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Justin K. Hughes, Licensed Professional Counselor: Dallas CBT and Exposure Therapy for OCD, Anxiety, Addictions & More
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Justin's Blog

The Real Cost of Therapy

10/30/2020

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Photo by Adeolu Eletu on Unsplash
How much do you charge? 
This is a very loaded question, indeed.  I’m going to give you straight answers to how much therapy actually costs, and why.  If you are a consumer of health services, you’ve likely asked it many times between doctors, dentists, and insurance plans.  Therapy is no different, yet it is unique in many ways.  Knowing your role in securing treatment and its cost can help you achieve a win-win.

Why are you writing this?
More than a therapist, I am an advocate.  This post has been a long time coming, and clinicians rarely talk about money on a personal level.  When there’s a good reason to do so, it’s an opportunity for growth.  This post is intended to help:
  1. Consumers of mental health services make the best decisions for themselves with fuller knowledge of what they’re getting.
  2. Professionals (colleagues and students) to understand the dynamics that exist to create a win-win.
  3. Advocates of mental health who fiercely support their neighbor’s mental health and need tools to communicate and steer people to the best option that exists for their current circumstances.

Business theory.
When a good or service is offered, utility and/or providing for a human need or want occurs.  In fact, this is why the term “goods and services” uses the word, ‘goods.’[1]  In less than ideal circumstances, either the service is not provided (or provided poorly), or the exchange is NET negative (i.e., the provider loses money or the consumer can’t afford a service important to them).  
IDEAL: Good Service Provided <--> suitable exchange (money) = both parties win

How much is an average therapy session?  
Here are common rate structures:
  • Free (through no copay insurance- highly uncommon- plans or state-run and non-profit services)
  • ~$20-75+ for practicum/interns (little training or early in their training, but way more advanced than talking to your friend who “took some psychology classes”).
  • ~$50 - $125 for a non-specialized therapist and/or online only therapy
  • ~$150-250 per hour in urban areas and/or for specialists
  • $300-600+ for clinicians who are truly at the top of their fields (think of hiring a celebrity to do a commercial vs. someone unknown from a talent agency)  [2]

What is a realistic win-win?
We live in the real world.  And while we can seek to change things we can change (see below under the “Systems that be” section), acceptance of what we can’t is a crucial part of mental health.  Work within the reality you exist.  

  • Free therapy usually means it has been massively subsidized (or you are paying for it in another way, like insurance or a benefactor).  
    • However, to keep overhead low and have a NET profit to stay in business, they may not possess one or more of the following:
      • Expert level status (10+ concurrent years treating a specific condition)
      • Specialization (more than 50% of cases)
      • Additional amenities:
        • Great location
        • Easy access (right off main roads or highways, downtown, etc.)
        • Telehealth or other options, like home visits
        • A snack bar, great coffee, ambiance
  • Interns and Practicum Students for $20-25 per hour can be wonderful for those with little financial wherewithal and/or if you need a listening ear with only some training- but be realistic in expectations.
  • Online therapy is a great option that is often affordable and accessible, even possibly accepting your insurance.  Limits are a lack of the in-person experience or in-person exposure therapy with objects or places.  
  • Generalists may be more likely to accept insurance or only charge rates in the range of insurance reimbursement.  However, the same limits apply as to the first bullet point.  
  • Specialists are great if you have a very specific problem you need to address very specifically (like OCD, PTSD, Schizophrenia, etc.).  If you can afford them, it’s not a bad place to start, and if they’re being honest they can tell you how you can achieve results- even if it doesn’t include them.
  • Famous clinicians are so cool!  If you can afford it and want to, go for it!  The Gottmans, Edna Foa, Sue Johnson, Steven Pinker, Daniel Kahneman, Reid Wilson.  

