Welcome to the Online Counselling Podcast. Exploring the practice of counseling through technology. Here’s your host, Clay Cockrell.
Clay Cockrell: Hello and welcome to the Online Counseling Podcast. I’m your host, Clay Cockrell. Thank you for joining us as we explore the ins and outs of online counseling. As always our hope is to educate therapists around the world about the ethical legal and effective ways that you can add technology to your practices. I will say right off the top I’m recovering from a bit of a cold, so my normal croaky low voice is even croakier and lower. Sorry. I feel better I just sound terrible. Anyway, I want to thank everyone for the very kind and encouraging comments that we’ve been receiving since our last podcast episode that reviewed Epstein Becker and Greene’s 50-state review on telemental health. If you haven’t had a chance to listen please do because this project breaks down each state in the United States and lists their regulations about online therapy. Let’s say you get a call from a client in Pennsylvania and you don’t have a Pennsylvania license. You can go through this document and it’ll tell you if you can legally work with that person. It really is an exhaustive and complete listing of everything you need to know and I think it’s invaluable for all of us. We’re going to have it up on our site soon which is of course onlinecounselling.com and we’re going to put it in the Therapist Toolbox section. But for now you can see it at ebglaw.com. Check it out.
An update I recently saw on Facebook was that our friend Kat Love who was in a previous podcast episode has launched a new part of their business. If you remember Kat Love is a wonderful website designer that splits her time between Greece and California. She does custom websites for psychotherapists, but now she has launched what she’s calling empathy websites which is a way for therapists to get their work at a smaller price point using templates that they have designed and you pay up I think a small monthly fee and they maintain the site and any updates or tech needs you may have they take care of all that on an ongoing basis. It looks really great. I don’t think they launch until January 2017 but there is an email list you can sign up for to be part of it when it does launch. Just go over to Katlove.com and that’s Kat spelled with a k and check it out. They really are beautiful templates. No, Kat didn’t pay for that little blurb. I just wanted to do a shout out to a friend of the directory. There you go.
Speaking of the directory, we are growing. Many of you signed up for our newsletter and that will be launching soon so check your email boxes. Our push for international therapist is ongoing. We now have several therapists in Ireland, Northern Ireland and other parts of the UK, Australia, Canada, France even. If you know someone who is outside the US, let them know about us.
On to today’s podcast. I was introduced to our guest Stefan Charidge by another friend of ours, Jeff Simons who heads Online Therapy Hub and the Private Practice Hub in the UK. Stefan is a psychotherapist in the UK that has developed an app to help clients who are struggling with anxiety. So while as a therapist, he mainly works with clients either face-to-face or by phone. I thought he’d be a great guest for us because it is a way that technology is impacting and assisting our clients. While not strictly about online counseling, I like to mix it up a bit and add something that I think will help us in other technology influenced ways because there’s a lot of apps out there and I really like this one. I hope you enjoy. Here’s the interview.
Clay: Hello and welcome to the Online Counseling Podcast. I am very excited to welcome Stefan Charidge from the UK and going to talk about his Break Free Anxiety app. Probably what I’ll say in the intro before this is that this is going to be a little different that we’re going to talk about technology and mental health but not necessarily online counseling although I’m sure we’ll get into that. But anyway, welcome, Stefan. Thank you for coming on the show.
Stefan Charidge: Thank you. Thank you for inviting me.
Clay: Tell us a little bit about you, your history. You’re in the U. Where about in the UK are you now?
Stefan: On the southern coast. I live in between Portsmouth and Southampton. My background as a profession is actually baking. I was a baker for 30 years.
Clay: Really?
Stefan: Yeah managed various organizations and such like and then have my own business. In the late eighties, I went through marital issues, etcetera, had some counseling myself and felt that this was something but I’d be interested in actually doing myself. At the same time I was interested in getting a good degree and I decided I’d have a business degree and went off to university, attended several lectures to find out what it would actually incorporate. I came to the conclusion that there was nothing I could actually learn by taking this degree but also aware that I wasn’t actually putting best practice into effect. I came to the conclusion that it was actually myself and my process and way of being that was getting in the way of actually best practice. That was also another catalyst for me to actually explore my own emotions, internal process, and media making process.
