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Mental Health

Five Tips for Overcoming Self-Doubt

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Your comfort zone

Some self-disclosure here—I’m a rather sensitive person and I often tend towards self-doubt, thinking something is my fault if it doesn’t go well and lots of critical voices in my head always.  With time, I’ve learned to see this as a strength since it means I’m constantly evaluating myself and pushing myself to become better.  However, often in the day to day, this self-doubt can be difficult.  And especially so in the field of social work, where decisions made often have far-reaching repercussions.

Over the years I’ve had to develop methods to help me not to linger in my own self-doubt and to feel more confident in my decision-making.  I’m guessing there are other social workers out there who have struggles with self-doubt as well, so wanted to share the methods I’ve used and continue to use today, to help feel confident and to shake off the nagging self-doubt voice.  These are applicable to non-social workers, as well so feel free to share with others you know who might find these ideas helpful.

1. Regular self-reflection.

This almost seems counter-intuitive, but I’ve found it to be very helpful. For years, I don’t think I recognized or acknowledged my struggles with self-doubt and so maybe didn’t realize I needed the extra support.  It can be helpful to talk with your supervisor about your own self-doubt so that they can help you process what is reality versus what is going on in your mind. Once you become more accustomed to those kinds of questions, you can ask them of yourself.  This will help you to be able to figure out what is the truth in the situation compared to thoughts based on self-doubt. Are there tangible things to be learned that will help you improve your practice in the future? If so, learn from the experience and move on.

2. Continued professional development.

I love learning…and have found that when I know more about myself, about the profession, about current practices, current issues, etc., the more I feel like and am a competent social worker. It’s interesting, but I feel this area has actually gotten harder to take time for as my personal life has gotten busier and required more of me.  I didn’t realize how much I craved professional development until I did take two days a few months ago and went to a conference that for me was all about professional development.  I left feeling so recharged, confident, excited…and during a timeframe when if I had not gone I probably would have felt professionally drained and would have questioned myself lots and lots.  By taking the time for professional development, one grows. And when you know you are growing, self-doubt can take a back seat.

3. Be aware of your biases.

Letting my supervisors and/or trusted colleagues know my biases and asking them to push me on certain topics based on my own self-awareness has been extremely helpful. Self-reflection leads to self-awareness.  I know most of my biases…and have been sure to share the ones I know about with my supervisors. Often this has been within the context of case-specific work. When I know I’m struggling with a decision because of my own experiences and biases I share that.

I think it’s so important to know and acknowledge my lens and share it with others, not to convince them that my lens is right, but so that they can help by asking further questions and making sure my assessment is based on all of the facts of the situation.  Having others there to help me explore means a more collective decision-making process as well, and more minds and eyes on the situation generally lead to better, more well-thought-out decisions and less self-doubt.

4. Learn from perceived mistakes and trust your gut.

I’ve been in the same general profession, a social worker in child welfare for over a decade.  I’ve seen my successes and I’ve seen my failures.  There are, sadly, cases I worked on over 10 years ago that I ran across again because of failed adoptions or failed reunification…adoptions and reunifications that I was in some capacity a part of.  And hearing about these cases breaks my heart and makes me want to crawl under a rock because of my participation in something that did not turn out to be the positive ending that I thought it would.

But, once I’m ready to pop my head back out and again go back to #1 and reflect, usually there is some wisdom gained.  Sometimes it means I realize I had a gut reaction, and the next time someone else brings me a gut reaction about a case I will push them further—will point out the importance of the decision and will ask what else can we assess so that the gut reaction isn’t just a gut.   If you are a natural self-doubter and in social work, then PLEASE, PLEASE, PLEASE, trust your gut. And then dig…you may find something concrete to support your gut.  I’m 98% sure of it.

5. Practice self-compassion.

No one is perfect. Even those who don’t struggle with self-doubt are not perfect.  As a natural self-doubter, you are also a natural self-improvement person and that is actually a sign of a true leader.  You will take the time to recognize what you need improvement in and improve it.  And when you doubt yourself and it’s not warranted, with time you will learn to treat yourself with the same compassion that you treat others with.  I’m still working on this piece, but am realizing how important it is to treat myself as I would a friend–listen, acknowledge, support, and be kind.  By doing so, I can move on and be better next time, without unnecessary guilt to hold me back.

