GinaMarie Guarino, LMHC
As therapists, we know that most issues and concerns our clients face are more dynamic and intricate than the client may realize. Many components contribute to presenting issues with our clients, and often there is more than meets the eye. When working with clients on issues like emotional regulation, mood disorders, anxiety, and self-esteem, it […]
GinaMarie Guarino, LMHC
Sometimes clients struggle with learning how to feel happy and fulfilled in their lives. Whether it is due to depression, low self-esteem, or motivation issues, it is not uncommon for clients in therapy to struggle to find traction toward happiness or contentment. These clients will ultimately feel lost and sometimes hopeless in their efforts to […]
GinaMarie Guarino, LMHC
When teaching a client how to use CBT for managing anxiety it helps a great deal to provide a visual aid. Clients who suffer from severe or chronic anxiety struggle to maintain control over anxious thoughts and resulting anxious feelings and behavior. It is important to teach clients in CBT treatment to begin working through […]
GinaMarie Guarino, LMHC
Sometimes our clients have a hard time expressing how they feel to their therapist and others. There could be several reasons for this, like the client was not brought up to express their emotions, they struggled to relate to how others feel, or they simply struggle to make the connection between feeling and expressing their […]
GinaMarie Guarino, LMHC
There are a number or reasons why our clients develop a tendency of stunting their emotional expression. Many grow up in homes where they learn to silence their feelings, some suffer from mood disorders that cause unfamiliar feelings, and some come from traumatic, abusive, or negligent situations that prevent them from being able to understand […]
GinaMarie Guarino, LMHC
Helping a patient build self-esteem can be a challenging process. Many patients suffer from poor self-esteem, and that poor self-esteem contributes to their presenting concerns. It also will hold patients back from reaching their full therapeutic potential and feeling confident in themselves to make the changes in their lives that will help them improve their […]
GinaMarie Guarino, LMHC
Interpersonal issues like assertiveness, aggression, and confrontation are often things people struggle to know how to handle. There is a fine line between assertiveness and aggression, hostility, and submission, when dealing with confrontation. Sometimes it can be difficult to know which road to take, whether to be assertive, aggressive or submissive, and the confusion can […]
GinaMarie Guarino, LMHC
We all know that worrying consumes time and energy, and is a feeling that is often hard to shake. Patients often struggle to cope with worrying, and may not even realize how severely they are affected by their worrying. do not quite understand that they have the power to control how their thoughts affect their […]
GinaMarie Guarino, LMHC
When working with patients who struggle with relationship issues and communication issues, it is important to be sure the patient understands the core elements needed in developing relationships. Patients often struggle with building relationships, getting to know people, being open to others, and communicating. When patients struggle with these issues it is important to teach […]
GinaMarie Guarino, LMHC
Many patients will struggle with a major issue that all people are best coming to terms with: we cannot control what happens around us. Wanting to remain in control is a natural thing for people, but it can sometimes be difficult for a patient to understand that he or she cannot control the environment or […]
GinaMarie Guarino, LMHC
One major cause for stress for patients is understanding how to handle confrontation and interactions with others. Sometimes people struggle with being assertive, controlling their temper, or simply expressing how they are feeling or what they are thinking in a given situation. When patients struggle with such challenges it helps to help them understand social […]
GinaMarie Guarino, LMHC
Cravings to engage in dangerous or indulgent behaviors like drinking, using drugs, overeating, or sex are a difficult thing for a patient to work through. Each time a patient experiences a craving or a trigger to engage in something they know is not good for them they are confronted with the conflict between doing what […]
GinaMarie Guarino, LMHC
When it comes to teaching children proper behavior it helps a great deal to have a reward system in place in which the child can watch his or her progress grow. Such positive reinforcement helps with keeping children motivated to keep growing and working hard to learn good behavior and responsibility. Especially when dealing with […]
GinaMarie Guarino, LMHC
Negative thoughts have the potential to control the way people perceive and interpret almost every aspect of their lives. Some may have negative thoughts about themselves, others, or the way of the world. Negative thoughts generate negative feelings, and negative feelings contribute to negative behavior and mood disorders. That is why it is important to […]
GinaMarie Guarino, LMHC
It is important for children to feel empowered and confident in themselves. Confidence helps a child feel proud, motivates them to learn and engage with others, and helps them build social skills and resilience that will be useful in the real world. Unfortunately, many children find it difficult to identify their positive qualities and what […]
GinaMarie Guarino, LMHC
It is sometimes difficult for to control anger. Whether it is an isolated situation or a long-term problem , triggers for anger have the potential to cause the affected to react in alarming and sometimes dangerous ways. Those who suffer from anger management issues find it difficult to understand and control their anger. That is […]
GinaMarie Guarino, LMHC
