Who’s Who in Mental Health


Ashley Womack, LCDC

I understand the challenges people face while navigating the mental health system.  It seems that there are endless choices in therapists, each with different letters appearing after their name. To the lay person this can be quite confusing!  I hope this article will serve as a guide for deciphering who’s who in mental health!


A psychiatrist is a medical doctor who specializes in the diagnosis, treatment and prevention of mental illnesses, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological disturbance.  A psychiatrist has completed medical school (is an M.D. or D. O.) and an additional four or more years of residency training in psychiatry. Psychiatrist and mental health nurse practitioner are the only mental health professionals that can prescribe medication in the state of Texas.

Mental Health Nurse Practitioner

A Masters or Doctorate is needed to credential a nurse practitioner as a board certified Psychiatric/Mental-Health Nurse Practitioner (PMHNP-BC).  PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical mental conditions or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessment of their patients, treatment plans, and manage patient care.


Psychologists are doctorally-trained professionals who conduct research, perform testing, and evaluate and treat a full range of emotional and psychological challenges.  Licensure requires a Doctoral degree (Ph.D., Psy.D., Ed.D.) and at least two years of supervised experience in direct clinical service.

Licensed Psychological Associate

Licensed Psychological Associates (LPA) have a minimum of a master’s degree.  Common requirements are 2 to 4 years of post-Masters supervised clinical experience and passing a Psychological Associates Examination. Licensed Psychological Associates provide a full range of psychological services, including assessment, consultation, and therapy. LPA’s must work under the supervision of a licensed psychologist.

Licensed Professional Counselor

Licensed Professional Counselors (LPC) have a minimum of a master’s degree.  They must also complete 3000 post masters clinical hours, during this time they are called interns (LPC-I) and are supervised by Licensed Professional Counselor Supervisors (LPC-S).  LPC-S’s have been a counselor for at least two years (post clinical hours) and have had special training in clinical supervision. LPC’s are generalist and can work with a broad spectrum of people and issues: couples, family, children, individuals, mental health issues, and addiction issues.

Social Worker

Social workers have to have a minimum of a bachelor’s degree (BSW). There are three master level social worker credentials: social workers with a master’s degree (MSW); social worker with a master’s degree that is licensed (LMSW); and finally social worker that has a master’s  degree, is licensed and has completed 3000 clinical hours (LCSW).  Social workers offer a broad range of services, from emotional support to referrals for community resources. They may provide counseling services, advocate for a patient, or work with community groups to develop resources that will aid patients.

Licensed Family and Marriage Therapist

Licensed Family and Marriage Therapist (LMFT) have a minimum of a master’s degree.  LMFT’s are trained in psychotherapy and family systems and are licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems. The focus of LMFT’s are relationships.

Licensed Chemical Dependency Counselor

A licensed chemical dependency counselor (LCDC) is a professional who provides counseling to those struggling with alcohol or drug addiction.  Those applying for an LCDC certification generally must have at least an associate degree in a related field of study, such as social science. LCDC’s must complete 4000 hours post education during which time they are referred to as interns (CI).  Much of the job of an LCDC is similar to that of almost anybody working in a therapeutic capacity. The LCDC provides information and counseling as any other therapist, but with a focus on dealing with chemical dependency.

Ashley Womack has a bachelor’s degree in psychology, a master’s degree in counseling and is currently a doctoral student at Texas A&M University-Commerce. She is a licensed chemical dependency counselor. She has worked in community mental health for several years and is now a therapist at Insight Counseling of Paris  www.insightcounselinggroup.com . She will be teaching counseling classes at A&M in the fall. She is also owner/operator of www.thepaperhelper.com

Living on Purpose

It is that time of year again.  Dare I say it? Back to School!!!  I have to admit, as nice as these lazy summer days have been, with two wild boys at home, I am more than ready for some structure and routine back in our lives and also a few quiet moments around the house. I also look forward to this time of year, because it is a new beginning, like hitting the reset button.  At our house we clean out all the closets, buy new clothes, new school supplies, etc.  Everything is as fresh as the new box of crayons. This year we also made a new family plan, a list of individual and family goals for the new school year.  Admittedly, my husband and children were less than thrilled when I announced that we would be having a family meeting to discuss our “Family Plan,” but in the end we all had a great time contributing to our plan, and are looking forward to carrying it out. Which brings me to the real topic of this article: “Living on Purpose.”

