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By Margot Gaggini, Taproot Therapy Clinical Trainee
As outpatient therapists, we often see children for one hour a week. Schools see them for six to eight hours a day. When a child is struggling emotionally, behaviorally, or academically, meaningful support almost always requires collaboration between clinical and educational systems. As someone who worked in an elementary school for three years before returning to graduate school, there were common misconceptions I heard from external therapists/providers I would talk to. Understanding how school-based services work allows clinicians to better advocate for clients and guide families through what can feel like an overwhelming process. Below are key things every child therapist should know when working with students and their schools. 1. The Difference Between an IEP and a 504 Plan While both provide support in school settings, an Individualized Education Program (IEP) and a 504 Plan are legally distinct and offer different levels of intervention. IEP (Individualized Education Program) - An IEP is governed by the Individuals with Disabilities Education Act (IDEA). It is designed for students who qualify for special education services under one of 13 disability categories (e.g., emotional disability, specific learning disability, autism, other health impairment). An IEP:
504 Plan - A 504 Plan falls under Section 504 of the Rehabilitation Act. It provides accommodations to ensure access to learning but does not include specialized instruction. A 504 Plan:
2. Special Education Classrooms Are Not One-Size-Fits-All Many families fear that “special ed” means a separate school or significantly restricted setting. In reality, services exist along a continuum. Common classroom models include:
As therapists, it’s important to help families move away from stigma and toward understanding what environment best supports regulation, learning, and safety. 3. Parents Can Request an Evaluation At Any Time One of the most important things clinicians can communicate to families: Parents have the right to request a formal evaluation in writing if they suspect their child has a disability. This applies even if the child has never received school-based services, the school has not raised concerns, or the child is performing “okay” academically but struggling emotionally. Once a written request is submitted, schools are legally required to respond within a specific timeline (which varies by state). The evaluation may include psychological testing, academic assessments, speech/language evaluations, classroom observations, and behavioral assessments. Sometimes families don’t pursue evaluation because:
4. Mental Health Impacts Educational Access Children do not need a diagnosed learning disability to qualify for support. Emotional and behavioral conditions can significantly impact educational functioning. Examples include:
5. Clinicians Can Participate in the School Process Outpatient therapists are allowed, and often welcomed, to collaborate with schools when families provide consent. Ways clinicians can support include writing brief clinical summaries. A short report can:
When therapists attend, conversations often shift from “behavior management” to “regulation and support.” For students with suicidality or self-harm, coordination between outpatient providers and school staff is critical. Clear communication can prevent fragmented safety plans and reduce risk. 6. Ethical Considerations When collaborating with schools:
Understanding the differences between IEPs and 504 Plans, recognizing when evaluation may be warranted, and knowing that therapists can meaningfully participate in school meetings empowers clinicians to better serve their clients. Effective child therapy does not stop at the office door. When we collaborate thoughtfully with schools, we help ensure children receive consistent, coordinated support, both in the therapy room and in the classroom. By Allison Torsiglieri, Taproot Therapy Clinical Trainee
For some of us, shopping is more than a way to get the things we need; it can also be a temporary mood-booster. And while “retail therapy” is not traditional therapy, it can take on the role of a coping skill, helping us regulate our emotions. Coping skills are useful when we cannot immediately process a difficult emotion, or when a difficult emotion feels overwhelming or distressing and we want to soften its intensity. Shopping as coping can be helpful in moderation—and of course, when you need to buy something, you need to buy something! But becoming over-reliant on shopping as coping can have negative repercussions—including financial strain, which can in turn lead to stress and even familial conflict. When we shop as a way to cope with an unwanted emotion, we are delaying processing that emotion. But we ultimately do want to sit with and make sense of that emotion: what is it trying to tell us? When we overrely on shopping as a coping mechanism we also miss out on the opportunity to practice using other coping skills—including those without a price tag! What Happens When We Shop? Dopamine is a neurotransmitter that functions as part of our reward system: when we anticipate or engage in something we enjoy, a high amount of dopamine is released in the brain. Behaviors that release dopamine in the brain become behaviors we are motivated to seek out again. (Read more about dopamine in Zoe Chambers-Daniel’s blog post, Dopamine’s Role in Motivation.) Because dopamine is released when we expect something pleasurable to happen, shopping can feel exciting even before we make a purchase; “window shopping” in itself is a stimulating activity. Even when we make a purchase we are anticipating a reward: a delivery of a package containing a new pair of shoes, for example. But once the new item is in our possession and we no longer feel any anticipation, dopamine levels drop. For some of us, this is when “buyer’s remorse” or even shame might kick in: why did I spend money on something I don’t need, and that doesn’t make me happy? And when the dopamine spike subsides, the original “unpleasant emotion” that triggered our purchase is often still there, now accompanied by possible financial guilt. In this way, shopping serves to mask or postpone our emotion, but does not resolve it. Exploring Shopping Alternatives If you’re looking to cut down on using shopping to cope with unpleasant emotions, consider these interventions: 1. Next time you feel the impulse to shop around or make a purchase, ask yourself what you were thinking about or feeling right before the impulse emerged.