It is important for therapists who are trained in CBT to teach their patients how to deal with automatic negative thoughts (ANTs). ANTs are huge catalysts for negative behavior like lashing out at others and self-destructive behaviors, but if a patient is able to identify and understand how ANTs are able to affect their perception […]
GinaMarie Guarino, LMHC
Cognitive behavioral therapy (CBT) is a very popular and effective treatment modality that is used for many different types of cases. Whether the patient has depression, anxiety, borderline personality, low self-esteem, poor impulse control, anger management issues or otherwise, CBT is an excellent form of treatment that provides the patient with tools needed to identify […]
GinaMarie Guarino, LMHC
A major reason why patients suffer from low self-esteem or emotional issues is a poor sense-of-self. There are many reasons for a person to develop a poor sense-of-self, but one common reason being aware of or understanding the things they value in life. Helping a patient discover what is important to them and their moral […]
GinaMarie Guarino, LMHC
There are many reasons why people tend to have trouble sleeping. Among the most common symptom of insomnia or sleep issues is having racing thoughts right before going to sleep. Many patients will struggle with falling asleep because as they try to fall asleep they are overwhelmed with thoughts that seem to demand their attention. […]
GinaMarie Guarino, LMHC
People who suffer from eating disorders have a difficult time staying on track with a healthy diet. Whether they are inclined to eat too much or not enough, it can be a difficult keep track of the progress they are making in their journey back to health. Often when a patient is first starting out […]
GinaMarie Guarino, LMHC
Grief is one of the most difficult things in life that we have to go through. It is confusing, upsetting, painful, and sometimes traumatic. A child is especially affected by grief and loss because they do not understand they may not understand what it means to lose someone, and certainly do not understand how to […]
GinaMarie Guarino, LMHC
Children find it hard to cope with things they do not understand. There are many people, places and things in the world that scare children, and when children are afraid they feel lost, alone and vulnerable. Children who are fearful sometimes have a hard time developing the confidence they need to face the fears they […]
GinaMarie Guarino, LMHC
Working with children is as challenging as it is rewarding. As we know, children perceive and interpret their world very differently than adults. As children develop they begin to understand their lives and their influence on it in different ways. While they grow their understanding and expression of their emotions become more complex, which makes […]
GinaMarie Guarino, LMHC
When patients suffer from more debilitating emotional issues like depression and severe anxiety it can be difficult for them to keep from falling into bad habits like isolating and cutting off things that bring them joy. Of course this is understandable, as with such mental illnesses it can be difficult for a patient to enjoy […]
GinaMarie Guarino, LMHC
When we are confronted with a situation in which a patient is expressing to us that he or she is in danger of causing harm to himself or herself or is in danger of being harmed by someone it is important that as clinicians we do all we can do to keep our patient safe. […]
GinaMarie Guarino, LMHC
It is always alarming when a patient comes into our office and begins to express plans or thoughts about harming himself or herself. We are trained as professionals to take any and all reports like this seriously and need to be able to collect all of the information we need to effectively and safely assess […]
GinaMarie Guarino, LMHC
When we are confronted with patients who are fixated on the negative it is difficult to break away from the bad and shift focus on the good. Often we will have a patient who does not acknowledge anything besides the negative in his or her life which not only is detrimental to their overall health, […]
GinaMarie Guarino, LMHC
One of the most important things we do as therapists is screen our patients to make sure they are safe after they leave our office. Whether the patient is struggling with depression, anger, eating disorders, substance abuse, family issues, abuse, or suicidal ideation, it is imperative that we make sure our patients are safe and […]
GinaMarie Guarino, LMHC
In 1969 Dr. Elizabeth Kübler-Ross developed the 5 stages of grief, where the grieving process is broken down into 5 stages: denial, anger, bargaining, depression and acceptance. Each stage is a part of the difficult process of grieving that almost everyone who experiences loss faces. Although the theory behind the stages are pretty straightforward each […]
GinaMarie Guarino, LMHC
Sometimes when people suffer from low self-esteem, low confidence, or mood disorders like anxiety and depression it is easy to focus on the negative and forget about the positive that they have in their lives. When patients focus only on the negative it is hard to imagine a happy and positive life that has hope, […]
GinaMarie Guarino, LMHC
When starting with recovery from substance use it is so important that the patient be able to identify and understand the people, places and things to avoid. The more a patient learns about sobriety and themselves the more they realize the patterns that people, places and things cause and how detrimental it is to their […]
GinaMarie Guarino, LMHC
When a substance abuser first starts therapy it is important for both the therapist and patient to have a full understanding of the history and progression of the substance abuse. Such details as reasons behind first use, point in time where use increased, and difficulty with stopping use can be very telling when trying to […]
GinaMarie Guarino, LMHC
When we are struggling with understanding our mood and emotions it helps a great deal to use a mood journal to keep track of daily activities, triggers from the day, and how we managed out feelings. Sometimes we get caught up in the day and forget to focus on what we are feeling, which causes […]
