How do I Choose a Therapist? Credentials vs Chemistry

You know you need support but have no idea how to find it or how to choose the right therapist for you?

There’s a lot of options out there, so it’s understandable why most people don’t know who to go to and how to decide.

Do credentials matter?  And what do all those letters mean?

Different credentials involve different types of training, varying across many dimensions including, but not limited to:
– length of training
– types of client populations to work with
– amount and type of research that must be conducted
– strategies learned to help clients.

Even more confusing is that a lot of this is very dependent on school and country a therapists or Psychologist has been trained.

Clinical Psychologist is protected title in the US and many western countries.  This means that a certain level of training is required- and almost universally training to be a Clinical Psychologist is the longest, includes the most hours of clinical experience in different settings and integrates research. In addition, Psychologists have to complete additional training, typically 1-2 years of clinical work AFTER completing their PhD to get licensed.

So for me as a PhD level Clinical Psychologist, all in I went to school for 7 years after undergrad and completed a 2 years postdoctoral fellowship to specialize further.

Chemistry IS Essential!

Now some research has shown that outcomes in therapy aren’t correlated or predicted by the level of training a therapist has, but that it’s the strength of the therapeutic relationship that’s most important.  This means, it’s all about the chemistry and rapport you have with your therapist that predicts how beneficial therapy can be for you.

So while I am highly trained PhD Clinical Psychologist, I want you to find the right fit FOR YOU.  This is why I’m giving you lots of info and resources about me and how I work, so that YOU feel confident about choosing me as your therapist.  Feel free to sign up to receive more info from my library of resources or give me a call for a FREE consultation, so we can talk about how we can work together.  Cheers!

Sex After Cancer Amongst Latina Cancer Survivors

A community-based approach for developing novel web-based psychosexual resources for
Latina cancer survivors

Changes to sexual wellbeing have been reported as one of the most distressing quality of life issues among cancer survivors. Over 60% of breast and gynecological cancer survivors experience sexual dysfunction after treatment^1, 2 including vaginal atrophy, painful intercourse and decreased desire. Latinas present at later stages of disease^1, 3 and require more aggressive treatment. Compared to non-Latina cancer survivors, Latina survivors have reported worse sexual function, less sexual desire, greater difficulty relaxing and enjoying sex, becoming aroused and reaching orgasm.⁴ Recently, Bober & Varela⁵ proposed a biopsychosocial model that integrates the combined influence of biological (physical functioning), psychological (sexual satisfaction, body image) and social (cultural norms surrounding sexuality) factors in the development and treatment of sexual concerns.  This model emphasizes the importance of including sociocultural phenomena, such as gender roles machismo and marianismo and the significance of familia, to provide a theoretical framework that appreciates the impact of culture on sexual concerns.  Unfortunately, the majority of the research on sexual changes after cancer has focused on middle to upper-middle income, non-Hispanic White women (NHW).⁴ It is imperative that culturally-sensitive interventions be developed specifically for Latina cancer populations.

Numerous strategies have proven effective in managing sexual changes after cancer⁶ stemming from the broader sex therapy literature. Web-based psychosexual interventions have proven as efficacious⁷ as face-to-face interventions; web-based approaches overcome barriers to access including shame and embarrassment amongst both survivors and providers.^8,9  Unfortunately, clinical referral and uptake of psychosexual support continues to be low,⁷ and among Latinas uptake is almost non-existent, leading Latina cancer survivors to live in a “sexual silence”.¹⁰  Even if information about sexual wellbeing is presented in Spanish, it is likely that it is not presented in a culturally congruent fashion.¹¹Compared to NHW and African American (AA) cancer survivors, Latinas report not only the greatest psychosexual concerns, but also the greatest interest in receiving support for managing sexual changes.^9, 12Intervention approaches that provide individualized tailoring and presentation of skills and strategies in culturally sensitive ways may be useful to engage and retain Latinas in a psychosexual intervention.¹³

Despite the importance of sexual wellbeing to this population, no prior interventions have been developed to address sexual concerns among Latina cancer survivors. We have recently translated evidence-based interventions into an accessible, highly tailored, video-based and interactive psychosexual web-based resource, Rekindle.¹⁴ Rekindle has exceeded recruitment expectations and highlights the need for and receptivity of tailored, web-based, psychosexual resources for cancer survivors.  Building on our work with Rekindle and guided by Bober and Varela’s⁵ model and a Community Advisory Board, the proposed study will apply a “ground up”^15, 16 approach to confirm how to best address sexual concerns among Latina survivors and develop a novel psychosexual resource that is socio-culturally and linguistically sensitive specifically for this underserved population. Data from this preliminary study will inform the application for funding of a future larger-scale randomized controlled trial.

Sex and Cancer. The Unspoken Side Effect

Sex and cancer.

We rarely hear these two words together, and that’s a problem because up to seventy percent of breast cancer patients and almost all gynecological cancer patients experience physical and emotional changes that impact their ability and desire to engage in sexual activity.

Side effects from treatment including pain, fatigue and emotional distress all impact sexual wellbeing.  Over time, the complex interplay between physical and emotional concerns can leave long-lasting changes to cancer survivor’s sexual wellbeing.

Common sexual changes amongst woman affected by cancer include vaginal dryness and shrinkage, decreased libido, pain during or after sex and changes to orgasm.

If you have experienced any of these sexual changes, YOU ARE NOT ALONE.

Unfortunately, many cancer patients are not informed of these sexual side effects of cancer treatment, therefore many don’t expect these changes and don’t know how to manage them.  Fortunately, WITH SUPPORT up to 70 percent of cancer survivors CAN improve their sexual wellbeing.

There are several medical and psychological strategies that can help manage these side effects to improve your sexual wellbeing.

I’m going to share a few effective strategies to address sexual changes, specifically to manage vaginal dryness as it’s one of the most common sexual side effects after cancer.

Here are 3 effective strategies to manage
vaginal changes:

• First, there’s Vaginal Dilators. Vaginal dilators can help stretch, lengthen and strengthen the vagina while also helping women gradually reconnect with their bodies

• Secondly, women can use Vaginal moisturizers.  Vaginal moisturizers can help stabilize PH levels to reduce dryness and pain.  These are very effective and need to be used daily for long-term results

• Lastly, I recommend patients to try Lubricants.  Lubricants can help in the moment during sexual activity to improve moisture and reduce pain.  Venture out to a local sex shop to test a few different ones in the store to see which you like best.

There are several strategies out there to manage vaginal dryness.  I always recommend patients to try one at a time to see what works best for them.  Keep in mind that many of these strategies must be practiced and maintained for long-term benefit.  This can be hard, so if you feel a bit tired of trying these strategies, keep in mind that while it may be annoying at first, taking a few minutes each day can have a lasting impact on your sexual wellbeing.

If you would like to learn more about how to manage sexual concerns after cancer, feel free to check out my website http://www.PsychotherapyWithoutBorders.com or schedule an appointment with me for individual support.

Cancer takes away a lot, it doesn’t have to take away your sexual wellbeing.