2. Consider alternative coping strategies. It can be helpful to create a list for yourself of alternative mood-boosting activities you can reference and select from when an emotion arises that you might otherwise cope with using shopping. You might also consider exploring these alternatives with your therapist, who can draw from Dialectical Behavior Therapy’s approach to distress tolerance. 3. Ask yourself: would I still want to buy this if I had to wait a few days to do so? Try pausing for 48 hours before making the purchase, and see if the urge is still there. 4. Ask yourself how long this item will realistically serve you before it needs to be replaced or discarded. How much effort will you have to expend to find another home for it—e.g., selling it, donating it, or discarding it? 5. To lessen the financial strain of shopping as coping, consider keeping purchases to a very small dollar amount, or even sticking to window shopping; anticipation will still trigger the release in dopamine that serves as a temporary mood boost. Living in a society that values consumerism means that we are surrounded by reminders to shop: ads on podcasts, social media, websites, and even billboards. Sometimes it can feel like fighting an uphill battle when we are trying to overcome the urge to shop. Remember to give yourself grace, and to seek out support from your community, and your therapist. References Cleveland Clinic. (2022, March 23). Dopamine: What it is, function & symptoms. https://my.clevelandclinic.org/health/articles/22581-dopamine Cleveland Clinic. (2024, December 10). Why ‘retail therapy’ makes you feel happier. https://health.clevelandclinic.org/retail-therapy-shopping-compulsion Brain Academy. (2025, August 11). The neuroscience of buying things you don’t need [Video]. YouTube. https://www.youtube.com/watch?v=i8ZP7ZM6nH8 By Cathy Wang, Taproot Therapy Clinical Trainee
Hello dear reader! This blog will be exactly what it says on the tin — I started therapy in my sophomore year of high school and knew from there I wanted it as a part of my life. Now, pursuing therapy as a career, I’ve been reflecting on some of the most lasting takeaways (in no particular order) I learned from my own time in therapy that I bring into the work I do. So follow along and I hope you find something that sticks with you too! 1. Your best may not always be the best This was one of my very first “aha” moments in therapy. Growing up in an immigrant household and attending an extremely competitive high school, I was frequently stricken with imposter syndrome and anxieties that I would never measure up to the markers of success that had long been ingrained in me—straight A’s, a perfect SAT score, and the Ivy League. High school was also, not-so-coincidentally, when I was confronted with the reality that even if I gave my all to something, it still may not end in “success” (aka a less than satisfactory SAT score). It was in a session with my therapist, talking through the immense disappointment I felt in myself (and that SAT score), that my therapist noted this glaring truth I had always managed to overlook. Constraints of time, energy, and effort would always get in the way of “perfection” and it was simply unsustainable to continue chasing after it. What truly mattered was giving it my all and understanding that simple fact made the end result of a test score superfluous. Of course, it would still feel good to achieve “the best” and of course it was still a marker to shoot for but if I didn’t quite get there, I could rest easier knowing I did the best I could even if it didn’t quite achieve the best. 2. There are no “good” and “bad” feelings When I first started therapy, it was my belief that if I did it right and if I did it for long enough, I would reach some hypothetical enlightened me that was eternally at peace. She was calm and happy and content. She didn’t get angry or sad or frustrated, those feelings would simply blow over her. In my mind, that would be the complete me, the best version of me, and someone within reach. With this goal in mind, I began to avoid hard feelings, labeling them as purely negative, fearing they would overtake me and hinder my progress. In reality, this only made those hard feelings bigger and stickier. No longer was it a reasonable sadness or momentary anger, it was some hulking monster that threatened my progress. When I brought that distress into the room, I realized I was standing in the way of my own progress—not towards that hypothetical me that didn’t feel hard feelings but one that wasn’t bowled over by it. Hard feelings are essential. They tell us something, teach us something, and make those lighter feelings all the more bright. It was then that I stopped fearing those hard feelings and certainly stopped seeing them as bad or a sign that something was deeply wrong with me. Feelings are feelings, they make up a human life, and it’s a privilege to experience them. 3. Two things can be true at the same time Holding two seemingly conflicting truths at the same time is something I’m still working on. It feels at odds with the natural way of the world and is something I feel most acutely when examining certain relationships in my life. Someone could have hurt me deeply and I could still desperately want to be in relationship with them and be vulnerable with them again even as my scared sensibilities tell me to protect myself. Trying to decide which side to be on, if I should be angry at them or forgive and forget, wasn’t working as both sides felt deeply true. Taking the time to honor both those feelings granted me a needed reprieve and I find solace in the simple fact that feelings and life are complicated. I am complicated and to try and shove myself on one side or another would be a disservice to myself. 