Do you struggle with self-doubt in regards to your decision-making and/or work life in general?  How do you help to overcome it? Do you (like me) see this as a potential strength?  I’d love to hear from you so we can learn from one another!

Rachel Castillo, MSW is a licensed Advanced Practice Social Worker and has been working in the area of child welfare for over 10 years. She is the founder of www.socialworkcommunity.com, a website/blog with the goal of creating a positive community for social workers to gather, connect, and inspire one another. Rachel is also a proud mama and is always on the lookout for ways to improve her own self-care as well as encouraging those around her to do the same.

          
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Mental Health

Smartphones Help UB Researcher Better Understand the Nature of Depression and Anxiety

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Decades of research into anxiety and depression have resulted in the development of models that help explain the causes and dimensions of the two disorders.

For all of their well-established utility however, these models measure differences between individuals and are derived from studies designed using few assessments that can be months or even years apart.

In other words, the models are highly informative, but not optimal for examining what’s happening emotionally in a particular person from moment to moment.

Now, a University at Buffalo psychologist is extending that valuable research to repeatedly and frequently measure symptoms of specific individuals, in real time, to learn how immediate feelings relate to later symptoms.

The research casts anxiety and depression in a manner not previously studied and the results suggest that some emotions linger in a way that predicts feelings beyond what’s happening at specific times. This information could provide treatment benefits for patients struggling with the disorders, according to Kristin Gainey, an assistant professor in UB’s psychology department and the study’s author.

“Clinicians aren’t primarily interested in how one person’s symptoms compare to someone else, which is what most studies focus on. Rather, they’re most interested in how to shift the feelings of someone with anxiety or depression. In other words, they want to understand how to change the emotional experiences of a given individual over time and across different situations,” says Gainey, an expert on emotion and affect in mood and anxiety disorders and a recent recipient of one of the American Psychological Association’s Early Career Distinguished Scientific awards. “The only way to get at that directly is to measure these processes repeatedly within a person as they’re happening.”

To do that, Gainey conducted baseline assessments on 135 participants, each of whom were already seeking some kind of psychological treatment.

Three times a day for 10 weeks, the participants received surveys on their smartphones about their feelings and symptoms. They completed the survey within 20 minutes of its arrival.

“That generated enough reports to provide a good sense for each person’s fluctuations and trajectories of symptoms and affect (defined as the objective feeling state that’s part of an emotion),” says Gainey.

A smartphone provides a portrait of immediacy that questionnaires distributed in a lab that summarize feelings over extended periods are unable to achieve.

“We can’t always remember accurately how we felt days and weeks ago, especially if there were some days you felt really bad and other days you felt great,” she says. “That’s not easy to summarize in a single index.”

Anxiety and depression are each unique disorders, but they often appear together in a single patient. Both disorders share high levels of negative emotions, such as fear, sadness, and anger, while low levels of positive emotions, like excitement and interest, are unique to depression.

Gainey says it’s not surprising that particular affective states, like feeling happy or feeling sad, might be responsible for symptoms experienced soon afterward. What researchers don’t know much about is how long those effects tend to persist, and which specific symptoms they lead to hours or days later.

“This study let us see that some effects were short-lived, but for depression, if you were feeling high levels of negative affect, even if we control for how depressed a participant was at that time, it was still predictive of increased depression 24 hours later,” says Gainey.

That might suggest that clinicians could track peoples’ positive and negative affect in real time and plot trajectories that are indicative of increased risk.

“If we can identify specific risk factors for increased symptoms in real time, we could even use smartphones to send suggestions about helpful strategies or alert the person’s mental health care provider,” she says.

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Environmental Justice

Climate Change Increases Potential for Conflict and Violence

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Images of extensive flooding or fire-ravaged communities help us see how climate change is accelerating the severity of natural disasters. The devastation is obvious, but what is not as clear is the indirect effect of these disasters, or more generally of rapid climate change, on violence and aggression.

That is what Craig Anderson sees. The Iowa State University Distinguished Professor of psychology and Andreas Miles-Novelo, an ISU graduate student and lead author, identified three ways climate change will increase the likelihood of violence, based on established models of aggression and violence. Their research is published in the journal Current Climate Change Reports.