Around the 90s, I started doing some counseling courses. I’ve done various counseling courses and also attended the Mankind Project Weekend for men which is very good. Actually had some training in shadow work as well which was originated over in the US by Cliff Barry. Lots of different modalities and lots of different ways of working. Just about 10 years ago, I started setting of different aspects of my business to free myself up and then make the complete transition to become a fulltime therapist.
Clay: About ten years ago is when you were doing full time.
Stefan: Yeah.
Clay: Fascinating. How has it been I mean being a business owner? I didn’t know that about you. It’s kind of fun. I always had a little fantasy of being a baker. How has it been for you starting a different kind of business? You certainly had a business mindset. What was that like for you?
Stefan: Expensive. It took a long time. It took a long time to actually generate a decent client base and took a long time to actually get all of my accreditation together that I was able to market myself effectively within the counseling environment and wean myself off of the needs of the bakery. And then when I actually sold the last aspects of my business, I had very few clients but over the years it’s built up and my diary’s full.
Clay: I think a lot of the listeners are maybe it’s heartening to hear that someone even with a business mindset. This is a different kind of business and you grow slowly hopefully. You’re learning how to find that niche and how to market and it does happen eventually. You are accredited with the British Association of Counselling and Psychotherapy, correct?
Stefan: Right.
Clay: You have a full schedule and are you do face to face and online counseling, right?
Stefan: Well I do face to face and phone work. I do very virtual online work and very little Skype, so probably about 60 to 70 percent of my work is now on the phone which accesses a much larger client base, and then the remainder is face-to-face. Some are client referrals via employers and some are private clients.
Clay: But we’re going to talk about an app that you have developed. Is this your first app?
Stefan: Yeah definitely. It might be the last. I don’t know.
Clay: So we go from baker to psychotherapist and now technology app developer. Tell me how did this come about? What was the process like for you?
Stefan: Well it came about to predominantly working with my clients. More and more of my clients were talking about anxiety issues and fears. Within my therapy, within the work that was actually being delivered we’ve been looking about and talking and exploring how clients might work through these issues. I don’t know if you’re familiar with the Worry Diary within counseling. A lot of people talk about the Worry Diary. I was introduced to in effect the Worry Diary to some of my clients. I thought to myself, “Wouldn’t it be nice if there was an app specifically built on that framework with a few bolt-on aspects?” With that I decided to actually develop the app so that I could just refer clients to the app to work through their issues and access more of their anger energy as opposed to staying with their fear. My belief is my experiences that the film Inside Out is very informative and educational and I might refer some of my clients to actually view the film working on the premise of the four core emotions: fear, anger, joy, and sadness.
Clay: Just to break in. I saw that on Netflix just a couple of months ago. If the listeners aren’t familiar with it, it’s an animated film. It might be Pixar. It’s these four little characters are living inside this girl’s head, and as she matures, the emotions, these characters that play these emotions they try to save her or hurt her. I sat down and went “This is brilliant.”
Stefan: Yeah lovely.
Clay: And tragic at times. It was just beautiful. Just to break in. But you say there’s more than the four characters.
Stefan: Well in the film I think oddly they get it a bit wrong because they refer to a fifth emotion being disgust. But disgust is not an emotion. It’s a judgment some people judge Brussels sprouts as lovely. Others judge them as disgusting. Fifth emotion is actually shame. Shame is like a spinning plate at a circus act. The plate cannot spin. Shame cannot be experienced unless it’s supported by a stick and the potential stick that might support shame is again the four core emotions of joy, anger, fear, and sadness. The other aspects of the film being a little bit disjointed it is that fear I believe is predominantly in the head, whereas the other emotions live more in the body. There’s more of an experience as opposed to a cognitive process.
Clay: Fascinating.
Stefan: The antidote to fear is to take an action. We’ve all heard about the fight flight response to the fear. I think that the fight and flight whilst they rhyme well, that’s an inappropriate statement. It should actually change to mobilization to mobilize towards or mobilize away from. Otherwise there’s a little bit of a stigma or assessment as to what a fight or a flight is. To flight and run away it carries certain connotations. To eliminate that, to mobilize towards or away from I think is far healthier. The app is designed to actually identify what would be a healthy form of mobilization and to work through that process.
Clay: I want to get to the actual app and what it does. I guess what I’m fascinated by is the mindset of how you decide I’m going to jump into that. I’m going to make an app. I see that as courageous. I see that as a lot of fear, a lot of how in the world does one do that. How did you learn to develop an app?
