Author: jenlombardo

COVID RESOURCES (Red Cross FL)

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Did you know that the Red Cross has a Disaster Mental Health Program? They are working behind the scenes to gather resources and support the red cross volunteers responding to crises, in addition to gathering resources for the community. Here are some helpful resources compiled thus far (4/6/20). Some of the links before are to be supports for the mental health providers as well, as they are learning how to work online and across state lines.

“Assistance

Children – Dr. Wendy Time

“I wanted to do something to help children and families during this stressful and uncertain time.  Starting today, I will be posting a video I’m calling Dr. Wendy Time.  I will post segments 2-3 times a week.  The program will consist of activities to help children, around the ages 4-11 years, cope emotionally as well as activities to do at home for fun.  The videos can be accessed on my Facebook page,  https://www.facebook.com/Wendy-Blumenthal-PhD-160539851101571/ “

Florida coronavirus 24/7 hotline available for emotional support. Bilingual hotline available for all Floridians: https://www.clickorlando.com/news/2020/03/13/florida-coronavirus-247-hotline-available-for-emotional-support/

Florida Blue said licensed clinicians are available to speak to anyone in Florida free of charge in both English and Spanish, including those who do not have insurance or have coverage with another health plan. The emotional support line can be reached at 833-848-1762.

Orange County Resident Resources – Coronavirus (COVID-19): https://www.ocfl.net/EmergencySafety/Coronavirus/Coronavirus-ResidentResources.aspx#.

Mental Health Assistance: Aspire Health Partners is offering a dedicated telephone line to assist residents with mental health concerns related to COVID-19. Residents can call the helpline to be connected with a caring mental health professional. 407-875-3700 X2 | Aspire Health Partners

Disaster Distress Helpline – SAMHSA’s Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters. Call 1-800-985-5990 or text TalkWithUs to 66746 to connect with a trained crisis counselor. https://www.samhsa.gov/find-help/disaster-distress-helpline

The Mental Health Association of Central Florida: https://www.mhacf.org/ Will connect those who need assistance to counselors, (407) 898-0110. In Central Florida will give info for other areas.

NAMI Pinellas County, Florida: http://nami-pinellas.org/ NAMI Help Line:  Offers free information, referrals and support can be reached by calling 727-791-3434, the Peer Support Help Line can be reached at 727-600-5838

Telehealth State Rules

For Mental Health Professionals: State-by-state guide to the rules/laws about telehealth services across state lines https://cmhc.utexas.edu/state_telehealth.html

Health Care Workers

The Covid-19 crisis too few are talking about: health care workers’ mental health https://www.statnews.com/2020/04/03/the-covid-19-crisis-too-few-are-talking-about-health-care-workers-mental-health/

Hospital – UNC – Mental Health/Emotional Support Resources for Co-workers and Providers

https://www.unchealthcare.org/wellbeing/toolkit/toolkit-overview/mental-healthemotional-support-resources-for-co-workers-and-prov/

Hospital – UCSF – Resources to Support Your Mental Health During the COVID-19 Outbreak

https://psychiatry.ucsf.edu/coronavirus

COVID Resources

Coronavirus (COVID-19)

https://www.cdc.gov/coronavirus/2019-ncov/index.html

Covid-19 and Suicide Prevention

https://www.myflfamilies.com/service-programs/samh/prevention/suicide-prevention/covid-19-and-suicide-prevention.shtml

Give An Hour

Resources – https://giveanhour.org/coronavirus-resources/

Coronavirus PSAs – https://vimeo.com/showcase/6912221

NAMI’s helpline and a 15 page comprehensive brochure for all kinds of services plus mental health

http://wesh.com/article/doctor-resources-detail-steps-to-stay-mentally-healthy-during-the-covid-19-pandemic/32038995?src=app

Stress and Coping

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

COVID-19 Overview (about 1 hour video)

The video is by a physician, Dr. David Price, at Cornell Medical Center who works with COVID-19 patients everyday. His message is simple and empowering. You’ll feel better and less afraid after watching the video. https://vimeo.com/399733860

A guide to the COVID-19 pandemic

https://www.theverge.com/2020/3/12/21175486/coronavirus-covid-19-pandemic-cases-outbreak-guide-information-who-cdc

Speaking of Psychology: Managing Your Mental Health During COVID-19 with Lynn Bufka, PhD

https://www.apa.org/research/action/speaking-of-psychology/covid-19-mental-health

