HEARTPRINTS COUNSELING LLC

Teen Counseling:

Welcome to counseling designed for adolescent girls and early adulthood. Kristal has been working with teenagers clinically since 2007. Teenage girls need to be able to trust the person with whom they are talking, they need to be taken seriously, and see their potential. Kristal approaches each teenager with their family in mind knowing they are one member of a bigger system. Kristal will work with your teen to identify the barriers to living a full life and implement strategies to overcome them.

After the intake (first appointment), where I ask lots of nosy questions to get to know the big picture, I will make recommendations and you can tell me what will work best for you. It can be helpful to keep your grownups in the loop so they know how to support you but it’s up to you, legally speaking, if you are 13 years of age or older.

Sometimes I get asked what type of therapy I do. Therapy is more than listening although it is a part of the work. I come from a systemic perspective meaning I look at a person as part of a bigger family system. Any goals we make in therapy, focus on what you want to get out of our time. I am solution focused. This means I will give you practical strategies to try something different to get to your goals. I have been trained in Dialectical Behavioral Therapy and use it especially for self-harm and suicidal ideation. DBT is a mix of cognitive and behavioral therapies (CBT) and is evidenced based and highly effective. I also look at clients holistically. We may explore sleep hygiene, nutrition, relationships, and community supports. I have also been trained in EMDR, a specific tool to reduce reactivity to triggering memories or situations. Based on the need presented, I work specifically to support positive change for you. If you don’t like something I say or recommend, tell me. You are the expert on you.

Depression

I have heard some parents say “What do they have to be depressed about? Look at all they get! They have such a good life compared to what I went through as a teen. I don’t understand.” You don’t need to have had bad things happen to you, to feel depressed. Sometimes we don’t know what is causing our depression and our families can be equally confused because we have what we need. Sometimes we can feel guilty about being depressed.

Young people get depressed. For the last decade, depression in teens has been on the rise. The Covid Pandemic did not help. You are not alone. Sometimes it’s genetic. Sometimes it’s about what’s going on in our world. Sometimes it’s both. Sometimes something bad happened and we struggle to process it. Sometimes changes outside of our control disappoint our plans for our lives. Sometimes, we want to disappear or hurt ourselves. This can be really scary for those that love us (and we may even scare ourselves). If you have been struggling with depression somewhat consistently for over two weeks, it may no longer be a mood but something to address with professional support. We all need help sometimes. In session, expect for me to ask lots of questions initially so I can better help. I will make recommendations and together, we will find strategies to help you get to your goals.

It can be helpful to keep your grownups in the loop so they know how to support you but it’s up to you if you are 13 years of age or older. After eight consecutive sessions, if you are not feeling better, it can be helpful to loop in your primary care provider if you haven’t already contacted them. While medication is not for everyone, for some it can be incredibly helpful even just for a season. Before medication is prescribed, I recommend completing genetic testing for mental health medications to reduce complications with a bad medication matches (www.genesight.com is an example other clients have used but your doctor may know of others).

Self Harm

17-30% of teenage girls will engage in self harm at least once during adolescence. Working with them is my speciality. I can offer psychoeducation information to better understand the brain work behind the behavior. Many clients report feeling numb or no pain during the act which may confuse the grownup’s mind. Yet, we can tell from brain imaging, neuron activity can be soothed with this behavior explaining an almost addictive type relationship with self-harm at times. Each client has their own reason for engaging in the behavior. If you want to eliminate this behavior, I can give you the tools to substitute healthier behaviors that won’t alarm those you love. It is a process. Good things take time.

Dialectical Behavior therapy is extremely effective with self-harm and suicidal ideation. Created and researched by Dr. Marsha Linahan at the University of Washington, clients are taught skills to tolerate distress, understand and observe their own emotions, and effectively communicate with loved ones. Here is a short overview of DBT work.

Anxiety

Anxiety is not always logical. This can be very frustrating to the grownups. They may have expectations you cannot meet even though you try your best. Anxiety can even come out as cranky. Young people get anxious. Anxiety has increased significantly in the last decade. Some of us are wired more anxiously than others. Some of us have had experiences to which the only natural response is anxiety. When we are anxious, our default can be to avoid what is making us anxious. Unfortunately, this only makes our anxiety worse. No matter what, there are strategies we can implement to help life be more manageable. CBT can be particularly effective in reducing anxiety.

If you are wanting medication support (I would wait for at least 8 sessions of therapy over a 2-month period), it can be tricky because anxious bodies are more sensitive to physical side effects. Sometimes prescribers offer options that will stop a panic attack but essentially just put you to sleep. It is not an effective long-term solution though it can be helpful to have on hand for emergencies. I can work with your provider to find the best solutions together.

Trauma, Loss, and EMDR

Trauma is anything in the past or present you perceive at deeply distressful or disturbing. It is very subjective. Some people experience traumatic events but for whatever reason, continue to function in the same way. Perhaps they had support around the event. Perhaps they externalized it. Other people go through similar events and are deeply affected. One method of assessing for trauma is the Adverse Childhood Experience assessment. Do you know your ACE number? Take it here. The higher the score, the more indicators there are for physical and mental health issues according to the Kaiser Permanente study. Even if you have a zero on the assessment, you might still have had a traumatic experience (i.e. car accident, death of a relative, cruel teacher, cyberbullying) bothering you and getting in the way of what you love to do.

Our brains and bodies are connected which is why it is important to address past traumas. Even if it happened a long time ago, each developmental level we achieve, we must reprocess the trauma at that new developmental level. It can be rough. One of the best treatments for trauma is EMDR (Eye Movement Desensitization and Reprocessing). It is the most cost effective treatment for trauma. Past neglect, physical, and sexual abuse of a minor even have a financial toll. Per the CDC, it is about $210,000 in lost income and education plus physical and mental health expenses per victim (2012). This emphasizes the importance of addressing the traumas as soon as possible to reduce its long-term impact.