When a loved one dies, many people experience grief that eventually subsides as they acclimate back into their life and routine. However, complicated grief, or chronic bereavement disorder, is a clinical term that refers to grief that is ingrained in a person’s habits to a disabling degree, impairing functioning.

Complicated grief can affect more than just emotions; it can take over someone’s life. According to the Mayo Clinic, this form of grief can lead to feelings of worthlessness and even suicide, similar to mental health disorders such as depression. It’s important to recognize the struggle people with complicated grief experience – when starting over again feels like the last thing they want to do.

Grief doesn’t look the same for everyone. Depending on the time frame, grief can come in three stages, according to Columbia University’s Center for Complicated Grief.

ACUTE GRIEF

The initial period after a loss,  where emotions tend to be more unpredictable. Grief and yearning are coupled with anxiety, anger and guilt. Thoughts are focused on the deceased and it’s difficult to concentrate on anything else. Grief dominates the person’s life.

INTEGRATED GRIEF

The adaptation period after a loss.  Integrated grief focuses on adjusting to the loss. The behaviors related to the loss are integrated into a person’s life in a way that allows them to honor the deceased.

COMPLICATED GRIEF

A situation in which something interferes with adaptation,  causing prolonged acute grief. It can be accompanied by intense emotional pain and a fear of a future without the deceased, which causes clinically significant distress or impairment in life functioning.

Complicated grief affects how someone adapts to a loss. According to the Center for Complicated Grief, there are three processes related to loss adaption:

Dr. Natalia Skritskaya, a psychologist at the Center for Complicated Grief, believes all people have a built-in biological capacity to adapt that helps restore normalcy, re-envision the future, and re-engage with life. But when something gets in the way of this process, the grief freezes and intensity of emotions stay high.

“We’ve been using the six-month benchmark for adaption to loss, but there’s some debate about certain losses being harder to adapt to – such as a loss of a parent or child, a violent loss, or sudden, unexpected loss of a younger person,” Skritskaya said.

According to a report from the Melissa Institute for Violence Prevention, 5% to 20% of people who are grieving experience complicated grief (PDF, 289 KB). The report backed up Skritskaya’s assertion that developing complicated grief depends heavily on circumstances surrounding the death and is difficult to measure because it’s so subjective for each person.

Grieving a loss can be strenuous and debilitating. Many complicated grief symptoms appear like acute grief; the difference is that the symptoms persist after six to 12 months and impair daily functioning, according to the Melissa Institute.

The Mayo Clinic adds that people who experience complicated grief may have difficulty continuing with normal routines, may experience social isolation, and may have feelings of self-blame.

“It’s very natural to start thinking of alternative scenarios or things you could have done to prevent the death,” said Skritskaya.

Grief affects more than emotional responses – it’s also linked to physical responses. Physiological dysregulation manifests through various areas of the body due to grief, said Skritskaya. From sleep to appetite, it can impact daily functioning

The body responds physically to grief through stress response in the brain, loss of sleep, lack of appetite, and weakened immune function in the cardiac system.

Many people who grieve feel pressure to recover from a loss.

“I think we have a cultural attitude that no one wants to hear about death or that they might feel awkward around a grieving person, so people don’t know what to say,” said Skritskaya. “But we don’t grieve well alone.”

One place to turn for support is to a counselor.

Interviewing is one way a counselor can assist with a client’s grieving process and take a closer look at complicated grief. The Grief and Mourning Status Interview and Inventory (GAMSII), highlighted in the Melissa Institute’s report, is a guided interview to address the circumstances of the death, the meaning of what’s been lost, coping mechanisms, the grieving person’s response to death, and overall understanding and comprehension of the grieving process. The interview technique offers suggestions for questions covering the five topics.

Counselors may also encourage the use of self-monitoring procedures, such as the Grief Monitoring Diary. Journaling allows people with complicated grief to rate their grief intensity. By using this diary, clients better understand where they’re at with grief. Coping this way can help clients sort out their emotions and map triggers and variability in responses to grief.

With the COVID-19 pandemic, unrelenting natural disasters, international conflict and high-profile incidents of violence, many people are collectively grappling with loss and subsequent grief. Some may experience grief more intensely than others do, for longer periods of time. 

There are ways to deal with prolonged grief by taking anticipatory steps to address loss. A study on surrogate decision-makers for the critically ill indicates that social workers and counselors can help caregivers mentally prepare for a loved one’s death, which could stave off symptoms of complicated or prolonged grief. Many people who experience loss may not have the chance to anticipate it, but for those who do, Psychology Today and Mental Health America (PDF, 2MB) offer the following suggestions for dealing with grief: 

Having social support is key to helping with adaptation. Active listening can be a good approach to help a grieving person. Active listening starts with asking how someone who is grieving is feeling and letting them guide the direction of the conversation. It’s important not to interrupt, but rather to be encouraging and responsive with positive feedback and focus closely on what the bereaved person is saying and feeling.

“Don’t push what you think is helpful,” Skritskaya said. “Let them take the lead and be sensitive to what they prefer to talk about.”