There will always be exceptions to the rule, and the above is no different. For example, some people offer excellent services through charity, passion for helping, faith, or other reasons.  Of course, this doesn't mean that anything is free- these services are simply subsidized through that person and often additional income streams like books and speaking fees.  A great example in Dallas would be the experts Drs. Harville Hendrix and Helen LaKelly Hunt.  They offer free community-based marriage building seminars and trainings (Safe Conversations).  Dr. Reid Wilson offers a free 2 day intensive every year at the Annual Conference of the International OCD Foundation   Many churches and places of worship do the same.  

How much clinicians make.
Income ranges wildly, from those famous clinicians to practice owners to social workers to private practice and more.  I don’t know anyone who’s getting rich off of therapy.  Most of us got into counseling/therapy as a helping profession in the first place.  I told my wife when we were dating I would very likely make less than her as a nurse at a prominent Dallas hospital, and I wanted to make sure she was okay with that.  Let’s just say she didn’t dump me.  :)  The median Master’s Level counselor in the U.S. makes about $50-75k per year.[3]  Besides gross income, clinicians have a lot of other factors that take off the top:
  • Overhead/Expenses 
    • Office Rent is usually the largest single expense for most clinicians.  Most folks I know will pay somewhere in the vicinity of $500-3000 per month just for their office space.
    • Telehealth, Electronic Health Records, Marketing efforts, and more add to the expense.
  • Degree/Licensure
    • Master’s degrees require college plus 2-3 years full time along with an internship usually an additional 2 years beyond this.
    • Psychologists (doctoral level) have an additional 3-5 years with school and practicum/internship above a master’s degree.
  • Ongoing training
    • Base level continuing education is usually around 12-15 hours per year.  Those with certifications or other training (EMDR, CSAT) have their own separate upkeep.
    • Expert Clinicians are generally speaking/writing/training at conferences (1-3 per year for many), which is more time and cost.  Travel costs wrack up easily, and for those heavily invested in being at conferences, it can easily add $5-10,000+ per year in travel expenses and associated costs- all to stay up to date and invested.
  • Self-Employment Tax, which Depending on income bracket, is much higher than when an employer covers a chunk of taxes.  Take about 20-35% off the adjusted gross income for total taxes in a year.
  • Health insurance.  This may be the biggest expense of all for clinicians if they have to purchase their own health insurance, which can cost around $3,500-12,000 per year- just to have the insurance.
  • Limited codes to bill.  Therapists have only a few billing codes they can submit to insurance; many only use one code based on the hour of therapy (90837).  Insurance is not typically known to give raises.  
    • Doctors have, as of this date, literally 70,000 codes to bill!  [Some of my favorites: Y93.D: Activities involved arts and handcrafts and W55.41XA: Bitten by pig, initial encounter, W61.62XD: Struck by duck, subsequent encounter.]
  • Cost of living (L.A. and New York and Chicago will see many non-specialized therapists charging $200 or more per hour).
  • Number of clients- what is feasible depends greatly, but most clinicians I talk to can see about 15-30 clients per week before they start burning out.  For every client hour, many clinicians have to spend at least an hour for administration, marketing, training, etc., that they don’t get paid for.

I’ll let you do the math.  

So yes, I get it.  Therapy can be expensive.  If my clients say “this is expensive,” I agree.  “Yes, it is.  You are making a sacrifice.  Thank you so much for your prioritization in being here.  My goal is to help you reach your goals and get you on your way as soon as is reasonably possible (unless you want to stay around longer).”

I hope this post is helpful in helping you make a decision or in supporting others considering decisions for therapy in our current world.  Remember the old truism: “you get what you pay for.”  Or maybe what somebody else pays for.


References:
[1]  https://en.wikipedia.org/wiki/Goods
[2] How do I come by those figures?  They’re rarely published, but it is my personal experience and through research and conversations behind the scenes. This makes it subjective, but I hope it helps.
[3]https://www.salary.com/research/salary/posting/counselor-salary, https://www.payscale.com/research/US/Job=Licensed_Professional_Counselor/Salary



​
Addendum (i.e., for further reading)

It is worth noting that there are whole systems at play at any given points with healthcare. it is not the purpose of this article to get into these complexities, but I do want to at least acknowledge that they are there and need addressing in their own right.  

