By Fiona Soltes
Mina Nguyen-Driver, PsyD, can easily run through different types of mental health therapies. In choosing a therapist, however, the most important thing is that they listen well and are easy to talk to.
“Find a therapist you connect with,” Dr. Nguyen-Driver said. “One that you feel understands you, someone you can trust who makes you feel safe.” It’s also important that a therapist can explain things, can be flexible, and will be sensitive to your background. Everyone comes with history, she said.
Dr. Nguyen-Driver, professor in the department of pediatrics at the University of Arkansas for Medical Sciences, presented EMDR and Emerging Therapies for Mental Health during the 2023 BDC. She has provided mental health treatment for patients and families with bleeding disorders for more than 20 years and is involved with direct patient care at the Arkansas Center for Bleeding Disorders Clinic.
In addition to providing a brief overview of eye movement desensitization and reprocessing (EMDR), Dr. Nguyen-Driver delineated different types of therapists – including the level of education required for each. “Not all therapists are created equally,” she noted.
Psychologists (PhDs) and clinical psychologists (PsyD), for example, can practice independently. There are also counselors and therapists, likely with a master’s degree (either MS or MA); they might be a licensed professional counselor (LPC); licensed marriage and family therapist (LMFT); or licensed clinical alcohol and drug counselor (LCADC). As for social workers, they provide general case management, planning or services to support clients, but may only have a bachelor’s degree (BA or BS). Clinical social workers may carry a master’s degree (MSW); may be a licensed independent social worker (LISCW) or licensed clinical social worker (LCSW); or may be a PhD or hold a credential from the Academy of Certified Social Workers (ACSW). Then there are psychiatric mental health nurse practitioners (PMHNP) and primary care physicians and psychiatrists. In general, only PMHNPs, nurse practitioners and MDs can prescribe psychiatric medications, though some states allow licensed psychologists to do so.
Regardless of training, she said, it’s important that any therapist practice based on research, and it’s a good idea to ask what kind of therapy they provide. Evidence-based practices will not only be more effective, but also more cost effective.
As for EMDR, it’s an evidence-based treatment originally used for post-traumatic stress disorder. It’s not like typical therapy, she said. Rather, it retrains the brain to process trauma in a different way. The eight steps of EMDR include significant history taking; client preparation; assessment; desensitization; installation; body scan; closure; and re-evaluation. The history taking should include not only the person’s story, but also what types of therapy they have tried in the past.
On a basic level, the brain’s frontal lobe is where information is processed; the amygdala, in the center of the brain, deals with emotional responses; and the hippocampus, in the back, works with memory. When we get into an overwhelming situation, she said, the frontal lobe shuts down. The amygdala houses the trauma, and the hippocampus relives the negative feelings. Constant reprocessing of traumas, she said, only makes them stronger. EMDR, however, allows traumas to be remembered without bringing the same sort of response. One audience member, for example, spoke about how EMDR had desensitized her to the feelings in the pit in her stomach that appeared when she thought about a past relationship.
During EMDR treatment, the therapist will move fingers back in forth in front of a patient’s face. The patient will follow the therapist’s hands with their eyes, simultaneously recalling a traumatic event. It has been proven helpful not only with PTSD, but also with anxiety, depression and even chronic pain.
Dr. Nyugen-Driver also spoke on cognitive behavioral therapy (CBT), which involves changing thinking and behavior, and facing fears rather than avoiding them. It might involve role playing, as well as learning to calm one’s mind and relax one’s body. Also discussed: mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), transcranial magnetic stimulation (TMS) and virtual reality therapy (VRT).
For those looking for support, she suggested exploring www.psychologytoday.com, www.betterhelp.com and www.talkspace.com, in addition to asking an HTC social worker, HTC psychologist or primary care physician for recommendations. It might take some time and patience; current mental health needs have outpaced the number of people able to provide help.
