What Happens on the First Visit?

“Begin, be bold, and venture to be wise.” ~Horace Everything has a beginning. The beginning of therapy is the first session. The first session provides the client an opportunity to express what has brought them to therapy. The first session also provides the client an opportunity to meet the therapist and determine if the therapist is an appropriate “fit”. Here is a guide of what to expect in the first session: What to expect: A Safe environment. Expect to be in a comfortable environment in an office with just you and your therapist. Confidentiality. Expect the therapist to keep everything that you express confidential between the two of you. There are certain situations where confidentiality must be broken. Those situations include when a client is at risk to hurt themselves or somebody else. Questions. The therapist will likely ask a variety of questions seeking to understand what has brought you into therapy. Opportunity to ask questions. The therapist will give you opportunity to ask questions about whatever you like. Be prepared to ask questions. You might want to ask questions about the therapist, the process, or even the techniques that they use. Asking questions will help you establish more rapport with your therapist. Clarification of goals. Often in the first therapy session the therapist will attempt to understand and clarify your goals. The goals set during this first session are not “set in stone” but rather a way to understand you and your objectives better. Discomfort. The process of therapy can make people feel uncomfortable. Expressing your feelings and past history can be intimidating. Understand that the therapist is... read more

What is therapy?

“We may define therapy as a search for value” ~ Abraham Maslow Therapy can be defined many different ways and it is not as simple a definition as you might imagine. A variety of words may be utilized interchangeably with therapy for example counseling and therapy tend to be interchangeable. Other words that might be utilized interchangeably include psychoanalysis, and increasingly the term life coaching.  Technically the term “therapy” for our purpose, is shortened from the word “psychotherapy”. Psychotherapy is a therapeutic process related to the mind (psyche) and is unique as compared to say physical therapy. In this book, when the term “therapy” is used we are referring to psychotherapy.  Below is a simple definition of therapy that will be utilized for our purposes: “The process of improving a psychological, emotional, or behavioral element in an individual’s life. The process is facilitated by a trained professional in a safe environment”  It is important for individuals seeking therapy to understand a basic definition of what therapy is. It is important is because participants will benefit from understanding exactly what they are getting into. In the definition above, it is important to note several key points: Therapy is a process. In therapy there is seldom a specific event that makes change happen. Instead therapy tends to be a process where change happens through ups and downs. Humans are very complex, and good therapy recognizes these complexities. Therapy is about making improvements. Beginning therapy does not mean that you are “sick” or that something is “wrong” with you. An individual may seek therapy to improve many areas of their life and... read more


Times: Tuesdays 6-7:30 Starting: March 3rd Ages: 18+ Price: $20 per group Phone: 208-699-6817 Location: Cultivation Counseling 211 E. CDA Ave Ste 102 Facilitated by: Darlene Pessein LCSW & Randi Devine LMSW   Yearning For Change? Needing More Clear Direction for Your Life? Want to Feel Balanced and Expansive?   Join us for a supportive women’s group that explores how you ultimately want to feel each and every day, and help you identify and set goals based on those feelings.   We will discuss the four core areas of our lives and ways in which to practice gratitude and live with clearer intention in each one of those... read more

A More Balanced Look at How Gaming Affects the Brain

I recently ran across a great article about the effects gaming has on the brain.  The best part of the article by far is this info-graphic.  This takes a less biased look at what we know so far about how gaming is affecting the brains of those prone to over use.  I have found that I get a better result with the young people I work with by taking a more balanced approach when discussing gaming addiction and its effects.  Take a look and see how you can incorporate the information below when setting limits with your kids or loved ones.  It looks to me like if you aspire to be an obese, moody person who is good at solving new problems, then violent video games are for... read more

New Therapist Joins the Cultivation Team!