Grief Issues

New Grief: Staying Connected to Help | COVID-19 Coronavirus

https://www.shiva.com/learning-center/coping/a-new-grief-staying-connected-to-help-covid-19-coronavirus/

Grief support systems have been wrecked by COVID-19

https://www.theverge.com/2020/3/12/21175486/coronavirus-covid-19-pandemic-cases-outbreak-guide-information-who-cdc

Managing Mental Health -Resources Spreadsheet

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Hi there,

I thought it would be a good time to compile resources that I often share with clients and to add more that I keep coming across.
We are collectively feeling the stress and worries, but we can get through this together and perhaps even find opportunities from this challenge.
To add to the list, feel free to email me at JenniferL.Lombardo@gmail.com or send info through the contact page. Stay healthy, calm, and informed!

~Jen

Here is the Google Spreadsheets Link

Amidst Social Distancing, How to Enjoy Your Own Company

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Enjoy your own company.
Picture taken during a lovely solo trip to Japan in 2018.

One of the common stressors I encounter are related to social interactions; sometimes there is anxiety if there is too much and other times depression/anxiety if there is too little. With social distancing as a recent recommendation to prevent further spread of the Coronavirus, there are ways to maintain connections to our social supports (technology, using appropriate precautions when gathering, etc.), but I think this is also a great time to learn how to hang out with yourself. Once, I recommended to a client “just try sitting and…do nothing”. Following a look of disbelief and confusion, I explained more.

We have become accustomed to constantly being stimulated and entertained, so much so, that when we find ourselves without something to do, we become “bored” or anxious, or those unprocessed events/emotions may peek out to say “Hey, remember me?” This, then leads to a constant avoidance of just being still, so we revert to more distractions! How about learning to live with…just you. Wonderful, perfectly imperfect you. Rather than avoiding yourself, how about:

Just sitting: Being curious and mindful as you just sit. You can observe your thoughts and emotions, without judgment, just taking note of where your brain goes when not stimulated externally. Some are fearful to do this because of negative thoughts of self or others. Can you just allow those thoughts to come up and pass on through (like a cloud floating by)? Maybe write them down and then we can try to better understand them in session? My clients also like to smile (and eye-roll) at me when I repeatedly suggest meditation practices, but now is a GREAT time for this and you can check out the resources page for some helpful tools. As you just sit, you can allow yourself to: still have value without having to do something, relax, learn more about yourself, ponder dreams and your own curiosities, decrease your dependence on the need to be entertained/engaged at all times, and also allow your body and mind to take a break and rest.

Time for reflection: Now would be a cool time to develop a practice of gratitude. Or check in with yourself about your goals/objectives. Create a vision board. Re-commit and strategize for healthy habits. To take note of what is working well for you and give yourself some props! Social isolation may not be the best time to intentionally process traumatic experiences or difficult emotions on your own, but remember that I, and other therapists, are still available for online counseling and support. So, if you find that during reflection, you are having a strong reaction to something, you can appropriately set it aside or develop a visualized container to set the event/topic in. While reflection should allow for all emotions/experiences, be mindful to put more effort towards positive reflection as social isolation can sometimes lead our brains into funky, depressed places. By intentionally engaging in more positive reflective experiences, you can practice this very important habit (which then becomes a worldview) of seeing the good despite the challenges life throws our way. My clients know that I am happy to help point out the positive items if they are struggling to see it in themselves and their lives.

Enjoying non-screen activities: Yes, this is still Doing (and somewhat ironic coming from an online therapist), but can also allow space for thoughts to arise, talents to be developed and enjoyment of yourself or those you are with. You can engage in hobbies you enjoy, or try new ones. If you’re isolating with a friend/loved one, how about time for those re-connection activities, such as the Ungame Cards, or the couples Gottman App)? What about pulling out all those dusty craft supplies you’ve been collecting? That book you’ve been meaning to read? Since starting the traveling lifestyle, I’ve made sure to bring books, colored pencils, the Spotify music app, yoga mat, the mini Buddha Board with me wherever I go, so that I can have something to learn, means of expression, and a way to release energy in a positive/healthy way. Others are into knitting, painting, music, costume (cosplay) creation, home decoration, Zumba, origami. I promise that you are more interesting than anything I’ve ever seen on television, Facebook, or Instagram. Especially now, with so much media focus on various anxiety-provoking topics, it’s a great idea to do brief updates from reliable sources, but then take a break. Constant exposure can be debilitating.