Depending on where you were born, your skin color, or any factor of diversity, you may face a substantially harder time in life pursuing things that come easier for others.  That sucks.  It’s unfair; it’s unjust.  I want you to know you are seen.  You are heard.  You have value, whoever you are.  

This is where advocating for the plight of the hurting and the poor is so key.  I hope you will join me in doing so if you can. Or if you are hurting and in need that you will check out one of the many resources listed on my page, https://www.justinkhughes.com/resources.html.  

I hope readers will be careful in making judgments or interpretations about the intentions of others (I’m talking to you, clinicians, consumers, and advocates). PERIOD. That underscores a basic principle of CBT and emotional health. 

Therapists as a whole struggle at times with charging anything.  I've been there, and I still wrestle with cases of extreme need and how to approach.  I remember when I helped run an intensive program for teens struggling with substance abuse.  One of the young teens once exclaimed, “For $20 per person, you guys are getting rich.”  We had about 15 kids a night, for 3 hours per day clinical and 1 hour admin., with about 4 staff members and an owner.  That’s $15 average per employee, or Costco’s minimum wage.  Some of my colleagues who charge the most are also most involved in advocacy and a number of outside free resources, be it free clinics that they put on, short-term workshops, educational content online, training of clinicians and lay persons, etc.  In fact, though I may be biased here, I think that some of those that charge the most are more involved in these efforts. If they're making a decent living what they're doing, it can actually free up their time, energy, and passions for more advocacy and help.  

Paying less or more does not have to be an inherent good or bad; it's often a question of many factors and considerations that you must weigh for yourself and with your loved ones.  As I tell all of my clients, advocate for your health! People who are assertive in their treatment get the best outcomes.

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Feelings ARE Facts

10/23/2020

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Photo by Q'AILA on Unsplash
Experiment:  Look at the picture above.  What do you feel?  Those feelings are real.  However, how you interpret what you feel makes all the difference (whether you think cats are cute, a nuisance, practical, fun, allergic furballs, or pure joy).  

​

I see a common phrase that goes around: “Feelings are not facts.”  While I agree with the inherent sentiments, it’s wrong.  Feelings are facts.  Your interpretation of feelings may not be factual.  

Actual feelings are factual insomuch as they reflect disparate and connected processes within the body and mind, occurring in real time.  They give you information.  Sensations and emotions link us in to a wealth of details.  Researchers have long struggled to pinpoint feelings exactly (this is one of the reasons why there are no definitive feelings charts/references and why therapists will list anywhere from 3 basic emotions and as many as 100 or more), and though neuroscience is helping us understand more what occurs biologically in the brain, the conclusion is far from definitive.  

Making this separation that feelings are facts may seem a bit pedantic- splitting hairs.  My first supervisor I ever had in my internship would tell me something along the lines of this: “Separating feelings from thoughts is foundational for emotional intelligence.”  Agreed.  And it’s just plain healthy.  CBT (Cognitive Behavioral Therapy) helps us get really good at being honest with the interaction between thoughts, feelings, and behaviors.  Problems with anxiety, depression, dissociation, psychosis, narcissism, and all of mental health at some level deals with how much a person is living in reality.  None of us are 100% or will be perfect at it.  However, we can grow.  Do our thoughts line up with the bigger picture?  Are thoughts and emotions congruent?  Do behaviors fit what we believe?  If I feel chest tightness, racing heart, or my stomach drop when I’m around another person, the conclusion is not necessarily that that person is bad or I need to get away.  Yes, sometimes that is the case.  I have also had these feelings around people I trust implicitly.  There are a number of factors that can lead to feelings- amount of sleep I got last night, hunger, and stress in general, to name a small few.