Anderson says the first route is the most direct: higher temperatures increase irritability and hostility, which can lead to violence. The other two are more indirect and stem from the effects of climate change on natural disasters, failing crops and economic instability. A natural disaster, such as a hurricane or wildfire, does not directly increase violence, but the economic disruption, displacement of families and strain on natural resources that result are what Anderson finds problematic.

One indirect way natural disasters increase violence is through the development of babies, children and adolescents into violence-prone adults, he said. For example, poor living conditions, disrupted families and inadequate prenatal and child nutrition are risk factors for creating violence-prone adults. Anderson and Miles-Novelo noted these risk factors will become more prevalent as a result of climate change-induced disasters, such as hurricanes, droughts, floods, water shortages and changing agricultural practices for efficient production of food.

Another indirect effect: Some natural disasters are so extensive and long term that large groups of people are forced to migrate from their homeland. Anderson says this “eco-migration” creates intergroup conflicts over resources, which may result in political violence, civil wars or wars between nations.

“This is a global issue with very serious consequences. We need to plan for ways to reduce the negative impacts,” Anderson said. “An inadequate food supply and economic disparity make it difficult to raise healthy and productive citizens, which is one way to reduce long-term violence. We also need to plan for and devote resources to aid eco-migrants in their relocation to new lands and countries.”

Which is worse?

There are no data and there is no method to estimate which of the three factors will be most damaging, Anderson said. The link between heat and aggression has the potential to affect the greatest number of people, and existing research, including Anderson’s, shows hotter regions have more violent crime, poverty, and unemployment.

However, Anderson fears the third effect he and Miles-Novelo identified – eco-migration and conflict – could be the most destructive. He says we are already seeing the migration of large groups in response to physical, economic or political instability resulting from ecological disasters. The conflict in Syria is one example.

Differences between migrants and the people living in areas where migrants are relocating can be a source of tension and violence, Anderson said. As the level of such conflicts escalates, combined with the availability of weapons of mass destruction, the results could be devastating.

“Although the most extreme events, such as all-out war, are relatively unlikely, the consequences are so severe that we cannot afford to ignore them,” Anderson said.  “That is why the U.S. and other countries must make sure these regional conflicts and eco-migration problems don’t get out of hand. One way to do that is to provide appropriate aid to refugees and make it easier for them to migrate to regions where they can be productive, healthy and happy.”

Taking action now

Anderson and Miles-Novelo say the purpose of their research is to raise awareness among the scientific community to work on prevention efforts or ways to limit harmful consequences. The long-term goal is to educate the public on the potential for increased violence.

“From past experience with natural disasters, we should be able to prepare for future problems by setting aside emergency resources and funds,” Miles-Novelo said. “We should tear down negative stereotypes and prejudices about those who will need help and humanely assist refugees and others who are displaced. By doing all these things we can reduce conflict and hostility.”

Changing attitudes and policies about immigration also will lessen the potential for conflict, Anderson said. He points to the backlash against refugees in many European countries.

“The view that citizens of wealthy countries often have about refugees needs to change – from seeing them as a threat to a view that emphasizes humanitarian values and the benefits refugees bring when they are welcomed into the community,” Anderson said.

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Mental Health

The Importance of Finding a Facility That Offers Both Inpatient Drug Rehab and Inpatient Alcohol Rehab

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Navigating life with an addiction to alcohol or drugs can be especially difficult and exhausting. It always feels like the substance is taking over. If it’s not in the foreground dominating life, then it’s in the background, always in the back of your mind. Through treatment at an inpatient alcohol rehab or an inpatient drug rehab, life can finally be different, changing for the better.

Of course, not all rehab facilities are the same. Some offer only outpatient care. With this form of rehab, the enrollee is attending the facility but still going home to their daily life. While outpatient rehab may help some enrollees work through their alcohol or drug addiction, recovery doesn’t always stick.

Inpatient rehab, on the other hand, offers more comprehensive care. That’s because enrollees are at the facility around the clock for a set amount of days (although not in all instances).

Finding a facility with inpatient rehabilitation for alcohol and drug addiction may have seemed impossible until now. However, there are more options now than before. The care administered at the new breed of treatment centers is holistic, meaning there’s more to recovery than simple withdrawal, therapy, and then out the door. Instead, there’s work done to improve the lives of enrollees by nourishing and restoring their spirit, body, and mind.