Loved ones can help a grieving person plan and organize opportunities for positive emotions to emerge by doing simple things like going on a walk together or reminding them of an activity they used to enjoy.

“People who are struggling with grief feel they have to accommodate other people when it comes to their emotions, so just being there for someone makes a big difference,” she said.

One thing to remember is that people may want to talk about their deceased loved ones but fear they will make others uncomfortable by sharing old memories. Loved ones should give them the space to voice their thoughts and feelings in an honest way.

“Loss adaptation is like relearning life again,” said Skritskaya. “You have to give it time.”

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

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.

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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. 

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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. 

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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. 

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Retirement is a major life change. It can bring on a wide range of emotions, from feelings of excitement and freedom to fears and anxiety about finances and filling your time once you no longer have the daily routine of a job. This is especially true for people whose identity was closely tied to their career. Many people discover that retirement is not an event but rather a much longer transition that has many phases. 

Even if they are financially prepared to stop working, many people are simply not psychologically ready to retire.

“I struggled with it. It wasn’t what I expected,” Nancy Schlossberg told MarketWatch in an article about the psychological burden of retirement. Today, she is an expert on transitions and the author of several books about retirement and aging. 

Schlossberg and other experts advise people considering retirement to start planning several years before their target date. Then expect a year or so of adjustment after the novelty wears off. Flexibility and resilience are key. 

“This is an entirely new experience,” says gerontologist Ken Dychtwald, coauthor of the 1989 best seller Age Wave and founder of a consulting firm that bears the same name. “You’ve been in patterns for decades. How is a person to know what will satisfy them?”

Dychtwald has identified five stages of retirement. 

Surveys conducted by Harris Poll on behalf of Edward Jones and Age Wave were the basis for the recent report The Four Pillars of the New Retirement: What a Difference a Year Makes (PDF, 3.3 MB). According to the report, most retirees say all four interdependent pillars—health, family, purpose and finances—are essential to optimal well-being in retirement. 

While finances typically get the most attention when it comes to retirement, “being financially secure” was actually rated least important (by 59% of survey respondents) compared to the other three pillars. “Having good physical/mental health” was rated most important, with 85% of survey respondents putting that at the top of their list.

Experts recommend using the following coping strategies for dealing with the challenges retirement presents in order to facilitate the transition to this next part of life.

Online Counseling Programs collected the following resources for retirees as they navigate the mental health challenges of this new phase of life. 

Age Wave: Billed as “the nation’s foremost thought leader on issues relating to an aging population,” Age Wave offers research and consulting, educational programs and publications related to expectations, attitudes, hopes and fears regarding retirement.

RetirementWisdom: This website offers coaching, a newsletter, blog, podcast and other resources to help you prepare for the transition to retirement and create the second act you want. 

Transamerica Center for Retirement Studies: This nonprofit publishes a wide range of research on various topics, including an annual survey and reports on women and retirement and planning for travel in retirement. 

Encore.org: With a focus on intergenerational connection, this nonprofit offers opportunities and ideas to bridge divides, bring joy to the second half of life and help all ages thrive. 

You’re Probably Not Ready to Retire — Psychologically, MarketWatch: Research shows that adjusting to retirement is difficult for people whose identity is tied to their job. They report more boredom, anxiety and feelings of uselessness. 

How to Deal With Depression After Retirement, Verywell Mind: Graphic and list of tips to make the transition to retirement smoother, and what to do if your depression is more serious.

Retirement Blues: Taking It Too Easy Can Be Hard on You, Harvard Health Publishing: Harvard experts say that for optimal well-being in retirement, you need to stay engaged with your own interests and with other people. Doing either too little or too much can lead to symptoms of anxiety, depression, appetite loss, memory impairment and insomnia.

The One Retirement Risk You’re Probably Not Preparing For? Depression, USA Today: Statistics on mental health in older people, top sources of stress and how a “phased” retirement may help. 

6 Tips to Combat Post-Retirement Depression, Investopedia: Studies show that staying in shape and giving back through volunteer work positively impact mental well-being. 

Depression After Retirement: Symptoms, Treatments and How to Cope Choosing Therapy: How to find mental health support, including online options, group therapy or a therapist or counselor who has expertise working with older adults and retirees. 

10 Tips to Help Your Marriage Survive Retirement, U.S. News & World Report: Tips for adjusting to a spouse’s retirement, such as planning how you’ll spend your time, pursuing individual interests and negotiating household chores.

Advice for Couples Who Stagger Retirement, AARP: When one spouse retires before the other, it can cause stress in a relationship. Here are some common issues many couples encounter.

Helping a Loved One Cope with a Mental Illness, American Psychiatric Association: How to spot the warning signs, how to approach the issue and how to find support for the person and yourself. 

Depression and Suicide in Older Adults, American Psychological Association: Articles, books and resources for addressing depression, a common mental health issue in the elderly.

The RetirementWisdom Podcast: Retirement planning often focuses on only the financial piece. This podcast covers the other aspects of preparing for life after full-time work through interviews with experts.

