COVID and Masking Policies

[April 2022]

 

At this time we are continuing to mask in our office. Please arrive wearing a mask and continue to wear a mask throughout your appointment and while you are waiting. Some clinicians are still opting for mostly virtual appointments but in person appointments are still available. We will continue to assess our masking policy and local healthcare decisions. If you have questions please contact our office at 269-588-1441.

 

 

COVID-19 Policy and Procedure Updates

[1/1/2022]

This year we are continuing to focus on client safety with the increase in COVID-19 cases in our area. At this time most clinicians are only accepting virtual appointments until further notice. If you are attending an in person appointment we ask that you continue to notify us ahead of your appointment if you have been exposed or test positive for COVID and we will swith your appointment to virtual. If you test positive for COVID you must remain home for 10 days from start of symptoms and/or positive test before you can return to in person visits. You must also be fever free for at least 24 hours before returning in office. This is regardless of vaccination status at this time. We continue to ask if you have any symptoms of illness to please switch to a virtual appointment. Questions please contact our support staff at 269-588-1441 press 3.

 

 

Updates

[9/1/2021]

 

We are excited to announce we are working on opening our new location at 4341 S. Westnedge Ave, Suite 2212 Kalamazoo, MI 49008. Our new location was designed to expand our services to the community and includes a large waiting room, reception area for our new staff, and many offices for our providers to utilize. In the process of opening our new location, we have also done some re-branding, with more information on these chagnes coming soon!

Given the on going concerns about COVID-19 and considering our area is now a hot spot for an increase in cases, we are implimenting masking again at our new location for those vaccinated and unvaccinated. We are still offering virtual appointments and the option to switch to virtual appointments when necessary. Therapists may offer some in person appointments or a hybrid of in person and virtual appointments. As we continue into Fall we will keep you updated of any changes in our office due to COVID-19 and appreciate your patience with these ongoing changes.

We hope to see you soon at our new location!

 

 

COVID-19 Response Updates

[Updated June 2021]

 

Due to changes in the masking mandate in Michigan, if you are a vaccinated individual, you are not required to wear a mask during your therapy sessions at our office. We still ask that you wear a mask in our waiting area, as we are considered a healthcare office. If you are not a vaccinated individual you must still wear a mask in our waiting area and in your therapy session. Therapists may or may not wear masks in our office, based on their vaccination status. Your therapist may also allow you to remove your mask during your therapy session only, without asking your vaccination status. Please be aware of the ongoing risks of not wearing a mask if you are not vaccinated, if your therapist does allow mask removal in their personal office. You will still be ask to follow health department guidelines about social distancing and quarantining when necessary. Please let your therapist know if you are feeling ill and do not come to your appointment. Thank you. 

 

 

 

 

 

COVID-19 Response Updates

[Updated 5/18/2021]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVID-19 Response Updates

[Updated 2/3/2021]

 

At this time many of our therapists have continued to see clients virtually for the safety of our clients and the therapists, during this ongoing pandemic. As a practice we have decided that in 2021 we would leave the option of in-person availability up to our therapists, as they have since the beginning been delicate in making decisions about their own caseloads and comfortableness with in-person sessions as cases surged in 2020. Most therapists are continuing to choose virtual only appointments, until the foreseeable future, while others are choosing a hybrid of in-person and virtual appointments. We ask you connect with your individual therapist to see what their preference is and that you continue to abide by the practice-wide COVID-19 Response Plan, as required by the state for all businesses in the state of Michigan. In the event that there is a state shut down again, we will re-evaluate whether our office space will be available to clients or if in-person sessions will be suspended again temporarily. But as it was in 2020 this would only be a temporary transition until it was safe for all parties involved to return to meeting in-person. Our therapists are hopeful that 2021will bring transition and movement towards more in-person treatment for everyone. As always you can still request a virtual appointment at any time and we appreciate our clients for being flexible in scheduling, as we have had to be flexible with how we do our work. If you have further questionst please do not hesistate to reach out to us at 269-588-1441. Thank you!

 

 

 

COVID-19 Response Plan

[Updated last on 12/7/2020]

 

We greatly appreciate our client's patience and understanding during 2020, as we have had to transition, more than once, with how we deliver services. At this time due to a recent update in orders, we will continue to stay virtual for all clients. We understand this can be difficult for some clients who have barriers with their treatment. Whether that is privacy in their home or lack of technology for telehealth to be successful. We hope that in the New Year, we will be able to resume some face-to-face sessions for those who need it. In the meantime, we will continue to try our best to provide the best services possible through technology. 

