WEBVTT
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Welcome to The Factor podcast, where we talk about the
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stuff they didn't teach you in school, how to grow
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your practice, refine your clinical skills, and get better results
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for your patients. We're here to help you navigate the
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real world challenges of being a healthcare provider, from delivering
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top notch patient care to running a business that doesn't
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run you into the ground. Whether you're fresh out of
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school or scaling your practice, we're diving into effective, cutting
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edge treatments to get patients better, faster. We'll also talk
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about business strategies and tactics to help you work smarter
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and not harder, and the mindset shifts required to thrive
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as a top performer in your field so you can
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build a career you love without burning out. If you're
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ready to learn what works and what doesn't from leading experts,
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industry innovators, and respective clinicians across a wide range of specialties,
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you're in the right place, my friend. Let's dive in.
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Welcome back to the Factor podcast, where we bridge the
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gap between rehabilitation performance and real world clinical practice. I'm
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your host, Jessica Riddle, and today we're continuing our conversation
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with doctor Carolina Shander, licensed psychologist and certified mental performance
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consultant who specializes in sports and performance psychology. In Part one,
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we talked about the whole human behind the athlete, how identity,
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mental health, relationships, rest, recovery, and performance are all deeply connected.
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We also discussed why trust matters when integrating mental health
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support into sports medicine and performance environments. In Part two,
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we'll move into the practical side of that conversation. Doctor
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Shander shares how healthcare providers can broach the topic of
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mental health support with patients without making them feel dismissed, judged,
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or like their symptoms are all on their head. We
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also talk about agency, patient buy in, injury recovery, career
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ending injuries, burnout, and how providers can use curiosity and
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better questions to understand what is really happening beneath the surface.
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This episode also includes an important conversation for healthcare providers themselves,
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especially those of you who are high achieving, deeply empathetic,
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and constantly giving of yourself. In practice, Doctor Shander will
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offer practical insight into recognizing burnout, building small moments of recovery,
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and creating rituals that help providers reset their own nervous
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systems between patients and at the end of each day,
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whether you work with athletes, active individuals, performers, or patients
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that are navigating pain, injury, stress, or identity shifts, this
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conversation is a reminder that healing is rarely just about
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the issue. It's about the person attached to it. Let's
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get in and depart two of my conversation with doctor
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Carolina Schander.
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Well, and I've heard time and time again from providers,
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especially those that are a little bit more seasoned in practice,
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that sometimes even a patient you've been seeing for a while,
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you have to ask questions multiple ways sometimes to get
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the true answer. And it's so funny because even being
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a patient myself, I realize that sometimes it's hard for
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me to articulate, well, it hurts he but it's like,
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where does that really hurt? Or where's that coming from?
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Or sometimes I know, especially for chiropractors, for pets, for
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people who are treating kind of the whole person from
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a physical standpoint, people forget to tell them things. Oh yeah,
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I forgot to tell you I had this car accident
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to weeks ago, or I broke this thing in the past,
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and it's bothered me ever since then. So I think
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there is a lot to be said, as you mentioned,
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for kind of like being very observant and kind of
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picking up on cues and picking up little subtleties that
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sometimes are not things that are at the forefront of
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people's mind when they're speaking to you about their pain,
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but certainly are things that if you have an awareness
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of what to look for, you certainly can see differently
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when it comes to being in the office with that
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patient having that visit. Let's say I'm a provider and
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I've noticed some things that you've mentioned are kind of
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those not necessarily red flags to where I think they
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need immediate help, but those kind of yellow flag things
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to where it's like, this person could really benefit from
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speaking to someone. How do I broach that topic without
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number one, making them think that I'm doing that because
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I don't feel like I can help them, and then
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I potentially set them up to lose trust in me
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and my ability to treat them. And or how do
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I broach that topic in a way that doesn't offend
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them or have them think, oh, you think it's just
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all in my head. It's such a delicate dance right,
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especially when those physical symptoms.
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No, it's it definitely is a delicate dance. And I
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even find myself a delicate conversation too, whether it's with
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coaches or even parents that are sending their kids into
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my office. But a big part of what you just
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said right before this is like how do we get
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curious about the person that's on our table or in
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their office? And so I use that kind of same
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lens of if you know the person sitting on your
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table is prone to maybe feeling helpless, or maybe it's
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prone to feeling like they're a problem, right, Like suggesting
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seeing an additional practitioner may feel really difficult and may
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feel really scary and unwelcomed. And so I think what
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I recommend to practitioners is to first get their understanding of,
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like what do they think about mental health or a
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sport performance person? Have they ever had experience with anybody?