Those who want to are ready to make a change in their lives may be interested in these inpatient rehabilitation facilities. Here are several reasons inpatient care can be so significant for enrollees looking to become sober.

Inpatient Treatment May Be More Successful Than Outpatient Programs

According to data cited from the National Institute of Alcohol Abuse on Alcoholism, inpatient alcohol rehab may have better sobriety rates than outpatient care. To back up that claim, 303 alcohol rehab enrollees were tracked over five years. Of those 303 enrollees, 120 of them participated in outpatient rehab while the other 183 did an inpatient program.

In the study, enrollees with intact social support systems and in better psychiatric health were proven to do equally well in an outpatient versus inpatient rehab setting. Those with weaker social support and a higher rate of mental illness did better exclusively in inpatient settings.

Regardless of the social support and mental health of enrollees, the National Institute of Alcohol Abuse on Alcoholism discovered that those who were in outpatient rehab programs had a four times higher chance of relapsing into alcohol use over those in an inpatient program.

This could because those in an outpatient rehab program can keep going back to their same old haunts or toxic relationships that provide alcohol, drugs, or other addictive substances. Even though they show up for rehab, if they’re still using when they’re home, a vicious cycle repeats itself. True recovery becomes practically impossible.

Whether it’s for inpatient alcohol rehab or inpatient drug rehab, then, a facility with comprehensive inpatient care is best.

Alcohol and Drug Addiction Are Not Alike

Those who are addicted to alcohol will not necessarily need to go through the same treatment modalities as those with a drug addiction, and vice-versa. When a rehab facility only offers treatment for one type of addiction over another, it gets easy for an enrollee to be pigeonholed.

For example, perhaps an enrollee with an alcohol addiction enters a drug rehab center because it’s conveniently close to them or it’s more affordable. They figure that an addiction is an addiction and they’ll come out on the other side sober.

Without special attention and focus on what factors created the addiction in the first place as well as individualized care, it’s unlikely the rehab will work. It’s much better for someone who’s addicted to alcohol to receive inpatient alcohol rehab and someone who is addicted to drugs to get their own care at an inpatient facility.

Looking for Inpatient Rehabilitation Facilities for Alcohol or Drug Addiction?

Whether addicted to alcohol, drugs, or even both, getting the right help at inpatient rehabilitation facilities is crucial. QUality programs will provide both inpatient and outpatient care to treat addiction. Through this comprehensive, holistic approach, which combines medically-supervised withdrawals, therapy modalities, physical exercise, improved diet, meditation, and more can renew an enrollee’s entire being.

We don’t put a limit on the length of our inpatient care, either. While some patients will stay at an inpatient program for 30 days, others will need more time. A quality inpatient addiction center is willing to work with those enrollees for as long as it takes to make a return to a healthy, addiction-free life.

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Mental Health

The More the Merrier? Children with Multiple Siblings More Susceptible to Bullying

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A child with more than one brother or sister is more likely to be the victim of sibling bullying than those with only one sibling, and firstborn children and older brothers tend to be the perpetrators, according to research published by the American Psychological Association.

“Sibling bullying is the most frequent form of family violence and it is often seen as a normal part of growing up by parents and health professionals, but there is increasing evidence that it can have long-term consequences, like increased loneliness, delinquency and mental health problems,” said Dieter Wolke, PhD, of the University of Warwick and lead author of the study. It was published in the journal Developmental Psychology.

Wolke and his co-author, Slava Dantchev, B.Sc., also of the University of Warwick, wanted to understand the underlying causes of sibling bullying and examined the possible impact of family structure, parenting behaviors, early social experiences and a child’s temperament.

The researchers analyzed data from a longitudinal study of 6,838 British children born in either 1991 or 1992 and their mothers. They defined sibling bullying as psychological abuse (e.g., saying nasty or hurtful things), physical abuse (e.g., hitting, kicking or pushing) or emotional abuse (e.g., ignoring one’s sibling, telling lies or spreading false rumors). The kids were put into four categories: victims, bully victims (defined as being both a perpetrator and victim of bullying), bullies or uninvolved.