4. Don’t “should” on yourself This is a fairly new adage for me and one I learned from a mentor of mine that felt particularly pertinent to work I’ve been doing in therapy. It’s natural to develop expectations—of yourself, of others, of the future—but more often than not they lead to disappointment and judgement. I often think, “I should be studying instead of watching TV,” “I should have reacted differently,” “My parents should have treated me in this way” and it eats away at me and my time. I’m left judging myself and my situation instead of actually doing anything. This is something I’ve also noticed in clients of mine. Often, they will report distress which comes as a result of not measuring up to some imagined and desirable hypothetical they’ve come up with rather than noticing and honoring the very real circumstances they are dealing with. Practicing patience and kindness with themselves and with myself has been immeasurably fruitful. 5. Believing something takes practice and time So much of my time in therapy has been rehashing the same essential problems and reaching the same conclusions. At first I found it frustrating: Why couldn’t I just get these things through my head? This lasted until a few psychology classes in undergrad and some kind words from my therapist made me realize I have been guided by certain thought patterns for a majority of my life, decades of believing certain truths. How could all those years of strengthening certain pathways in my brain, mental shortcuts that define my world, change in an instant? Changing means changing my brain, it means literally building new pathways and of course that takes time and practice! That doesn’t mean I don’t still get frustrated (that’s a pathway I’m still working on) but it helps to alleviate the frustration that comes with some “shoulds” that inevitably creep up as I continue therapy. 6. Vulnerability breeds vulnerability I believe it’s true for a lot of people that it feels a whole lot safer to hold our feelings close to our chests and guard them, especially when entering into conflict. It feels like the smarter option to prepare a logical argument or deflect and point out what may be going on for the other person. As I work to rebuild a challenging relationship, I’ve found myself trying to steel myself for upcoming confrontation, prepare a tool-belt of rebuttals but at the behest of my therapist, I entered into a recent one with nothing but the truth of what I was feeling (and a little bit of emotional preparation in the form of affirmation). The conversation was better than any we’d ever had. Did it still hurt? Of course! But we were able to see each other. I may be particularly lucky with the people in my life but I’ve found that vulnerability without defenses or presumptions typically breeds more vulnerability. Without the shields and defenses up, people are able to truly see each other. To be willing to share my hurt feelings and center the truth of the matter, that we are two people who care for each other, has helped bridge so many gaps. In all areas of my life, I try to lead with my feelings, with honesty that doesn’t bite, and have found that it makes those around me feel safe enough to do the same and open themselves up. 7. Be kind to yourself I had to end with this one. I think this was a very apparent through-line in all of my takeaways but I felt it still deserved to have a line of its own. Through everything, give yourself grace, kindness, patience, and love. You’re quite literally stuck with yourself for the rest of your life. If you can’t make your own heart and mind a safe space, who else can? Don’t do yourself a disservice by making the skin you’re living in hostile. Be kind to yourself, give yourself room to grow, and don’t waste your time judging yourself for those growing pains! Well, that’s it! I hope you were able to find something here that you can take and plant in your own life. By Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
Have you ever needed to complete a task and the motivation to start was nowhere to be found? Whether it be doing laundry, studying for an exam, or making an appointment over the phone, our ability to get things done can be understood in the context of the neurotransmitter dopamine. Dopamine, also known as the brain’s reward system, is released when we engage in activities that bring pleasure, which in turn reinforces us to continue engaging in that behavior. Dopamine is also released when we are anticipating that pleasure (Bromberg-Martin, 2010). For example, someone that knows that when they finish writing their final paper for the semester, they will have dinner at their favorite restaurant with their friends, gets a dopamine hit that acts as a motivator to complete a task that may not bring pleasure by itself. In thinking about dopamine’s role in motivation, it is important to note that tasks such as laundry can’t always be completed with a fancy dinner waiting at the finish line. What can we do to motivate ourselves and use dopamine to our advantage? A dopamine menu is a possible solution to the person struggling to start tasks such as studying and household chores. A customizable tool to stimulate dopamine receptors, a dopamine menu is a list of activities that are organized using restaurant menu language to engage in during different times when you need a boost (McCabe, 2020). This is what you can expect from a dopamine menu: Starters Similar to appetizers at a restaurant, “starters” are activities that don’t take long but still give us a boost of energy, something that is crucial in finding the motivation to complete a task. Examples of starters include