Mary Smith headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype application on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Smith, a 33-year-old high school teacher, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer!”

And, she added, “I even e-mailed him that I was panicked about a first date, and he wrote back and said we could do a 20-minute mini-session.”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype has made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly.

“In three years, this will take off like a rocket,” said Eric A. Harris, a lawyer and psychologist who consults with the American Psychological Association Insurance Trust. “Everyone will have real-time audiovisual availability. There will be a group of true believers who will think that being in a room with a client is special and you can’t replicate that by remote involvement. But a lot of people, especially younger clinicians, will feel there is no basis for thinking this. Still, appropriate professional standards will have to be followed.”

The pragmatic benefits are obvious. “No parking necessary!” touts one online therapist. Some therapists charge less for sessions since they, too, can do it from home, saving on gas and office rent. Blizzards, broken legs and business trips no longer cancel appointments. The anxiety of shrink-less August could be, dare one say … curable?

Ms. Smith came to the approach through geographical necessity. When her therapist moved, she was apprehensive about transferring to the other psychologist in her small town,  who would certainly know her prominent ex-boyfriend. So her therapist referred her to another doctor, whose practice was a day’s drive away. But he was willing to use Skype with long-distance patients. She was game.

Now she prefers these sessions to the old-fashioned kind.

But does knowing that your therapist is just a phone tap or mouse click away create a 21st-century version of shrink-neediness?

“There’s that comfort of carrying your doctor around with you like a security blanket,” Ms. Smith acknowledged. “But,” she added, “because he’s more accessible, I feel like I need him less.”

The technology does have its speed bumps. Online treatment upends a basic element of therapeutic connection: eye contact.

Patient and therapist typically look at each other’s faces on a computer screen. But in many setups, the camera is perched atop a monitor. Their gazes are then off-kilter.

“So patients can think you’re not looking them in the eye,” said Lynn Bufka, a staff psychologist with the American Psychological Association. “You need to acknowledge that upfront to the patient, or the provider has to be trained to look at the camera instead of the screen.”

The quirkiness of Internet connections can also be an impediment. “You have to prepare vulnerable people for the possibility that just when they are saying something that’s difficult, the screen can go blank,” said DeeAnna Merz Nagel, a psychotherapist licensed in New Jersey and New York. “So I always say, ‘I will never disconnect from you online on purpose.’ You make arrangements ahead of time to call each other if that happens.”

Research on the effectiveness of on-line therapy shows the same effects, essentially, as in person therapy, so the practicality of on-line therapy outweighs the few negative issues, such as not sitting in front of the client and seeing his/her body language, eye contact, etc.  In addition, I am able to Skype with clients who are on vacation in other locals, and with athletes, who are out of town performing in major events and want to touch base with me before or after their events.  In short, I have found using Skype has grown my practice and dramatically increased my access to clients.

Dr. Jack Singer offers Skype Therapy with clients all over the world.  For more information, contact Dr. Jack at (800) 497-9880.

By Dr. Jack Singer

Stress and World Class Coaches by Dr. Jack Singer

Much attention is paid to the impact of stress on elite athletes, but until recently, the impact of stress on their coaches has been largely ignored.  What is really important about this new discovery is that the way coaches deal with their own stress directly impacts the performance of their athletes. 

The amount of stress a world class or Olympic coach experiences is a function of his/her perception of the demands (stressors) made by their job and their own ability to cope with stressors.  So much attention has been given to teaching athletes how to cope with the stressors of performing their sport,  but we now know that if their coaches do not cope, it will impact their coaching skills and ultimately, the athlete’s performance. 

World class and Olympic coaches complain about psychological, physical and behavioral responses to their stress, such as having low frustration tolerance, acting fidgety, and agitated.  These coaches complain of burnout symptoms, including mental fatigue and a sense of reduced enjoyment about their coaching roles.  This impacts their athletes, both because of the coach’s body language  and the tone of voice from the coach to the athlete.  These are both potential sources of strain for their athletes.

The solution is that professional Sport Psychologists should pay as much attention to helping coaches develop the skills and strategies needed to cope with the demands of world class coaching.  Only then will the elite athlete have the best opportunity to let his/her true talent shine.

I am also available for phone consultations with athletes around the U.S. and in-person visits with athletes in Southern California. Call today toll free at 1-800-497-9880 for a free 20 minute telephone consultation with Dr. Jack Singer.

Jack N. Singer, Ph.D.
Certified and Licensed Sport and Clinical Psychologist
Diplomate, National Institute of Sports Professionals, Division of Psychologists
Diplomate, American Academy of Behavioral Medicine
Certified Hypnotherapist, American Academy of Clinical Hypnosis

Here are some basic tips to help you in the selection process. 

Get a referral from someone you trust.  Believe it or not, your physician may not be the best person to ask for a referral to a competent therapist.  The reason for this is that many physicians refer to people who refer back to them, regardless of the competency of the therapist!  So, if you really do want the name of a therapist from your physician, be sure to ask if he or she has had patients who reported excellent progress with that therapist.

