Winter Blues

Winter landscape branches form a heart-shaped pattern

Clients at my practice have shown an increase in depressive symptoms in the past month. This is typical for this time of year. The decrease in sunlight causes the Winter Blues, or technically, Seasonal Affective Disorder (SAD).

Our brains are dependent on chemicals from sunlight to create the happy chemicals. You may have noticed you are feeling more: sad, irritable, grumpy, touchy, or frustrated this month. If this is you, make an effort to get more sunlight. Sit outside during lunch. Go for a short walk before work. Anywhere you can get an extra 20-40 minutes of sunlight will be an improvement.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Is My Child Suicidal?

Child sitting alone, curled up

If you are worried about your child, whatever their age, it is good that you are paying attention. Let’s talk about warning signs and give you the tools to act appropriately.

Warning signs of depression in children:

  • Irritability
  • Aggression
  • Crying spells
  • Isolation – not wanting to talk, not wanting to be around their friends
  • Lack of pleasure in things – do not want to play with their toys, their pets, their friends

Talking about suicide is okay. Talking about or asking about suicidal thoughts does not increase them, so ask. “Are you thinking of suicide at all?” An open-ended question like this invites the child to talk about what they have been thinking, so you know what is on their mind, if they choose to share.

If your child says they have been thinking about suicide, or thinking “it would be better if I were not alive” or “sometimes I think about being dead” or “it would be easier if I were just gone”, this does not mean they are suicidal. These are normal thoughts that many people have, no matter their age. Therapy would be a good intervention at this point. Your child is saying they are in pain and need relief.

Probe to the next level “Do you have a plan to kill yourself? Do you want to kill yourself?” Use plain language like this and be direct. You need to know the information and asking like this will get you what you need. If your child has a plan and a desire to attempt suicide, intervene immediately. Google “mobile crisis team [your county]” to find the number for who to call. A mobile crisis team will come to your home, interview you and your child, and make a determination as to the severity of the suicidality. If warranted, they will take your child (or refer you) to the nearest psychiatric admitting hospital. If not warranted, meaning there is not immediate danger, they will encourage you to seek therapy for your child, which you should start as soon as possible. To find a therapist, you can search Psychology Today for your city and insurance, but be aware that many therapists (like myself) use telebehavioral health and you can see them from anywhere in the state, so you have additional options if you open your search to include telehealth.

If your child is cutting, that is, you see marks on their arms, legs, or torso, ask about it. “Why do you cut yourself? How often do you do so? What is the benefit you get from that? When was the last time that you did it? Are you taking care of the wound so they heal properly and don’t get infected?” Cutting is not suicide. Please take cutting for what it is: a way to release emotion, or a way to feel something when numbness is all that they are feeling. Cutting behavior should always be accompanied by therapy because either cause is a sign of deep sadness.

If you have a child that is hurting, having your own therapy is a benefit to you and to the family. You can learn how to support your child, have an outlet to express your frustration or sadness, and get support as you go through this tough time for your family.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Multiple State Licenses

Autumn Hahn, Licensed Mental Health Counselor, Licensed Professional Counselor, Certified Clinical Hypnotherapist

There is a lot of confusion when it comes to getting licensed in multiple states. How do I begin? What is it called? What’s the benefit? I’ll demystify some of that here. I am licensed in Florida, my primary state, and state of residence, since 2010. I got licensed in Georgia in 2021, and have licenses pending in Washington DC and New York.

Why get licensed in multiple states?

The more states I am able to see clients in, the more business I stand to get. I accept insurance, and utilize a number of referral sources to get clients (if you are interested in information on those, please email me and I’ll refer you).

Having a wider base allows me to see the clients who are the most appropriate fit for my specialty. I specialize in trauma, and typically work with only those clients, so I don’t see everyone who needs therapy, only those who seek me out.

Working in multiple states allows me to serve a wider population. Being in telebehavioral health (seeing clients by video) allows me to serve clients in underserved areas, across the entire state.

The American Counseling Association is working on an Interstate Compact that will allow us to practice across state lines for those states participating in the compact, provided you are licensed in one of those states. The American Psychiatric Association has something similar for psychiatrists. You can learn more about the Compact here.

