How would you feel if you could stay home, open your computer or laptop, and have a therapy session? What about if your therapist offered to speak with you over Skype or some other online platform? Would you feel like a fish out of water or would you very much like to try that experience? What about if your anxiety was so bad that you couldn’t leave your home? For many people suffering from agoraphobia (fear of open places/spaces), panic disorders (panic attacks), or generalized anxiety disorder (anxiety triggered by worry of multiple things), it’s like heaven on earth to do therapy at home in one’s pajamas.
This is one of the reasons why Dr. Russ Morfitt has decided to start his online therapeutic services titled Learn to Live. Dr. Morfitt’s team and I have communicated via Twitter and email quite a few times and most of his teams’ information is geared toward normalizing the experiencing of anxiety, making tools available to people who cannot see him face-to-face, and bringing awareness to the crippling components of anxiety using his website and social media platforms.
The field of psychiatry, psychology, and counseling has both a scientific and artistic component to it. All treatment for mental health conditions are built on both a scientific and artistic foundation. It is common consensus in the healthcare field that science is often limited and requires someone who can incorporate just the right amount of art to give patients or client exactly what they need. When a therapist can see holes in the system and creates a program to fill the space where the hole is, that is art. Science is book knowledge, while art is skill, ability, compassion, and intuition. I would have to say that Dr. Morfitt has ventured to create a both scientifically and artistically sound service for international clients in need of support.
Let’s listen to what Dr. Morfitt would like to share with us today and please feel free to ask him any questions you may have.
1. Thank you Dr. Russ for taking time out of your schedule to participate in Personal Stories Week. I’m delighted to have you join us. Please share with us your interesting background and what got you started in psychology?
First off, thank you so much for inviting me to participate in your Personal Stories Week. I previously worked in the technology industry and suffered social anxiety for many years before I realized what it was. This struggle, and my wish to help others, is part of the reason I got into psychology. I studied psychology at the University of Minnesota and have had a professional practice providing Cognitive Behavioral Therapy (CBT) for anxiety, depression, and other mental health problems for nearly 20 years. Every time I see someone get past their fears or discouragement, I know I chose the right profession.
2. What gave you the idea to offer online-based services and what is the research on the effectiveness of online counseling? What’s the name of your online service?
I’ve had patients drive hundreds of miles to see me because they couldn’t find a CBT therapist near them, particularly one who would provide manual-based, high-fidelity CBT with a strong behavioral component. I started to think about alternative delivery methods to help them and quickly thought of the Internet as the ideal delivery channel. I encountered Internet-delivered CBT at various research conferences and found there’s abundant research supporting the effectiveness of online CBT. It’s already a standard treatment option in England, Sweden, Australia, and elsewhere but only now being offered in the US. I co-founded our company, Learn to Live, to bring CBT to more people. So while I continue to see patients in my office practice, I am delighted to finally be able to offer people an online option.
3. Tele-mental health services have become a very useful service for many mental health professionals. Online counseling or tele-mental health is something many offer to clients in addition to face-to-face counseling services. How do you provide your services to clients? Do you offer face-to-face sessions?
People who sign up for the Learn to Live program go through the same materials that we use in the face-to-face therapy setting but there are no face-to-face sessions. Instead, they rely on our online lessons (which feature videos, interactive games, and challenging practice exercises) to learn the materials at their own pace, and are encouraged to sign up two Teammates, advocates who follow their progress and encourage them through difficulties or celebrate their milestones with them. Though the process starts online, our members quickly learn that success means engaging others face-to-face as they practice and polish their new CBT-based skills.
4. Would you say that your online services are HIPAA (Health Insurance and Portability and Accountability Act) compliant? Are services confidential?
Absolutely, our internet-based treatment solutions are completely confidential and HIPAA compliant.
5. Your online-based service focuses on cognitive behavior therapy, a type of therapy that focuses on the influence of thoughts on behavior and feelings. Please share with us some basic knowledge of CBT.
CBT is an action-oriented, problem-focused intervention that relies on homework (practice or exercises) to get past symptoms of excessive anxiety, depression and related problems. For many people, analyzing our thoughts is one of the best ways to break the negative feedback loop between dysfunctional thoughts (they think I’m stupid), emotional suffering (excessive fear), and maladaptive behaviors (isolation, avoidance, precautions). So, in CBT, people learn to examine the thoughts, but they also learn to change the behavior patterns that keep them stuck. They learn to become more active if they are depressed and sedentary, or to be less cautious and confront their fears if they suffer from anxiety or related problems. Many learn to adopt a new mindset where they no longer consider the emotions themselves as emergencies, but temporary experiences that accompany their lives for the moment.
6. About 40 million adults experience anxiety today. It’s something most of us have had to experience and learn to cope with. Anxiety, as you know, can be fleeting (momentary) or chronic (long-term). What are some common cases that you see and what’s the research behind CBT for anxiety-related disorders?
