Lifting Spirits: How to Increase Energy in Depressed Clients

Major depression is one of the most common mental disorders, according to the National Institute of Mental Health. The most recent figures from 2017 show that an estimated 17.3 million adults in the United States have had at least one major depressive episode. That’s about 7% of all adults.

People struggling with depression often complain of sleeping too much and feeling fatigued. They will put off getting help until the depression starts having major impacts on their home and work life - until they feel overwhelmed and like they can no longer keep up. When they do finally get counseling, they may show up for therapy exhausted and stuck in negative thought patterns, ruminating over the same dark scenarios.

Counselors are faced with trying to motivate clients who may have used up most of their energy just getting to the session. This is where telehealth can really be helpful. It takes much less energy to turn on a webcam or pick up the phone than to drive several miles to therapy.

But which telehealth interventions work best for depressed clients?

Dr. Margaret Wehrenberg, a clinical psychologist and internationally known trainer for mental health professionals, is the author of “Pandemic Anxiety: Fear, Stress, and Loss in Traumatic Times” and “The 10 Best-Ever Depression Management Techniques.” She’ll be speaking at the Telehealth Certification Institute’s upcoming “2021 Summit: Telemental Health Tailored to Your Practice.” She is noted for her down-to-earth, pragmatic teaching style.

“When clients come to us lethargic and negative, it’s hard to get them moving,” Dr. Wehrenberg said.

She trains counselors to use interventions that lift the client’s energy, and to turn their thoughts toward more positive thoughts and actions. The therapeutic interventions she uses include teaching clients to:

  • Enhance motivation and mobilize the client with lethargy
  • Diminish the impact of negative attention bias
  • Build the brain circuitry for joy and positive emotions
  • Stop the damage of chronic stress
  • Interrupt the plunge to despair common in trauma survivors and learn new, healthy coping styles
  • Replace their automatic thoughts of hopelessness and despair with more optimistic thoughts

For example, Dr. Wehrenberg says clients need to learn to recognize triggers for their depression and to plan new responses.

Clients also have to learn to keep moving and to fight the depression urges telling them to just stop and plop down in a chair or on the bed.

Dr. Wehrenberg encourages clients to seek satisfaction - not a huge cheery feeling. Satisfaction is more sustainable.

Clients can also learn to “talk back” to their depression. In her book, “The 10 Best-Ever Depression Management Techniques,” Dr. Wehrenberg suggests teaching clients how to practice healthier self-talk with phrases like:

  • I can think what I want. And I want to think I have many good traits.
  • I don’t have to leave my negative brain on autopilot. I can override it to think something positive.
  • What I think affects what I do. I will think about using my strengths.

Counselors using video conferencing can use screen share to show phrases like these to clients during sessions. Encourage clients to create their own positive phrases and to write them down on sticky notes or a notebook that they can easily access. It’s very important they practice.

Dr. Wehrenberg also suggests a good old-fashioned “to do” list - but with a therapeutic twist: Have clients create a list of easy-to-do, simple activities that they can actually accomplish. Examples include:

  • Read an article
  • Call a friend
  • Take a bath

Again, using telehealth, you can have these examples ready to share on your screen during your video conference with the client. You can even add images for illustration if you want to share the list on a document or Powerpoint.

If your video conferencing tool doesn’t allow for screen-sharing, or you’re using the phone for your session, send the exercise as an email attachment before the session.

To learn more ways to get your depressed clients moving again, you can hear Dr. Wehrenberg speak on March 22nd, 3:30 p.m. - 7:00 p.m. EST at the pre-summit for TCI’s “2021 Summit: Telemental Health Tailored to Your Practice."

By Amanda Barnett, LPC, NCC, EdS

Key resources

2021 Summit: Telemental Health Tailored to Your Practice

National Institute of Mental Health

Dr. Margaret Wehrenberg

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Vincent Amador
School Psychologist / Thornridge High School
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Nellie Decker
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This course was very interesting and allowing me to understand the way telementalhealth services need to work correctly.
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Housing Case Manager / Bridgeways
Very well done. Encourages active engagement in telemental health process while guiding effectively.
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I learned a lot in this course and will put what I learned into practice when I move my home office space.
Raymond Corbo
Clinical Supervisor and Counselor / Redeemer Counseling Services
Wonderful free training. Helpful discussion on how to aid clients in breaking out of the negative thought trap.
Jaime Wright
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Private practice / Thaxton Holistic Wellness
This course was extremely helpful understanding the legal requirements for interstate telehealth counseling.
Donald Kirk Henderson
Licensed Professional Counselor / Milestone Family Resources
Educational and informative content that was easy to follow and comprehend.
Scott Lipp, Ph.D., LMHC, LAC, NCC
Licensed Mental Health Counselor; Adjunct Professor / Greater Things, LLC; Florida Atlantic University
Necessary technological guidance!
Frances D Murdock
This course is more comprehensive than all the other HIPAA courses I've taken combined.
Michelle R. Gould, LMHC
Mental Health Counselor
Great, course. Really helped me during this challenging time to connect with students.
Priscilla Robinson
School Counselor / Baltimore County Public Schools
Thank you for an informational, relevant course to help me obtain my TMH certificate. Excellent presentation.
Tomica Horton
counselor/therapist / Jodi Province Counseling Services
This course is providing me with valuable information that will be helpful in providing competent and effective services for clients.
Nancy Sweet-Holp, LMSW
Therapist / Liberty House of Albany
The course was so informative and I was glued to my screen for the entire duration. I received so much knowledge concerning ethics in telehealth and I am greatly encouraged to read about all the standards and policies that pertain to my practice. Thank you!
Bridgette Nalumu
Public health consultant / Green and Purple Consultancy Network
I took the Board Certified-TeleMental Health Provider Training Certification Course in 2018, I feel so lucky to have found the TeleHealth Certification Institute. It's a top notch training center which has continued to provide me with tools and the knowledge to grow my private teletherapy practice. I recently participated in the TeleMental Health Preparedness Summit 2020 and was definitely not disappointed. The excitement and enthusiasm from the participants and TeleHealth Certification Institute staff is contagious. I've been inspired, since, to look into taking more courses, and joined their FaceBook group. I will likely join their consultation group in the near future. I don't believe there is another training institute out there that is as good as this one for everything telebehavioral health. Thank you Ray! You are a visionary!
Larissa Golloub, LCSW-R
Psychotherapist, solo practitioner / Larissa Golloub, LCSW
Brillant concept and a great way to support counselors as they transition into on-line therapy/services.
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License Professional Counselor / The Wellness Institute of Atlanta

The course was very detailed and informative. It covered everything that is necessary to work with Tele mental health.

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Director of Counselling & Student Activities / Bbermuda College
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Pediatric Psychotherapist / East Texas Family Guidance Center
This was quite beneficial. You explained well at a comfortable pace and you provided sufficient details for me to develop an Emergency Management Plan. Thank you!
I really gained a deeper understanding of Telehealth. I think this course helps pave the way for success in our field. This was very convenient. I am so blessed to take a course like this during the crisis we are facing as a nation. This course really helps me perform at a high level for my job. THANKS!!!!!!!
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