Stefan: Well I didn’t write software. I have no understanding of how the software actually works. My first thoughts were how you know to develop an app because it’s a handy bit of kit. It’s going to be in the majority of people’s phones. They can use it any time of day or night and utilize it and work through their anxieties. My first port of call was just to do a search online as to which people actually write apps etcetera and nearly fell off my chair with the prices they were proposing. We’re talking like £6000 or £7000 to actually write the app, and really it’s an open-ended because subject to how it’s added to or modified it would cost more. But fortunately I put a call out to a niece of mine and she is into software writing, not apps. She bounced out an email to her friends. Is anybody interested in writing an app? I managed to find a university student still in the university and he can write it for me in a very reasonable fee.
Clay: I love it. You network. I say that all day long. Use your network. There’s somebody out there that can help you. You worked with this person then. That must have been a process of you finding out what you wanted and him explaining the how that could manifest.
Stefan: There was a few tweaks on the way to actually write up the instructions, the information actually needed and making decisions as to where within the app there’s an ideas page, what will go on the ideas, and how, if somebody were to identify what their worry was, how it’d be lifted in going to the Google search or on to YouTube and so on and so forth so that people could actually press a couple of buttons and go straight to without having to write, rewrite, or retype etcetera. There’s quite a lot of links and bits of resource that is available right at the app.
Clay: Excellent. You uploaded to iTunes and begin sharing it with people and letting it have a life, right?
Stefan: Yeah.
Clay: What’s the feedback that you’ve gotten?
Stefan: The feedback is very positive. The biggest hurdle is actually supporting people in doing something and if somebody’s chronically depressed or very skeptic, which is also basically a fear, they’re less likely to actually use it or enter it. But those that do are literally some of them are blown away. They can’t believe how much information, how much resource, how much support there is, and how supportive it has been for them it is on an individual basis. Yeah, I think it’s fantastic. It’s a free app, so free to download. There are some free resources via the YouTube etcetera, and also a free audio that is a very clever piece of technology that uses almost like hypnotic type techniques and a cognitive process to eliminate fears and anxieties.
Clay: So back it up. Tell me about that because I’ve used holosync and I’ve used Life Flow. Some of the audio is this around kind of like that?
Stefan: This is an audio which is almost like a hypnosis type commentary through the process where Tim employs the person to scale the level of anxiety and listen to that theme, 0 to 10 in beginning. He gives them three sounds, and as you hear each of the sounds, he invites to tap with the right hand, left hand, or both hands together. And then at the end about 12 minutes later, he’d ask the person to rescale the anxiety. It will definitely go back down but by how much? You don’t know. It might go from 7 to a 6 or a 7 to the 2. Only the person using it can actually decide what that score is.
Technology with the tapping as well, as you’re probably aware, the left side of the body issues by the right lobe of the brain vice versa. As you’re tapping and changing, you’re moving from left to right lobe of the brain. As you interchange from left to right, you’re interrupting the neural network, the pattern that’s actually generated in the brain. The more we use a particular neural network of pattern, the stronger it gets. If somebody starts with a phobia or a fear, the more they repeat that phobia or fear, the stronger it gets. Whereas the tapping literally within the brain it breaks that network up, and then the thinker can’t actually use the old network has to find a new network. If it finds a new network, it’s a much weaker connection. It’s not as strong as it used to be. Very pleased to have a kit free of charge.
Clay: Yeah that’s fascinating. I’ve been doing tapping work with some of my clients for several years. It’s incredibly effective. Let’s talk about this app. Again it’s called the Break Free Anxiety app. It’s free. You can get it on the App Store it at iTunes.
Stefan: And Android.
Clay: Apple and Android. Good. I always forget. What is it? What does it do? How do you walk through a client for them to use this?