The Retire With Purpose Podcast: Designed to help retirees and pre-retirees improve their financial confidence, this podcast features interviews with experts in finance and retirement, and also covers topics such as mending relationships and finding a retirement coach. 

The Psychology of Aging Podcast: Hosted by clinical geropsychologist Regina Koepp, experts discuss topics surrounding mental health and aging, dementia, caregiving and end of life. Recent episodes featured care for LGTBQ seniors and preventing elder financial abuse.

7 Must-Listen Retirement Podcasts That Aren’t About Money, Kiplinger: From health to news to making friends, these wide-ranging podcasts may be of interest to retirees. 

Video: How to Help with Retirement Depression: Dr. Joseph Sivak, director of behavioral health at The Villages Health, a 55+ community in Florida, explains the phenomenon of retirement depression and offers some tips for coping with it. 

TEDxDrogheda: Retirement: From Foreboding to Fulfillment: A former software developer for IBM Ireland discusses his journey through the stages of grief following retirement and how he redefined himself. 

West End Seniors’ Network: A 5-Minute Video on Retirement and Loss of Identity: A woman discusses how cultivating creative pursuits helped her reinvent herself after a 35-year career. 

Your Next Chapter: A Woman’s Guide to Successful Retirement, by Alexandra Armstrong, CFP, and Mary R. Donahue, Ph.D.: This book, written by a financial planner and a psychologist, helps women navigate this transition in their lives, emotionally and financially. 

The Best Is Yet To Be: Discovering the Secret to a Creative, Happy Retirement, by Mike Bellah, Ph.D.: When college professor Mike Bellah retired early, he expected his golden years to be happy and carefree. But within weeks fears of lost identity and limited funds left him panicked and depressed. In this book, the author combines research and personal narrative to explain how he got his hope back.

Retirement Heaven or Hell: 9 Principles for Designing Your Ideal Post-Career Lifestyle, by Mike Drak, Susan Williams and Rob Morrison, CFP: Sudden, “full-stop” retirement can be a shock, found the author. This book outlines nine key principles to coach you on how to transition successfully to retirement and eliminate the stress that comes with this huge life change.

Winning at Retirement: A Guide to Health, Wealth & Purpose in the Best Years of Your Life, by Patrick Foley and Kristin Hillsley: This book aims to be a comprehensive guide to maintaining your health, managing your money and finding a greater purpose in retirement. The authors believe that far too many people plan only for the financial aspects without recognizing the importance of seeking a meaningful identity.

Keys to a Successful Retirement: Staying Happy, Active, and Productive in Your Retired Years, by Fritz Gilbert: An in-depth guide to retired living, covering topics including dealing with feelings of aimlessness, grief and depression that may surface and how to manage your mental health.

Retirement Your Way: The No Stress Roadmap for Designing Your Next Chapter and Loving Your Future, by Gail M. McDonald and Marilyn L. Bushey: A seven-step roadmap to help you discover and forge the right retirement path for you. Includes practical guidance, research and inspiring personal stories.

What Color Is Your Parachute? for Retirement: Planning a Prosperous, Healthy, and Happy Future, by John E. Nelson and Richard N. Bolles: From the authors of best-selling career book What Color Is Your Parachute?, this guide provides practical tools including an exercise on values and how they inform your retirement, and the retirement well-being Pprofile, a resource for organizing the vast amount of information on finances and mental and physical health.

Purposeful Retirement: How to Bring Happiness and Meaning to Your Retirement, by Hyrum W. Smith: The former chairman and CEO of FranklinCovey and a renowned expert on time management challenges the conventional views of retirement and offers practical ideas on how to shift your mindset, embrace the transition and live life fully in retirement. 

A Couple’s Guide to Happy Retirement and Aging: 15 Keys to Long-Lasting Vitality and Connection, by Sara Yogev: Written by a psychologist specializing in work and family issues, this book summarizes the latest research findings and draws from stories of real couples. This book is intended to help partners prepare emotionally for the major life changes during retirement, nurture their relationship and find strategies to deal with differences around money, time together versus apart, housework and family.

How to Retire Happy, Wild, and Free: Retirement Wisdom That You Won’t Get from Your Financial Advisor, by Ernie J. Zelinski: Inspirational advice on achieving an active and satisfying retirement that includes interesting leisure activities, creative pursuits, physical and mental well-being and solid social support.

The Substance Abuse and Mental Health Administration (SAMHSA) national helpline is open 24 hours a day, 365 days a year. 1-800-662-HELP (1-800-622-4357).

The toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255) is available 24 hours a day, seven days a week to anyone in crisis. All calls are confidential. 

Institute on Aging’s Friendship Line is the only accredited crisis line in the country for people 60 years and older and adults living with disabilities. The 24-hour toll-free Friendship Line (800-971-0016) is a crisis intervention hotline and a warmline for non-emergency emotional support calls. 

AARP’s Friendly Voice service connects trained volunteers with callers who are isolated or experiencing challenges and want to talk. Call 1-888-281-0145 and leave your information and a volunteer will call you back.