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What do they know about it? And then offer your
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own kind of understanding of like, hey, like I've been
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talking about this, or I've been reading about this, or
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I know this person that kind of offers this kind
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of support. Do you know anybody who's done that before?
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Or even talk about other athletes that are really in
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the news space that have talked about it frequently. There's
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a lot of women's soccer players currently talking about their
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mental health and the challenges that they went through throughout
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their years of performing and playing, or people who have
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come back from injury and have utilized those kinds of
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resources being able to just showcase, like, hey, that might
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be something that would be worthwhile, but no worries if not,
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just want to put that out there, that can be
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an additional person on your team to help support you.
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I'm definitely not going to be the catch all beyond
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the savior in any way of shape or form, But
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can I be a part of the team that.
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Can help support that athlete or that person on that table.
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Most people are a lot more willing to hear that
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somebody is going to be just another part of the
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system versus being somebody that's going to either fix it
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all or do it all, or be the thing that's
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going to change everything, because we may not be offering
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that as maybe a potential option. And then another kind
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of aspect or component for me at least, is this
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kind of like backdoor approach of like, hey, have you
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ever thought about incorporating something else into your practice or
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into your sport to amplify your performance, because a lot
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of the times we get people coming in here and
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saying like, oh, I want to be a better free
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throw shooter, or I want to be a better quarterback,
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I want to have better focus, and then we end
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up also being able to build up their confidence and
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their worth and how they see themselves in relationships. And
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so sometimes that approach also works too to give them, hey,
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you might learn something about this, that or the other,
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and once they get into our office, we realize maybe
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it's a little bit more than that. Absolutely well.
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And I can only imagine too, when you have an
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athlete who has had an injury, maybe one that is
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a career ending or a sport ending injury. And as
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you mentioned earlier, like so much of an athlete's identity
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can be wrapped up in being this thing. We as
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humans always tend to label ourselves in one way or
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another because there's there's safety and there's comfort in that,
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especially if that's something that has been your identity for
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so long. And I would imagine that when an athlete
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is at that place where they've had a catastrophic so
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to speak injury that it's like, Okay, I'm not going
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to be able to be this thing anymore. How do you,
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as a mental health professional kind of help guide them
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through figuring out who they are after that? Like, maybe
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you're not this anymore, but that doesn't mean that you
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can't become something different or that there's so much more
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to you than just this one.
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Thing you asked one of my favorite things, I think
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because a big part of also my research in school
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was about transition out of sport and athletes who are
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experiencing a career ending injury. I mean, it's devastating. First
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of all, there's a ton of shock and then grief.
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So we typically work with that first and be able
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to process, understand, and make meaning out of what's happening.
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That's one of the most important parts about transitioning out
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of sport or injury in that kind of career ending
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way is to make meaning from it and understand it
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a little bit more and conceptualize it. Because once we're
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able to experience it and make meaning from it, then we.
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Can actually make choices and do something with it.
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The other part that you talked about of identity, I
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mean athletes typically all so foreclosed on a lot of
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other parts of their identity because they're so committed to
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the sport or their craft. And so it's about building
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those other pieces up too, while managing the grief about
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letting go of the primary one or moving the primary
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identity to a different spot. And I like to talk
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about it that way of you will always be an athlete,
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or you will always be a performer. It's just that
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performer may change shape and look different. Like, for example,
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the way that I see performing and being an athlete
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is I technically have to be an athlete with my
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ten month old and my two and a half year old.
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Every day, I have to figure out how to have
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my energy in a certain place, how to show up
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as my best self despite many circumstances. That may not
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mean I'm sprinting and going off the blocks and swimming
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as fast as I can, but I'm utilizing those same skills.
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And so how do we see the transfer of those
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skills in a way that actually builds confidence and worth
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versus just being like, oh, yeah, you can do other
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things too. You don't have to be an athlete, Because
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the reality is most of the humans sitting in my
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office want to continue to feel like an athlete, So
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how do we build that up and allow them to
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feel also this agency that they can choose how they
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use their athletes self and how they want to see it,
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and how they can transfer it in a way that
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actually feels real to them because they may not identify
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with the fact of using it as a mother. They
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might not they may identify it as like, oh, I
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might actually want to find a different craft that I do.