Stefan: Well the idea is that the person would actually state what the worry is, and with stating what the worry is, I always encourage them and ask them literally sometimes, ”If you imagine you had a 10 ounce steak in front of you, how would you actually physically eat it?” Well the answer is it has to be chopped up into little pieces, bite-sized pieces. I’ll encourage the client to actually break up their worry into bite-sized pieces. There’s no point saying “I’m worried about work.” Work is too big. Which aspect of work? Is it a particular relationship? Is it an activity? Is it an assessment? So on and so forth. Break it down into smaller chunks and then to identify each of the chunks. Once it’s identified to then scale it from 0 to 10, and once they had to scale the can you do anything about this? Yes or no. If it’s a yes, the person will actually state what they can do in relation to this topic and then give it a date and time as to when they’re going to take this action because saying they’re going to do it later on doesn’t work. It’s actually given oneself a commitment to say and I’m going to do it tomorrow at 12:00. I’m going to phone the bank manager or the boss or whoever it might be. Once that date and time has latched, the app will ask, “Did you take the planned action?” Remembering that action is using that anger energy and moving away from fear. If the answer is yes, you just follow the prompts through and you rescale the level of anxiety in relation to that specific topic. It’s inevitable it’ll go down because some action has been taken. Over a period of time that repetitive process will inform the client that they’re able to take action. They won’t actually need the app they just know they need to do something about the worry or sustained with it. If they say no they didn’t take the planned action, the app asks, “Did the problem resolve itself winning the lottery or did another worry get in the way?” That worry might need some attention before coming back to the original. That ultimately is the process.
Going back to can you do anything about this, yes or no, if the person says no there’s actually nothing I can do about this, it takes them to an ideas page. On the ideas paid it has things about phone-a-friend, so it will link into their phone directory, finds something out, either do some research, call a helpline. There’s a catalog or library of help lines. Will be UK-based obviously.
Clay: All in the app, these resources you’re talking about.
Stefan: All in the app. These are the resources in the app. It will take them to breathing exercises, positive affirmations, positive thinking, sleep help, and indeed this audio that I’ve been referring to with the tapping. There’s an arsenal of things that are actually there. The other thing I do actually say that once you’ve broken the worry down into smaller pieces, don’t put them all down to be done tomorrow because that becomes an anxiety within itself. It’s a bit of a cluster in the diary and then procrastination sets in.
Clay: Wow. Excuse me. I’m sorry. I’m recovering from a cold. How does this inform your work with them? Because I know there’s somebody out there who’s thinking I’ve technology is just replacing counseling. Like the robots taking away some of the manufacturing jobs, the apps are going to take away all our jobs. Let’s talk about that.
Stefan: Well the first thing is that a lot of my work is very short-term, very short-term. The majority of my referrals are limited to just six sessions. I have some clients that I work with for six months or maybe even a couple of years, but those clients have particular psychological needs as opposed to an anxiety issue. With the referrals that I get with some as few as three sessions, it’s like to impart as much information as much knowledge as possible whilst holding and containing the theme. But if it’s fear-based, if the client is saying to me I’m thinking a lot, I’m puzzled a lot, I don’t know what to do, I don’t know which way to turn, I feel stuck, I feel in limbo, then it’s a fear-based thing. I will invite them to download the app and to talk through and process those anxieties. Because even by having the counseling session, they’re taking some sort of action in relation to their anxiety. There’s a possibility of an affirmation there. If somebody says, “I feel bad actually phoning up and having to get this help,” it’s actually identifying what it is about themselves that empower themselves to pick up the phone. They step through the fear of the “I’m not good enough” and pick up the phone for the counseling and indeed given them this tool, this resource for anxiety is very helpful and it’s something they can take away with them. It’s longer lasting.
Clay: Absolutely. I would imagine then that the next session it informs that session of how it went, what were the obstacles, what it felt like, what were the emotions around doing this, and getting some feedback and tweaking as it were.
Stefan: Once they’re given some feedback, then the app from my perspective is part. I don’t really go there again. If they say that “I was particularly worried about something,” I might ask them did you did you run the audio. If they did run the audio and it didn’t make much difference or it didn’t make difference or whatever the case might be. Therapy is a mixed bag. It’s slippery and it’s actually being able to have enough tools and resources to support that individual in that moment in time. This is a fantastic tool. Many clients have actually said that to me “Oh it’s good. I’ve actually recommended it to my friends, my family. My daughter’s using it. These people are using it.” The take-up in the few months it’s actually been available in my judgment and assessment is quite good because we’re over the thousands which in terms is probably very small, but from a one-man-band I think it’s pretty impressive.
Clay: I’m impressed. I’m absolutely impressed. I just want to get the name in, the Break Free Anxiety app and it is free.
Stefan: It’s free.
Clay: Wonderful. Anything else that you wanted to add about the app maybe that we didn’t cover?