Cultivation Counseling is excited to welcome the newest addition to their team- Tiffany Farrar. Tiffany is a Licensed Professional Counselor. Originally from Texas, Tiffany attended college at Henderson State University in Arkansas where she received a bachelor’s degree in sports and community recreation. Tiffany went on to receive her master’s degree in clinical mental health counseling from Henderson State. During this time she also worked for the Baptist Collegiate Ministry, which reaffirmed to Tiffany that she wanted a career working with people. After receiving her master’s, Tiffany started an internship at Eliada Homes in North Carolina where she worked with adolescents in foster care within a residential treatment setting. After her internship, Tiffany began working at the residential treatment program, Innercept, in the Coeur d’Alene area.   Tiffany specializes in working with adolescents and young adults who have anxiety, depression, a history of self-harm, a history of substance abuse, or are bi-polar. In her therapeutic approach, Tiffany uses Cognitive Behavioral Therapy (CBT), client or person-centered therapy, and Dialectic Behavioral Therapy (DBT). Tiffany enjoys long distance running, camping, hiking, and playing with her two dogs. Cultivation Counseling is excited to have Tiffany as a member of our team! Tiffany is now accepting new clients in both our Coeur d’Alene and Moscow... read more

How to Drink Water!

Drinking water is super important, and has great health benefits. Some people find that staying hydrated is pretty easy, but to others (like myself) drinking enough water doesn’t come naturally. This blog first lists some of the wonderful benefits that come with drinking enough water. Then I will list a couple of strategies that have worked for me to become better at drinking water. The Benefits of Drinking Water: helps control calorie intake by using water as a healthy substitute for other higher calorie drinks prevents muscles from getting too tired by provided hydration to cells helps your kidneys do their job more effectively prevents constipation prevents headaches caused by dehydration can improve your complexion increases cognitive functioning Tips to Start Drinking More Water Get Your Own Bottle: To save money and the environment, invest in your own re-usable bottle for water. I picked out own that I thought was cute, and that had a straw. For some reason I have found that having a straw allows me to drink more during the day. Prepare: Thoroughly wash out your bottle before bed, refill it, and stick it in the fridge. This way you will have a fresh bottle in the morning that is easy to grab on your way out the door. Be Accountable: Something that has really helped me drink more water was making a pact with someone who I knew would hold me accountable, and check up with my water drinking. Ask someone in your life to hold you accountable to drinking water. Add Flavor: I have been putting lemon slices in my water, and it is... read more


A new study finds that limiting screen time has a “ripple effect” for kids: “Douglas Gentile, lead author and an associate professor of psychology at Iowa State University, says the effect is not immediate and that makes it difficult for parents to recognize. As a result, parents may think it is not worth the effort to monitor and limit their children’s media use. But Gentile says they have more power than they realize.” Our experience at Cultivation Counseling backs up the evidence presented in this study. Limiting screen time tends to have dramatic effects on the way that children behave and families function. Screen time in many families tends to be dramatically more than the American Association of Pediatrics recommendation of 2 hours.  Setting this limit can be difficult. Sometimes working with a facilitator or outside party can help clarify reasons limits are beneficial. Families would benefit from acting sooner rather than later to set limits regarding screen time. Another consideration is putting in other activities that are healthier that include interacting with family members to replace the screen time. Read the original article here:... read more

Coping with Suicidal Thoughts

I ran across a great web site today and wanted to share it as a resource.  Many people suffer from suicidal thoughts.  After working for over a year in a local emergency department performing psychological evaluations I found that these types of thoughts don’t discriminate.  People from all walks of life, with a range of life circumstances and situations can be affected by these thoughts. There are a few common threads that would show up with these individuals.  Most of them suffered from depression, and had been dealing with it for a long time.  Another common theme was lack of support.  Many individuals had strained family relationships, had stopped going/never started counseling and felt pretty hopeless.  Often times as well these thoughts were circumstantial, meaning that they had just had a major life event, death of a loved one, broken relationship, among others. If you or a loved one suffer from depression, anxiety, or suicidal thoughts, it is time to reach out.  There are numerous resources available to help. Counseling can be a great way to move through these feelings and move toward happiness and fulfillment.  We can help, give us a call and set up an appointment today. Resources:  1(800)-273-TALK (National Suicide Prevention... read more

10 Reasons Animals and Pets are Awesome for Mental Health

Increases opportunity for socialization provides comfort offers non-judgmental companionship produces opportunity for healthy exercise routines forms opportunities to express empathy creates examples of behavioral cues that can help build social skills intelligence can serve as examples of strong, healthy relationships offers opportunities to learn responsibility decreases lonlieness can teach respect for living... read more

Internet & Gaming Addiction: New Drug of Choice?