I feel profoundly fortunate to be able to help people with the full range of anxiety disorders in my office practice, ranging from Social Anxiety Disorder to Obsessive Compulsive Disorder, Panic Disorder, Generalized Anxiety Disorder, Specific Phobias, and Post Traumatic Stress Disorder, to name a few. My work is consistent with the hundreds of individual research studies and at least 48 meta-analyses that have identified CBT as the most powerful talk therapy for these conditions. Interestingly, there is a growing body of research showing that internet-delivered CBT can be equally effective as well.
7. Some of us know that you have a blog. Please tell us about your blog and what the goal is?
I keep the blog because now that I’ve become a bit more of a public figure in this area, I think it’s important to have a place to share and comment on the latest research in the mental health sphere. I also try to share tips and tricks with readers, things that I’ve found especially helpful or useful in my practice. Much like your blog here, it’s helpful for people to share their own stories. Anecdotes are a very powerful tool for people wanting to know they’re not alone.
8. Because Personal Stories Week allows parents and families to discuss their experience with mental illness and the mental health system, I’d like to ask what you think are the two biggest barriers to proper mental health treatment in general?
In general, I’d say the two biggest barriers are cost and awareness. As people who have lived only in our own skin and grown accustomed to our own suffering and stuckness, we are often unaware of our own issues. Cost is a related issue. Drugs and face-to-face therapy are expensive. We have these wonderful inexpensive treatment options and nobody knows about them. We’re also victims of our own stigmatization. Nobody wants others to think they’re “crazy.” So we stay quiet and develop (mal)adaptive behaviors just to survive. But just surviving isn’t good enough; we can do so much better.
9. What are some of the biggest hurdles for those seeking mental health treatment for anxiety?
There are two specific issues that our online program is designed to address: stigma and accessibility. The stigma of social anxiety means that many people don’t want others to know they’re seeking treatment. Walking into a therapist’s office can be an insurmountable step for many. For others, it’s lack of access to qualified therapists providing exposure-based CBT, which is crucial for anxiety. If you live outside a major urban center you’re even more likely to have this issue. The online environment makes CBT available to more people and allows members to go through the program in privacy, without missing work or school.
10. Do you think anxiety is less stigmatized than other disorders such as depression or bipolar disorder? Why do you think this is? I’ve heard many youngsters say “I just have anxiety, but I don’t have bipolar disorder or depression.” Many of my adolescent client’s feel more comfortable seeking treatment for anxiety than they do for depression.
In my experience, it seems to really depend on the specific anxiety issue. Generalized anxiety and specific phobias may have less stigma, so people seem to acknowledge them a bit more freely. But we often want to conceal our social anxiety, as the fear of having others know about our discomfort can be the greatest fear for sufferers. OCD fears and behaviors can seem extremely shameful. A lot depends on our perception of the audience.
11. Would you say that the presentation of anxiety symptoms in adults is different from those seen in children?
It’s an interesting question because we know that so many of the anxiety disorders have childhood onset for most sufferers. Many people asked to recount their first memory of the anxiety simply reply, “As long as I can remember.” Adults are often able to articulate their distress, their nervousness, their internal sensations, and their urge to escape or avoid so much more easily than children. As you know, we often have to look harder for the somatic complaints and subtle avoidance of children, but those markers can be pretty important clues for adults as well.
12. Tell us about your social media and some of the things you have done to bring awareness?
We consider our social media presence, which includes Facebook, Twitter, YouTube, Pinterest, Google+ and more, an extension of our programs. The irony of using social media to reach out to socially anxious people is not lost on us. But social media is really a meaningful way of engaging with social anxiety sufferers on their own terms. They can join the conversation, or not. For some, the Internet offers the right format for them to find their voice. We have sought to provide a unique and valuable perspective in the ongoing conversation around social anxiety. Based on the feedback so far, it seems like people have appreciated our contribution, whether they use us for analysis, tips, or the whole program.
Dr. Russell Morfitt Bio:
Dr. Russell Morfitt is a practicing psychologist and co-founder of Learn to Live, a company developing a suite of online programs for people with social anxiety and other mental health disorders. He has over 18 years of experience in treating patients with Cognitive Behavioral Therapy (CBT) and manages the CBT Center, a specialty anxiety clinic he founded in Minnesota. He has provided training to other practitioners in CBT and speaks frequently at colleges and universities. Dr. Morfitt has been involved in development of internet–delivered CBT since 2006. He is also a founding member of the International Society for Research on Internet Interventions (ISRII). Dr. Morfitt holds a PhD. from the University of Minnesota.
Dr. Russ I want to thank you again for taking time out of your busy schedule to share your knowledge with us today. I believe that online counseling has its pros and cons and many of us are still unsure of the true benefits. So I appreciate you showing us the positives of such a service. With the advent of new technology almost every year, it’s important that mental health professionals and clients understand how that technology can serve us well.
All the best with Learn to Live!
We have had some really insightful stories this week. Stay tuned for tomorrow’s final story about another mother who received a diagnosis of schizo-affective disorder and how she copes with her daughter’s illness.