When the children were 5 years old, their mothers reported how often the children were victims or perpetrators of bullying in the household. Sibling relations were analyzed two years later when the mothers were asked how much time the children spent engaging with their siblings on various activities, such as crafts or drawing. Several years later, at age 12, the children reported if they had been bullied by a sibling or if they had bullied a sibling within the previous six months. The boys and girls were also asked their ages when they first experienced sibling bullying and when they first bullied a sibling.

Researchers also collected family statistics from the mothers, including the number of children living in the household, the mother’s marital status, the family’s socioeconomic background, maternal mental health during and after pregnancy, parental conflicts, domestic violence and child abuse and the mother-child relations. They also assessed each child’s temperament, mental health, IQ and social/emotional intelligence at various points during their early years.

Approximately 28 percent of the children in the study were involved in sibling bullying and psychological abuse was the most common form. The majority of those children were found to be bully victims, meaning they bullied and were bullied, according to the study.

“Bullying occurs in situations where we cannot choose our peers, like in families,” said Wolke. “Siblings live in close quarters and the familiarity allows them to know what buttons to press to upset their brothers or sisters. This can go both ways and allows a child to be both a victim and a perpetrator of bullying.”

Family structure and gender were the strongest predictors of sibling bullying by middle childhood, according to the authors.

“Bullying was more likely to occur in families with three or more children and the eldest child or older brothers were more often the bullies,” said Dantchev. “Female children and younger children were more often targeted.”

Wolke and Dantchev believe bullying can happen in larger families because resources such as parental affection or attention and material goods are more limited.

“Despite our cultural differences, humans are still very biologically driven. A firstborn child will have their resources halved with the birth of a sibling, and even more so as more siblings are added to the family,” said Wolke. “This causes siblings to fight for those limited resources through dominance.”

Although the researchers investigated whether marital and socioeconomic status would be associated with more or less bullying, they did not find any evidence.

“Sibling bullying does not discriminate. It occurs in wealthy families just as much as lower-income families and it occurs in single-parent households just as much as two-parent households,” said Wolke.

These findings may be helpful to parents as they welcome new additions to their families, Wolke said.

“It will be important for parents to realize and understand that resource loss can affect an older child,” he said. “It is a good idea for parents to manage this from the beginning by spending quality time with their firstborn or older children and by involving them in caring for younger siblings.”

Article: “Trouble in the Nest: Antecedents of Sibling Bullying Victimization and Perpetration” by Slava Dantchev, B.Sc., and Dieter Wolke, PhD, University of Warwick. Developmental Psychology. Published online Feb. 14, 2019.

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Health

Effective Self-Control Strategies Involve Much More Than Willpower, Research Shows

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It’s mid-February, around the time that most people waver in their commitment to the resolutions they’ve made for the new year. Many of these resolutions – whether it’s to spend less time looking at screens, eat more vegetables, or save money for retirement – require us to forego a behavior we want to engage in for the one we think we should engage in. In a new report, leading researchers in behavioral science propose a new framework that outlines different types of self-control strategies and emphasizes that self-control entails more than sheer willpower to be effective.

The report comes at a time when environmental pressures and societal problems are making strategies for boosting self-control more important than ever, says Angela Duckworth, a University of Pennsylvania psychology professor and one of report’s authors.

“Temptations are arguably more readily available, more creatively engineered, and cheaper than any time in history,” Duckworth says. “Junk food gets tastier and cheaper every year. And then there’s video games, social media, the list goes on. In parallel, there are public policy issues such as obesity, educational underachievement, and undersaving that result, in part, from failures of self-control.”

Duckworth’s coauthors on the report– published in Psychological Science in the Public Interest, a journal of the Association for Psychological Science–are Katherine L. Milkman (The Wharton School of the University of Pennsylvania) and David Laibson (Harvard University). George Loewenstein (Carnegie Mellon University), a leading researcher in the science of decision making, is an author of an accompanying commentary.

Based on their comprehensive review of available research, Duckworth, Milkman, and Laibson propose a framework that organizes evidence-based self-control strategies along two dimensions based on how the strategies are implemented and who is initiating them.