What are the types of license across states?

License by reciprocity – This is outdated. I have heard rumors that some states used to let you practice across state lines simply because you held a license in your state of origin. This is not true now, with the exception of some ability to do so during the pandemic. Do not pursue this. Even if you find it is true for some pandemic-related rules, it will go away at some point soon, if it hasn’t already. This is not a modern law or rule.

License by endorsement – This is your search criteria. If you want to become licensed in another state, search “License by endorsement counselor [state]” and follow the rules on their webpage. You may find that you need to have been licensed for a certain amount of years in your state of origin to qualify (in New York, for example, you have to be licensed for 5 years to qualify), or there may be other rules related to how many practicum hours you need to have completed, certain coursework your school needed to provide you, etc. You may also have to take an additional continuing education course to qualify; New York has a 2 hour child abuse awareness and reporting course everyone has to take. Complete the paperwork and send in your fee. Be aware that you will need access to: your unofficial transcript, your employment and education history, your existing license(s), professional references, and will likely have to send official transcripts, may have to get finger prints done, and more. The process varies by state. The verification and licensing process also varies by state. Georgia, for example, took less than 6 weeks to process all of my information and approve my license. DC, however, has had my paperwork for over 3 months and it is still “pending” with no reason given.

Your title may change as you apply across state lines. I am a Licensed Mental Health Counselor in Florida, but my title in Georgia is Licensed Professional Counselor. It is the same information, same degree, same everything, but certain states have different titles. It does not functionally mean or change anything.

Now what?

Once your secondary (or more) license has been approved, do a couple of things:

Update your referral sources to reflect the new status so you can begin advertising to those states. This includes your Psychology Today profile, website, email signature (mine says I am accepting clients in Florida and Georgia), and any paid referral sites that send you clients where you have a profile.

Go to your CE tracker and enter the new information so you can log all your appropriate CEUs and be certain you don’t miss any renewal dates. Make a note in your calendar to take a course that you need, as appropriate. I use CEBroker for Florida and CEWindow for Georgia.

I hope this information was helpful to you!

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

ADHD in Adults and My Experience

October is ADHD-Awareness Month. I thought I’d speak to my experience.

I was diagnosed with ADHD in my 40s. Looking back, I see the early symptoms in my childhood – lots of daydreaming, easily distracted, unable to have single-focus. I was raised in the kind of home where manners were important and was taught to pay attention, entertain myself in quiet situations (like in a restaurant), and respect my elders and others. This meant I always had a book with me so I had something to occupy my mind, did not interrupt, waited my turn, and adhered to all of the social niceties. Interrupting, getting out of your seat, and being loud or messy are symptoms of ADHD in children, especially boys, that I did not display because I was taught that they were unacceptable behaviors. But when I think back to being in school, I remember looking out of the window for long periods of time, doodling in the margins of my notes, writing poems during class lectures, and other distractible behaviors that were unnoticed by others. In college, I applied the behaviors I learned growing up; I had good study skills and was always a straight-A student. College was not difficult for me, but did require a lot of reading and studying outside of class.

As an young adult, I had learned to make my brain work for me. I multi-tasked constantly and always had 15 tabs open in my brain’s computer, including one always playing music of some sort. Working in an office was fine for me, but keeping to a clock always bothered me. I’m super-efficient, and get a job organized in just a few months and am bored thereafter. I hate punching a clock and find that I have usually finished my 8 hours of work in a few hours, so why be chained to the desk before I’m allowed to leave? This caused me to feel resentment and I thought there was something wrong with how I thought about work, as people I talked to did not feel this way, and simply slacked off more during the day; I would rather slack off at home, where my video games were. I always worked and attended school, as well as raised my kid, was in a relationship, and managed both my home and my kid’s extra-curricular activity. I was so busy outside of work, that having down time at work felt unacceptable.

In my later adulthood and career, I own and run multiple businesses, write books, play and run D&D games, am always planning business ideas, and all the normal things like see my friends and do hobbies. This works much better for me. I set my own schedule, can work a few hours here and there, jump from project to project, and utilize lists to get multiple things done. I use the calendar to set up my tasks and be sure they are done; I live and die by my calendar. I have used the Sticky Notes app on my computer, with a different note for each “category” (each business, home things, writing) to stay organized.