I have to give credit where it is due; last Sunday at church, our pastor delivered a sermon entitled, “The Search for the Real Deal.”  In this sermon, he spoke about living our lives with intent or on purpose if you will.   The main idea was that we need to know where we are going in life and just how we plan on getting there.  As a professional in the mental health field, one thing I hear from people probably more than any other is that they do not have a sense of purpose or meaning in their life.  So many people do not even know where they are going.  Many others may have some end goal or destination in mind, but have not the faintest idea how to get there.  Either way, they are likely not going to end up where they want to be; they are not “living on purpose.”  Hearing my preacher speak about the topic I realized that even though I have reached certain personal, educational, and career goals in my life, there are still many areas in which I too am guilty of just idling by and hoping everything works out the way I want.  With it being the end of summer already, I guess it just hit me: time really does fly by, and even though I have so many hopes, plans, and dreams for my children and our family, I do not actively and intently work toward reaching those goals everyday.  And thus, our family plan was born.  Each member of our family came up with goals for themselves as individuals and also goals for the family as a whole, and then we all brainstormed to come up with at least three ways we could accomplish each goal.  My oldest son, for example, suggested that we set a family goal to go green.  So we decided to invest in some recycling bins, to buy a water filter instead of bottled water, and to try harder to turn out the lights every time we leave a room (a suggestion my husband was all too happy to endorse).  The money we make from recycling will go to Caleb’s savings account since it was his idea.  

Whether it is as a family or on the individual level it is important not only that we have goals, but that we actively work toward them.  There are things we can do everyday to reach our goals.  I think that most of us have a need to feel as though we are doing something worthwhile, that has meaning, and we are generally happier and more fulfilled when we are living with intent.  In fact, one of the key symptoms of depression is hopelessness. When we have a goal, a plan of action to reach that goal, and are making steps of that plan everyday, we have hope.  Of course I will admit that this is all easier said than done.  As I said earlier many people do not even know where they want to end up, and in that case it is impossible to choose the correct path, or to recognize the wrong one for that matter.  This tends to happen to people at various stages of life, especially during transition stages after we accomplish one goal or a set of goals and are not sure where to go next.  For example, after high school or college graduation when one has met educational goals or in one’s forty’s or fifty’s after having met family and career goals are typical periods in which people tend to feel lost or without purpose and direction.  This is often why we hear about things like the boomerang effect, a midlife crisis, and empty nest syndrome.  If this is you, take comfort in the fact that you are not alone.  In fact the majority of people will experience a lack of direction and/or purpose at some point during their life.  Try to look at it as a wide open opportunity. If you do not have any where to go, you can go anywhere you choose!  If you are having trouble setting goals and destinations know that there is much help available. Try making a list of your interests and natural talents and abilities, talking to close friends and family members, seeing a counselor or pastor, or check out a self-help section of your local library or book store.  For educational or career paths try doing some research at a local college or university – they usually have guidance counselors who can provide lots of free information.  Once you know where you are headed, you just have to make sure that you stay on the right path.  Many counselors are able to provide tests and assessments that can help you understand your personality and your intellectual capabilities, which careers, schools, or other plans may be best suited for you according to those results, and also help you decide on how to apply your natural abilities to reach your goals. 

My family has definitely been inspired this week to work our plan this new school year.  From my training in psychology and as a mother, I am looking forward to the benefits of confidence and fulfillment my children will experience when they see their goals realized.  In our situation, it was not that we did not have direction; we just got so caught up in day to day life, that we forgot to actively work toward our goals everyday. I hope that you can find some way to use these ideas in your own lives where it is needed. Live on purpose!  


Talor Trenchard, a Paris, Texas native and happily married mother of two, has a bachelor’s degree in psychology and a master’s degree in applied psychology. She is currently working as a therapist at Insight Counseling Group.(www.insightcounselinggroup.com) Talor is trained in psychological and neuropsychological evaluations and specializes in cognitive, achievement, and personality assessments. She has experience diagnosing and working with individuals with a variety of psychological conditions including but not limited to, ADHD, dyslexia, mental retardation, personality disorders, depression, anxiety, reactive attachment disorder, schizoaffective disorder, and schizophrenia.