The following resources are for informational purposes only; individuals should consult with a clinician before making decisions about mental health.

Coping with life’s stressors isn’t always easy to do alone. However, not all therapeutic relationships work out for the best, leaving clients questioning whether or not they should terminate their therapy sessions. 

“People’s goals for therapy sometimes change, and therapy might not always end up meeting those goals,” said Catherine Eubanks, an associate professor of clinical psychology at Yeshiva University and an expert in therapeutic relationships. 

If you’re considering ending your relationship with your therapist, it can be important to recognize the signs when the relationship is no longer in your best interest. Doing so can then allow clients to explore appropriate ways to end the relationship with mutual understanding. 

“Therapy is 45 minutes of your life every single week with the same person who knows such intimate information about you and your experiences,” said Marissa Robinson, a psychotherapist from myTherapyNYC. “You want to leave that in a closed way that feels emotionally connected with the therapist that went on this journey with you.”

In psychology, a therapist-client relationship is called a working alliance, Eubanks explained. According to research about therapeutic relationships from the American Psychological Association, key components of a healthy working alliance include:

The report also noted that it’s important for therapists to express their feelings when appropriate. However, according to Eubanks, clients should not be made to feel unsafe, criticized, judged, unheard or belittled. 

Robinson echoed this sentiment noting that no good progress is made unless there is a strong, trusting and collaborative therapeutic relationship. 

Sometimes, a therapeutic relationship doesn’t work out because a therapist is not the right fit. In other instances, a client may have outgrown the relationship, or it didn’t achieve the desired goals. Eubanks said this is called an “alliance rupture.”

“Ruptures can be opportunities to really learn something valuable about ourselves. It gives us a chance to handle relationship difficulty in a different way,” she said.

But even when ruptures occur, clients can take a more measured approach to addressing the situation. It’s important for clients to remember that a healthy therapeutic relationship should feel like the process is helping them, Eubanks said. 

When gauging whether or not to end a relationship with a therapist, clients can consider the following questions: 

“Knowing this information about yourself can help guide your future decisions about therapy and what works for you,” Eubanks said. 

Ending a therapeutic relationship can be a tricky space to navigate, considering that it’s both an inherently intimate and professional relationship. Before deciding to terminate sessions, clients can consider whether repairing the relationship is possible and whether goals should be re-evaluated or improved upon. 

Eubanks and Robinson offered guidance on how to evaluate whether to end or repair an alliance.

It may seem daunting to start over and find a new therapist. However, clients can reflect on what they have learned from their previous experience to help identify what they need. 

“If you seek out another therapist, you should ask yourself if you are able to spot the warning signs that you’ve learned from your previous one,” Eubanks said. “Evaluate what works for you and what doesn’t. This way you can really gain something from a challenging experience.”

Eubanks said it’s important to be able to do two things:

Robinson emphasized the importance of going “therapist shopping.” Clients can schedule a first-time introductory session with more than one person to get a sense of what they are like. They can make it known to each therapist that they are trying to determine fit so that therapists know they aren’t committing yet. 

“Every therapist you meet might not be a good match for you,” she said. “It’s okay to not find that perfect fit on the first try.”

She also pointed out that the first meetings are usually when a therapist is simply learning information about the client and what they are looking for, which may not give the client the most accurate picture of the therapist’s style. Having questions prepared for a potential new therapist may be helpful for clients.

After choosing a new therapist, clients should set expectations with them and explain their concerns and what they would like to avoid happening again, according to Eubanks. Routine check-ins about how the process is working can also be helpful.

“You really want somebody who’s going to help create a space to be open and thoughtful and reflective and appreciate how relationships are complicated,” Eubanks said. 

Terminating a relationship with a therapist and finding a new one can be challenging, so it’s important to remember to be patient during this time. 

“It’s really not an easy task to find a therapist, to shop, to terminate. It’s a lot of time, effort, money, and it’s hard,” Robinson said. “Show yourself compassion and create space for the process.”

Clients may be able to find a new therapist through referrals and recommendations from people they know, Eubanks said. However, for people who want to start from scratch, here are resources to help guide their therapist shopping. 

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.

If you and your partner are constantly arguing about finances, your problems could run deeper than an overdue power bill or an expensive restaurant meal. Conflicts about debt, purchases and other money problems may indicate relationship issues that need to be addressed sooner rather than later.

“For couples, the hardest thing to talk about is sex and finances, and that’s because our parents didn’t talk about it when we were growing up,” said Jordie Smith, licensed marriage and family therapist (LMFT) and owner of Jordie Smith Counseling, LLC in Canton, Michigan. Having conversations about money with a romantic partner is important for developing and maintaining lasting and healthy relationships, she said. 

“When you are in a relationship, you want to be safe with that person,” Smith said. “When you have some outside factors that aren’t addressed, that threatens the safety.” 

Being transparent and open to discussions about spending and saving keeps relationships strong and prevents financial infidelity—when a partner hides debt or purchases. Those unpleasant surprises do not help build relationships, she said.