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Maybe it's I don't know, stock trading, maybe it's baking,
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maybe it's some kind of art. But being able to
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give them the opportunity to explore is also a massive
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part of the work once they get into my office.
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Well, it's something you said there I think is so
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important and I'm curious to hear your thoughts. You mentioned
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that them having the agency to make that choice and
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make that decision. How important do you feel agency is
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to the healing process in general?
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It's like one of the most important parts, right, like feeling.
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And it's so hard because let's say you have you
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tear your acl right or something that you disc bulges
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in your back that never technically will go back to
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where it was before, because that's not how that works, right,
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But feeling like you have agency over what you're healing
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looks like and how much you get to incorporate the
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way that you utilize, whether it's the PTE or whether
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it's like some of these other kind of medical interventions,
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is incredibly valuable, right, not just timing, but who they
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work with and how they work with them. Giving just
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somebody little pieces of choice allows them to feel like, Okay,
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I'm not just I don't have to just do this
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and manage it. But it allows them to feel like
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I get to I have the opportunity to. It's a
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little bit harder when you have like a career ending
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or like life changing injury where your life really does
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no longer look the same, not just about getting back
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to where you were, but more so adjusting to a
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new life completely. That's where it's a little bit harder.
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And then we try and figure out what kinds of
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places of agency they have in other spaces other than
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there may be physical health, but can they change maybe
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even where they work, or like what their schedule might be,
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or even things as simple as like when I get
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up in the morning or when I go to sleep,
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to be able to feel like, no, I don't just
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have to adjust because of my injury, but I'm going
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to adjust also corporate some healing when it comes to
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my injury, but then be able to feel like I
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have a life that I'm building, not just because of
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something that changed.
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Absolutely, and there's an old I don't know how old
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it is, but there's a common saying. You've probably heard
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it too, the physical therapy, physical medicine space and the
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questions always posed, well, what's the best exercise to give
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a patient togrit the patient, and it's the one they'll
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actually do. And I think that really speaks to what
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you were saying about agency, because so many providers are
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frustrated that they will prescribe home exercises. They'll prescribe home
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care to their patients, whether it's an athlete, whether it's
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just your normal.
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Everyday Joe.
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And then the patient comes back in and they're like, well,
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how did your exercise goes? And they're like, I didn't
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have time, all right, I didn't figure it out or whatnot?
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What do you feel like are some fundamental aspects of
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and I know you already mentioned agency, I think is
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a big thing they have to buy in. They have
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to feel like this is something that is their choice
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to do and they're a partner in this. What are
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some ways that you would suggest for healthcare providers to
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get better buy in from their patients when it comes
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to their care plan. I mean from a factor standpoint.
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A lot of our healthcare providers they're very performance minded,
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so they do take into consideration activities of daily living
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that the person already is doing, goals that they have.
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If they're an athlete, they certainly take into consideration the
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sport that they utilize. But and you're sitting down with
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a patient saying, okay, this is what I want you
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to do at home, what are those things that they
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should really have at the forefront of their mind to
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make sure that the patient actually follows through and takes
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responsibility for their care. It's a real question that every
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provider wants to get the answer on.
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Right.
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It's like, what is the one thing I can say
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or the few things I can say to really make
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them understand they have to participate in this. They're not
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just going to come here and get a magic wand
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that I can wave and make.
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It all better. I think I come at a place
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with that from curiosity and transparency. I think the people
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that know me best is I'm pretty direct and so
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like similarly, like if I want somebody to practice imagery
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or some focus or some things that we practice in session,
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and I ask them pretty directly of like, how willing
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are you at this point as much as you know
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from a conscious mind, how willing are you to practice this?
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How also likely are you to practice this? Because this
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is an additional task, right, And so I try to
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understand what it would look like and what kind of
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barriers they are going to be for them, whether it's yeah,
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they have kids, or maybe they have a really tough schedule.