If you have further questions please do not hesitate to contact our Practice Manager -- Kristi Karel at 269-588-1441 x200 or email at kkarel@intentionaljourneycounseling.com 

Take care!

 

 

 

COVID-19 Response Plan

[updated last on 9/14/2020]

 

I greatly appreciate your patience during this time as I have had to adjust the way we provide services due to COVID-19. After much collaboration and consultation with various agencies, boards, and individuals who can provide guidance on “best practices” I have put together a COVID-19 Response Plan that will be implemented for in person/in office sessions if you choose this option.

 

Therefore, I am notifying you of the following plan purely in accordance with Governor Whitmer’s Executive order 2020-91 from May 18, 2020, which requires business to have a response plan “readily available to employees, labor unions, and customers, whether via website, internal network, or by hard copy”.

 

My practice will continue to follow best practices to reduce the risk of spreading COVID-19 on site. Efforts I personally will be taking at Intentional Journey Counseling Services, PLLC to reduce transmission include the following:

 

  • Increased distance between chairs in my waiting room.
  • Wiping down communal surfaces between in-person visits.
  • Eliminating access to the communal beverages.
  • Personally wearing a face covering during in-person visits.
  • Adjusting the distance of my therapy chair to be 6 feet apart from clients.
  • Avoidance of physical contact (e.g. handshaking) when in the office.
  • Requiring face coverings to be worn when on site.
  • Washing my hands or using hand sanitizer in between visits.
  • Opening doors for clients upon their exit in order to minimize the touching of communal space or leaving doors open to reduce physical touch of surfaces.
  • Frequent cleaning and sanitizing of the office space and waiting area.
  • Having all clients sign an Informed Consent of risk before an in-person visit can be completed.
  • Requiring that those on site report any symptoms of illness prior to their visit.
  • Relaxation of office policies to allow for a waived no show/late cancellation fee if an absence is due to suspected COVID-19 infection.
  • Screening all clients prior to in-person visits if they have any symptoms of any illness, have traveled recently, or have come in contact with anyone they know who is at higher risk for COVID-19 infection (e.g. someone else who has traveled recently or has symptoms of COVID-19).
  • Compliance of the regulation to notify local health authorities if a client or myself have tested positive for COVID-19; in addition to informing clients if anyone who has been in my office tests positive for the virus. This notification will, however, only include information that is absolutely necessary for medical purposes.
  • Posting this Response Plan on my website and office door.
  • Updating any policies as needed in order to maintain best practices for prevention.

 

Related to such a Response Plan, I also ask that, per both the CDC guidelines and my landlord’s requirements, you adhere to the following precautions when in-person services resume in order to help keep everyone safe. If you have any concerns about any of the following or are uncomfortable maintaining telehealth services until otherwise notified, please contact me to discuss options.

 

  • Wear a face covering while on the premises.
  • Notify me if you are deemed an “essential worker.”
  • Avoid touching your face or eyes with your hands.
  • Keep a 6 foot distance from others and do not engage in physical contact with others.
  • Avoid non-essential contact with communal surfaces/areas (e.g. countertops, books, children’s toys, restroom).
  • Immediately upon entering the building washing your hands with soap and water before entering the suite. Bringing your own hand sanitizer is encouraged.
  • Avoid having any guests accompany you to your appointment unless medically necessary or unless previously planned.
  • Arrive as close to your appointment time as possible. If you arrive to your visit and there is another person waiting in the waiting room, please return to your vehicle and wait to enter until that person has exited the building. Or, if you feel more comfortable doing so, message me (e.g. email or text) at the time of your appointment to get confirmation that you are ready to enter.
  • Notify me immediately if you are experiencing symptoms of any illness (e.g. fever, cough, difficulty breathing).
  • Do not attend your in-person appointment if you have symptoms of any illness. Telehealth services will be gladly provided for you, instead.

 

Please note that we are all doing our best to stay abreast of changes and requirements as they continue to shift. Therefore, please also note that this formal Response Plan may be updated at any time and that it is your responsibility to check for any updates prior to your visit and to inform me if there are any changes in the status of your health or concerns related to such policies. Please review an adhere to the above policies to promote safety until you are notified that such a Response Plan no longer applies.