A Time to Mourn – Grief Explained

Ashley Womack

No one gets out of this world unscathed.  A part of living is dealing with loss. With loss comes grief.  We grieve a lot of things: the loss of a relationship, the loss of the way we thought things would turn out, the loss of a job, and of course the death of loved ones.  I spoke with Becky Trantham, a Registered Nurse who is board certified as a Psychiatric Mental Health Nurse.  She has 29 years experience working inpatient and outpatient psychiatric settings and currently works at Lakes Regional MHMR in Paris.  She reports “Grief is a natural and normal reaction to loss. You have to go through grief in order to heal.” 

Grief is personal, there is no right or wrong way, and everyone does it differently.  That said, there are “typical” stages to the grieving process. When asked about the stages of grief Becky stated “Initial grief reaction is usually shock and disbelief. When a person moves through the stages of grief, anger and resentment come next, then there is often guilt, fear, deep sadness, and physical reactions before the acceptance of the loss is reached.”

The traditional grief model included only five stages, but the latest model has been extended to seven.  The following information was retrieved from www.recover-from-grief.com a wonderful resource for those suffering from grief.  The stages are as follows:

You will probably react to learning of the loss with numbed disbelief. You may deny the reality of the loss at some level, in order to avoid the pain. Shock provides emotional protection from being overwhelmed all at once. This may last for weeks.

As the shock wears off, it is replaced with the suffering of unbelievable pain. Although excruciating and almost unbearable, it is important that you experience the pain fully, and not hide it, avoid it or escape from it with alcohol or drugs.

You may have guilty feelings or remorse over things you did or didn’t do with your loved one. Life feels chaotic and scary during this phase.

Frustration gives way to anger, and you may lash out and lay unwarranted blame for the death on someone else. Please try to control this, as permanent damage to your relationships may result. This is a time for the release of bottled up emotion.

You may rail against fate, questioning “Why me?” You may also try to bargain in vain with the powers that be for a way out of your despair (“I will never drink again if you just bring him back”)

Just when your friends may think you should be getting on with your life, a long period of sad reflection will likely overtake you. This is a normal stage of grief, so do not be “talked out of it” by well-meaning outsiders. Encouragement from others is not helpful to you during this stage of grieving.

During this time, you finally realize the true magnitude of your loss, and it depresses you. You may isolate yourself on purpose, reflect on things you did with your lost one, and focus on memories of the past. You may sense feelings of emptiness or despair.

As you start to adjust to life without your dear one, your life becomes a little calmer and more organized. Your physical symptoms lessen, and your “depression” begins to lift slightly.

As you become more functional, your mind starts working again, and you will find yourself seeking realistic solutions to problems posed by life without your loved one. You will start to work on practical and financial problems and reconstructing yourself and your life without him or her.

During this, the last of the seven stages in this grief model, you learn to accept and deal with the reality of your situation. Acceptance does not necessarily mean instant happiness. Given the pain and turmoil you have experienced, you can never return to the carefree, untroubled YOU that existed before this tragedy. But you will find a way forward.

I asked Becky what was most important to know about grieving and she stated “Let yourself grieve in a way that feels natural to you. There is no time frame connected to grief. It takes some people longer than others to work through this pain. Allow your feelings and thoughts to come forth because there is no right or wrong way to feel or think about your loss. Don’t allow other people to tell you how you should be feeling and thinking! Reach out to people you trust and who will be supportive of your thoughts and feelings.”

 Ashley Womack has a bachelor’s degree in psychology, a master’s degree in counseling and is currently a doctoral student at Texas A&M University-Commerce. She is a licensed chemical dependency counselor. She has worked in community mental health for several years and is now a therapist at Insight Counseling of Paris. She will be teaching counseling classes at A&M in the fall. She is also owner/operator of www.thepaperhelper.com

Anxiety… Something to Worry About?

Is your Anxiety Something to Worry About? 