As for me, I’ll be hiking in the mountains next week and taking time to reconnect with nature. I’ll be back to sessions on the 23rd of March and if you can’t reach me (as I’ll be disconnecting…), you can schedule through the client portal. See you shortly! I look forward to hearing how you’re making good use of this time! Feel free to share additional ideas below!

New Year Updates!

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Happy 2020 to you all! 2019 was another year of growth and changes. In June 2019, as most of you know, my practice became fully telehealth (video and phone counseling), which allowed me to pursue my own dreams and goals – because, practice what I preach, right?! This was a difficult decision for me as I knew that it would mean disruptions for others. However, many reported that this new format provided additional convenience for scheduling and making sure therapy happens despite our busy schedules. For others, I was happy to find providers in their communities who could provide continued face to face sessions.

As this new year rolls in, I’m appreciating seeing more and more who are committing or recommitting to therapy. Currently, I’m pursuing additional training/education in trauma therapies and other areas; with the aim that my continued growth will help me to best serve you. With EAP work, we can continue to be solutions-focused and boost coping skills, as that is the intent of the short-term work. Beyond that, I’m finding that many of us (as is common in human nature) continue to struggle with the narratives and stories we tell ourselves about situations, ourselves, and others. This can be in relation to traumatic events or just our general outlook on life. I have found that if we can make a habit of being aware of those stories and our “inner dialogue”, we can certainly find more helpful language and viewpoints that makes us better able to move forward to healthier relationships with ourselves and others.

Insurance changes may have occurred in January for many of you, so as a reminder, I am currently paneled with and accepting Cigna Insurance and the following EAP companies: ComPsych, Cigna EAP, and Health Advocate (though HA only allows phone sessions and not video). Please check to see if your benefits have changed (deductibles, co-pays, etc.) due to the new year. As mentioned in my previous post I choose to pay out of pocket for my therapist, because my insurance isn’t stellar and she does not take that insurance anyway. You can check to see if your insurance would reimburse you for out of network costs. We can also modify session frequency and come up with a plan for how to have check-ins with yourself in between our sessions, which is what we would want to be encouraging anyway! I also plan to create content that can assist with daily practice and more sustainable habits. As I have said to many, the idea is for you to practice what we do in session on a daily basis, as I only get to see you maybe 45-55 minutes each week!

As always, I’m open to feedback! What content or tools would be helpful for attaining your mind/body goals this year? Although we can’t be best friends forever (BFF) on social media, feel free to check in on the facebook and/or instagram pages for content, which I intend to be more consistent with! #2020goals

Affording Counseling and Therapy

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Insurance, EAP, Community Support, and Budgeting

We all know that accessing healthcare can be daunting, especially when it seems (or is) not affordable. Here are some options to check out that may make it easier for you to get going with a provider.

Insurance

If you’re paying for it-may as well see what you can get from it, right? The easiest way to find out what your plan offers is to just call the number on your insurance card (and it’s also a good opportunity to practice managing emotions and reactions as you breathe patiently through the fiftymillion prompts until you get to a person). So after you get through to a human, what do you ask?

Hi, I’m calling to find out about my mental health benefits through my plan.

At this point, the lovely representative will likely tell you if you have a deductible, which is the amount you would have to pay before the insurance will pay for services. Even if you have a high deductible, most insurance plans require that therapists only charge the rate that they would receive from the insurance company. For example, if the insurance company pays the therapist $80 for a traditional 55 minute session, the therapist can only ask this of you, rather than the self-pay rate they may have. After the deductible is met, there may be a co-pay or the insurance may cover the session in full. A co-pay is the portion of that example $80 fee that you would be responsible for. So if your co-pay is $20, your therapist would bill the remaining $60 to your insurance.  This is at least how it works in my practice. Some therapists prefer to have you handle the insurance by submitting bills/statements to the company so that you can be reimbursed directly by the insurance.

If you are calling to be referred to provider, the insurance company will provide a list of in-network providers, but if you are connected to a therapist already that is NOT in-network, you can ask if your insurance provides out-of-network benefits. My experience has been that not many do, but it’s worth asking anyway.

