• “Coach might cut my playing time now.”

• “I’m letting my teammates down.”

• “I have to make the next shot, otherwise we could lose this game and not make playoffs”

• “This ref hates me!”

• “He calls everything on me and completely misses the same calls on the other end!”

This is an example that demonstrates an athlete’s stream of consciousness while
struggling with negative thinking and performance pressure. As an athlete there is a large
focus on physical factors, and understandably so. However, mental and emotional
processes play a critical role in performance, influencing the likelihood of either success
or failure.

Sport and performance psychology could help this athlete navigate stressors more
effectively with three of the following strategies inspired by Cognitive Behavioral
Therapy (CBT):

Positive Reframing:
This is not to be confused with toxic positivity (“That didn’t matter. You’re fine.”) which
ignores life’s challenges. There are two important parts of positive reframing, first,
validating your challenges (frustration with missing shots). Second, is applying a ‘glass
half full’ perspective. How to use positive reframing to address one of the automatic
negative thoughts from the example above: “I am frustrated about that missed shot and I
got the next one! Nice and smooth”.

Process Focused versus Outcome Focused:
Being process oriented helps athletes to be mindful and truly focused on the task at hand
(shooting a shot or running a play). Being focused on the outcome is thinking about a
made or missed shot or winning or losing a game. Being process oriented is helping pull
an individual’s focus to the here and now and building small actions or tasks towards an
outcome. If an athlete is worried about winning or losing they are distracted from what is
happening right in front of them.

Focus on What is in Your Control:
During games, matches, or competitions there are many factors outside of an athlete’s
control that can easily influence their thoughts and emotions (missed calls by referees,
rude fans, or inclement weather). By focusing on things in an athlete’s control can assist
with regulating emotions, building confidence, and letting go of uncontrollables.
Overall, sport psychology views athletes as multidimensional people. Athletic
performance not only requires physical training (they are not just a body), but also
intentional development of mental and emotional skills. While these strategies take time,
effort, and consistency to implement initially, they can be beneficial towards an athlete’s
performance in the long-term.
Please feel free to reach out if you believe you would benefit from the expertise of a
psychologist that specializes in sports and performance to assist you in enhancing your
mental and physical capabilities.

Kayla Kovach, Ph.D.
Post-doctoral Psychology Fellow
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #302 F: 440 565 2349
kkovach@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

Supervisor: John A. Glovan, Psy.D.
Phone: 440-392-2222 #302 Fax: 440-565-2349
jglovan@behavioralwellnessgroup.com

The post Sport Psychology on Negative Thinking and Performance Pressure appeared first on Behavioral Wellness Group.

• Take breaks from the hospital when you can. If you have support from a partner, friend or family member, it can be beneficial to step out of your child’s room to walk around the hospital, get a cup of tea and get some natural sunlight to reset so you can show up as your best for your child.
• Eat regular meals and healthy snacks to have energy to maintain understanding of your child’s procedure and continued care. It can be easy to eat convenient food items that may not be the healthiest, so if possible, pack snacks and have a reusable water bottle to fill up with water to stay hydrated.
• Reach out for support to friends and family to discuss what is going on, your thoughts and feelings or to have them stop by the hospital to provide a break for you and to provide connection to your child while they are away from home. It can be helpful to identify 1-2 close support people to connect with regularly who can disseminate information to other loved ones so you are not inundated with text messages and phone calls for updates.
• Reach out to hospital support staff to assist you or your child to manage their hospital stay. Hospitals have chaplain services to provide a safe space to explore emotions or child life specialists who can provide toy rooms or developmentally appropriate toys for your child to allow them to have options to pass the time during an in-patient hospital stay.
• Pack comfortable clothes, blankets, and pillows to have while you are staying over at the hospital. Most rooms will have a pull out sofa bed but it can be helpful to bring some comforts of home to help your stay overnight be more relaxing and recharging to get a good night’s sleep.
• Pack items that can help you pass the time and be relaxing activities to assist – in managing your stress. These items can include: books, crafts, ear buds, magazines, puzzles, sudoku/word searches, knitting or crocheting, coloring books, and a tablet or kindle with downloaded content like your favorite movies or TV shows.
• Pack toiletries that can help to refresh yourself while you are staying away from home. These can include: toothpaste, toothbrush, mouth wash, soap, moisturizer and skin care routine, wash cloth, hand towel, soap, lip balm, and hair care items.

If you recognize that you are needing additional support due to the stress that you are experiencing because of your child’s medical condition, it could be helpful to reach out to a licensed therapist to meet with regularly to discuss this with. To set up an appointment with a licensed therapist you can contact our front office staff at 440-392-2222.

Stephanie Cerula, LPCC
Clinical Counselor, The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #404 F: 440 565 2349
scerula@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

The post Managing Stress During a Child’s Hospital Stay appeared first on Behavioral Wellness Group.