So when people say feelings are not facts, I understand what they’re saying and support the gist.  I think your mental health will thank you, though, if you appreciate that your body and brain is created to give you information- and that information is factual insomuch as it exists and is connected to you.  How you interpret the meaning may not be factual.  If you separate these two, you will better honor what your body and mind are telling you, while, if you pursue growth, you can learn to line up your life more congruently for your mental health and the wellbeing of those around you.  ​
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The Unforgivable Sin and Scrupulosity

10/15/2020

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This post is intended for Christians looking to deepen their faith and mental health and may not apply to my entire reader base.
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Maruxa Lomoljo Koren on Pexels
If you have obsessions on this topic, please set some boundaries up front as to how you will engage in this content, which can be distressing and triggering especially for those dealing with scrupulosity.  You may easily worsen your fear if you allow yourself to obsess on the content or perform rituals surrounding it.
The unforgivable/unpardonable sin (also called the eternal sin or blasphemy against the Holy Spirit) can induce some level of fear for even the most convinced of Christians.  To the person who gets stuck on the concept, such as in OCD, Generalized Anxiety, and/or scrupulosity, misery would not be too strong of a word to describe it.  Personally, I suffered for several years in my childhood and for passing days in my adulthood with questioning my salvation- so I understand a lot of this on a personal and professional level.  So what exactly are we talking about when we say “the unforgivable sin?”

What is the Unforgivable Sin?

Can there be a sin so terrible, horrendous and vile that it leads straight to hell without the option to ask forgiveness?  Can this sin be accidental?  Is it stated verbally, or through one’s thoughts, or confirmed by actions?  Here are the 3 occurrences found in the Synoptic Gospels (Matthew, Mark, and Luke), describing the unforgivable sin:

  • “Therefore I tell you, every sin and blasphemy will be forgiven people, but the blasphemy against the Spirit will not be forgiven. And whoever speaks a word against the Son of Man will be forgiven, but whoever speaks against the Holy Spirit will not be forgiven, either in this age or in the age to come” (Matt 12:31–32).
  • “Truly, I say to you, all sins will be forgiven the children of man, and whatever blasphemies they utter, but whoever blasphemes against the Holy Spirit never has forgiveness, but is guilty of an eternal sin” (Mark 3:28–29).
  • “And everyone who speaks a word against the Son of Man will be forgiven, but the one who blasphemes against the Holy Spirit will not be forgiven” (Luke 12:10).

What does it mean?  I would like to offer you a simple explanation and definition that alleviates all fears.  But I can’t, literally- I don’t have it.  That would be pretty arrogant of me if revered church theologians since the time of Christ still lack a simple explanation.  If you’re a super nerd like me, you may find it interesting to know that Martin Luther, John Chrysostom, St. Augustine, John Wesley, Jonathan Edwards, John Calvin (lots of guys named John, right?), and more have all had slightly different takes.  

Summarizing 4 key perspectives on what the unforgivable sin is:
  1. Committing a terrible sin
  2. Stating falsehoods about the Holy Spirit
  3. Linking actual miracles done by the Spirit to Satan
  4. “Decisively reject[ing] clear truth the Spirit revealed about Jesus by attributing his mighty works to Satan.”

Context of the unforgivable sin.

For the sake of brevity and the fact that there are a wealth of commentaries and studies that explore this topic, let me just say that we must look at the whole of Scriptures if we are to take Scripture seriously.  A major problem in modern day interpretation lies in “sound bites” and quick references that disregard context.  Rule #1: know your context.  Context is something you will be unable to get or see if you are LOCKED up in fear.  Fear narrows focus.  Its purpose, when functional, is to place our focus to a pinpoint so we can appropriately respond.  If you have a disorder involving fear, you likely get stuck on a whole host of topics (or one major one) that requires re-learning that those without disorders take for granted.

For those of you looking simply for more knowledge on defining the topic, feel free to check out the great resources I’ve provided at the end to dig into the Scripture passages above, look at original languages and the context, audience of the passage, and so forth.    