I think back to the first time I held the original Nintendo controller in my hands.  It was 1987, I was just 7 years old when Nintendo introduced their first console on the market.  I couldn’t have been more excited.  I had played a little Atari before this, and while I loved the Star Wars game on that platform, it was nothing compared to Super Mario Brothers and their quest to save Princess Peach in all of its 16 bit glory!  I’m sure there are other thirty somethings out there who can identify.  I wanted to start this blog off with warm happy feelings in regard to gaming because it will likely not end that way.  Those same thirty somethings that remember gaming so fondly are the same people who are wondering why they can’t get their kids away from the console/internet.  The games of today are not the same, nor are the issues and difficulties faced by the most recent generation when it comes to gaming and Internet use.  I am hoping to shed some light on this problem, as well as offer support. The first real question that I get is “is gaming/internet addiction a real thing?”  My answer is an emphatic yes!  Companies that create games and gaming platforms depend on it.  The whole point behind producing a game today is to hook the player of the game so they become dependent on it and continue to play/purchase/rate/review/watch the game, thus effectively funding and advertising the game for the company.  The latest edition of the DSM (DSM-V) mentions gaming/internet addiction and will likely be including it... read more

The Big 4

There is often a common theme that continually comes up in the counseling office when working with individuals struggling with Depression, Anxiety, ADHD, or any number of diagnosis.  This theme is almost always brought up by the therapist, and if you have ever utilized counseling in the past this may be old news.  I often will focus on what I think of as “The Big 4.” These are four areas of a person’s life in which if there is any imbalance or disharmony, that person will no doubt suffer the effects.  Here is what I am talking about.   1.  Exercise 2.  Sleep 3.  Diet 4.  Social support I have found that when treating most clients we will often focus on one or all of these areas.  There have been numerous studies that show how maintaining these areas of our lives can help us physically, there is no question to this.  But along with a healthy body comes a healthy mind.  I recently ran across a short article called The Side of Support Networks We Often Forget, that pointed out an obvious that I had previously overlooked. We are always discussing how important it is to get exercise, rest, and a healthy diet.  The one thing that often leads to success in these areas, the glue that binds them together if you will, is support from those around us.  I think back to the times in my life when I have been in the best shape (my first triathlon) and can pinpoint my success to the fact that I had a ton of support.  My wife, kids, friends, family... read more

How to Be Happy in the Middle of Winter!

I don’t know about where you live, but where I am there is about a foot of snow on the ground! As we near the end of February, it feels like spring should be right around the corner. However, if you live in the northern hemisphere as I do, then you probably know that just because the calendar may say spring is on the way, doesn’t mean the winterish weather is over. This fact can be extremely depressing! It seems winter will never end! Well, don’t despair too much because below is a list of 9 tips that will help you survive and have some happiness during the remainder of winter.     Tip 1: Have a “winter-friendly” exercise routine. The winter weather can make exercising more challenging, but exercise is key in helping you to feel good and maintain happiness levels. There are a large range indoor exercises you can do during the winter. You could try swimming, setting up a stationary bike in you living room, or try out a wide variety of work-out classes at gyms. If you really feel like you still want to exercise outside, try a winter sport. Cross country skiing, snow shoeing, and ice skating are great work outs!   Tip 2: Try not to eat “comfort foods” with a lot of carbohydrates. When you are cold, meals like macaroni and cheese may be something you are craving, but eating too many carbs can cause you to have a “sugar crash,” and then feel tired and sluggish. Try to boost your fruits and and vegetables!   Tip 3: Try not to isolate... read more

Take Five!