Often, a good referral source is a family member or friend who has had excellent outcomes working with a particular therapist.

Check on the therapist’s credentials. Make sure you’re considering a therapist who is licensed in your state and has passed national licensing examinations.  Therapists come in a multitude of specialties, from Masters level family and marriage therapists, to licensed clinical social workers, to licensed psychologists.

Unlicensed practitioners can call themselves psychotherapists, therapists and counselors, so be careful to only choose a licensed therapist.  No one can use the title of “psychologist” without a license.

Therapists have different specialties and experience levels.  Depending on your issues (such as relationship issues, eating disorders, sports performance, chronic illnesses), you can easily locate therapists who actually specialize in those issues.

Interview therapists via phone before making this very important decision. A good therapist will be willing to speak to you over the phone before you commit to an appointment.  Don’t be hesitant to ask questions, such as the following:

• How long has he or she been in practice?
• What is his or her area of expertise?
• What methods does he or she use to treat patients?
• What is the typical length of treatment?
• Does he or she accept your type of insurance?

Don’t be afraid to ask the therapist about where she/he went to school.  You can quickly determine which schools have higher academic standards and you are generally better selecting one who went to a well qualified school.

Another advantage of that initial phone call is to make sure that you feel comfortable and safe with this person.  Be sure to inquire about the confidentiality issues that the therapist is bound by.

If you do your homework, in selecting a therapist, there is a much greater probability that your therapy experience will be wonderful!

I am also available for phone consultations with athletes around the U.S. and in-person visits with athletes in Southern California.

Jack N. Singer, Ph.D.
Certified and Licensed Sport and Clinical Psychologist
Diplomate, National Institute of Sports Professionals, Division of Psychologists
Diplomate, American Academy of Behavioral Medicine
Certified Hypnotherapist, American Academy of Clinical Hypnosis

The Sports Psychologist, who should be Certified and well-trained in examining the whole person, can provide the athlete with skills that can really develop an elite athlete from a good athlete. Coaches and trainers focus almost exclusively on left brain activities, including game plans, strategy, technique, speed, agility, muscle building, etc. Most athletes focus exclusively on training using the left brain. Accordingly, athletes are cheated because their right brains are being ignored.

Right brain activities include balance, emotions, music, and visualization, all of which can really enhance performance. The Sports Psychologist trains the athlete to exercise the right brain along with the left brain. For example, teaching mental toughness skills (including intensity, confidence and emotions during key moments in competition) critically important in peak performance.

Overcoming pressure is another right brain activity that can be taught to athletes. These skills include recognizing the causes of emotions during key moments in competition and how to modify those emotions, if necessary.

Stress management skills are critical and necessary if the athlete wants to compete successfully and consistently. Interestingly, a certain amount of tension (i.e., being on edge, pumped up, psyched) is crucial for peak performance to be maintained. In fact, the athlete with too much relaxation is at the same disadvantage as the athlete with too much tension. The key for each athlete is to learn where the exact mixture of relaxation and tension lies. This is where the Clinical Sports Psychologist with hypnosis training can really help the athlete zone in on that level and learn to modify it as game conditions warrant. Too much tension is lowered by deep breathing and calming thoughts and not enough tension is raised by jumping, exercises, etc. to raise the heart beat.

Goal setting, while a left brain activity, is closely linked with right brain activities, such as emotions, patience, optimism and learning to overcome obstacles. These are also key skills that the Sports Psychologist can teach the athlete.

In addition, there are many issues in an athlete’s life that can impact her/his sports performance. Relationship stressors, personality traits (e.g., perfectionism, anger vulnerability), attention deficits, mood changes, and the lack of life skills (e.g., assertiveness) are just a few of the factors that can dramatically impact ones performance on the playing field. Consequently, a comprehensive initial history and mental status exam is necessary in order to plan the treatment. In fact, many parents bring their youngsters to me in order to teach them life skills that will also be used in their sport. For example, the young athlete who gets overly anxious during competition also gets overly anxious prior to taking a test. The same coping skills can be taught for both issues.

Perhaps the best right brain skill the athlete can learn is self-hypnosis and visualization. I have referred to these skill sets as the “unfair advantage,” because they really propel athletes to enhance their performance.

Jack N. Singer, Ph.D.
Certified and Licensed Sport and Clinical Psychologist
Diplomate, National Institute of Sports Professionals, Division of Psychologists
Diplomate, American Academy of Behavioral Medicine
Certified Hypnotherapist, American Academy of Clinical Hypnosis

There are plenty of episodes of athletes out of control . . . Serena Williams has a complete meltdown in front of thousands of her fans at the U.S. Open. Oregon football player LaGarette Blount punches a Boise State player after a frustrating game and then losing his cool with a fan. A 2004 melee between the Detroit Pistons and Indian Pacers, where fans were also involved. And a few seasons ago, a brawl between most of the football players from the University of Miami and FIU.