They observe that in some cases the best self-control strategy involves us changing the situation to create incentives or obstacles that help us exercise self-control, such as using apps that restrict our phone usage or keeping junk food out of the house. In other cases, it’s more effective to change how we think about the situation — for example, by making an if­-then plan to anticipate how we’ll deal with treats in the office — so that exercising self-control becomes more appealing or easier to accomplish.

Other strategies work better when someone else implements them for us. For example, our electricity company might use social norms to prompt a change in our thinking, showing us how our energy usage compares with that of our neighbors. And policymakers often use situational constraints to prompt behavior focused on the long-term. Examples range from incentives (e.g., tax rebates for eco-friendly building materials) to penalties (e.g., raising taxes on cigarettes and alcohol). Employers are increasingly using another type of situational constraint, defaults, to encourage employees to save for retirement; many are requiring people to opt out of an employer-provided retirement plan if they don’t want to participate.

The strategies, drawing from insights in psychological science and economics, can inform the efforts of policymakers, employers, healthcare professionals, educators, and other practitioners to address pressing issues that stem, at least in part, from failures in self-control, the authors write.

Identifying four types of self-control strategies that go beyond willpower sends an important message, Loewenstein writes in his commentary, given that people often believe willpower is sufficient despite its high failure rate. One of the reasons people tend to fail in their New Year’s resolutions is “naivety about the limitations of the brute-force approach and ignorance of the far more effective strategies enumerated in the review,” he writes.

But Loewenstein notes some important caveats to keep in mind when interpreting the research, which the researchers also acknowledge in the report. Many studies have examined self-control strategies in small groups of participants over brief periods of time, which raises questions about whether they will remain effective if implemented at a broader scale and how long the effects will last.

Duckworth, Milkman, and Laibson hope that their review helps to integrate existing research on self-control from several disciplines into a comprehensive whole.

“There is an urgent need for a cumulative and applied science of self-control–one that incorporates insights from theoretical traditions in both psychological science and economics,” the researchers write. “We hope this review is a step in that direction.

The full report and commentary are available online.

Report: Beyond Willpower: Strategies for Reducing Failures of Self-Control https://journals.sagepub.com/doi/full/10.1177/1529100618821893

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Mental Health

Want to Help Your Teens? Make Their Lives Predictable

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Establishing consistent routines at home for your teen may generate pushback, but it could also set him or her up for future success.

Researchers at the University of Georgia found teens with more family routines during adolescence had higher rates of college enrollment and were less likely to use alcohol in young adulthood, among other positive outcomes.

The findings were published recently in the Journal of Adolescent Health.

“If we’re going to make a difference in our lives and in our family members’ lives, we have to make a difference in the everyday,” said lead author Allen Barton, an assistant research scientist at the Center from the Family Research and the UGA College of Family and Consumer Sciences. “Routines play an important role in making that happen.”

Researchers analyzed data collected from more than 500 rural African American teens beginning when they were 16 and continuing until they were 21.

The teens whose primary caregivers reported more family routines – such as regular meal times, consistent bedtimes and afterschool schedules – reported less alcohol use, greater self-control and emotional well-being and higher rates of college enrollment in young adulthood.

Researchers also analyzed biological samples from the teens and found that those with more family routines during adolescence showed lower levels of epinephrine, a stress hormone.

The benefits of family routines generally persisted even after the researchers took other factors into account such as levels of supportive parenting, household chaos and socioeconomic status.

Routine, consistency and predictability, the research suggested, are powerful influences on a teen’s life.

“We often lose sight of the mundane aspects of life, but if we can get control of the mundane or the everyday parts of life, then I think we can have a major impact on some bigger things,” Barton said. “These findings highlight how you structure your teen’s home environment really matters.”

The research has important implications for family-centered interventions, Barton said, including focusing more attention on increasing predictability and positive routines at home.

“The big takeaway is to help your child navigate the teen years, make their lives predictable,” Barton said. “There has been a lot of research about the importance of routines for healthy development with young kids. These results are some of the first to show that even with teens, it appears routines are similarly powerful.”

The paper, “The profundity of the everyday: Family routines in adolescence predict development in young adulthood,” is available at https://www.sciencedirect.com/science/article/pii/S1054139X18304130?via%3Dihub

Additional authors are Gene H. Brody, Tianyi Yu, Steven M. Kogan and Katherine B. Ehrlich from the University of Georgia and Edith Chen from Northwestern University.

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