LoBo Counseling Services, LLC

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Paul Borish, MA, LPC

  • Licensed Professional Counselor
  • Certified Advanced Alcohol and Drug Counselor
  • Certified Clinical Anxiety Treatment Professional

Now Accepting New Clients!

Telehealth Psychotherapy in Lancaster and Berks County, PA

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  • Having problems adjusting to daily life in the age of COVID?
  • Are you turning to alcohol or drugs to cope?
  • Do you feel you’ve lost control over your life during quarantine?
  • Have you heard of Cognitive Behavioral Therapy (CBT), but don’t know what it is?

Successful therapy requires that we have a specific goal to achieve. This can be fewer panic attacks, overcoming a phobia, or relief of depression. These symptoms are caused by an interplay between how you think, what you do and, ultimately, how you feel. In therapy, you will learn how to recognize distorted thoughts as they happen, so you can question, and change them. You will begin to recognize unhealthy behaviors and substitute more healthy coping skills. As thinking and behavior changes, so do our emotions, and the symptoms we experience. The skills to this are learned in counseling and practiced in between sessions. 

How Else Can Counseling Help Me?

Along the way, you’ll learn about what motivates you. You’ll gain insight into how you go about making meaning of things that happen in your life. You will feel a decrease in painful emotions and unhelpful behaviors. You will develop more healthy coping skills. Your thinking will be more realistic. You’ll see an improvement in functioning and well being. The skills you gain will help you navigate challenges in the future, as well.


Teletherapy For Depression and Anxiety

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  • Teletherapy is preferable to a lot of people.
  • Telecounseling is convenient for those who travel often, because sessions can still happen regularly, no matter where you actually are. 
  • Ability to provide cognitive behavioral therapy online
  • Counseling can continue through teletherapy, even when offices are closed during events such as the COVID pandemic.
  • Teletherapy sessions are easier on your schedule, since you don’t have to drive there or back.

Is Teletherapy Actually Helpful?

Teletherapy is a new concept for most and some may be skeptical about whether it is “as good as ” traditional therapy. While it’s new to many, telecounseling has been done for years. I have successfully offered teletherapy in my practice for the last three years, long before the pandemic made it a household term. My private practice, based in Ephrata, Pennsylvania, has specialized in treating clients suffering from anxiety, phobias and panic, especially those suffering from Fear of Flying or Travel Anxiety.

My teletherapy practice utilizes a state of the art, HIPAA compliant video and audio.

I have been working with clients for over 20 years, teaching them how to manage anxiety, depression, and addictions. My practice uses evidence- based techniques including Cognitive Behavior Therapy (CBT), Neuropsychologically Informed CBT, and Mindfulness.  I will teach you the tools to manage your depression, anxiety, and/or addictive behavior today, tomorrow and into the future.


What is Cognitive Behavioral Therapy (CBT) For Depression and Anxiety?

CBT teaches the connection between thoughts, feelings, and behaviors. Patterns of unrealistic thinking and unhealthy behavior are believed to fuel disorders such as depression and anxiety.

  • Identifying these negative thought patterns
  • Replacing distorted thinking with more realistic thinking
  • Substituting healthy, effective behaviors for maladaptive ones

Of course, if it was that simple, there would be no need for therapists. CBT is however, a process that can be learned in therapy, either by teletherapy, or in my office in Lancaster County.


For a Beck Institute FAQ about CBT with Aaron Beck, MD; founder of Cognitive Therapy, click here.


What Does Depression Feel Like?

Many of my counseling clients in Lancaster find it helpful to think of depression as having to go through life wearing a pair of scratchy grey sunglasses. Everything looks gloomy and dark. It feels flat and cold. Just as scratchy, grey glasses distort what we see, so does depression. Thoughts such as “there is nothing to look forward to” contribute to feeling sad and hopeless.

  • It’s hard to get the energy to get going
  • Depression can cause physical pain
  • It becomes difficult to focus

 

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How Does Cognitive Behavioral Therapy Help Depression and Anxiety?

CBT helps to challenge, or question, some of the automatic thoughts we have, that we assume are accurate. CBT helps us realize that the world isn’t actually gloomy and dark, it just seems that way because of the scratched lenses we wear. When we are able to remove those lenses, we can see a more realistic picture.