Online Counseling Programs has rounded up resources for couples to help them understand why money should not be a taboo topic and how to consider finances at different stages in their relationship.

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Before the commitment stage of a relationship, couples should discuss money in the same way that they talk about their work, their friends and their families, Smith said. 

“Oftentimes, we will ask how your relationship was with your mom or your sister, but we don’t talk about our relationship with finances,” she said.

As individuals grow closer, those conversations should begin to touch on subjects such as their philosophy toward money and their spending habits. 

When people commit to a relationship, they should continue to engage in productive financial conversations. Smith offered strategies to help facilitate the discussions:

Finding ways to approach the subject of money may require sensitivity, but transparency encourages trust. Relationships require trust and effort, Smith said. She offered tips for partners to use when they are having the difficult conversations: 

Use the Speaker-Listener method. This facilitates active listening. By allowing one person to speak at a time while the other listens and confirms what they heard before responding, the process slows down to a more thoughtful interaction.

Use “I” language. Blame does not get assigned to the other person when starting the conversation with “I feel” or “I get stressed out.”

Move the discussion forward. Dwelling on the problem is not helpful and potentially continues a blaming cycle. Acknowledge it, and then discuss common goals to reach resolution.

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As couples mature, their relationships change. Their money needs may evolve as expenses are affected by moving to new locations for jobs, unexpected medical costs or a growing family. The money conversations should continue at every stage.  

Because being in a new relationship can be exciting and distracting, couples might overlook the importance of talking about finances and/or money problems. Smith said that having those discussions is essential to avoiding future misunderstandings.

“If I value ‘high’ in clothing and my partner doesn’t, that might be an issue. We want to think (and talk) about what are some of these values when we’re having conversations so that we have clear expectations,” she added. 

To ease into the subject of finances, ask conversationally, “Do you like to keep up with the latest fashion trends or tech gadgets?” or “If you had more money, what would you spend it on?”. Smith said that once you’ve opened the door to the subject of spending, you can start asking important questions.

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Purchasing a home is another kind of commitment that requires careful consideration, Smith said. Being homeowners requires resources beyond money. Couples may have to put time into any desired upgrades or modifications, including researching, hiring and dealing with contractors.

Couples should not feel like they have to do everything by themselves. “If there’s an issue, there’s usually someone who specializes in it,” Smith said. “People just aren’t always aware of what’s available.” 

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When couples start planning a family, they must budget for the obvious expenses: medical, food, clothing, supplies and more. Children’s needs have to be addressed.

“It always feels like there’s never enough money for children, and there’s always something else that we could spend or be saving toward,” Smith said.

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For people who have the resources to plan ahead, Smith said that conversations about what retirement looks like for each partner can happen even in the early stages of a relationship. Retirement should be part of overall discussions about goals that happen regularly.

Couples should share their vision of retirement and discuss ways to accomplish that goal. Do they see themselves lounging on a beach or enjoying the pace of a small town? 

Smith acknowledged that retirement planning can be a matter of privilege because saving can be difficult for many people.

“Sometimes people are just struggling and can’t think far enough toward retirement,” she said. 

“If you can’t think that far ahead, that’s OK,” she added. “For some people, it’s about thinking about how to save a little bit just for a rainy day fund right now.”

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Financial difficulties don’t always have easy answers. Sometimes couples need to seek help from a counselor, therapist or financial expert. 

“Typically, intuition will tell us that we don’t like the situation and that we should reach out,” Smith said.

Screaming, withdrawal, avoidance or anything that a partner’s instincts tell them is wrong is worthy of attention because of the effects on the relationship. 

“Once we start seeing changes that may not feel healthy to us, it never hurts to reach out for help,” Smith said.

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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.

In the age of social media and mixed-messages about how girls are supposed to look, act and learn, girls can face significant self-esteem issues during adolescence—a crucial period for forming and developing one’s identity, according to the Child Mind Institute. 

Even within the few years of adolescence, messaging and appropriate strategies can vary widely depending on girls’ ages.

View the available resources that are geared toward unique age groups using the links below: 

The following resources are for informational purposes only; individuals should consult with a clinician before making decisions about mental health.

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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.

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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.”

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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.

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“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.

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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.

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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.

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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.

The content in this article is for informational purposes only; individuals should always consult with a mental health professional before making decisions related to personal health.

The National Institute of Mental Health reported in 2019 that more than 1 in 5 adults in the United States has a mental health condition. While symptoms can affect a person’s behavior and engagement with their work, the outcomes are different for everyone—and often not what people would assume.

“The bottom line is that many workers with serious mental illness are capable of working in regular, competitive workplaces and supporting themselves,” said health economist Marjorie L. Baldwin, PhD.

Baldwin, a professor at Arizona State University, is currently the principal investigator conducting a four-year study about the process of disclosing a severe mental health condition to an employer, including data about the decision to disclose and others’ reactions to a disclosure.

Being open about a mental health condition can be daunting, but ongoing research shows that avoiding disclosure can lead to burnout and other negative outcomes while transparency can lead to better workplace environments and reduce stigma about mental health.