In my 40s, I went to the psychiatrist and asked about being assessed for ADHD. He asked me for a list of my current projects and I told him to clear out his calendar for the rest of the day. I listed them (take a deep breath): 3 projects for my board-game business in various stages of readiness, building my counseling business (including counseling, seeing interns, doing the social media, marketing, bookkeeping, etc.), planning auditing as a service, writing a curriculum for treatment centers, planning online courses to sell, and writing a fiction novel. He did some testing and prescribed me a medication. I’ve been on it since, including a dose increase. It took about a month before I noticed the change I was looking for: decreased distractibility. I want to finish more projects, spend more time on a project once I’ve begun it, and be more satisfied with the work that I am doing. Medication has helped me with this focus.

Here are a few of my favorite videos on how ADHD symptoms present in adults, and they’re in bite-sized format, perfect for the mind that has trouble concentrating.

https://vm.tiktok.com/ZMdYrE9K1/

https://vm.tiktok.com/ZMdYrgHAD/

https://vm.tiktok.com/ZMdYrKkXL/

https://vm.tiktok.com/ZMdYrKbeD/

https://vm.tiktok.com/ZMdYh6Exv/

https://vm.tiktok.com/ZMdYrKDx8/

https://vm.tiktok.com/ZMdYhjUrD/

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Suicide Can Wait

It’s okay if all you do today is survive.

Vineyard with hills in the background

If you are considering ending your life, do nothing for 24 hours. That is an accomplishment you can build upon. Avoiding an action is an action. 

How many small moments will you have today? Spend a little time outside, or just looking outside from inside. What do you notice? What made you smile, surprised, or captured your attention? What thoughts did you have? Those are the everyday moments that make life interesting. Share them with someone. What did they say? Did they share your feeling? What did they say? Those connections make life a shared experience. 

At this moment, it may be difficult, or even impossible, to see a life that doesn’t look like the one you have. But the experience of life is not constant and situations will change. Some may deteriorate and some may strengthen, but it is certain there will be change. Think of your life before it was how it feels now; maybe that was a year ago, or 5 or 10 years ago, but it was different. You haven’t always felt this badly. You won’t always feel this way, either. But it can take time. That might feel heavy to hear, but compare that other time to this one. Now compare this time to 1, 5, 10 years from now, even if may be difficult to imagine, know that it will be changed. You have to stick it out, get through this rough part to get to that good part again. 

This is a valley surrounded by hills. Keep climbing.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

On Victim Blaming

The only people who rape are rapists. Full stop.

If an attractive person, without a stitch of clothing on, appeared in front of you, I would hope that your reaction would be to get that person to safety, offering a way to cover them, and the ability to get to a place where they will be okay. If your first reaction is to attempt to have sex with them, this is problematic behavior.

This sounds like farce, right? But if you listen to victim blaming, they will say “If they weren’t dressed like that” or “if they weren’t in that place” or “if they were sober at the time” as justification for rape.

At no time, would I consider forcing or coercing someone to have sex with me. I hope that is true for you, also. That makes us not rapists! If someone were not sober, were dressed scantily, and/or were in a place that was unsafe, I would, and I hope you would, get them to safety as your first order of business.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

The Benefits of Not Using your Insurance

Most people believe that going to therapy is a process earmarked by privacy. And it is, sort of, if you don’t use your insurance. I have worked in therapy both as a therapist and as a medical biller for a therapy agency, so I know both sides of this fence intimately. When you see your therapist, the therapist, by law, generates an intake, a treatment plan, and notes. They likely also diagnose you with one or more conditions, which may be transient or permanent, depending on the client.

If you use your insurance, this information is all available to the insurance company, and is part of the contract either your therapist or their agency signs when agreeing to be paid by the insurance company. The insurance company can reject payment if they do not have “justification” that your problem is significant enough, which can result in a therapist making an addendum to the note to state you are worse off then you are, or that they require more information about your case; this results in the therapist sending more information from your file (extra copies of notes or additional notes or summaries) stating your problem, when it began, problems with treatment (perhaps you missed an appointment, were late, or did not do a homework assignment), or additional facts about your case that were not initially captured in the session note. While, ethically, all of this information should be factual, it is also private and is not the business of the insurance company.