A remarkable reality is that there is no example in all of Scripture wherein a person who asks God's forgiveness doesn't receive it (which is a large support as to the views espoused in the resources, namely that blasphemy of the Holy Spirit must be a person who has decisively turned against God and rejects the opportunity to be forgiven).  There are of course temporary consequences to sin and poor decisions (e.g., Moses not getting to see the Promised Land, David losing a child, Martha missing out on Jesus' presence, Peter feeling intense feelings and shame about denying Christ, etc.). 

“All that the Father gives me will come to me, and whoever comes to me I will never cast out” (John 6:37).

Hope

If you suffer with the thought of the unforgivable sin and scrupulosity (like many saints throughout history), you'll need different tools to respond- rather than living in fear.  4 suggestions:
  1. With the help of someone you trust in your faith community, identify a simple definition that you can live by, the same definition most people in your community live by.  You'll have to learn to lean into uncertainty. I know, it’s hard.  It may feel impossible.
  2. Ask God for His help, but limit this prayer in a way that doesn’t let you ritualize or get stuck.
  3. Consider a therapist who is specialized or someone who can help you separate out obsessive fear and compulsions that do more harm than help.
  4. Once you identify unhelpful behaviors and thought processes, you will need to have powerful enough tools to implement different strategies for approaching this topic.  Many clergy throughout history have done incredible with this; many have not.  Your therapist needs to respect that you actually value this topic and not flippantly dismiss your faith.

Many of you have come to this article to get "the answer" (to feel “just right” or get reassurance). The harder and necessary task of faith may be to discover how to not obsess or feed your fear (which is not God's desire for you, see "Fear Not"). If you came here today with a lack of information, then by all means go to the links below explaining some perspectives on what the unforgivable sin is. But if you're like me at times in my life, or like the clients I see daily in therapy who can get stuck on verses like these, I prayerfully ask that our Lord would grant you strength to sit with difficult Bible passages without reacting out of fear- whatever that looks like today for you, my friend. 







For more information:

R.C. Sproul: https://www.ligonier.org/blog/what-unpardonable-sin/
John Piper: https://www.desiringgod.org/articles/what-is-the-unforgivable-sin
David Jeremiah: https://www.crosswalk.com/slideshows/10-things-you-need-to-know-unforgivable-sin.html

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The Gospel of Anxiety

10/7/2020

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This post is intended for Christians looking to deepen their faith and mental health and may not apply to my entire reader base.
PicturePhoto by Ben White on Unsplash
America today sees one of the highest levels of anxiety of any place in the world.[1] We are clamoring for attention online, wanting to be seen, to be loved.  Suicides by teens and young adults appear to be higher than they’ve been in years.[2]  We are the wealthiest nation on the face of the planet,[3] and we can’t rest.  We have more than anyone else (as a whole), and we can’t stop.  Children who are now becoming adults are feeling this crushing weight of anxiety and expectation (whether on themselves or from outside)- ‘get the degree and the top job, get married, have the house, have children, don’t screw it up.’   And we know that anxiety has biological and genetic influences, but these are not 100% causal by any means.  Our response makes a difference.[4]

  • “Like most individual characteristics, psychopathologic symptoms are determined by many factors. The individual family environment is a relatively weak predictor of neuroticism and other personality traits, with genetics explaining much more of the variance…. There are also strong cultural influences on psychiatric symptoms — that is, an environmental influence outside of the individual family. Over time, American culture has increasingly shifted toward an environment in which more and more young people experience poor mental health and psychopathology, possibly due to an increased focus on money, appearance, and status rather than on community and close relationships” (emphasis mine).[6]

Generalized Anxiety Disorder (or GAD, the disorder most connected to general worries) is more impairing in higher income countries.[6]  The occurrence of GAD (lifetime prevalence) boiled down to:
  • Countries with the following incomes:
  • Low:        1.6%
  • Middle:        2.8%
  • High [U.S.]:    5.0% 
This is different from OCD, for instance, which sees about a 1-2% worldwide occurrence and doesn’t seem to vary a whole lot from country to country.  Depression seems to occur fairly consistently across the world, as well.  