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So what are some places that I can have them
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do their skills or their kind of rehab, not in
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addition to but while they're doing something else, right, So
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that might look like getting curious of like when do
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you have three or four minutes between things that you
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can incorporate this that it's not an additional task but
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just something you do instead. Right, Like I might have
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some breathwork to do for public floor therapy, I could
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do that in my chair right like between clients. And
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so if I were to say, like, oh, I have
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to go do this thing I'm probably not likely to
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do it, but more so of like, Okay, every time
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I take my time and a break, I'm going to
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practice these lifts in my chair. So getting curious about
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like when are they actually able to maybe implement it
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without it being an additional task, and then being really
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curious of what do you think is gonna hold you back?
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Is it time? Is it willingness? Is it that you're
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afraid also that you're not gonna get better? Right? Like
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that's also maybe a barrier at times. And so I
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like to be pretty direct and sometimes clients or patients
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are pretty forthcoming and sometimes they're not, but at least
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it opens up the conversation and the door because maybe
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the first time they come back to you and say, yeah,
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I didn't do them or I forgot, and then you
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ask the question again, I'm like, yeah, we talked about
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this last time, and I'm curious, like, is there anything different,
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Like you said this was a barrier or this was
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gonna be something that was gonna be a challenge.
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Is that what happened?
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Because if so, then like let's get curious and invite
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them to also offer Maybe is it a different exercise
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that doesn't feel as vulnerable or as like shameful, right
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like if I really struggle to do my heel lifts
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or something like that because I feel stupid at practice,
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is there something else that I can do that doesn't
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make me look as silly right in front of my
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teammates or in front of my coaches, or that makes
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me feel strong and capable.
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I know not all exercises make us feel strong and capable.
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But maybe there's another one that can make us feel
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capable that I might do before I do something that's
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really really vulnerable. And so those are the things that
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I would think about. The buy in, though, is for
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us to also remember that if somebody is not willing
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to maybe put in some of the work, all we
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can really do is get curious and understand them and
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offer them the fact that, like, that's okay, and also
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you I want to do this for you at home,
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But how can we together craft a plan that you're going.
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To be actually going to be following.
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And if they don't also being okay without them, maybe
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they're not in the place to implement this help just yet.
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I think that's one of my growth edges throughout the
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last decade has been that sometimes people aren't in the
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place that they're ready to change or to receive support
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and help, that we can just continue to offer, continue
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to either and remind them that I'm here even if
348
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even if they don't take a ton of action right now.
349
00:19:05.240 --> 00:19:08.319
The best clinicians aren't the ones who know the most techniques.
350
00:19:08.519 --> 00:19:11.680
They're the ones who can execute the right system consistently.
351
00:19:12.039 --> 00:19:13.799
The Factor Rehab System teaches.
352
00:19:13.640 --> 00:19:18.119
Made with wondercraft Start Creating today at wondercraft dot Ai.
353
00:19:18.319 --> 00:19:21.799
To guide patients beyond pain relief and into performance optimization.
354
00:19:22.640 --> 00:19:25.200
Attending a live, hands on Factor training allows you to
355
00:19:25.200 --> 00:19:27.799
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356
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Made with wondercraft, Start creating today at wondercraft dot Ai
357
00:19:32.359 --> 00:19:33.400
Houston and Buffalo.
358
00:19:33.640 --> 00:19:37.000
Each is limited to only twenty seats and they're selling fast.
359
00:19:37.759 --> 00:19:40.680
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360
00:19:41.039 --> 00:19:46.319
That's fakt r education dot com now made with Wondercraft.
361
00:19:49.279 --> 00:19:52.240
I think that's really important too, especially for new providers,
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because when you are the provider, when you are the
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product and the service, so to speak, that's some one
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is coming to that is spending their money, spending their
365
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time investing in Yeah, I'm sure there's a lot of
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feelings that you as an individual have when a patient
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goes to you when you felt like things were going
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great and then they just never came back. So I
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think that was huge in what you're saying about having
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those conversations. Would you recommend that it's better to ask
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questions early on about their availability in terms of time
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their normal schedule, like, so that you can go ahead
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and be proactive about coming up with that treatment plan,
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keeping in mind, well, they have multiple kids and they're
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often in the car running from place to place, so
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that you can incorporate a little bit of that into
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the plan from the start.
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Yeah, that's actually one of the things I love here.