Disclosing a mental health condition is not a legal requirement, but there can be benefits to being open about it with your employer or professional peers.

The Americans with Disabilities Act (ADA) ensures rights to protections and accommodations in the workplace for people with disabilities, which they define as “physical or mental impairment that substantially limits one or more major life activities.”

Any mental illness (AMI) is a term used by the National Institute of Mental Health to describe a mental, behavioral or emotional disorder.

Go to a tabular version at the bottom of this page of Prevalence of Any Mental Illness in the Past Year Among U.S. Adults, 2019.

Discrimination is illegal under the ADA, and employees with a qualifying disability are entitled to two main protections: the right to privacy about their personal information and the right to receive accommodations that help them perform their jobs.  

Baldwin says people need to be more aware of their rights under the ADA.

“That goes for the employer’s side and the counselor’s side, too,” she said. “Employers need to know what they’re required to do for a worker with a disability and that they cannot reveal any personal health information to other employees.”

While some protections can be addressed by the ADA, some workers may not have a clinically diagnosed condition and may feel their needs aren’t legitimate enough to discuss with an employer. Research from the National Association for Mental Illness shows this misconception, and the resulting insecurities lead to higher rates of employee burnout and more severe outcomes for mental illness (PDF, 4.4MB).

“In some cases, if the employer has any experience of mental illness themselves or their own family, they might be able to relate to the worker’s experience compassionately,” Baldwin said of her research findings so far. But each person and work environment is different, and it can be hard to predict how a manager might react.

Before deciding whether to disclose, it can be helpful for workers to consider the benefits and costs of making their mental illness known to an employer (PDF, 591KB).

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Baldwin said that the fear of discrimination is commonly cited by respondents in her research surveys.

“When we stigmatize a group, we tend to not want to be around them,” she said. Social isolation, microaggressions and harassment are all results of the stigma related to mental illness. While discrimination is illegal, it can take many forms, and can sometimes be displayed so subtly that the recipient feels unable to report it or be taken seriously.

She also noted that the fear of having private information outed to coworkers is a common risk calculation that individuals take when disclosing a condition. Outing others’ mental health concerns is an invasion of privacy, but Baldwin said that sometimes the results can be positive.

“In some cases when people were outed, the employer’s response was compassionate, helpful, understanding,” she said. “So, it doesn’t always necessarily be a negative situation, and sometimes it happens in ways that an employee might be able to predict.” 

A professional mental health counselor or therapist can offer support with creating a plan for disclosure. Dr. Zeyad Layous, a clinical psychologist in Falls Church, Virginia, says that counselors can work with clients to help them consider crucial aspects of the disclosure process and provide strategies for effective communication.

“The first thing to think about with the client would be formulating what they hope to achieve by disclosing,” Layous said, “and making sure their goals are realistic or feasible.”

For example, identifying specific accommodations that would help with job performance or comfort in the workplace like flexible hours, frequent breaks or the ability to work remotely. Not every accommodation will be possible in different work environments, but Layous recommends speaking directly with a representative from human resources because they’re likely to have experience with accommodations and mental health concerns.  

Layous also said counselors can help clients work through their fears of sharing sensitive information and develop strategies for initiating a conversation with an employer based on individual symptoms or conditions.  

“If they have a lot of anxiety, they might prefer to craft an email and control exactly what they write,” he said, “rather than getting nervous in person and not getting the information across as clearly as they want.”

Talking about mental health can be vulnerable and complicated, so Layous and Baldwin recommend making a few considerations before jumping into a candid conversation.

In addition to creating a plan, Layous said counselors can help clients by providing emotional support, offering to speak with employers and even confirming with HR representatives why specific accommodations may be clinically effective.

“Workplace realities often make it difficult for employers to implement the kind of accommodations that are being asked, even if we believe it’s perfectly legal,” he said. “So people have to really feel ready to disclose, and they have to know what sort of accommodations they’re looking for.”

“Mental illness is cyclical—symptoms might be controlled for a while, but then there might be a recurrence,” Baldwin said. “In some cases, the symptoms themselves out a worker, and we had a number of workers tell us that their employer came to them and noticed.” Baldwin said.  

If workers aren’t able to manage their symptoms, they may have to talk about their condition before they’re ready. 

Baldwin said there’s much to be gained from acknowledging an employee’s symptoms, even if you’re worried about overstepping or saying the wrong thing. Even if an employee is not experiencing a clinically diagnosed condition, being open and affirming of their needs can make a difference.  

“It shows their manager is sensitive enough to know something was wrong and caring enough to inquire about it,” Baldwin said.

While each situation is unique, Baldwin and Layous identified several strategies for affirming, inclusive and nonjudgmental ways to respond to an employee who has decided to disclose a mental health condition.

When employers are intentional about the culture they are maintaining among employees, they can create accommodating, healthy work environments to help employees stay productive and stay in the workforce. 

“We all benefit when people with mental illness are able to work,” Baldwin said. “Workers benefit because they can support themselves, and society benefits because people are being productive and contributing.”