We are all familiar with feelings of stress and anxiety; indeed they are normal, functional parts of our physical and psychological make up.  Our bodies and minds use anxiety as a normal reaction to cope with stress. Whether that stress be physical or psychological, real or imagined, or scary or exciting, our brain and body react in very real ways by producing chemicals that cause varying emotional and mental states as well as changes in our bodies. While anxiety can be a needed tool that helps us to deal with a particular situation, it can also become negative, excessive, and even disabling. 

When we perceive a certain situation or event as stressful, our body responds by increasing the levels of certain hormones, such as cortisol and adrenaline.  These hormones are meant to enable our bodies to better cope with a stressful situation.  Consider for example, the common tale of the mother who is able to lift a car to save her child.  The same concept occurs on a psychological level as well; anxiety can allow one to stay up later, while remaining alert and focused to study for a big exam or prepare for an important presentation.  There are of course negative side effects as well.  People whose levels of stress hormones, such as cortisol, remain high over a prolonged period of time have been found to be more vulnerable to everything from the common cold to high blood pressure, heart disease, and anxiety disorders. 

Aside from the negative effects on one’s physical health, excessive anxiety may significantly interfere in one’s daily functioning.  Anxiety that interferes with an individual’s ability to lead a normal life may indicate an anxiety disorder. According to the National Institute of Mental Health, Anxiety Disorders affect about 40 million American in a given year.  While there are many different types of anxiety disorders, all involve some sort of excessive worry, irrational fear and dread that last for a prolonged period of time.  Unlike the normal anxiety discussed earlier, caused by a stressful event (such as a job interview or public speaking), anxiety disorders last at least 6 months and can get worse if they are not treated.

There are effective treatments that can help most people with anxiety disorders lead productive, fulfilling lives. There are also many simple changes one can make at home to combat normal levels of stress and anxiety.  Below are some simple, yet successful tips to help reduce stress and anxiety:

  1. Do not underestimate a balanced diet and proper nutrition.  Okay, it is probably an overused metaphor, but I am going to use it anyway; you would not expect your car to function properly without gasoline and oil, and your body is also a machine that requires fuel!  So overall your body needs a balanced diet to function, especially during times of stress.  Proper nutrition, which includes vitamins B and C, can help offset the effects of stress by boosting the immune system. Furthermore, certain foods increase relaxing neurotransmitters (chemicals in the brain). All carbohydrates increase serotonin, which promotes relaxation, restful sleep, and feelings of happiness; choosing complex carbs slows digestion and prolongs effects.  Try starting your day with a piece of whole-wheat toast or oatmeal.  Be sure to include some fatty fish, like tuna or salmon, or nuts and seeds, like pistachios or almonds which are rich in Omega-3 fatty acids, known to reduce stress hormones.  Meanwhile, avoid or at least limit, foods such as chocolate, alcohol, caffeine, and red meat, which can increase stress hormones.  Remember you can always consult your physician about vitamin supplements. 
  2. Everyday make the time to take some time for yourself! Do something relaxing that you enjoy.  This does not require hours of time or a trip to a spa.  Just set aside 20 or 30 minutes a day that is “your time.”  Read a book, make a cup of tea, pray, or just sit for a while.  Just relax and enjoy yourself!  If you find you are having trouble putting your worries aside, keep a journal handy, write them down, and promise yourself to deal with them after your relaxation time.  Sometimes putting them on paper can help keep them off your mind – at least for a few minutes. 
  3. Get plenty of restful sleep!  This one can be tricky.  One of the classic symptoms of anxiety is difficulty falling and staying asleep.  It can quickly become a vicious circle: you cannot sleep because you are anxious, then you worry about not getting enough sleep, the next day your body is less able to adequately deal with other stressors.  Developing a bedtime routine or ritual can help your body and mind know that it is time to put the worries aside and get some sleep.  A lot of the age old tricks we have all heard really do seem to help; try a relaxing bath with lavender oils, a glass of warm milk, and a piece of toast to boost serotonin.  If the day’s worries are still weighing on your mind, try using the journal outlined above. 

The tips outlined above are often useful in reducing normal levels of stress and anxiety, however excessive or irrational worry and fear may indicate something more serious.  Please review the checklist below; if you can answer yes to any of the following questions, your anxiety may warrant a professional consult.