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Doctor don and I have a little kind of like
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spreadsheet that's included in our intake paperwork of like their
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daily schedule and weekly kind of performance habits, because again
382
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that may not give us the complete details, but gives
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us a better understanding of like, yeah, how often are
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you sitting, how long are you in the car, do
385
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you have a ton of commuting time? Yeah? How long
386
00:21:09.799 --> 00:21:12.160
are your practices? Are you really active in them? And
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so to get some of that information upfront, and then
388
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be able to elaborate in session of what does it
389
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really look like and what's feasible Because again, like I
390
00:21:19.960 --> 00:21:22.720
can know a ton of stuff about imagery, and I
391
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can give them a ton of skills and tools to
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work on when it comes to confidence. But if they
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only really can focus for thirty minutes each day, okay, wow,
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then we're going to be kind of working uphill. And
395
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if I don't know that, I can tell them a
396
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ton of things and that's not going to be really
397
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all that useful to them.
398
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I think that's huge to get that information right from
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the get go with their intake information. And I think too,
400
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as you mentioned earlier, having those conversations, being intentional with
401
00:21:53.000 --> 00:21:55.400
your communication and the way you speak to patients is
402
00:21:55.400 --> 00:21:59.279
so important. I know that, especially too when it comes
403
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to the physical metad in space.
404
00:22:01.920 --> 00:22:02.759
Words have an.
405
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Extreme amount of power over patients, and while as a
406
00:22:07.839 --> 00:22:11.839
profession health care providers, I think are at least a
407
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little more aware now of the power of their words
408
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when it comes to catastrophizing pain or giving specific terminology
409
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or gnostic terms that patients can now go to. Used
410
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to be it was just go to Google and WebMD
411
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and freak themselves out. Now they can have a higher
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conversation with GPT or claude and get a full diagnosis
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for better or worse, and long term forecast of what
414
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their life could be like. What do you suggest healthcare
415
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providers should keep in mind when it comes to delivering
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difficult news or informing a patient about maybe something that's
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a little bit more disappointing than what they had hoped
418
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was going to be the prognosis or diagnosis.
419
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Yeah, what can I ask, what is like one of
420
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the harder diagnoses do you feel like to deliver? Because
421
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I can think of maybe their progress as slower, so
422
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their return to play is slower, right, Like, Okay, I
423
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can respond to that, But what diagnoses do you feel
424
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like are the hardest to deliver?
425
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And again, as a non clinician, I can't speak from experience,
426
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but I can say having had a front row seat
427
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for it sometimes I think some of the harder ones
428
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involve things like identity, as you mentioned saying we're going
429
00:23:31.279 --> 00:23:34.000
to have to refer you for surgery now, or if
430
00:23:34.000 --> 00:23:39.480
there's someone who's post injury, post surgery and they're just
431
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never able to get quite back to where they used
432
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to be. Or then for providers that treat a lot
433
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of weekend warriors and former athletes, like, hey, dude, you're
434
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seventy now, your seventy year old body is not going
435
00:23:53.279 --> 00:23:55.720
to work the same way that your twenty five year
436
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old body did. Things like that that can be really
437
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crushing when that is such a core part of their identity.
438
00:24:03.680 --> 00:24:06.279
Okay, that's what That's what I was kind of hoping for.