 

If you have further questions please do not hesitate to contact me [Practice Manager – Kristi Karel] at 269-588-1441 x200 or kkarel@intentionaljourneycounseling.com

 

 

 

 

 

Amendment Added 9/14/2020

 

Due to recent changes and additions to the Executive Orders in the state of Michigan, we are now restricted in who can be seen in the office. The most recent order on 9/5/2020 states we must provide services via telehealth. If you are requesting to be seen in the office you must provide a valid reason for not being able to do telehealth and this reason must be documented and assessed for each visit. A valid reason may one of the following:

 

  • No privacy within your home to allow for confidentiality
  • No access to technology or internet for telehealth to occur
  • Unsafe home environment
  • A medical condition which makes it difficult to do telehealth
  • Unacceptable reasons to be seen in the office:
  • “I just want to”
  • “I feel it’s more personal in the office”
  • “I feel comfortable with visit’s in person”
  • “I’m okay with the risk”

 

 

 

 

COVID-19 Response Plan (June 2020)

 

I greatly appreciate your patience during this time as I have had to adjust the way we provide services over the past several months due to COVID-19. After much collaboration and consultation with various agencies, boards, and individuals who can provide guidance on “best practices” I have put together a COVID-19 Response Plan that will be implemented for in person/in office sessions if you choose this option.

 

Therefore, I am notifying you of the following plan purely in accordance with Governor Whitmer’s Executive order 2020-91 from May 18, 2020, which requires business to have a response plan “readily available to employees, labor unions, and customers, whether via website, internal network, or by hard copy”.

My practice will continue to follow best practices to reduce the risk of spreading COVID-19 on site. Efforts I personally will be taking at Intentional Journey Counseling Services, PLLC to reduce transmission include the following:

Increased distance between chairs in my waiting room.

 

  • Wiping down communal surfaces between in-person visits.
  • Eliminating access to the communal beverages.
  • Personally wearing a face covering during in-person visits.
  • Adjusting the distance of my therapy chair to be 6 feet apart from clients.
  • Avoidance of physical contact (e.g. handshaking) when in the office.
  • Requiring face coverings to be worn when on site.
  • Washing my hands or using hand sanitizer in between visits.
  • Opening doors for clients upon their exit in order to minimize the touching of communal space or leaving doors open to reduce physical touch of surfaces.
  • Frequent cleaning and sanitizing of the office space and waiting area.
  • Having all clients sign an Informed Consent of risk before an in-person visit can be completed.
  • Requiring that those on site report any symptoms of illness prior to their visit.
  • Relaxation of office policies to allow for a waived no show/late cancellation fee if an absence is due to suspected COVID-19 infection.
  • Screening all clients prior to in-person visits if they have any symptoms of any illness, have traveled recently, or have come in contact with anyone they know who is at higher risk for COVID-19 infection (e.g. someone else who has traveled recently or has symptoms of COVID-19).
  • Compliance of the regulation to notify local health authorities if a client or myself have tested positive for COVID-19; in addition to informing clients if anyone who has been in my office tests positive for the virus. This notification will, however, only include information that is absolutely necessary for medical purposes.
  • Posting this Response Plan on my website and office door.
  • Updating any policies as needed in order to maintain best practices for prevention.

 

Related to such a Response Plan, I also ask that, per both the CDC guidelines and my landlord’s requirements, you adhere to the following precautions when in-person services resume in order to help keep everyone safe. If you have any concerns about any of the following or are uncomfortable maintaining telehealth services until otherwise notified, please contact me to discuss options.

 

  • Wear a face covering while on the premises.
  • Notify me if you are deemed an “essential worker.”
  • Avoid touching your face or eyes with your hands.
  • Keep a 6 foot distance from others and do not engage in physical contact with others.
  • Avoid non-essential contact with communal surfaces/areas (e.g. countertops, books, children’s toys, restroom).
  • Immediately upon entering the building washing your hands with soap and water before entering the suite. Bringing your own hand sanitizer is encouraged.
  • Avoid having any guests accompany you to your appointment unless medically necessary or unless previously planned.
  • Arrive as close to your appointment time as possible. If you arrive to your visit and there is another person waiting in the waiting room, please return to your vehicle and wait to enter until that person has exited the building. Or, if you feel more comfortable doing so, message me (e.g. email or text) at the time of your appointment to get confirmation that you are ready to enter.
  • Notify me immediately if you are experiencing symptoms of any illness (e.g. fever, cough, difficulty breathing).
  • Do not attend your in-person appointment if you have symptoms of any illness. Telehealth services will be gladly provided for you, instead.