Also make sure to ask specifically about the type of counseling you are doing. Individual sessions are billed in various increments and standard for my practice is an individual 55 minute session (code 90837), but I’ve also billed for inclusion of family members, or for shorter sessions, so you will want to ask the insurance company specifically if they cover couples or family sessions, as not all may. Further, I am finding that most plans cover in office sessions at the same rate as online sessions, BUT that may be true. Luckily, there have been cases where the plan actually offers better benefits for online sessions, which was a nice surprise!

*Please be aware that to use your medical insurance, providers have to provide a diagnosis and prove that sessions are “medically necessary” to access your insurance benefits.

Employee Assistance Programs

I’ve been finding that many people do not know about their EAP benefits, which is a shame, because there are usually free sessions! EAP benefits usually include a variety of services, with the idea that a supported employee is a more effective employee. Companies usually outsource these benefits, so it’s important for you to ask and understand the name of the company that is providing the mental health/counseling sessions (i.e. ComPsych, Health Advocate, Cigna). This is separate from insurance and my experience thus far has been that I do not have to provide a diagnosis to the company. EAP is intended to be short-term stabilization/connection to resources and the 3-10 sessions can do just that. For those that want to continue with their counselor, they typically continue through self-pay or use of their insurance. Since we already know that EAP is short-term, if you have an idea you would like to continue with the counselor, it’s best to discuss this up-front.

Hi, I’m calling to find out about counseling sessions available through your program; can you tell me how it works?

The lovely EAP representative will likely ask you what issue you are working on (as they sometimes provide additional sessions for a different issue later on), who it is for (EAP sessions may sometimes be available to family members), and if you have specifications for a provider (location, demographics, takes whatever insurance). If you already have a counselor in mind, the EAP company can see if they are already contracted with them or may be willing to on-board the counselor, which your counselor may or may not choose to do.

EAP rep. will then notify the provider that they’ve been assigned to you, and/or will provide you with an authorization number (*remember* to ask and write down how many sessions/dates allowed to give to your therapist). The therapist usually submits a request for payment directly to the EAP company without needing you to do anything.

Community Support

There are various free or low-cost options for various needs and each agency will usually specify through their website or a phone call what those requirements are. For example on the Mental Health Association of Central Florida’s website, their criteria for the Outlook Program is: over 18 years of age or older, primary psychiatric diagnosis of depressive or anxiety disorder, comorbid medical conditions, permanent residence in Orange County, uninsured, and of preference, recent medical hospitalization or visit to the emergency room. A quick online search for “free counseling in *your city*” should return some leads to explore in your community.

There are also national resources such as Open Path Collective that gather counselors who are willing to provide low cost services to those that sign up/qualify.

Many counselors also provide spaces for “sliding scale” for those who cannot afford their full-fee. This would be negotiated according to the therapist’s practice. While I would not be able to pay my own bills if I offered sliding scale to everyone, it is important to me that people get the help they need, whether that is with me or another option.

Budgeting

This is the path I chose for myself as I don’t have an EAP program and I wanted to continue with the provider I was already working with, even though she does not take my insurance. I’ve had to do some mental cartwheels around this to reframe how I view where my money goes. This really only became clearer after I kept better track of where my money was going. When I found that I was spending more on going out to restaurants than on my health, I had to make some adjustments because while socialization and experiences do contribute to my own healthy state of mind, I needed to find a better balance. So, I add it to my “medical” budget each month and adjust other budget items as needed to be able to make this happen for myself. Interestingly…I have found that by doing “the work” with her, my money/budget habits have improved anyway!  

Regardless of what path you choose, it’s important to determine your “why” and the strength of your “why”, which will fuel your determination to finding any way to get the support you need.

* Photo by Fabian Blank on Unsplash

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After getting the opportunity to work with some social workers, fire fighters, teachers and other helpers in our community, I’ve found that I really enjoy supporting those that support others. I remember the secondary trauma I experienced myself as a younger social worker, the many times of burnout, and seeing those around me leave their professions due to the usually thankless, high-stress work environments.

If there is anything to be done to support you and keep you doing the important work you do, let’s make it easier for you to do this thing called “self-care”. Helpers tend to have interesting work hours; I offer flexibility during the day so that we can work around your schedule. And because it’s via video/online, you’re saved a commute to another office. All you need is an internet connection and device with video capabilities. Any questions? Feel free to call or message me at 407-437-5076. See you soon.