If you are seeking treatment for substance abuse, for example, it needs to be cited what drugs you were taking, but what means, in what amounts, for how long, and what previous steps you have taken to try and quit. If you have not tried unsuccessfully to quit on your own, most insurance companies will not cover your inpatient services. If you have tried to quit several times through inpatient and outpatient services, they may deny you as too big of a risk for failure. The insurance company is not on your side in these matters, but looks at you as part of risk-analysis.

I believe the client-therapist relationship is one based on honesty, privacy, ethics, and rapport. I want my clients to know that their information stays with me and no one else. I do not believe that most people understand how their information will be used and to whom and how it will be disclosed. Now you know. Feel free to share this.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Metaphor Consultation

When working with the subconscious, you have to connect with the subconscious in it’s language.

Think of a birthday party you once had. Do you remember who was there? What happened? How you felt? Music that played? What was said? There’s little chance you remember specifically what was said because the mind stores information in pictures and feelings. Language is an overlay that we have worked hard to create over time, but is translated at the conscious level.

Working with the subconscious is best done through the use of accurate metaphors. Metaphor creates a layer of protection between the client’s threatening memory and the therapy process, taking the sting out of therapy and making it much more fun to participate in; this leads to additional client engagement and less cancelled sessions.

If you would like to hear your client’s story, noting the relevant items, relationships, and settings, and ignoring the irrelevant ones, to create metaphors that subconscious mind connects with in order to induce the most useful change, call me for a consultation.

For example: A woman recalls having been tripped in the cafeteria in middle school. She felt embarrassed, confused, and upset. She tells you that her peers and the adults in the room did nothing while the bully pointed and laughed at her. Take a moment to examine this example for what her subconscious mind remembered in that 2 second video clip or snapshot of the moment. What elements are relevant? Which are irrelevant?

I would construct a metaphor utilizing the feelings she verbalized (embarrassed, confused, upset), the notion that she was not saved by her community, and lightening that metaphor so that the memory of the original event is softened. This new metaphor is a subset of the original memory, which will be attached, but not replace, the original memory.

She is a court jester. Her job is to be embarrassed in front of her community, even though she does not always like that job, and most people do not love every moment of their jobs. She has to do pratfalls, get pied in the face, and be made fun of by royalty. This is much less threatening of an event to imagine than the actual event.

This takes me just a moment to concoct. I’d like you to be as excellent at working with the subconscious! There is no such thing as too many good therapists and if I can help you grow with this technique, it is my pleasure to do so.

Consultation is $100/hour as we can meet monthly or up to weekly, as is your preference, in small groups or individually. Please call 954-612-9553 to schedule. Video conferencing is available from me to where ever you are in the world.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Consultation: Write Better Notes

After a session, we are taught to write brief, but “good” notes. What does that even mean? Notes should take you 5-10 minutes to write. They should include a mini-mental status exam, what you did, how the client responded, and what you will do for next time.

I have streamlined this process and can teach you to do them quickly and well. My notes have gone through subpoena and I have been an expert witness with excellent results based on my notes.

Consultation is offered individually or in small groups and I am happy to work with your agency or group of interns. Cost is $100/hour and is estimated to take 1-2 hours. I am also happy to customize a training for you on what to include/exclude, working with specialty populations, treatment planning, and more. Please call to schedule an appointment at 954-612-9553.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

For the Sheer Joy of Doing it

Have you heard the expression “for the sheer joy of doing it”? As in: Look at that kid skipping down the sidewalk, just for the sheer joy of doing it.

Halloween child friendly treats with bananas and clementines made to look like pumpkins and ghosts

When is the last time you did something just for fun? Now take it even deeper. When is the last time you did something just for the sheer joy of doing it? I do lots of things for fun, but is it for joy? I thought about this for a couple of weeks and found that one thing I do for the sheer joy of doing it is dancing. Most of my hobbies are enjoyable, but don’t bring me joy. Perhaps I need more hobbies, or more dancing in my life.

What do you need more of, or to start doing?

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.