Often athletes who engage in out-of-control behaviors rationalize that everyone in the situation would react that way. Obviously, there is plenty of evidence to the contrary, where athletes are provoked continuously and most do not melt down. Another rationalization is that in hockey, for example, fighting is often encouraged by coaches and is condoned as a motivational technique. Research was conducted over the course of one hockey season, in which the numbers of fighting penalties among NHL teams were matched up with their league standings. The results showed a strong NEGATIVE relationship between the number of fighting penalties and the teams’ standings!

Typical justifications for fighting take the form of “I need to stand up for our teammates, or I’ll look soft,” “You can’t embarrass us in our house,” and “You need to respect me as a man/woman.” The sad fact is that emotional meltdowns always trump intelligence.

So, given that there are hundreds of provocations made to elite athletics each season, why do some athletes melt down, while others don’t? The answer lies in team leadership, from the manager/coach to the team captains and whether anger proneness is recognized early on and treated in a proactive manner or ignored. And for individual melt downs, the answer lies in an athlete understanding the triggers to their own anger.

Anger mastery programs help. Once such program is my athletes Anti-Provocation Training (APTitude)Program.

This program is based on the athlete learning the exact triggers which provoke his/her anger and temporary loss of control. For example, in Serena’s case, I’m sure that her embarrassment while her match was in jeopardy (to huge underdog Kim Clijsters) set her up for losing control of her emotions and the unusual and rare foot fault penalty put her over the top.

Once the athlete recognizes his/her trigger points, alternative thought patterns are taught and rehearsed, so that the “bang-bang” reaction is interrupted by a more rational thought and plan of action.

My program involves a ten-step strategy, where the end result is calmer heads prevailing, separation skills, active listening skills and an immediate cooling down.

For more information on Dr. Jack Singer’s Anti-Provocation Training (APTitude) Programs please call toll free at 1-800-497-9880.

**You have permission to reprint in your publication or to your website/blog any articles by Dr.Jack Singer found on this Website as long as Dr. Jack Singer’s name and contact information is included. Jack Singer, Ph.D., Licensed Clinical Pyschologist, Sport Psychologist, Marriage, Family & Relationship Therapist, Professional Motivational Speaker. http://drjacksinger.com, toll free 800-497-9880.

PESSIMISTIC  VS. OPTIMISTIC ORIENTATIONS

The world’s expert in the study of Optimism is Dr. Martin Seligman, whose book, “Learned Optimism,” is a classic in the field. Seligman’s research shows that pessimistic athletes and teams believe that losses and even poor performance during crunch time reflect their lack of ability to succeed .  These athletes and teams have learned to feel helpless in terms of controlling their performance, and thus their success or failure.

The research shows that when these athletes are confronted by unfortunate circumstances–such as, in tennis,  a series of double faults, windy conditions or the belief that their opponent is cheating — they will weaken, get angry, tighten up and believe they cannot succeed. This self-fulfilling prophecy almost always leads to continued poor performance, so the athlete will ultimately lose the set and match.  These pessimistic thinkers don’t expect to win the next time out and with this negative expectation, they most likely will lose subsequent matches.  This, of course, reinforces their negative view of themselves and their abilities and the negativity snowball is rolling down hill.

On the other hand, optimistic athletes look at the same negative events as temporary setbacks, and as opportunities to actually re-focus and crank up their performance during the rest of the match.  They recognize that they have ultimate control over their internal dialogue and how they view negative events.  For example, they may “blame” a poor game or set on being distracted by fans cheering for their opponent or on the weather on getting irritated by the opponent cheating.  They recognize that they can now change their thinking, re-focus on their game plan, re-capture the momentum and still grasp victory. Even if they eventually lose the match, these optimistic thinkers understand how to change their internal dialogue prior to and during their next match.  Accordingly, these players will go into the next match expecting success and will usually win!

WHAT COACHES NEED TO KNOW

There are wonderfully researched, brief methods available to determine whether a person (or even a team) is oriented more toward optimism or pessimism.  This is great news for both the athlete and his/her coach:

• All other things being equal, coaches should concentrate on recruiting athletes who are optimistically oriented.  They are definitely more successful over time than are pessimistically oriented athletes;
• For athletes already on a tennis team, learning their orientation can help the coach make better decisions related to spot positions and substitutions.
• The really good news is that a pessimistic orientation is a learned phenomenon.  Therefore, once the athlete understands her/his degree of pessimistic thinking, there are excellent programs for retraining that athlete to develop an optimistic orientation.  This will definitely lead to improved and more consistent performance.
• Entire teams can learn how to interpret defeat in an optimistic way.  This is a powerful and proven tool for improving team performance, particularly after a tough loss.

**You have permission to reprint in your publication or to your website/blog any articles by Dr.Jack Singer found on this Website as long as Dr. Jack Singer’s name and contact information is included. Jack Singer, Ph.D., Licensed Clinical Pyschologist, Sport Psychologist, Marriage, Family & Relationship Therapist, Professional Motivational Speaker. http://drjacksinger.com, toll free 800-497-9880.