going on a short walk or listening to your favorite song. Mains “Mains” take a little longer. Think of activities that are enjoyable for you such as calling a loved one on the phone or watching an hour of television. Similar to an entree in a restaurant, this activity can be used when you need a little bit more time to build up the momentum to start a task. Sides “Sides” are activities that give you a dopamine boost while you are completing your task. An example of this is listening to a curated playlist while you are cleaning your bedroom. Sides accompany you while you are doing something that may not bring enjoyment on its own. Desserts “Desserts” are dopamine boosting activities that are done in moderation such as scrolling on social media, or actually getting a sweet treat. This aspect of the menu can be used as a motivator after the task you set out to do is complete. Specials “Specials” are the big celebrations like going out to your favorite restaurant at the end of a long semester or going on vacation. With specials you play the long game and it can serve as a motivating factor for longer periods of time. A dopamine menu is an accessible tool to use when you are lacking motivation. Because you can make it your own, incorporating activities into your schedule is easier because you choose what goes in each section. This creative way of stimulating our brains to get tasks done also affects our attitudes toward our own levels of competency. Knowing that we can complete tasks that we may be dreading increases our self determination (Morsink, 2021). However you decide to customize your dopamine menu, know that you have autonomy over what gets you motivated to complete tasks. Embrace the creativity that comes with making your menu. It is not a one-size-fits-all approach. References Bromberg-Martin, E. S., Matsumoto, M., & Hikosaka, O. (2010). Dopamine in motivational control: rewarding, aversive, and alerting. Neuron, 68(5), 815–834. https://doi.org/10.1016/j.neuron.2010.11.022 McCabe, J. (2020, May 26). How to give your brain the stimulation it needs [Video]. YouTube. https://www.youtube.com/watch?v=-6WCkTwW6xg Morsink, S., Van Der Oord, S., Antrop, I., Danckaerts, M., & Scheres, A. (2021). Studying Motivation in ADHD: The role of internal motives and the relevance of Self Determination Theory. Journal of Attention Disorders, 26(8), 1139–1158. https://doi.org/10.1177/10870547211050948 By Margot Gaggini, Taproot Therapy Clinical Trainee
By late winter, many clients present with increased fatigue, irritability, reduced motivation, emotional blunting, or a vague sense of dissatisfaction. While these symptoms may resemble depression, they often reflect a seasonal “winter slump”, a pattern of emotional and behavioral change shaped by environmental, biological, and psychosocial factors. These presentations are common, yet frequently minimized, particularly when clients remain high functioning in their daily lives. Biological and Circadian Influences Reduced exposure to daylight during winter months disrupts circadian rhythms, affecting sleep-wake cycles, energy regulation, and mood. Seasonal changes in light exposure have been linked to alterations in serotonin turnover and melatonin secretion, both of which play a role in affect regulation and emotional resilience (Lambert et al., 2002). Even in the absence of Seasonal Affective Disorder, circadian misalignment can contribute to low mood, cognitive fatigue, and emotional flattening. Behavioral Constriction and Loss of Reinforcement Winter is also associated with decreased physical activity, reduced social engagement, and fewer opportunities for pleasurable or meaningful experiences. From a behavioral activation framework, this reinforcement can contribute to mood decline and increased withdrawal, even when cognitive distortions or acute stressors are not prominent (Martell et al., 2010). Psychosocial and Emotional Amplification As external structure and novelty decrease, underlying stressors such as occupational burnout, caregiving strain, relational tension, or unresolved grief often become more salient. Clients may report increased rumination, self-criticism, or a sense of stagnation rather than overt sadness. Many express confusion or shame about their emotional state, particularly those who identify as high-achieving or self-reliant. Differential Considerations Clinically, it is important to differentiate the winter slump from major depressive disorder, Seasonal Affective Disorder, adjustment disorders, or burnout. While symptom overlap exists, the winter slump often lacks pervasive anhedonia, hopelessness, or significant functional impairment. Nonetheless, research suggests that subthreshold seasonal symptoms are associated with meaningful distress and reduced quality of life and warrant clinical attention. Therapeutic Interventions and Clinical Focus Evidence-based interventions that are particularly effective during winter months include:
Therapeutically, the goal is often not rapid symptom resolution, but rather supporting adaptive pacing, emotional attunement, and sustainable coping. Normalizing seasonal vulnerability while maintaining clinical curiosity allows clients to engage with this period without pathologizing themselves or feeling pressured to “push through.” Takeaway The winter slump reflects an interaction between biological rhythms, environmental constraints, and psychosocial stress. Addressing these experiences with contextualized, rhythm-aware, and compassionate care can be both stabilizing and clinically productive. References
By Allison Torsiglieri, MPH, Taproot Therapy Clinical Trainee