I think the ultimate answer lies in Christ.  Hebrews 4:9 says, “...there remains a Sabbath rest for the people of God.”  Matthew 11:30: “My yoke is easy and my burden is light.”  

*Insert deep relaxing breath.
  

God ordained rest from the beginning of creation.  Genesis 2:2-3: says, “And on the seventh day God finished his work that he had done, and he rested on the seventh day from all his work that he had done. So God blessed the seventh day and made it holy, because on it God rested from all his work that he had done in creation.”  God purposed rest for us, his creation.  God wasn’t winded and saying, “Oh boy, that creating sure made me tired...let me sit back and take it easy.”  We know he created it for us.  Jesus states, “The Sabbath was made for man, not man for the Sabbath” (Mark 2:27).  If we back up to the institution of the Sabbath given as law to the Israelites, in Deuteronomy 5:15 we are given a reason why God so seriously wanted His people to be obedient in this: “remember that you were a slave….and the Lord your God brought you out…”  So to pause and rest is to say, GOD is my provider, and my striving only results in results because of God (Seriously, check out these passages: Deuteronomy 2:7; 1 Chronicles 29:12; Psalms 23 and 147:8; Matthew 6:25-33; Philippians 4:19).

Observationally, we don’t have to look far to understand our need for regenerative rest.  Sleep is one of the greatest things we can “do” for our well being.[7]  Our bodies need one third of our day just to be restored.  ⅓!!  Living to 75 that’s 25 years of our life spent sleeping!  When we try to cheat this, various problems ensue.  And by the way, the U.S. has a tremendous problem with sleep, as well.[8]  It’s hard to even grasp the scope of this due to the myriad ways people attempt to rest that may not be directly researched or studied in any one experiment (sleep aids, watching media, abusing substances- including over-the-counter cough syrup and benadryl).

The Doctor Who episode “Sleep No More” features the attempt to cheat sleep and maximize productivity.  Scientists discover a device (“Morpheus”) that takes only a few minutes to compress a month of sleep.  Serious problems ensue (enter evil “Sandmen” into the equation, for any of you Doctor Who nerds).  Sleep and rest are common themes in literature and life.  No doubt, they play a substantial role in our well-being- or downfall. 

Though therapy is highly efficacious in addressing disorders specifically and often helpful for much personal growth, it is not set up to be a worldview (a personal understanding or philosophy of the world)- it was never meant to be!  Therapy is the clinical application resulting from theories and science on human thought and behavior, just like medical practitioners study from a particular perspective and approach (“Western”, naturopathic, Traditional/Chinese, etc.).  Psychology cannot be an entire worldview, by definition, because it’s only one subset of study, research, observation, and experience.

Back to Jesus: “Come to me, all who labor and are heavy laden, and I will give you rest.” (Matthew 11:28). 

Are you tired of striving in your own strength?  Jesus speaks to the question of trying to be good enough. The Bible presents a very large pill to swallow that is offensive to our Western, pluralistic and politically correct sensibilities: your striving is empty without God.  BUT, here is the hope, and this is the Gospel: being made right with the God of the universe through Christ, we have peace. We have freedom. We have hope. We have purpose. We are forgiven.  We are loved.
  • “Therefore, since we have been justified by faith, we have peace with God through our Lord Jesus Christ” (Rom 5:1).
  • “Thou hast made us for thyself, O Lord, and our heart is restless until it finds its rest in thee” (St. Augustine of Hippo).
  • “Unless the Lord builds the house, those who build it labor in vain.  Unless the Lord watches over the city, the watchman stays awake in vain.  It is in vain that you rise up early and go late to rest, eating the bread of anxious toil; for he gives to his beloved sleep” (Psalm 127:1-2).
  • “Cease striving and know that I am God” (Psalm 46:10a).