439
00:24:06.319 --> 00:24:10.880
Because the angle that I typically take right is, first
440
00:24:10.880 --> 00:24:14.119
of all, I take a step back and think, what
441
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is this going to mean for this person taking account
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into their identity? Right, So let's say this is a
443
00:24:19.200 --> 00:24:21.640
seven year old human takes a lot of pride in
444
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what they do and they love crushing it, but this
445
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is really starting to brittle their bones, right, or like,
446
00:24:27.480 --> 00:24:31.759
this is really detrimental if I know this about them,
447
00:24:31.920 --> 00:24:35.759
I think about Okay, I have I want to share
448
00:24:35.839 --> 00:24:40.039
with you this information about how your behavior is impacting
449
00:24:40.279 --> 00:24:43.200
your health and kind of look at it from a
450
00:24:43.480 --> 00:24:47.640
this doesn't define you, right, These behaviors are challenging your health,
451
00:24:48.079 --> 00:24:50.359
and I know this means a lot to you. So
452
00:24:50.480 --> 00:24:53.279
let's get kind of curious and creative of what it
453
00:24:53.319 --> 00:24:56.599
would look like to still honor your identities and the
454
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things that matter the most to you, while also keeping
455
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in mind that we have to adjust right the words
456
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of like, there's a whole kind of phenomenon about the
457
00:25:04.400 --> 00:25:07.480
power of yet right or and also the terminology or
458
00:25:07.519 --> 00:25:10.319
words about like we need to adjust, not fix, not stop,
459
00:25:10.480 --> 00:25:12.720
not you're never going to be the same, but more so,
460
00:25:13.240 --> 00:25:17.079
we need to adjust to a new new normal. We
461
00:25:17.160 --> 00:25:20.519
need to identify what's going to be the best path
462
00:25:20.599 --> 00:25:24.559
moving forward given the changes you've experienced, and to have
463
00:25:24.599 --> 00:25:27.640
this kind of almost like openness and idea and almost
464
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again curiosity to what it could look like to change
465
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our behaviors or how we see ourselves despite this really
466
00:25:36.119 --> 00:25:39.079
challenging news, right, Like, if I have an athlete coming
467
00:25:39.079 --> 00:25:41.759
in who's like they have some kind of injury and
468
00:25:41.799 --> 00:25:44.440
they're let's say it's a back injury and they're unable
469
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to return to the field as quickly as they would
470
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like to, I mean, first of all, it's honoring the
471
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fact that like this is really crappy. Is not the
472
00:25:55.839 --> 00:25:58.359
news you want to receive, and honestly, it's not the
473
00:25:58.720 --> 00:26:02.519
news I want to give you either, And what we
474
00:26:02.599 --> 00:26:05.720
need to do is see it as just information and
475
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not something that's defining the next couple steps, because I
476
00:26:09.559 --> 00:26:13.319
think what's really common for high achieving humans and a
477
00:26:13.359 --> 00:26:15.880
lot of people in this planet as we see things
478
00:26:15.960 --> 00:26:18.240
as black or white, like I'm either healed or I'm not,
479
00:26:18.839 --> 00:26:22.240
or I'm cleared to play or I'm not, versus yeah,
480
00:26:22.319 --> 00:26:25.200
I still have these challenges and can I still move
481
00:26:25.240 --> 00:26:27.519
forward in some way, shape or form, even if it's
482
00:26:27.559 --> 00:26:30.319
not the way that I had envision to begin with,
483
00:26:30.680 --> 00:26:34.160
So offering opportunities of maybe healing or growth that's not
484
00:26:34.279 --> 00:26:37.319
maybe just yeah, you're cleared and you're fine, versus like, hey,
485
00:26:37.319 --> 00:26:41.119
you've gotten a lot stronger here, and highlighting the growth
486
00:26:41.119 --> 00:26:44.599
that you've already seen while acknowledging the fact that they're
487
00:26:44.640 --> 00:26:47.720
not where they want to be yet absolutely well.
488
00:26:47.759 --> 00:26:50.400
And I think it's important to have they say to
489
00:26:50.440 --> 00:26:53.359
have and phrases instead of butt like, instead of just
490
00:26:53.759 --> 00:26:56.759
so much have and like, so that they can see
491
00:26:56.759 --> 00:27:03.319
that while you have this injury, you maybe have this
492
00:27:04.160 --> 00:27:06.599
long term thing that you may have to deal with
493
00:27:06.680 --> 00:27:11.400
moving forward, and you can also still be this thing.
494
00:27:11.960 --> 00:27:12.480
Yeah.
495
00:27:12.720 --> 00:27:14.759
It's not an either or there's not a choice to
496
00:27:14.799 --> 00:27:20.160
be made about one versus another. And I would imagine too,
497
00:27:20.200 --> 00:27:24.240
that that's also one of the things you want to
498
00:27:24.279 --> 00:27:26.839
listen for when it comes to having conversations with patients
499
00:27:26.839 --> 00:27:30.079
throughout their care journey is, as you mentioned before, how
500
00:27:30.079 --> 00:27:32.799
are they speaking, what type of language are they using?