It is hard to find a newspaper issue that does not sound an alarm about the negative impact of smartphones; this is perhaps no longer news at all. While we tend to worry most about how smartphones affect how we connect with others, it is also worth attending to how these devices change our relationship with our own emotions. Have you ever felt the sudden urge to check your phone, even in the absence of a notification? Waiting for the subway or waiting in line at a deli, the reflex kicks in: you’re looking at your phone—checking Instagram, texts, and even emails. You may not even enjoy answering emails! In this moment, your phone is not offering joy, or purpose, or connection; it is a distraction from boredom, and perhaps even a salve for any anxiety brought on by the awkwardness of waiting. Your phone is acting as a kind of buffer against whatever else might pop into your head if you do not proactively fill your head with memes and videos and sales and recipes. The Cycle Driving the Urge to Check and Scroll This familiar sudden urge to check your smartphone may be driven by a “cycle of avoidance"—a pattern that commonly shapes our thinking without our realizing it:
How Can We Interrupt the Cycle? A meaningful first step in interrupting our phone’s contribution to the cycle of avoidance is starting to notice its role. How often do you grab for your phone when an uncomfortable emotion starts to bubble up? And what are the feelings you are quickest to try to escape? Next, when you feel that urge to pick up your phone, try taking a short pause before you comply—taking just 10 seconds to sit with the emotion. Then try taking a 20-second pause. Extend the pause with time, to gradually weaken your attachment to your phone in moments of emotional distress—and to strengthen your comfortability sitting with yourself in that emotion. A great starter kit for coping with moments of distress comes from a Dialectical Behavior Therapy (DBT) distress tolerance skill, spelling the acronym “IMPROVE”: Imagery – Imagine you are somewhere that makes you feel happy, or somewhere you find calming. Or imagine yourself succeeding at the activity that is worrying you. Meaning – How can you make meaning of the uncomfortable emotion you’re feeling? Is there a way you can learn or grow from this feeling? What is it trying to tell you about what matters to you? Prayer – This might mean saying a prayer to a higher power, or it might mean zooming out and reminding ourselves of what unifies and connects us. Relax – Seek out an activity that relaxes you, that does not involve your phone. This might mean spending time with a friend, or going for a walk, or watching a nature documentary. One thing – Focus your attention on one thing at a time, rather than multi-tasking. Vacation – Take a trip! Whether that’s traveling or just taking a break from whatever you’re doing to take a trip in your mind, give yourself a true break. Encouragement – Speak kindly and supportively to yourself. What are reasons to be proud of yourself right now? When you choose to take a break from your phone in this way, you will simultaneously reduce your screen time and strengthen your relationship with yourself. By sitting with hard emotions you are deepening your emotional resilience—something TikTok cannot do for us. You are telling yourself that you can handle your internal world, and that you deserve your undivided attention. Therapy presents a unique opportunity to work through emotions you notice your phone is shielding you from, as well as to brainstorm other screen-free ways to regulate those emotions when processing is not possible in the moment. Taproot Therapy is here to support you in interrupting your own cycles, and in building a more mindful relationship with your phone—and your emotions. References Brand, M., Young, K. S., Laier, C., Wölfling, K., & Potenza, M. N. (2016). Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An interaction of person-affect-cognition-execution (I-PACE) model. Neuroscience & Biobehavioral Reviews, 71, 252–266. https://doi.org/10.1016/j.neubiorev.2016.08.033 Haynes, T. (2018). Dopamine, smartphones & you: A battle for your time. Harvard University Graduate School of Arts and Sciences. https://unplugged.sunygeneseoenglish.org/wp-content/uploads/sites/31/2019/11/Domamine-PDF.pdf Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168. https://doi.org/10.1037//0022-006x.64.6.1152 Linehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press. By: Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
Michael White, social worker and cofounder of narrative therapy eloquently said, “The most powerful therapeutic process I know is to contribute to rich story development.” Our lives consist of multiple stories starting from the moment we are born. These stories have power, giving us the motivation to pursue a specific career path, the openness to try new things, and the courage to persevere in the face of adversity. At the same time, the culmination of our life stories can also cause intense anxiety, preventing us from living a life that reflects our dreams and ambitions. Together Michael White and David Epston understood that the narrative we tell ourselves can influence our emotional wellbeing, therefore a therapeutic space should contribute to telling rich and productive stories about ourselves (White & Epston, 1990). Narrative therapy as a modality operates under these core principles: 1. You are the expert. In narrative therapy, you are given the space to share what is bringing you into therapy, and how your presenting concerns factor into multiple aspects of your life. There is no right or wrong way to express this to a professional. Once the narrative therapist is able to understand your narrative, collaborative work can begin to reframe the parts that are negatively impacting your wellbeing. 