Spring Update – April 2019

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I have so enjoyed working in my Orlando office and being in the Orlando area for many, many years. While there is never a perfect time for transitions such as this, I have decided that as of June 2019 I will be 100% providing video counseling, which allows me to see people located in Florida and Colorado, as I am licensed in both states. It may be something that people are not used to and I plan to offer free “try it out” sessions in the next few months. I prefer video counseling, but will also be available by telephone.

The platform I use is Doxy.me https://doxy.me/jenniferlombardolcsw  No need to download anything; you just need to click on the link a few minutes before so that you can test your video/audio quality! Many more insurances and Employee Assistance Programs (EAP) now cover tele-therapy. Some allow live video-to-video therapy sessions, others allow telephone only.  If you are interested, please reach out to them or me to discuss further.  

The “client portal” will continue to be utilized to schedule appointments and I will do my best to keep the calendar up to date. The schedule can be accessed here: Client Portal  (https://lombardocounseling.clientsecure.me/client_portal)

If you have any questions, feel free to call 407-437-5076 or message me through the Client Portal.

EMDR-What’s it about?

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It’s magic y’all. Brain magic! Well…maybe it’s just neuroscience, but still…it can feel like magic when other therapies are not working for you.

EMDR or Eye Movement Desensitization and Reprocessing (Francine Shapiro has noted that she would have shortened the name, but it kind of took off…and now it’s too late) is a therapeutic method aimed at desensitizing sensitive subjects and reprocessing events/memories. While it has been found to be effective for addressing traumatic events, it has also been found to work well with other troubles such as anxiety and phobias.

Ok, ok. So the mechanics of EMDR look a little different than your typical talk therapy. The old school, traditional method of EMDR involves me waving my arm in front of your eyes so that your eyes are going *right*left*right*left*right*. I can also use other “bi-lateral stimulation” devices such as “tappers” and/or a head set. Stay with me, I know it can sound odd and truthfully, it seemed odd to me too at first, but one reason I was trained in this method is because I was able to experience how well it worked myself! I also sought the training because it is evidence-based and worked well with so many.

So the idea behind EMDR is that it may replicate what is occurring during REM sleep. Have you ever seen someone sleeping and marveled (or freaked out) at the motions the eyes made? The idea is that your brain has a way of healing itself and wants to heal itself and this is occurring during sleep and also during EMDR sessions. I can tell you that there is absolutely a commonality in how people process during an EMDR session. I do not share these experiences before an EMDR session as I would not want to lead or influence someone’s process, but there are definitely themes I notice that indicate that something awesome is happening in your brain and body. In general, the goal is to reduce how distressing you find an event and to have a healthier way of thinking about the event and yourself in relation to that event. So while it may not be magic, it is absolutely amazing and I’m happy to answer any questions you may have about if it is right for you!

Call to Artists! Display your Art.

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Inspired by a very talented local artist whose work will likely be featured in my office in the near future, I’m reaching out to find other artists who would like to feature their art for a time span during this year. I find myself inspired by artists who can evoke emotions and thought with their art or who so ingeniously capture the experience of mood/emotion such as Toby Allen’s Real Monsters. Since I have the privilege of working with the young folks and families, along with adults, I would want to display something that all could benefit from.

While I thoroughly enjoyed the experience of creating this, below, I’m looking for something a tad bit more advanced! 😉

If interested, contact me at 407-455-2926 or JenLombardoMSW@gmail.com Emoji Art

The Body Keeps The Score

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when-we-are-no-longer-able-to-change-a-situation-we-are-challenged-to-change-ourselves-1

I absolutely love that I continue to be inspired in my career; there is a never-ending supply of information and learning to be the best therapist I can be…I only wish I could just download it all to my brain in one day!

Currently, I’m wrapping up with “The Body Keeps the Score” by Bessel A. van der Kolk. He discusses the impact of trauma and adverse childhood experiences and treatments that work well to help people heal. One of those, EMDR (Eye Movement Desensitization and Reprocessing) is a practice I am trained in and it was enjoyable to read the successes the author had with this treatment and others, including yoga and neurofeedback.

Some of these styles can be confusing…”sorry…you want me to watch you wave your hand in front of my eyes?”, so feel free to do your own research and ask your therapist more about it.  As an EMDR practitioner, I want those I work with to be informed about how it works and what to expect, so if this is something you want to try-just ask me about it!

Next up on the reading list: Francine Shapiro’s “Getting Past Your Past”. Have you read it or have other recommendations?