 

Please note that we are all doing our best to stay abreast of changes and requirements as they continue to shift. Therefore, please also note that this formal Response Plan may be updated at any time and that it is your responsibility to check for any updates prior to your visit and to inform me if there are any changes in the status of your health or concerns related to such policies. Please review an adhere to the above policies to promote safety until you are notified that such a Response Plan no longer applies.

 

If you have further questions please do not hesitate to contact me at 269-312-7454 or kkarel@intentionaljourneycounseling.com

 

 

 

 

Finding Balance: The Hectic Life of the Busy Parent

Being a parent is a task within itself but when we add on our relationships with our partners, our full time jobs, soccer practices, and dance recitals, things become hectic! The laundry list of chores parents perform, day in and day out can lead to burnout quickly. When we typically turn to our friends, family, even our therapists we hear the phrases: self care, work-life balance, date night or girls night, take a bubble bath or read. But what do those things mean and are they actually attainable and helpful to busy parents?

Let’s get real when parents hear the things listed above the first thing they think is something like “yea right, I don’t have time for those things”. The reality is that if parents do not make time for themselves and find balance, even in their busy schedules, they become overwhelmed, stressed, sad, even depressed at times. Typically when I see these clients in my office they are experiencing some type of burnout, which usually starts with issues at work or in their intimate relationships.

Is this balance attainable to stay healthy, happy, and on track with our lives? Yes and no. Let’s start with the yes and I’ll get to no in a bit. So, yes, we can make changes to our schedules to ease the pressure and feel balanced. This may look different depending on your schedule but small changes make big differences. First, talking with your partner about your stress is key, as they can help with some the burden. Maybe you need them to pick up or drop off the kids on Mondays and Wednesdays or you need them to get the groceries every other week. This could be huge for you, even if it seems like a small task to delegate.

Secondly, having good boundaries with work, again depending on your job requirements, can help keep work and home life separated. So that may mean not answering calls after 5pm, not checking emails on weekends, or telling your manager you just cannot take on that extra project right now. Finally, intentionally making time for yourself and for a date night are so important. I’m not saying you need to take hours of your week to make it happen. Maybe it’s a lunch date or 20 minutes before bed where you read or meditate. These things are so important to implement and can make a huge difference in keeping you feel balanced.

So, I also said no. What I mean when saying no, is that some days, weeks, or even that funky month will be stressful, unorganized, and feel “out of control”. We are not perfect and even when we follow the best laid plans things happen. Our kids will get sick, we will have an unexpected meeting, or forget about an afterschool event. The most important thing to remember when this happens, is that shit happens to everyone! As long as we get up the next day ready with our skills to balance things back out, things will be ok.

 

What is Trauma?: Part 2

Last time I talked about the definition of trauma, how to identify if you have experienced a trauma, symptoms of PTSD, and when to seek out treatment. In this post we will look at treatment options for treating trauma and PTSD.

When it comes to treatment, one size does not fit all. The same is true when it comes to treating survivors of trauma. If you noticed I said survivors, not victims. People who have experienced trauma are survivors. You may have been a victim of abuse or a criminal act or even a victim in a car accident, but you did survive. Changing how we address trauma is the first step in recovering from it.

Here are a list of treatment modalities used to treat trauma:

· Cognitive Behavioral Therapy (CBT)

· Prolonged Exposure Therapy

· Eye Movement Desensitization and Reprocessing (EMDR)

· Somatic experiencing

Cognitive behavioral therapy or CBT, is what most people think about when they think of therapy. Essentially it is what we consider “talk therapy”. During session you will process your feelings and experiences and work on changing negative thinking patterns related to your traumatic experience. CBT helps you gain understanding and acceptance through processing.

Prolonged exposure therapy is a type of CBT therapy that address trauma memories gradually. During the course of treatment you and your therapist will discuss in detail your traumatic experience and your feelings related to that experience. You will also be assigned homework to address triggers outside of treatment. Prolonged exposure therapy is thought to help clients confront their fears, memories, or triggers by facing them directly.

