T.H. & Associates · Behavioral Health · Telehealth · Virginia · Washington, DC · Maryland Dr. Tierra Hereford There is a wide gap between “once a week isn’t enough” and “this requires a hospital.” A lot of people are living in it. And because the options usually presented are keep going as you are or go inpatient, most people in that gap choose neither. They wait it out. They white-knuckle. And too often the next contact with the system is an emergency one. That middle is

T.H. & Associates · Behavioral Health · Telehealth · Virginia · Washington, DC · Maryland September — National Suicide Prevention Month Dr. Tierra Hereford September is Suicide Prevention Month, and the most useful thing I can offer isn’t a statistic. It’s this: asking someone directly whether they are thinking about suicide does not put the idea in their head. That worry is the single most common reason people stay quiet. It is also wrong and the research on it has been

International Overdose Awareness Day — August 31 T.H. & Associates · Behavioral Health · Telehealth · Virginia · Washington, DC · Maryland Dr. Tierra Hereford International Overdose Awareness Day turns 25 today. The theme is “25 Years On. Still Needed.” That phrasing is doing careful work. It acknowledges a quarter century of real progress — naloxone in ordinary hands, medications for opioid use disorder, a public conversation that has moved meaningfully away from treatin

Dr. Tierra Hereford T.H. & Associates · Behavioral Health · Telehealth · Virginia · Washington, DC · Maryland Burnout usually shows up in our office in November. This year it started arriving in August. The reason isn’t mysterious. A lot of people didn’t take a real break this summer — the trip cost more than it was worth, the PTO couldn’t be covered, the childcare math didn’t work, or the week off would have meant coming back to twice the workload. So they took the versio

There’s a sentence I hear in some form almost every week, and it always arrives with an apology attached: “I should be able to handle this with one session a week.” Sometimes it’s said by someone whose life has gotten genuinely harder in the last few months. Sometimes it’s said by someone who has been white-knuckling something for years and has finally run out of margin. Either way, the sentence is doing the same job — it’s converting a clinical question into a verdict about

Ask most people what the hard part of therapy is and they’ll describe the session. The talking. The crying in front of a stranger. The forty-five minutes of looking directly at something they’d been managing not to look at. That’s not usually it. The hard part is Thursday. It’s the argument at 9pm on a Saturday, three days out from your last session and four days from the next one, when everything you worked on evaporates and you handle it exactly the way you always have. It’