From the poorest and most overlooked member in the slums of Calcutta to the Billionaire on 57th Street in NYC: You are loved. You are valuable. Striving and anxious pursuits are nothing without God- let us seek his rest.

References:
[1] 
Newman, T. (n.d.). Is anxiety increasing in the United States? Retrieved October 07, 2020, from https://www.medicalnewstoday.com/articles/322877.  “When they compare the levels of depression, no single area has significantly higher rates. When it comes to anxiety disorders, however, it’s a different story; the Americas are head and shoulders above all other regions, including Africa and Europe.”
[2] 
  • ​Oren Miron, M. (2019, June 18). Suicide Rates in Adolescents and Young Adults, 2000 to 2017. Retrieved October 07, 2020, from https://jamanetwork.com/journals/jama/fullarticle/2735809
  • Santhanam, L. (2019, October 18). Youth suicide rates are on the rise in the U.S. Retrieved October 07, 2020, from https://www.pbs.org/newshour/health/youth-suicide-rates-are-on-the-rise-in-the-u-s
  • https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf
  • https://www.cdc.gov/nchs/data/databriefs/db352-h.pdf
[3] Silver, C. (2020, September 18). The Top 20 Economies in the World. Retrieved October 07, 2020, from https://www.investopedia.com/insights/worlds-top-economies/
[4] This is not to shame you.  You may have a legit challenge with anxiety due to disorder- if so, I’m sorry!  You may have tried seemingly everything to feel better and it just hangs around.  Keep reading, if this is you, because the post still applies, it’s just that I want you to know that you may have it harder than others, and you may need treatment.  Truly, this world is not fair.  But stay with me; there’s hope.
[5] 
http://www-personal.umich.edu/~daneis/symposium/2012/readings/Twenge2010.pdf
[6] The disorder is significantly more prevalent and impairing in high-income countries than in low- or middle-income countries.
[7] Walker, M. P. (2018). Why we sleep: The new science of sleep and dreams. London, UK: Penguin Books.
[8] CDC - Data and Statistics - Sleep and Sleep Disorders. (2017, May 02). Retrieved October 07, 2020, from https://www.cdc.gov/sleep/data_statistics.html
All Scripture quotations are ESV.  

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    The Jog:

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    All Content on this Site, justinkhughes.com, was created for informational purposes only. Content is not intended as a substitute for professional advice, treatment, or diagnosis.  Always seek the advice of your own personal health provider who is qualified to treat you, along with asking them any questions you may have regarding medical or other conditions. Never disregard professional medical advice or delay in seeking it because of something you have viewed on justinkhughes.com. Also, due to the sensitive nature of topics and material covered through this Site, which contains very descriptive and/or advanced content, you may not want to use justinkhughes.com. The Site and its Content are provided on an "as is" basis.  Some posts are written for specific populations (OCD, Christians, Professionals)- with the intent to remain respectful to all- some content may not fit or go counter to your beliefs, perspectives, and what is explored for you in a professional counseling session with Justin K. Hughes, MA, LPC.  The posts are intended solely for the population they are written to and can be designated by their titles and tags.
    Links to external educational content are taken at your own risk. Justin K. Hughes, MA, LPC is not responsible for external content.  

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    Justin K. Hughes, MA, LPC of Dallas Counseling, PLLC participates in the Amazon Services LLC Associates Program.  This means that some links on this site will produce a small commission from Amazon.com and affiliated sites.  I NEVER link products I don't use or clinically find benefit in.  Many of them have been recommended for years inside and outside therapy sessions.  You are under no obligation to purchase any book, product or service recommended on this site.  However, they are provided on this site only educationally and are not meant to be interpreted as treatment or therapy in any way.  I am not responsible for the quality or experience of any items purchased through affiliate links, as they are entities completely separate of myself.  

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​Justin K. Hughes, MA, LPC
Owner, Dallas Counseling, PLLC 

justin@dallascounseling.com
P: 469-490-2002

17330 Preston Road, Suite 102D
Dallas, TX 75252
 
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