Eye Movement Desensitization and Reprocessing or EMDR is unlike prolonged exposure therapy, in that you may or may not need to express details about your trauma to process it. EMDR focuses on the past, present, and future and uses eye movement, either by tracking your therapist’s hand, object, or using sound with a headset, to process your trauma. With EMDR you address disturbing memories and feelings and work on processing and changing thinking patterns.

Somatic experiencing is in some ways similar to prolonged exposure but focuses on releasing pent up energy from trauma and re-balancing your nervous system. You are introduced, during session, to something that may be a small trigger related to your trauma. During this time your therapist will monitor your reaction and frequently ask about your emotions or physical response. You will then work on increasing your tolerance to these uneasy feelings related to your trauma.

When seeking out a therapist to treat your trauma you may choose a therapist trained in one of the above treatment modalities. But as I stated before, not all treatment is the same and one size does not fit all. Many times therapists will utilize skills, techniques, and protocols from multiple modalities to treat clients, and that is ok. Just make sure to research the above modalities further, so you can make an informed decision about your treatment.

 

What is Trauma?: Part 1

Trauma by definition is a deeply distressing or disturbing experience. This experience can be either physical or mental in nature. The APA defines trauma  as “an emotional response to a terrible event like an accident, rape or natural disaster.” Trauma may look different depending on the precipitating events that lead up to it or the coping skills the person has learned over their life to deal with such stress. Not all trauma is the same, but trauma is trauma.

In my office when we are talking about trauma or a posttraumatic stress disorder, we are looking at the symptoms that point to a history of a traumatic event(s) and the coping mechanisms impacted by that event. These symptoms vary depending on the person and even symptoms can look different from person to person. For example not everyone will have nightmares or dissociate. As you can see trauma is a complex diagnosis and is not one size fits all.

So you must be asking yourself, do I meet criteria for posttraumatic stress disorder automatically if I have experienced a traumatic event. The answer may surprise you. Depending on your learned coping mechanisms you may not meet criteria. Yes, you may not have PTSD but still have experienced a trauma. You may still need to process your trauma but not meet a full diagnosis. Not being diagnosed with PTSD does not negate the fact that you witnessed or experienced a trauma.

But what if I am having difficulties related to my traumatic experience? Then you may meet criteria for PTSD. Here are the things you want to look out for and will signal you that treatment may be needed:

· You have experienced either directly, indirectly, learned of, or witnessed something traumatic (i.e. death, threat of death, serious injury, violence, abuse, etc.)

· You are experiencing unwanted and upsetting memories, flashbacks, nightmares, or emotional and/or physical distress

· You are avoiding thoughts, feelings, memories related to the trauma or triggers

· You have negative thoughts and/or feelings after the trauma, have the inability to recall details of the trauma, decrease interest in activities, negative affect, exaggerated blame of self or others, feel isolated, or have difficulty experiencing positives

· You see an increase in irritability or aggression, risky or destructive behavior, hypervigilance, heightened startle, have difficulty concentrating or sleeping

· You notice symptoms have lasted longer than 1 month and create distress or impairment

· Symptoms are not due to any other causes (i.e. an illness or medication)

· You may have periods of time where you feel outside or detached from yourself or experience distance or distortion in your related (this is called dissociation and it is not a requirement to meet diagnosis)

If you can relate to the symptoms above it may be beneficial to meet with a therapist to see if you have PTSD and discuss a treatment plan to address your symptoms. There are many types of therapies that are beneficial in the treatment of trauma and PTSD symptoms, which I will discuss in a later post. But know that you can recover from your trauma, you can move forward and increase your wellness.

 

Intentional Journey Counseling Services, PLLC is not a paid sponsor or representative of the above listed resources. We believe in and promote on the ongoing awareness and research in trauma informed treatments and PTSD studies.

 

 

 

 

© Intentional Journey Counseling Services, PLLC and www.intentinoaljourneycounseling.com 2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited.

 

 

 

Intentional Journey Counseling will continue to require clients and staff to wear masks in our office. We have made this decision to protect our clients and staff who are at higher risk of COVID-19 complications and/or cannot or have not receive their COVID-19 vaccine. Our waiting room will also continue to stay closed at this time to clients and guests. We care about your well-being and if you have questions about our policies you may contact us at 269-588-1441.