2. Your problems are external to your personhood. A common phrase of narrative therapy is “The person is not the problem. The problem is the problem.” Narrative therapy explores mental health symptoms, but does not explicitly use diagnoses. In this modality, you will learn to externalize your presenting concerns. Some people give their problems human characteristics, looking at the problem as if it has its mind of its own. When the external problem is given its own identity, you are less likely to feel shame surrounding your challenges. 3. Your social, cultural, and political context must be understood to understand your presenting concerns Your narrative does not exist without your socio-political context being discussed. It is the job of the narrative therapist to be curious about your identity, how your presenting concern exists in your specific context, and how goals can be established within that context (Ricks et al., 2014). Narrative therapy involves deconstructing unhelpful narratives, rewriting that narrative, understanding how the new narrative fits into your unique social context, ensuring the new narrative has the desired effects based on client feedback, and continuing to retell the story under the reconstructed identity (Dr. Todd Grande, 2016). This looks differently for everyone and with the support of a narrative therapist, you can assess what works best for you. Some techniques of narrative therapy include: 1. Exploratory Questioning Narrative therapists are interested in your past, present, and future. This involves asking questions about how the presenting problem influences you and how you influence others because of your concerns. What you see for yourself going forward is also important in creating goals that promote wellness. 2. Externalizing the Problem As mentioned previously, you will learn to externalize your presenting concerns. Not everyone gives their problem a name, but thinking of it as something outside of yourself is key to reducing shame and rewriting the narrative. 3. Creating Positive Stories It’s difficult to reframe a narrative that you have been telling yourself for your entire life. This is where the creation of positive stories comes in to help you see and be open to witnessing an alternative narrative. With a narrative therapist, you will be encouraged to look back on moments where you were proud of yourself or lived up to your values. This creates the foundation for a positive story that you can look to in relation to your unhelpful narrative. 4. Identifying Unique Outcomes a.k.a Sparkling Moments Sparkling moments in narrative therapy are helpful because they allow you to identify moments in your life that go against a negative narrative. Your strengths will be highlighted throughout the narrative therapy journey. 5. Creative Expression Narrative therapy offers opportunities to incorporate art, film, music, photography, writing, and other mediums of creative expression into the space (Ricks et al., 2014). Opening up the space to share creative work can be a sparkling moment on its own, and depending on your comfort level, it can be a regular part of sessions. 6. Inclusion of Supportive Family Members In circumstances where you have supportive family members that are involved in your journey towards mental wellbeing, involving them in narrative therapy can help in creating positive stories for you to hear about yourself. This is not a mandatory part of narrative therapy, but can play a significant role in reframing unhelpful stories. Narrative therapy is a great modality if you want to process the stories that make up your life, and need guidance in determining the usefulness of them. This modality promotes creative expression and autonomy in reshaping meaning making. References Dr. Todd Grande. (2016, January 21). Theories of Counseling - Narrative therapy [Video]. YouTube. https://www.youtube.com/watch?v=7HNw8LkTS68 Ricks, L., Kitchens, S., Goodrich, T., & Hancock, E. (2014). My story: The use of narrative therapy in individual and group counseling. Journal of Creativity in Mental Health, 9(1), 99–110. https://doi.org/10.1080/15401383.2013.870947 White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: Norton. By: Margot Gaggini, Taproot Therapy Clinical Trainee
Why Body Image Distress Matters Now In today’s world, young people are navigating constant messages about how they “should” look from on social media, in their friends groups, and even in well-intentioned conversations about “health.” In an international study of over 21,000 adolescents, 55% expressed dissatisfaction with their bodies and that rate was higher among those with greater social media screen time. Whether it’s a high schooler scrolling through TikTok or a college student adjusting to new routines and pressures, body image concerns can quietly shape self-esteem, relationships, and emotional health. What Body Image Distress Looks Like Body image distress isn’t always obvious. It can range from frequent negative self-talk (“I hate my stomach”) to avoidance behaviors (skipping social events or meals), or more serious patterns like disordered eating. Clinically, it often overlaps with anxiety, depression, and identity struggles. Recognizing these signs early and addressing them with empathy can make a significant difference. Three Therapeutic Frameworks That Help
Support starts with listening. Comments like “You’re beautiful, don’t worry about it” often minimize distress. Instead, try: “I notice you seem uncomfortable talking about your body, would you like to share what’s been hard lately?” Avoid focusing on appearance or food, and instead explore emotions and experiences. Collaborate on small realistic goals. If distress interferes with daily functioning like skipping meals, constant preoccupation, or self-harm thoughts, it’s time to seek professional help. Early intervention can prevent symptoms from deepening. Tools and Prompts to Try Right Now