Mental Health in the Workplace, Centers for Disease Control

Should You Disclose a Mental Illness During the Hiring Process?, TalkSpace

Should You Disclose Your Mental Illness to Your Employer?, Social Security Administration

Working With a Mental Health Condition, United States Office of Women’s Health

Resources to Support Employee Mental Health During COVID-19, Mind Share Partners

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Source: “Mental Illness,” National Institute of Mental Health, 2021.

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.

For Tamara Ferebee, executive director of administration and co-founder of the Virginia-based National Association of Black Counselors,  seeing the change in this young man was concerning. But activism and advocacy work against racial injustice takes a toll on mental health, especially as people become acutely aware of the oppression and mistreatment that occurs regularly and the arduous, unrelenting work it will take to stamp out racism and bigotry.

“When people get into this, I don’t think that they should expect immediate change because the larger white majority does not want to give up their economic gains, domination and power,” said Ferebee, who is a licensed professional counselor. “Racism is embedded in the foundation of this country.”

The work of fighting oppression includes putting yourself in vulnerable positions to witness incidents and have experiences that can be upsetting, alarming and traumatic. Preserving your mental health and building mental resilience is necessary to continue the fight for justice.

Preparation can help people who want to participate in the fight against racial injustice manage the effects on their mental health. As Ferebee noted, progress is not instantaneous, so those who choose to participate, particularly those who are new to the movement, should mentally prepare for a marathon rather than a sprint.

“Movements will continue to be a source of innovation and change in attitudes toward systemic racism, but it will take time,” Ferebee said. “Many of the conversations we’re having will very much remind you of conversations from the 1960s.”

Frustration with the pace of progress is just one emotional response that may challenge participants. Ferebee encourages those who engage in the cause to anticipate the other emotions that could arise, especially in overwhelming situations such as a protest.

“Protesters need to be mindful of how they could feel anger or hypervigilance, and understand the risk for a reaction,” she said.

4 PREVENTIVE STRATEGIES TO KEEP SAFE INCLUDE:

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1. Attending events with a familiar group to look out for each other.
2. Having a safe spot for people who need a pause from the action.
3. Identifying a point at which people may need to remove themselves.
4. Developing a safe route and backup plan in the event of confrontation.

However, the effects that witnessing racial injustice can have on mental health extend beyond the momentary situations when people are engaging in a protest. And advocates and those in the movement may need coping techniques to address mental health concerns that impact their everyday lives.

“Movements will continue to be a source of innovation and change in attitudes toward systemic racism, but it will take time.”

– Tamara Ferebee, co-founder of the National Association of Black Counselors

Brandon J. Johnson, a Maryland-based public health expert in mental health and suicide prevention, shared coping strategies in a video he first posted to YouTube soon after the George Floyd incident. Johnson has since launched the Black Mental Wellness Lounge YouTube Channel where the video “Tips for African Americans to Heal After Collectively Witnessing an Injustice” can be found.

Allies also need to be mindful not to pile on or add to the struggles that people of color deal with daily when it comes to racism, inequality and inequity.

Jacques L. Austin, executive director of the Alabama-based Black men’s mental health advocacy group Brother Let’s Talk, has heard from a number of friends who have experienced a different form of frustration and have made comments such as: “I’m tired of trying to explain things to white people.” “I’m tired of trying to help them understand.” “They just don’t get it.”

Instead of placing the emotional burden on people of color to educate them about the movement and about what they can do, allies can help the movement by educating themselves and confronting prejudice in their circles, whether at the workplace or among friends and family.

“When someone says something that you know is racist in nature, is biased, or is derogatory, and you feel uncomfortable, speak out,” Austin said. “Say something, because to not say anything is to be complicit.”

AAKOMA Project: nonprofit doing outreach and starting conversations about mental health, especially among young people of color.

Balanced Black Girl: online community providing a safe space for conversations about mental, spiritual and social well-being for Black women.

The Black Brain Campaign: organization with a mission to educate the Black community about mental health and provide therapy to high school students in the Philadelphia area.

BEAM, Black Emotional and Mental Health Collective: organization of advocates from various fields including the arts and health care working to address the emotional and mental health needs of Black communities.

Black Female Therapists: network supporting Black female therapists with a goal to provide safe spaces for the Black community.

Black Girls Smile: community providing young Black women support to lead mentally healthy lives.

Black Mental Health Alliance: organization supporting the health and well-being of Black people through culturally relevant educational forums, training, and referral services.

Black Mental Wellness: corporation founded by Black female clinical psychologists in Washington, D.C., addressing mental health and wellness concerns specific to the Black community.

The Boris Lawrence Henson Foundation: organization working to increase mental health support for members of the Black community and providing a directory of mental health providers and programs serving them.

Brother Let’s Talk: organization holding virtual support group conversations for men and women of color to talk about anger, stress, racial trauma, grief and suicide.

Call BlackLine: organization providing immediate crisis counseling hotline at 1-800-604-5841 through a Black, LGBTQ and Black Femme lens.

Community Healing Network: group encouraging Black people across the African diaspora to heal from trauma caused by anti-Black racism with summits and circles focused on healing.