GinaMarie Guarino, LMHC
Patients who are suffering from a mental illness can often feel discouraged from being able to achieve their goals. Sometimes their ambitions and efforts are cut off by thoughts like “why bother?”, “it’s too much, I won’t be able to do it” or “I will start tomorrow”. It helps a great deal to draft a […]
GinaMarie Guarino, LMHC
With all the responsibilities we have as adults it is all too easy to get wrapped up in the stress of the day and miss out on the things we appreciate in this world. When a patient is overwhelmed with their environment it is helpful to remind them to focus on things that they appreciate […]
GinaMarie Guarino, LMHC
Weekly mood charts are great ways to track the progress of a patient’s mood regulation exercises. With weekly mood charts the patient is able to record any successful or unsuccessful attempts of managing his or her moods and emotions. It is also very helpful for helping the patient identify his or her triggers and ability […]
GinaMarie Guarino, LMHC
An important step to understanding your anger is understanding how intense it can become and the situations that make it as intense as it can be. Patients with anger management issues sometimes find it difficult to assess a situation and their reaction to the situation. An anger thermometer is a good way to help patients […]
GinaMarie Guarino, LMHC
Anger is a difficult feeling to understand and control. When a patient suffers from anger management issues it is easy for them to identify through the feeling and behavior. Of course, holding on to anger is not a healthy habit, so we want to teach our patients a healthier way to handle emotions. In order […]
GinaMarie Guarino, LMHC
Anticipatory anxiety is a struggle for many people. Often we see things like catastrophizing when people experience anxiety about upcoming events. When it comes to anticipatory anxiety the thought of the worst case scenario is enough to have a patient be overcome with worry, which will sometimes affect performance and their mental and emotional health. […]
GinaMarie Guarino, LMHC
When a patient is learning what is affecting them and ways to feel better it is expected that they take lessons learned in therapy and to them to their lifestyles. Sometimes in the heat of emotions and stress patients can forget what they learned and how to implement them, and need a reminder of why […]
GinaMarie Guarino, LMHC
Patients often have a pattern of how their mood affects them. Throughout the day there are certain triggers based on responsibilities, encounters, etc. that may cause a patient’s mood to fluctuate. It helps a patient prepare for triggers when they are aware of when and where they are likely to encounter a trigger, along with […]
GinaMarie Guarino, LMHC
Often those with depression lose sight on what is important to them. Depression is mentally, emotionally, and physically debilitating and when a patient is depressed and does not understand what they can do to manage the depression the patient will feel hopeless about life and the future. It is important to encourage patients to find […]
GinaMarie Guarino, LMHC
Like all mood disorders, it is important for the patient to really understand their depression, how it affects them, and how they help or hinder their ability to stay well when managing their depression. Often people with depression feel hopeless to get better, which will prevent them from trying new things to manage their depressed […]
GinaMarie Guarino, LMHC
Depression is arguably one of the most difficult disorders to cope with on a daily basis. Many patients with depression truly believe that they cannot get better, and therefore tend to not be very hopeful in therapy at first. It is because of this belief that so many people with depression are sometimes resistant to […]
GinaMarie Guarino, LMHC
After learning what CBT is, how it works, and how components like cognitive distortions, automatic negative thoughts, emotions and behavior all contribute to our perceptions, it is important to provide the patient with an automatic thought record (ATR) assignment. An ATR pulls in all of the material to teach the patient how to use CBT […]
GinaMarie Guarino, LMHC
Cognitive distortions, or Automatic Negative Thoughts (ANTs) are important for patients to understand when they are learning to challenge their thoughts and behavior. ANTs are patterns in thinking that typically make someone think in the negative and have negative expectations. This can be detrimental to the patient for many reasons, the biggest being it holds […]
GinaMarie Guarino, LMHC
A huge part of CBT is understanding what core beliefs are and how they affect people. Core beliefs are the perceived conclusions a person makes about themselves, their world, and their future based on what they have learned through life experiences. When a person develops negative, irrational, or maladaptive core beliefs, the way they see […]
GinaMarie Guarino, LMHC
Arguably the most popular and useful therapeutic exercise for CBT is the automatic thought record (ATR). ATRs are so useful because they help the patient take a look at himself and reflect on his own reactions to a given situation. This empowers the patient to reflect and identify his own errors and how they affect […]
GinaMarie Guarino, LMHC
Anxiety may feel as though it is happening for no reason sometimes, but there is always a trigger that generates the symptoms of anxiety. It is important for patients to be able to identify those triggers because when we are able to identify and understand the triggers we experience, we know where we need to […]
GinaMarie Guarino, LMHC
It is important for a patient to understand what anxiety is and how it affects their life. Often people do not fully understand what anxiety is or how it affects them. Sometimes people do not even realize that they have anxiety until they speak about their symptoms with a professional. That’s why it is important […]