Depression can affect anyone, and watching a loved one struggle with it can be challenging, concerning and at times, maybe even scary. While you can’t “fix” their depression, your support can make a significant difference in their journey to recovery.

Educate Yourself About Depression
Self-Knowledge is one of the most crucial things you can do to help your loved one who is struggling with depression. Even having just a basic understanding of depression can make a difference. Mental health still has a lot of stigma attached to it, even in 2026. Depression is a condition, not a weakness or something people can just “snap out of.” If it were that easy, wouldn’t they have done it already?

Active Listening and Empathy
In addition to learning about depression, practice listening to your loved one without judgement. Actively listen to them. That means giving them the time to speak without you trying to fix it or make things better. Let your loved one share their feelings without fear of criticism or dismissal. Sometimes, just having someone listen is a powerful support.

What about well-intended advice? We’ve all been there. Someone trying to help us gives unsolicited advice and we may get upset about it because that isn’t what we currently need. Phrases like “just think positive” or “cheer up” can feel invalidating. Instead, express empathy and understanding and always practice active listening.

Offer Helpful Assistance
Depression often leads to intense feelings of being overwhelmed, and your loved one might not have the energy to do the everyday tasks they normally do when they are not in a depressive state. Preparing meals, running errands or helping with chores can go a long way in assisting your loved ones at this difficult time.

Encouraging Professional Help
If they are not currently seeking professional help, you can gently suggest this but please know that this is up to them. Everyone operates on their own timeline. Some people may not be ready to have professional help, possibly due to stigma and or their own beliefs. Some cultures are not receptive to seeking mental heath help and this is something to also consider.

Supporting a loved one with depression isn’t always easy, but your compassion and understanding can be a lifeline. Small gestures, like checking in regularly or simply listening, can make a meaningful difference in their recovery. Remember, your support can help them feel less alone as they navigate their mental health journey.

If you or your loved one need additional professional support, please feel free to reach out to the National Alliance for the Mentally Ill or call us at The Behavioral Wellness Group. We would
be glad to help.

Erin Pawlak, MS, LPCC-S
Therapist and Adolescent IOP Director
The Behavioral Wellness Group
55A Sheridan Park Circle   Bluffton SC 29910
8224 Mentor Ave #208     Mentor OH  44060
P: 843 278 0008 #307 F: 440 565 2349
P:  440 392 2222 #307    F:  440 565 2349
epawlak@behavioralwellnessgroup.com
www.behavioralwellnessgroup.comup.com

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Although we all struggle at times, a cluster of these symptoms which present for a couple of weeks may be a sign that your health is compromised and may require attention.  Symptoms to watch out for include:

• significant changes in appetite/eating / weight or sleeping patterns
• loss of interest in pleasurable activities
• loss of interest in sex or sexual problems
• decrease in motivation / energy / grades / work productivity
• extreme tiredness
• withdrawal from others and decreased social contacts
• feelings of sadness / unhappiness or increased tearfulness
• overwhelming feelings of anxiety / fear / rapid heartbeat / shortness of breath / sweating / dry mouth/ lightheadedness / dizziness
• physical symptoms such as back pain / muscle pain and tension / chest pains /stiff neck / general aches and pains / headaches / stomach issues / constipation / diarrhea
• high blood pressure
• feelings of hopelessness / helplessness / despair
• thoughts of self harm or suicide
• trouble concentrating / slowed thinking and decision making
• decreased accomplishments
• increased anger / irritability / frustration / guilt feelings
• self-medicating with alcohol, drugs, gambling or sex

To help us turn this around, here are 3 tips to help promote emotional and physical well-being:

Express Emotions.  To hold stress and emotions in our bodies creates what I call the “Pressure Cooker Effect”.  If we do not release our emotions in healthy and effective ways, they will find their own way out as the pressure builds, often resulting in a cluster of the above-mentioned symptoms.  Learning and using effective interpersonal skills to express ourselves, exercise and other healthy physical outlets, journalizing and writing, talking with a trusted family-friend or therapist can be very effective ways to help us release pent up emotions and stress. 

Commit to a Balanced Life.  A balanced lifestyle of healthy eating, time with meaningful friends and family, quiet time alone, hobbies, responsibilities and daily accomplishments, tending to our emotional and physical selves, spirituality and gratitude and stimulating our brains daily by learning new things can be very effective in promoting sound emotional and physical health. 

Engage in Daily Calming.  Activities such as yoga, visual imagery, deep breathing, meditation, tai chi, engaging in rhythmic movements or dance, progressive muscle relaxation involving tensing and relaxing major muscle groups, practicing mindfulness by focusing our attention solely in the moment and massage therapy are an extremely important part of sound emotional and physical health.  Most stress experts recommend setting aside at least 10 to 20 and preferably 30 minutes per day for such calming activities.  However, it can be as simple as a deep breath in through the nose for 4 seconds; hold for 2 seconds; exhale slowly through pursed lips for 6 seconds.  Doing this 3-5 times per day will reduce baseline levels of anxiety and stress that we walk around with, thus enhancing physical and emotional well-being.