Recently I attended a professional seminar on emotional literacy. In the seminar, the idea of a “meta-moment” was introduced. A meta-moment is when you take around 5 minutes out of what you are involved in, and take a step back. Use a meta-moment when you feel like your emotions may be getting out of control, or when you are in an emotionally charged situation. When you use a meta-moment, follow these steps: Breathe: Take breaths through your nose. This is important because breathing through your nose activates your parasympathetic nervous system, which is the part of the nervous system that calms you down. Breathing through your mouth triggers your sympathetic nervous system, which is your “fight or flight” response. Experiment alternating between breathing through your mouth, and then try breathing through your nose to see if you can feel a difference. When you are taking a meta-moment, inhale, expand your stomach and rib cage. When you exhale, allow your stomach and ribs to sink down slightly. Think positive: This is time to pretend you are a public relations expert. Try your very hardest to look at the situation in a positive light, at least just for this moment. Positive Self-Talk: Like a boxer about to enter the ring, pump yourself up. “I got this, I got this… I can do this. I’m the best.” Distraction: Do something else that requires all your attention Mindfulness: After you distracted yourself, bring yourself back to the present moment as completely as you can. Do this by noticing the details around you and noticing how you feel physically. REMEMBER: notice don’t judge! Allow... read more

Do You Suffer from Anxiety?

Not all Online tests are created equal. Some are research based and have actual applicability. Note that all tests should be considered informative only. they are not an actual diagnosis. Here is one of our favorite online tests for anxiety. From Psych Central: Do You Have... read more

What is Therapy?

  “We may define therapy as a search for value” ~ Abraham Maslow   Therapy can be defined many different ways and it is not as simple a definition as you might imagine. A variety of words may be utilized interchangeably with therapy for example counseling and therapy tend to be used interchangeably. Other words that might be utilized interchangeably include psychoanalysis, and increasingly the term life coaching. Technically the term “therapy” that we are talking about is shortened from the word “psychotherapy”. Psychotherapy is a therapeutic process related to the mind (psyche) and is unique as compared to say physical therapy. In this book, when the term “therapy” is used we are referring to psychotherapy. Below is a simple definition of therapy that will be utilized for the purpose of this post: “The process of improving a psychological, emotional, or behavioral aspect of a person’s life. The process is facilitated by a trained professional in a safe environment” It is important for individuals seeking therapy to understand a basic definition of what therapy is. It is important is because participants will benefit from understanding exactly what they are getting into. In the definition above, it is important to note several key points: Therapy is a process. In therapy there is seldom a specific event that makes change happen. Instead therapy tends to be a process where change happens through ups and downs. Humans are very complex, and good therapy recognizes these complexities. Therapy is about making improvements. Beginning therapy does not mean that you are “sick” or that something is “wrong” with you. An individual may seek therapy to improve many... read more

Cultivation Counseling Welcomes Darlene Pessein to the Team

The staff at Coeur d’ Alene’s Cultivation Counseling is excited to welcome Ms. Darlene Pessein to their staff. Darlene is an excellent addition to Cultivation Counseling’s talented group of therapists and life coaches, and she boasts an impressive resume. Graduating with her master’s in social work from Portland State University, Darlene went straight to work helping children and families in the heart of Portland, Oregon at a community mental health center and Lutheran Social Services. Later, Darlene practiced therapy in a private practice in Vancouver, Washington. In 1992 Darlene moved to Philadelphia where she practiced home-based family therapy, trained in sexual abuse assessment, and taught a graduate-level class at Widener University on trauma therapy. Darlene has been a prominent fixture in the mental health community of the Coeur d’ Alene area since 1999. Starting as the program director at the acute youth unit at Kootenai Behavioral Hospital, Darlene then worked for local residential program, Innercept, as clinical director in 2004. Darlene continued on to work at Auburn Crest Hospice, and then Morning Star Boys Ranch in Spokane, Washington. Most recently, Darlene has combined her love of horses and her love of helping people by becoming a certified equine therapist and expert. Darlene plans on developing some up-coming “passion projects” through Cultivation Counseling. These projects may include a women’s support group as well as an equine therapy practice. Some of Darlene’s areas of expertise include eating disorders, mood disorders, as well as therapy with clients who have experienced trauma. When asked what she enjoys about working with this population of clients Darlene responds, “Having people move from a victim to... read more

What Are You Looking For?