  • We are able to question how true it is that there is “nothing to look forward to.”
  • We recognize that what our thoughts tell us is not necessarily true.
  • We learn to talk back to our distorted thoughts, to say “Of course there are things to look forward to. Life has ups and downs. Things will most likely turn around for me.”

Can CBT Help Me Learn to Stay Healthy?

CBT also teaches us how unhelpful behavior plays a vital role in keeping us stuck in our depression and anxiety. Cognitive behavioral therapy teaches us that behavior such as calling out of work and staying in bed all day when feeling depressed, or putting off an important project until the day before, because of anxiety, are more hurtful than helpful and, rather than relieving our depression and anxiety, actually make it worse. CBT helps us to recognize when we’re engaging in unhelpful behavior, and teaches us to use more healthy coping skills, instead.

Can CBT Help Me Get Motivated?

If I can recognize that hiding under the covers has never helped before, I may be more likely to force myself to do something different, like get out of bed, take a shower, and get something accomplished, even if it’s just returning a few emails. In the latter example I am more likely to feel better, sooner, than in the former. 


The Role of Medication in Counseling for Depression and Anxiety

Research over the last several decades has consistently shown that a combination of medication and therapy (specifically, CBT) is most effective in alleviating symptoms of depression and anxiety.


Are My Lancaster Counseling Clients Required to Take Medications?

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Absolutely Not! All counseling clients in my practice are encouraged to discuss medications with their prescriber, but are free to decide on their own.


Myths About How Antidepressants Work for Depression and Anxiety

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For many years, there was a belief that antidepressants like SSRIs reduced depression solely by regulating the re-uptake of serotonin. The theory was that by preventing serotonin from being reabsorbed, and therefore making more of it available in the brain, the person experienced less depression.

The problem is, if that was the mechanism, the medications would offer instant relief, rather than the 2-6 weeks that is typical.

The real mechanism, while still not fully understood, is far more complex, and provides far more long term benefits than were believed.

Modern Views of How Medication Helps Depression and Anxiety

The brain, through a process known as “neurogenesis” becomes more flexible in it’s ability to adapt, to cope, and to change.

More recently, there is research suggesting that antidepressants actually work by increasing neuroplasticity of the brain. This is the process in which your brain, over a period of a few weeks seems to adapt to the higher levels of serotonin. Research suggests this allows the neurons in the brain to readjust, and even grow new connections.


The Benefits of Combining Medication With Psychotherapy

While medication increases neuroplasticity, enabling the conditions necessary for learning to take place, counseling provides the necessary insight, understanding, and skills training for change to occur. High quality Cognitive Behavioral Therapy, as practiced in my Lancaster County office, teaches the connection between thoughts, feelings, and behaviors. I have incorporated the field of Neuropsychologically Informed CBT into my practice, which does not require, but frequently benefits from concurrent SSRI treatment. To decrease the intensity of anxiety and depression, the distorted thinking and unhelpful behavior that has maintained those feelings must be changed to more realistic thinking and more adaptive behavior. In counseling, patients learn to recognize when thinking is distorted and they learn to think in a less distorted, more realistic manner. They also learn how to respond in a more healthy and adaptive manner. The change in thinking results in a decrease in depression and anxiety.


To Get Started, Contact Me For an Initial Consultation

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Real Client Testimonials

“Paul is incredible and I can’t recommend his services enough. He truly cares about you and has an amazing way of understanding you as an individual and your specific struggles.”


“6 weeks ago I’d fallen into a deep funk over the COVID-19 and my need to self quarantine. Didn’t like where It was taking me. Then I remembered a conversation, I’d been part of, with Paul at a seminar. Considered how it would be applicable to my situation and realised that I had the answer. Applied it and am now back to being myself.”


Paul is a dedicated professional that took the time to determine my needs and what areas of my life I wanted to improve. Not only was I able to greatly reduce my anxiety in travel situations that were at times debilitating, but I was able to put his recommendations to good use in my every day stressful life. I would not hesitate to recommend Paul and Travelers’ Psychological Services to anyone, regardless of your location. We were easily able to connect via technology long before the novel coronavirus changed healthcare as we know it. Thank you Paul for your assistance!