We can improve our emotional health and its impact upon our physical well-being by first of all, recognizing the aforementioned cluster of symptoms as a sign that it is time to start asking what our emotions are and to understand why we are having them.  Learn to release stress and emotions in positive ways.  Be committed to having a balanced lifestyle.  Engage in daily calming activities to self-soothe.  Although this may be difficult to do individually, reaching out to a primary care physician to discuss concerns can be a very positive first step.  Also ask about the possibility of a referral to a mental health practitioner.  This may include individual therapy, medication management or both.  When symptoms tend to be more intense or chronic in nature, an Intensive Outpatient Program is often indicated to learn effective tools to put us on the path to health and wellness.  This level of care typically meets for approximately three hours per day, three days per week for six to seven weeks.  The emphasis is on learning coping skills to manage emotions, be more effective interpersonally, communication skills, distress tolerance, learning how to stay mindful in the moment, changing negative thinking patterns, problem-solving skills, goal setting among others.

In conclusion, know the signs that you or someone you care about is struggling with poor physical health as a result of negative thoughts and related feelings, stressful life events or ineffective behaviors and poor coping skills.  Reach out and don’t suffer or watch others struggle in silence.  Know that there is effective help.  Learn to take care of yourself! Know that there is nothing in life that you cannot handle! Learn to be resilient!  Learn and Know that there is hope!  

John A. Glovan, Psy.D.
Director, Health and Wellness Program
Co-Founder, The Behavioral Wellness Group
8224 Mentor Ave #208     Mentor OH  44060
P:  440 392 2222 #302    F:  440 565 2349
jglovan@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com
www.campustherapy.com

The post Reducing Effects of Stress and Promoting Physical Health appeared first on Behavioral Wellness Group.

• Skills training works very well online– With DBTs structured approach-mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance skill sets- all fit naturally into a video format.
• Group participation is often stronger– Many clients feel more comfortable speaking from their homes; this can help people open up sooner.
• Fewer missed sessions– No commute, fewer barriers to attending, easier scheduling that leads to better attendance, one of the strongest predictors of success.
• Privacy- For some people logging in from home reduces the anxiety of walking into a new building and sitting in a new waiting room.
• VIRTUAL DBT IOPs ARE NOT A ‘LIGHTER’ VERSION OF THE REAL THING. THEY ARE THE SAME TREATMENT DELIVERD IN A MORE ACCESSIBLE WAY.

Virtual IOPs Are Just as Effective as In-Person Care: What BWG Research Shows:

The research compared patient outcomes from BWG’s pre-COVID, in-person DBT-based IOP (2019) with outcomes from the rapidly adapted virtual IOP provided in 2021. The programs used the same core curriculum, facilitators, and interventions—only the delivery format changed. This research was conducted by Licensed Psychologist, Dr. Barbara Ballash, who specializes in CBT and DBT.  

• Key Finding: Virtual IOPs Are Equally Effective
• Using validated screening tools for depression and anxiety, the study found no significant differences in symptom improvement between the in-person and virtual groups. In other words:
• BWG’s virtual IOP produced the same clinical gains as the traditional in-person IOP, even among individuals with serious mental illness.

How This Study Fits into the Larger Evidence Base

                  –Recent research aligns strongly with BWG’s findings   

• Telehealth IOPs show comparable outcomes to in-person programs, including similar reductions in depression, anxiety, and substance-use symptoms (Contreras-Schwartz et al., 2024; Bulkes et al., 2021).
• Attendance and completion rates are often higher for virtual IOPs, likely due to fewer logistical barriers (Waite et al., 2022)
• Virtual IOPs show equal improvements in depression, anxiety, and emotion dysregulation compared to in-person programs.
• Studies report high retention and satisfaction with telehealth DBT groups.
• Telehealth DBT is effective for individuals with complex needs, including SMI and chronic emotion dysregulation.

Bottom line:
Virtual DBT IOPs deliver the same outcomes as in-person care — with added flexibility that helps more people stay engaged and get better.

Please contact me with any questions about the virtual DBT IOP.

Cathryn E. Knezevich, M.Ed., PCC
Therapist and DBT IOP Director
The Behavioral Wellness Group
8224 Mentor Ave #208     Mentor OH  44060
P:  440 392 2222 #304    F:  440 565 2349
cknezevich@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

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Email: scerula@behavioralwellnessgroup.com
Phone: 440-392-2222 opt. 1
Facebook: https://www.facebook.com/thebehavioralwellnessgroup
Instagram: @thebehavioralwellness

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