Ethel’s Club: digital membership community focused on providing people of color with a space to heal and thrive.

Eustress: organization with events such as adult coloring nights and weekly men’s locker room conference calls to raise awareness about the importance of mental health in underserved communities.

Inclusive Therapists: community providing a directory of therapists that describes itself as an activist movement pursuing equity and justice in mental health care.

Loveland Therapy Fund: organization accepting applications for Black women and girls to get financial assistance for mental health therapy.

Melanin and Mental Health: website connecting people with culturally competent clinicians serving Black and Latinx communities.

National Queer and Trans Therapists of Color Network: healing justice organization working to increase access to mental health resources for QTPOC.

Ourselves Black: online magazine providing stories of Black experiences to promote mental health well-being and care.

Showing Up for Racial Justice: national network of groups and individuals working to fight for racial justice by using an inclusive approach to organizing.

Sister Afya: organization encouraging a community support approach to mental wellness and connecting Black women to mental wellness services.

Steel Smiling: program striving to connect every Black person in Allegheny County, Pennsylvania, to a positive mental health experience that improves their quality of life.

The Steve Fund: national organization supporting the mental health and emotional well-being of young people of color.

Therapy for Black Girls: online community providing a safe space for Black women to talk about mental health topics.

Therapy for Black Men: website offering a directory of therapists for men of color.

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Adverse Community Experiences and Resilience, Prevention Institute (PDF, 2.4 MB): publication offering a framework for communities dealing with violence to address and prevent community trauma.

Brother, You’re on My Mind Toolkit, National Institute of Minority Health and Health Disparities and Omega Psi Phi Fraternity: materials to help educate others in the community about depression and stress in Black men.

Coping With Discrimination Guide: Self-Care Tips for Discrimination-Induced Trauma and Stress, DoSomething: guide to methods to maintain mental health.

Family-Care, Community-Care and Self-Care Tool Kit: Healing in the Face of Cultural Trauma, Community Healing Network and The Association of Black Psychologists (PDF, 956 KB): guide to strategies for personal and community well-being,

Healing in Action: A Toolkit for Black Lives Matter Healing Justice & Direct Action, Black Lives Matter (PDF, 166 KB): lessons and guidance on ensuring that actions focus on achieving healing justice with tips on grounding exercises related to breathing and mindfulness.

Racial Trauma Toolkit, Institute for the Study and Promotion of Race and Culture: advice on daily maintenance, response plans and how to deal with triggers related to racial trauma.

Supporting Black LGBTQ Youth Mental Health, The Trevor Project: guidance on common emotions, self-care practices and how to be a good ally.

Talking to Your Kids About Racism, UNICEF: advice for parents on how to start the conversation about race and acceptance at different ages.

We Must Unmute, American Psychological Association: APA advice about the importance of emotional expression and self-care while fighting social injustice.

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“Balanced Black Girl:” podcast from the Balanced Black Girl online network.

“Between Sessions:” podcast from Melanin and Mental Health community.

Black Mental Wellness Lounge: YouTube channel managed by Brandon J. Johnson, M.H.S., mental health advocate and expert.

“Black Therapist Podcast:” series from psychotherapist Nikita Banks, LCSW.

“The Effects of Racism on Mental Health: How to Cope:” webinar from the Anxiety and Depression Association of America.

“Fireflies Unite:” podcast from mental health advocate T-Kea Blackman.

“Therapy for Black Girls:” podcast series for Black women and girls.

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“Black Men and Depression: Saving Our Lives, Healing Our Families and Friends,” John Head: an examination of emotional disorders among men in the Black community, its origins and why it is important to get rid of the stigma of mental health therapy.

“Black Pain: It Just Looks Like We’re Not Hurting,” Terrie M. Williams: a discussion about the importance of helping others suffering in silence by someone who experienced depression, with suggestions to get healthy and build a supportive network.

“The Color of Hope: People of Color Mental Health Narratives,” Iresha Picot: compilation of stories by different people of color living with mental illness.

“My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies,” Resmaa Menakem, MSW, LICSW, SEP: examination of racism’s effects from the perspective of body-centered psychology and what it does to our instincts to fight, flee or freeze.

“The Unapologetic Guide to Black Mental Health,”  Rheeda Walker, Ph.D.: guide to recognizing mental health problems, how they impact your health and quality of life, what tools to use to neutralize stressors, and how to navigate a mental health care system that is unequal.

“White Fragility: Why It’s So Hard for White People to Talk About Racism,” Robin DiAngelo, Ph.D.: discussion about why white people become defensive about race and how to change that dynamic to work toward racial justice.

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The Safe Place: mental health app for the Black community.

Liberate: meditation app for the Black, Indigenous and people of color communities.

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Information on OnlineCounselingPrograms.com is not intended to be a substitute for professional medical advice. Always consult your physician or other qualified professionals with any questions you may have regarding mental health issues.

Do you have a passion for helping people or color navigate challenges related to mental health? Learn more about how to become a mental health counselor.