  1. Does your anxiety interfere with your daily activities?
  2.  Do you experience sudden feelings of fear or anxiety when there is no apparent reason?
  3. Do you experience frequent anxiety attacks or nightmares?
  4. Do you experience feelings of restlessness or being “on edge”?
  5. Have your symptoms lasted longer than one week with home treatment?

Again, anxiety is a normal emotional reaction, which is often useful in coping with stress.  However, it can become excessive and may warrant professional intervention.  If you or someone you know has the symptoms of an anxiety disorder, please contact your physician or mental health professional.    

Talor Trenchard, a Paris, Texas native and happily married mother of two, has a bachelor’s degree in psychology and a master’s degree in applied psychology.  She is currently working as a therapist at Insight Counseling Group.(www.insightcounselinggroup.com)  Talor is trained in psychological and neuropsychological evaluations and specializes in cognitive, achievement, and personality assessments. She has experience diagnosing and working with individuals with a variety of psychological conditions including but not limited to, ADHD, dyslexia, mental retardation, personality disorders, depression, anxiety, reactive attachment disorder, schizoaffective disorder, and schizophrenia.


Dangerous Drugs, In Stores Near You!


Ashley Womack

I recently made a drug deal in Paris, Texas. It went like this “I can sell you our best stuff; it is $50 a gram. If you want I can cut it in half for you or I can even sell you an 8 ball. If you prefer, our next best is $40 a gram. It is still good, just doesn’t have the kick of the good stuff.”  This isn’t what you think. I wasn’t on a corner talking to a drug dealer. In fact, I wasn’t even breaking the law. I was speaking to the girl behind the counter at Da Water Pipe. Our transaction, had I gone through with it, would have been completely legit. She wasn’t selling meth or coke by the gram; she was selling bath salts, the newest craze in designer drugs. 

Designer drug is a term used to describe drugs which are created to get around existing drug laws. This is done by changing the molecular structure of an existing drug just enough to make a new substance. K2 is another designer drug that has recently soared in popularity. Bath salts are considered legal meth and K2 is considered legal marijuana.  The problem with both of these drugs, besides their easy availability, are the nasty and potentially fatal side effects.

 According to Bryan Mackey, a local EMT, emergency workers are “beginning to see it more often, possibly 3-4 a week, mostly bath salt, not seeing K2 as much…”. I also spoke with a registered nurse that works for Poison Control, she reports that the center she works for, which serves all of Texas, receives calls daily about K2 and bath salts. A typical caller to Poison Control complains of hallucinations, agitation (often to the point of requiring restraints), delirium, rapid heart rate and elevated body temperature. She also warned that the use of bath salts can cause kidney and liver damage, muscles to break down, seizures, and dangerously low or high blood pressure.

Bryan echoed this when he reported that “a wide variety of symptoms are usually present, most always extreme tachycardia (rapid heart rate), chest pain, paranoia, and agitation”.  The nurse stated “It takes a long time to recover from the use of bath salts. Typically the person has to be admitted to the hospital. Some don’t recover.”

Both Bryan and the RN for Poison Control report that there are fewer calls for K2.  Paris recently banned K2 from being sold inside the city limits, but it is still legal to have and use.  It takes a long time for legislation to catch up to new trends in drug use. Something has to be done and soon. Paris hasn’t had any reported deaths due to these two substances yet, but just this week a woman in her 20’s used bath salts and is now in critical condition at Medical City in Dallas.  It has been reported that she suffered a stroke, has brain damage, and paralysis on one side of her body.  Bryan reports that there are other confirmed strokes due to bath salts in Paris. All of this from something that you (or your kids) can buy easily in Paris, Texas!  Where do we go from here? This is not an easy question to answer. Until laws are passed to stop the sale and consumption of these designer drugs it is a good idea to talk to your children, friends, etc about the dangers of using these legal yet potentially life threatening drugs

Editor note: Since this article was written there has been one confirmed local death, another death of a local man who happened to be in Idabel when he died, two comas, and another suspected death that no autopy was performed to validate.

 Ashley Womack has a bachelor’s degree in psychology, a master’s degree in counseling and is currently a doctoral student at Texas A&M University-Commerce. She is a licensed chemical dependency counselor. She has worked in community mental health for several years and is now a therapist at Insight Counseling of Paris. She will be teaching counseling classes at A&M in the fall. She is also owner/operator of www.thepaperhelper.com