Body image distress doesn’t have a quick fix, but compassion, curiosity, and connection go a long way. Whether you’re a parent, clinician, or student, remember that healing starts with understanding and not judgment. If you or someone you know is struggling with body image or related anxiety, Taproot Therapy offers a supportive space to explore these challenges. Reference: University of Waterloo. (2023, May 30). Study: Negative body image among teens a global issue. University of Waterloo News. https://uwaterloo.ca/news/media/study-negative-body-image-among-teens-global-issue-0 By: Allison Torsiglieri, Taproot Therapy Clinical Trainee
“I think it's just knowledge that everyone should have. That you have this amplifier… potentially linked to your pain, and your perceptions, or the fears, or the dangers around what might be going on in your body can contribute to that pain, or headaches, or anxieties, or probably all kinds of other things” (Tankha et al., 2023, p. 1588). Pain Reprocessing Therapy (PRT) is a promising new approach to treating certain types of chronic pain (Pain Reprocessing Therapy Center, n.d.-c). Even after a painful injury heals, the brain can get stuck in a pattern of sensing bodily harm or danger when there is none, and in response, trigger pain unnecessarily. This remembered pain, which doesn’t have a meaningful physiological cause, is called neuroplastic pain (Pain Reprocessing Therapy Center, n.d.-b). PRT helps us to better differentiate between dangerous and safe signals from the body, thereby reducing neuroplastic pain. My personal experience with PRT: I first heard about PRT on a podcast, and thought I’d give it a try as part of my own journey to tackle chronic back pain. While I haven’t mastered any of the techniques (described below), after reading The Way Out (a book on PRT, by its developer) I’ve noticed I feel less fear surrounding my back pain and more in touch with what is really going on in my body when I do feel this pain (Gordon & Ziv, 2021). This blog post is my way of sharing what I know about PRT, in case anyone reading might benefit from this model of therapy! How Does PRT Work? There are two main processes PRT uses to help reduce pain (Tankha et al., 2023):
What’s Involved in PRT? PRT uses psychological techniques to retrain the brain to interrupt neuroplastic pain. The main technique PRT uses is called somatic tracking. Somatic tracking is a practice in which we are experiencing our pain while simultaneously experiencing a sense of safety (Pain Reprocessing Therapy Center, 2021). Somatic tracking has three main elements (Pain Reprocessing Therapy Center, 2021):
Therapists trained in PRT also work with clients to process other sources of fear and stress in their lives, which can be contributing to a generalized sense of danger, and exacerbating their experiences of pain by way of the pain–fear cycle. “...I never would have guessed that childhood issues could be affecting the way I feel in my physical body today” (Tankha et al., 2023, p. 1588). How Can I Learn More About PRT? Here are some ways to learn more about PRT:
References Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2021). Effect of Pain Reprocessing Therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry, 79(1), 13–23. https://doi.org/10.1001/jamapsychiatry.2021.2669 Fishbein, J. N., Schuster, N. M., Anders, A., Portera, A. M., & Herbert, M. S. (2025). Pain Reprocessing Therapy for migraine: A case series. Headache: The Journal of Head and Face Pain, 65(9), 1660-1665. https://doi.org/10.1111/head.15043 Gordon, A., & Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Vermilion. Pain Reprocessing Therapy Center. (n.d.-a). Free recovery resources. https://www.painreprocessingtherapy.com/free-resources/ Pain Reprocessing Therapy Center. (n.d.-b). Neuroplastic pain. Retrieved October 9, 2025, from https://www.painreprocessingtherapy.com/neuroplastic-pain/ Pain Reprocessing Therapy Center. (n.d.-c). Pain Reprocessing Therapy. Retrieved October 9, 2025, from https://www.painreprocessingtherapy.com/ Pain Reprocessing Therapy Center. (2021). Treatment outline for Pain Reprocessing Therapy. https://www.painreprocessingtherapy.com/wp-content/uploads/2021/03/PRT-Supplementary-Materials-for-Site.pdf Sturgeon, J., Trost, Z., Ashar, Y. K., Lumley, M. A., Schubiner, H., Clauw, D., & Hassett, A. L. (2025). Brief pain reprocessing therapy for fibromyalgia: A feasibility, acceptability, and preliminary efficacy pilot. Regional Anesthesia & Pain Medicine. Advance online publication. https://doi.org/10.1136/rapm-2025-107076 Tankha, H., Lumley, M. A., Gordon, A., Schubiner, H., Uipi, C., Harris, J., Wager, T. D., Ashar, Y. K. (2023). “I don't have chronic back pain anymore”: Patient experiences in Pain Reprocessing Therapy for chronic back pain. The Journal of Pain, 24(9), 1582-1593. https://doi.org/10.1016/j.jpain.2023.04.006 By: Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