Stefan: On the app per se, I don’t think so. I think really it’s like download it, give it a go, have a look at it yourself, see what a useful resource. Yeah it is ultimately going to make me redundant. Ultimately that is a counselor’s job. Our job is to make ourselves redundant to actually support our clients sufficiently that they’re able to work through their emotions, get the message, and the message from fear is one is to get prepared and two is to make the unknown known. Just like crossing the road. We need our fear because if we were fearless, we’d be dead. We’re going to cross the road. We stop and we look left and we look right. By looking left and right, we’re making the unknown known. When we know if there’s a suitable gap, then we can cross. But if the person is too fearful to even look, then there isn’t a hope. When people talk so much about “I don’t understand why I’m experiencing and this and I don’t want to have any fear in my life,” fear is a healthy emotion. We need it. It actually informs us. With all of our emotions we need to get the message. There’s a message that comes from each emotion. Once we talk about fear, that’s it. Get prepared and make the unknown known because fear is in the future and fear is always about the unknown. Because it’s in the future, there’s like a void. The universe doesn’t tolerate voids. It tries to fill voids. Mentally we try and fill voids, but we fill them with guesses and most of our guesses are wrong. We guess what the boss is going to say. We guess what our partner is going to say. We guess whether it’s going to rain or not tomorrow. Getting prepared it’s just like with the weather. We can’t change it, but we can change how we experience. We can change how we experience the weather and it’s actually preparing, buying the umbrella or the suntan lotion that actually supports us to experience.
Clay: Fascinating. I’m hearing everything you’re saying. I love when someone takes technology and creates a tool, these very complex, very human processes. This is a tool to assist people. You look at the worldwide need of people that are sometimes not able to see a therapist or counselor. This is something that certainly is—from my opinion—not going to replace what we do, but if there is nothing available for these people, this is something. Excellent. I’m sorry go ahead.
Stefan: Go on.
Clay: One of the things I’ve wanted to talk with and we talked briefly about this before we started recording, anytime I get someone outside the United States on one of these podcasts, I just want to pick your brain a little bit because here in the US we have licensure issues that prevent us. We are unable to do counseling at all unless we have a license. This limits us with online counseling because we can only do counseling within the particular state that we’re licensed in. Not so outside the United States. Let’s talk a little bit about accreditation and inside the UK. My understanding is anyone can actually do counseling, but in order to really get clients they need to be accredited. Talk to me about that distinction.
Stefan: As I understand things, counseling is unregulated in the UK. There have been calls for it to become regulated but it’s unregulated. Anybody could actually put a plaque on their door and say they’re a counselor. Employers, etcetera, majority of people do refer to the British Association of Counsellors and Psychotherapists. Most counseling courses are recognized by the BACP. If they’re not being recognized by the BACP or assessed as to the quality of the counseling training, then they don’t really carry very much weight. Once you’re actually qualified and you’re registered with the BACP, after doing I think about 400 more client hours, then you can actually apply to become accredited. Once you’re accredited, then that is, in my judgment, the gold standard in the UK to be in practice. The majority of employers or contractors that will refer clients to will actually be seeking the accreditation.
Clay: Taking that to some of our listeners and saying that I’m licensed in New York, if a client from Pennsylvania were to contact me to do online counseling, I would be breaking those regulations because I’m not licensed in Pennsylvania. If someone from London contacted me, it’s not illegal for anyone to do counseling. It’s an unregulated field in the UK so that therapists in New York working with someone in London they’re not breaking any kind of laws. A therapist in the UK doing counseling in Pennsylvania, you would be going against Pennsylvania regulations, but vice-versa not so.
Stefan: Yes. From speaking with the BACP, the brief is that providing the client is fully aware of where I’m working and the ethical codes within which I’m working is via the BACP and the client is referred to the BACP website so that they can actually do their research as to where I’m working from and how I’m actually working, and if there was a complaint or a concern that they could actually contact the BACP and do it that way providing the client is aware that technically I could actually work with anybody on Facebook or whatever.
Clay: Fascinating. Stefan Charidge, thank you so much for coming on and talking about some different issues but certainly about your app Break Free Anxiety available both on Apple and Android. Thank you so much. I’m looking forward to downloading it and trying it out.
Stefan: Thanks very much for the time. I will encourage all your listeners to do that and just check it out and see what they think and possibly refer on to potential users that would benefit from it.
Clay: Absolutely. Thank you.