Every day we wake up. Every day we think thoughts. Every day we engage in behavior or specific actions. Sometimes waking up feels meaningful and exciting. Other times waking leaves us with a feeling of purposelessness. Some days we wake up and accomplish great things, other times we may look back on weeks of our lives and notice we have fallen into the same pattern. This pattern of repetition can become quite depressing over time, even if we believe we chose all the elements to the repetitious life. Over time as the individual becomes depressed there can be a tendency to ask questions like “Why am I not happy?” or “How did I get here?”, these questions do not lead to an easy answer and can instead lead to more confusion.   The question we need to ask ourselves is “what am I looking for?”. If we are looking for pain, then we will find it. If we are looking for hurt, then we will find it. If we are looking for new experiences, we will also find those new experiences. If we are looking for “another relationship” then we will find it. The key is awareness, as opposed to mindlessly running the piece of paper through the copy machine over and over, we have to stop and change our pattern. The first step is noticing what we are doing, or else we are doomed to run the same piece of paper through the copier throughout our lives. Now as you read this, you may think to yourself “I am not looking for pain!” or “why would anyone look... read more

Acceptance is Powerful. Acceptance is Hard!

  So lets break this down a little.  What is acceptance?  At first glance I assumed that it was being OK with whatever is going on.  This is how I convinced myself I didn’t need to work on acceptance in the first place.  I have this ability to convince myself that I am OK with whatever circumstances are presenting themselves and move on.  This isn’t acceptance, this is a passive attempt to avoid something that I may or may not accept.  As I currently see it, in order to accept something you do not have to be “OK” with it.  Accepting something is acknowledging it’s presence, examining how it affects you, and determining what you will do about it. Acknowledging the presence of a problem, an obstacle, a difficult individual, or whatever, sounds pretty easy. The problem is that often times we push them aside, hide them and pretend they don’t exist, because if we accept that they exist this may require some type of action on our part.  This can cause anxiety, panic or a number of problems if you don’t have a game plan.  So now that you accept that this thing exists, lets move on to the next step. How does it affect you?  Often times we become very concerned with matters that don’t even impact us in any way.  This may sound a little self centered, but if it does not have an impact on you, why bother?  Many people get stuck here and end up obsessing over problems, obstacles, people, etc.  This is the stage in which we experience the racing thoughts, dread, fear,... read more

Save the Males: The Coeur d ‘Alene Men’s Group

Men in the 21st century are facing unique challenges that their fathers and grandfathers did not. Consequently we see men who appear lost, bored, or drifting through life without goals or direction. Fewer men are attending college, choosing to get married, and raise families, or seeking careers. Fewer men report satisfying relationships with other males and feel empty and lonely. The purpose of “Save the Males: the Coeur d ‘Alene Men’s Group”is to help men become aware of these issues and to provide a place for them to interact and connect with, and understand that other men are facing similar challenges. Men who attend these groups report the following benefits in their lives: Improving their balance in life Improving their ability to organize and follow through with difficult tasks Improving physical, mental, and emotional health Increasing confidence in themselves Finding direction, passion, vision, and adventure Facing and overcoming fear and indecision Dropping the “nice guy “boring persona that is more concerned with being comfortable and pleasing others Creating meaningful relationships with men and women Finding emotional and sexual fulfillment   When: Mondays at 6pm Where: 211 Coeur d’Alene Ave. Suite 102 What: Men’s group Who: Men 21 and older How Much?: $10 per group More information?: Call Trent Taggart... read more

Stop Shoulding on Yourself!

  Have you ever heard the term “Stop Shoulding on Yourself”? It’s a psychological term coined by Albert Ellis. The concept insists that humans stop attempting to utilize the word SHOULD to get themselves motivated. As the new year begins have you been trying to motivate yourself with the word SHOULD? Have you said something like “I should exercise this year”, “I should eat healthier”, or “I should change”. This should word is highly ineffective to make change, instead simply add in “I am”. “I am going to eat healthier”, “I am going to exercise”, or “I am going to change”. Try using “I am” to make positive change in your life in the new year. Happy 2014!   For more information on “shoulding”. Read Dan Hanks blog on the subject... read more