The availability of AI tools that are able to engage in a back-and-forth conversation and mimic human responses, is steadily growing. Tools such as ChatGPT, Replika, and Character AI can act as a personal assistant and a virtual companion all in one. Chat bot features are being used more as a support to cope with emotional distress, allowing us to disclose our mental health diagnoses and experiences of suicidal ideation to these tools. What does this mean for the decision making process in seeking out mental health care? Let’s start with the benefits. Using AI for emotional support gives us unrestricted access to something that listens and responds to what we type, and can create the feeling of being cared for (D’Alfonso, 2020). A key difference between human-human interaction and human-AI interaction is accessibility. AI does not get tired, and can continue a conversation until we decide to stop or pause. Many of us may feel safe talking to an AI tool because there isn’t a fear of judgment that exists in the same way when we are talking with another person face to face. We control the conversation and the environment. Imagine not having to leave your home to complete tasks or feel socially fulfilled! Although these benefits have impacted the daily lives of many, there are risks to using AI as a replacement for mental and emotional support services. The negative consequences of using AI for emotional support include the possibility of being too reliant on the tool, isolating ourselves from human companionship, and psychological distress from insufficient capabilities (De Freitas et al., 2023; Kalam et al., 2024). Being too reliant on AI to the point of isolation is connected to the benefit of having unrestricted access to it. This connection is important to think about through a culturally-informed lens. Marginalized communities who already feel isolated from the majority may use AI for support. Reliance is subjective with this growing development. De Freitas et al. (2023) identifies mental health risks that can form from using chatbots during a crisis and when we are seeking counsel in a vulnerable state. Companion AI from Cleverbot and Simsimi were analyzed, and the researchers found that the generative AI was usually unable to recognize signs of distress or when the user was hinting at intentions to self-harm. They also found that responses to distress were generally unhelpful. The AI either ignores the user’s distress, or provides encouraging commentary in response to suicidality (the user wishing they were dead, expressing intentions to harm themselves). Counselors and mental health professionals are thinking critically about AI use in mental health, weighing the benefits and drawbacks. Given the various effects identified, there is an aim to prioritize moderation when choosing to use AI tools and trying to seek out opportunities for human connection when possible (Alanezi, 2024). This does not in any way villainize AI or people who use it for companionship, but the distinction between human-human relationships and human-AI relationships needs to be acknowledged. If you or someone you know is seeking mental health support, please consider these points and resources: 1. Mental Health Professionals Are Here To Help Mental Health Professionals are able to consider your cultural context, assess your symptoms, provide empathy in a non-judgemental space, and create a treatment plan with you to support your journey towards emotional wellness. It can be scary to seek out help, and finding a professional may not be accessible for some. Keeping this in mind, there are professionals who are available to speak on the phone with you when you are in crisis. If you would like assistance finding support from a therapist who is a good fit for you, visit our Contact page, or reach out to [email protected]. 2. The Risk and Benefits of Using AI Depend on Your Unique Life Context The risks and benefits listed in this blogpost are not exhaustive. They are meant to accompany your examination of the utility of AI for mental health purposes. Please consider your own background and context, and what works best for your specific situation. Using chatbots may be your only accessible way to receive some support, and that’s okay. 3. Mental Health Wellness is a Journey We are not at a point where AI can be considered an appropriate replacement for mental health professionals. It can be a tool, however, in supporting that journey. Because wellness is a journey, remember to be kind to yourself when you are making decisions for your care. 988 Suicide & Crisis Lifeline The 988 Suicide & Crisis Lifeline connects you to trained crisis counselors 24/7. They can help anyone thinking about suicide, struggling with substance use, experiencing a mental health crisis, or any other kind of emotional distress. You can also call, text or chat 988 if you are worried about someone you care about who may need crisis support. OASAS HOPEline New York State’s 24/7 problem gambling and chemical dependency hotline. For Help and Hope call 1-877-8-HOPENY or text HOPENY Domestic Violence If you or someone else is in a relationship is being controlled by another individual through verbal, physical, or sexual abuse, or other tactics, please call: 1-800-942-6906 The Trevor Project 24/7 crisis services for LGBTQ+ people: 1-866-488-7386 References Alanezi, F. (2024). Assessing the effectiveness of CHATGPT in delivering mental health support: A qualitative study. Journal of Multidisciplinary Healthcare, Volume 17, 461–471. https://doi.org/10.2147/jmdh.s447368 Crisis prevention. (n.d.). https://omh.ny.gov/omhweb/bootstrap/crisis.html D’Alfonso, S. (2020). AI in mental health. Current Opinion in Psychology, 36, 112–117. https://doi.org/10.1016/j.copsyc.2020.04.005 De Freitas, J., Uğuralp, A. K., Oğuz‐Uğuralp, Z., & Puntoni, S. (2023). Chatbots and mental health: Insights into the safety of generative AI. Journal of Consumer Psychology. (John Wiley & Sons, Inc.), 1. https://doi.org/10.1002/jcpy.1393 Kalam, K. T., Rahman, J. M., Islam, M. R., & Dewan, S. M. R. (2024). ChatGPT and mental health: Friends or foes? Health Science Reports, 7(2). https://doi.org/10.1002/hsr2.1912 |
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