger.

And for students who want to move beyond the walls of their schools, Break the Cycle has created a Dating Abuse Advocacy Toolkit (PDF, 1.2 MB)  to help young people affect change on this issue at the state and national level.

If you’re interested in pursuing a career in school counseling, read more about how to become a school counselor and visit our list of master’s in school counseling online programs to find the right school for you.

The following section includes tabular data from the graphic in this post.

Back to graphic.

Source: Kann, L., McManus, T., Harris, W.A., Shanklin, S.L., Flint, K.H., Queen, B., … Ethier, K.A. (2018, June 15). Youth Risk Behavior Surveillance — United States, 2017. MMWR Surveillance Summaries, 67(8), 1–114.

About the author: Louis Venter Founder, Couples Help is passionate about helping couples in a vulnerable space to find good professional help and to experience love and connection again in their relationship.

You may feel that your current relationship is healthy, and indeed the idea of even entering couples’ therapy at all may be insulting to one or more parties within a relationship.

The truth, however, is that couples may be advised to seek therapy before they feel they “need” to, and that even so-called healthy relationships may benefit from couples’ counselling long before the stresses and strains begin to fully manifest themselves. Many couples arguably don’t have an objective view as to whether their relationship is “healthy”, and couples counselling can still have a positive impact even before any partnership hits any crisis point.

This may be the first warning sign for two parties in a “healthy” relationship – the general feeling that something is wrong, but they don’t know what to do for the best. Even if you don’t feel like your relationship has any perceived problem, a course of couples’ therapy may be the key to identifying the problem in the first place. It may be that one person in the couple has unknown feelings of resentment towards the other, but they don’t know why. Or it may be that a recent change in your relationship dynamic (a change of job, moving home, an illness) has affected both of you.

Relationships may have broken down, or couples may have in fact grown apart without knowing it. Sometimes simple facts of life such as conflicting work schedules, or a relationship’s longevity can lead to cracks appearing between a couple which may not seem immediately evident. Even healthy relationships can have problems with emotional intimacy or emotional articulacy as a result of internal or external factors.

Couples therapy can help resolve any communications issues, and an initial course of treatment may reveal some issues which you didn’t realise existed.

Argument can be a perfectly healthy component of a relationship, but it can also be a manifestation of future problems or potential breakdowns. It’s possible that one partner in the couple does not deal with anger in the right way, perhaps becoming passive aggressive, or lashing out unnecessarily. If these arguments are also increasing in frequency, then this could be a sign of something more serious which couples therapy can be used to treat.

A breakdown of trust can sometimes cause ruptures in a relationship, but these may not be evident. People often associate a breakdown of trust in a relationship with factors such as infidelity, an emotional affair, or some big dark secret which risks tearing a couple apart. But healthy relationships can suffer from trust issues of their own which can, if unchecked, grow worse over time.

In even seemingly healthy relationships, trust issues can form over conflicts as seemingly trivial as arguments about money, or smaller arguments where one partner may feel like the other doesn’t trust them.

Some relationships can find themselves tested by external shocks or traumas which can cause unforeseen damage to a relationship. It could be a health crisis, the death of a loved one, or even a traumatic accident. Couples counselling might not be the most obvious route for a couple who might think of themselves as strong, or able to weather most crises.

However, couples’ therapy might be worthwhile in the aftermath of a traumatic event and can help to minimise any future problems which may develop in your relationship.

Last updated: April 2020

According to the American Counseling Association, crisis counseling assists individuals with coping and support after a major crisis. Crisis counseling is brief and time-limited with specific goals for achieving stability, increasing an internal sense of empowerment and safety, and locating appropriate resources. Typically, this type of counseling can range from 15 minutes to 2 hours and is provided throughout 1-3 sessions. While it is not a substitute for long-term therapy or psychiatric care, crisis counseling can provide a safe outlet for immediate relief.

Crisis counselors often utilize psychological first aid, which focuses on reducing acute distress, restoring physical and mental stabilization, and integrates prosocial coping skills. Professionals trained in mental health first aid  assist with identifying and responding to signs of mental illness or substance use (i.e. someone experiencing a panic attack or experiencing suicidal ideation).

Crisis counseling can help in natural disasters, such as hurricanes, wildfires, or earthquakes. In 2017, for instance, the National Centers for Environmental Information estimated at least 15 major weather and climate disasters with losses exceeding over $1 billion each.

Hurricane Harvey caused 84 deaths and its flooding and damage affected approximately 200,000 homes and businesses. Hurricane Irma caused 95 deaths and significantly damaged up to 65% of buildings in the Florida Keys and U.S Virgin Islands.

Crisis counseling helped provide relief for those suffering from financial burdens, health consequences, and severe emotional distress or grief as a result of these weather disasters.

CBS news claims there were more mass shootings than days in 2019. As gun violence continues to surge, the destruction and carnage from these shootings also continue to rise. The aftermath of these mass shootings may be associated with feelings of anger, depression, psychosomatic symptoms, anxiety, depression, and preliminary symptoms of PTSD.

Fortunately, crisis counseling continues to provide a stable anchor for those in the wake of such violence.

More than 10 million men and women  are abused by their intimate partners each year. Resources, such as the National Domestic Violence Hotline, provide confidential support, resources and referrals, and safety planning for victims in domestic violent relationships.

Crisis counseling may offer emotional support and resources to help individuals with creating effective safety plans should they choose to leave to their violent relationship.

Over 100 Americans die by suicide , making it the 10th leading cause of death in the US. The National Suicide Prevention Lifeline  provides confidential crisis support for people across the US feeling actively suicidal or in severe emotional distress. A crisis counselor will explore the individual’s thoughts and feelings and refer to the appropriate resources if needed, such as calling the paramedics in acute situations.

In America, sexual assault occurs every 73 seconds . Sexual assault can evoke difficult reactions of anger, confusion, depression, or anxiety. Resources such as the National Sexual Assault Telephone Hotline , provide free and confidential support 24/7. These crisis counselors help with emotional processing and locating appropriate resources and referrals for recovery.

Crisis counselors can work in a variety of settings including:

Additionally, crisis counselors can also provide mobile services. In these cases, they directly work onsite near the location of a natural or human-caused disaster. When major disasters occur, many mental health therapists, social workers, and psychologists volunteer their time to provide crisis counseling services.

In the immediate aftermath of the Las Vegas Route 91 Harvest Festival shooting in October, 2017, several psychologists, marriage and family therapists, psychiatrists, and mental health clinics  offered free support groups and individual crisis counseling for victims and their loved ones. In Nevada, MGM Resorts International organized mobile crisis counseling  directly at one of their hotel properties. These services help victims, families, and other supporters receive appropriate emotional support for the initial feelings of shock, anger, and fear often associated with acute trauma.

Counselors are also encouraged to reach out to other colleagues, seek appropriate supervision or consultation, and receive their own personal therapy. Always consult your physician or other qualified professionals if you are experiencing mental health issues.

Last updated: April 2020