Coeur D’Alene’s ‘Northwest College Support’ Provides Expertise in Autism

www.collegesupportnw.com Dan Hanks M. Ed, Ed. S, LPC, owner of Cultivation Counseling in Coeur D’Alene (pictured above), noticed common themes in his work as a therapist of traditional out-patients, and his work as a school psychologist diagnosing students in CDA’s schools. “There was need for creative services that could be tailored to fit the needs of children both academically and therapeutically. Autistic young adults have a wide range of academic ability. Some young people on the Autism Spectrum have the cognitive skills to be highly successful in not only academics, but also in complex job settings after college. However the standard, traditional educational path is oftentimes ill-suited to help these individuals meet their full potential,” says Dan Hanks on the link (or lack thereof) between education and ASD. In the summer of 2012, Dan’s team at Cultivation Counseling launched a whole new division of the business: Northwest College Support. “We provide transitional and after care services for young people attending college. These young people may be just leaving home, graduating a residential program, or had a past college attempt that was unsuccessful. Our focus is on the individual as a whole, we provide our clients life coaching to help address day-to-day living challenges, educational coaching to help address learning challenges, and therapy to help with emotional challenges. Students typically work with us for at least two semesters.” NWCS’s services are centered around developing the executive functioning skills of their clients, the skill set that individuals with ASD are most commonly deficient in. Executive functioning includes abilities such as planning, focusing attention, creativity, organization of information, and control of impulsivity.... read more

Tips for Starting Off Spring Semester 2014!

Clean and Recycle! Go through your book bag and empty it out of all the garbage, old papers, and random junk. Do the same for your desk, drawers, and all around your dorm. If there is old papers or homework you want to keep, find a place to store them. The best system is to 1) dump out the drawer or backpack, 2) pick up each item and put in a pile for either garbage/ recycle, keep, or store, 3) after you toss all the stuff you don’t need, file away the stuff you want to store. 4) organize the items you want to keep back into you desk or backpack Take inventory and restock. After you have cleaned everything out, look at what school supplies you have, and make a list of things you think you need. You could go out and buy supplies now, or you could wait if you think you have enough for the first couple days ofclasses. After the first couple classes you may have a better sense of what you need. Also, don’t forget to buy your new textbooks! Print out syllabi and schedule. If your school has some kind of online interface for classes, you might be able to download and print your syllabus even before class starts. By looking over your syllabi you will have a good idea of what to expect from the class. Print out your class schedule. If your even a little bit anxious about new classes, walking around campus and finding the rooms your classes are in now is a nice way to make yourself feel more... read more

16 Health Benefits of Yoga

What is Yoga? yo·ga ˈyōgə/ noun noun: yoga 
a Hindu spiritual and ascetic discipline, a part of which, including breath control, simple meditation, and the adoption of specific bodily postures, is widely practiced for health and relaxation.   16 Benefits of Practicing Yoga: helps manage stress and anxiety of day-to-day life increases strength increases flexibility increases control over one’s own bodily movement increases control over one’s own thoughts enhances mood increases sense of well-being improves balance effective in injury prevention for other physical activities lowers blood pressure which can lead to the prevention of heart disease can improve sleep patterns can prevent depression due to the increase/ balanced level of the neurotransmitter GABA certain styles of yoga are aerobic, which improves endurance can improve body image increases energy certain styles can boost immune... read more

Helpful Tips for Parents and Students Coming Home for the Holidays

With the craziness and stress of finals behind them, students look forward to the winter break for some relaxation and fun. However, a college student coming home to the parent’s house for the holidays can present some stressors of it’s own for both students and parents. Below are some tips for both parties to follow that might relieve some stress and help the holidays go a little smoother. Communicate about changes before the student comes home! Students have likely experienced a lot of changes since they have been away from home. They made new friends from diverse backgrounds, were exposed to new ideas in their classes, maybe changed their appearance, maybe started new romantic relationships, and maybe started drinking. Students may even feel defensive of their new lifestyles partially because they don’t want family to assume they are the same as they were in high school. Also, coming home may represent a return to “old patterns” for many students, which may feel uncomfortable for the student. Likewise, there may have been some big changes at home since a student left. Maybe there was a divorce, the loss of a family pet, or some renovations to the house. Whatever the changes are, it is important that both sides communicate the changes that have occurred before the student comes home. This way both parents and students feel that they have an understanding of what the other has been going through, and has an idea of what to expect. Students, show gratitude. Parents, show pride. Students: as excited as you are about all the new ideas and changes you have gone through,... read more