501
00:27:33.319 --> 00:27:37.720
Are they using a lot of negative self talk? Are
502
00:27:37.759 --> 00:27:41.400
they making comments that make you question what kind of
503
00:27:41.400 --> 00:27:44.839
support system they may have outside of your interactions with
504
00:27:44.880 --> 00:27:48.359
them in the et cetera. There's been a lot of
505
00:27:48.440 --> 00:27:52.759
focus in the corporate world lately about burnout and about
506
00:27:53.359 --> 00:27:57.640
the signs of burnout what to look for. I'd imagine that,
507
00:27:57.880 --> 00:28:01.039
much like burnout can happen with people who are high
508
00:28:01.079 --> 00:28:05.519
achievers from a mental and a productivity standpoint at work,
509
00:28:06.200 --> 00:28:08.240
you have the same thing when it comes to dealing
510
00:28:08.279 --> 00:28:13.119
with athletes. If I'm a provider who treats the gamut
511
00:28:13.319 --> 00:28:18.440
of different patient demographics, what are some signs of burnout
512
00:28:18.559 --> 00:28:21.559
that I should look for that can kind of tip
513
00:28:21.640 --> 00:28:25.240
me off to the fact that this may shift or
514
00:28:25.319 --> 00:28:28.279
change my care plan a little bit in terms of
515
00:28:29.599 --> 00:28:33.079
kind of the timing and the sequencing of things, versus
516
00:28:33.480 --> 00:28:36.359
really kind of forcing that patient to slow down a
517
00:28:36.400 --> 00:28:38.359
little bit in some aspect of their life.
518
00:28:39.920 --> 00:28:43.000
Yeah, it's a good question. I mean, burnout can look
519
00:28:43.039 --> 00:28:45.240
a little bit different for different kinds of humans. But
520
00:28:45.279 --> 00:28:49.319
the things that stick out to me is probably their
521
00:28:49.400 --> 00:28:53.160
drive is lower, their excitement to improve is lower, so
522
00:28:53.200 --> 00:28:55.920
they're maybe not talking a lot about what they're doing additionally,
523
00:28:56.119 --> 00:28:58.599
or any of their practices or kind of maybe there's
524
00:28:58.599 --> 00:29:00.920
somebody who watches a lot of tape even other sports,
525
00:29:00.920 --> 00:29:03.279
you see kind of a decrease in that. You might
526
00:29:03.359 --> 00:29:07.480
see some really emotional dysregulation. May not just look like
527
00:29:07.480 --> 00:29:10.400
sadness or anger, but maybe some just like volatility and
528
00:29:11.839 --> 00:29:15.160
variability and how they're showing up in there in your office.
529
00:29:15.200 --> 00:29:17.680
If there's big shifts and changes like that's something to
530
00:29:17.720 --> 00:29:20.799
be paying attention to. Maybe also changes in how much
531
00:29:21.440 --> 00:29:23.839
if you ask, like how much they're sleeping, are they
532
00:29:23.839 --> 00:29:26.559
getting rest, are they feeling like rested? If that is
533
00:29:26.599 --> 00:29:30.759
also happening underneath the surface, you'll see some changes and
534
00:29:31.079 --> 00:29:35.400
how they're able to recover. Also, I mean any kinds
535
00:29:35.400 --> 00:29:38.039
of big shifts and changes in eating habits, and so
536
00:29:38.200 --> 00:29:40.839
paying attention to big weight loss with weight gain, or
537
00:29:40.839 --> 00:29:46.119
even comments regarding nutrition and hydrating, because that is typically
538
00:29:46.400 --> 00:29:48.559
falls by the wayside or is a big product of
539
00:29:49.079 --> 00:29:51.519
some of the burnout too, do I answer.
540
00:29:51.319 --> 00:29:54.160
Your question, Yeah, No, that's these are all huge like
541
00:29:54.200 --> 00:29:57.000
things to look for because I think so many people,
542
00:29:57.759 --> 00:30:01.680
especially because a lot of the providers that we have
543
00:30:01.799 --> 00:30:06.839
in our network are themselves high achievers. They are giving
544
00:30:06.880 --> 00:30:09.599
of themselves every day. They all went into the profession
545
00:30:09.640 --> 00:30:12.359
to heal and to help people. I think burnout is
546
00:30:12.400 --> 00:30:16.720
one of those things that while sometimes you may think
547
00:30:16.759 --> 00:30:19.480
you know what it looks like and other people, sometimes
548
00:30:19.480 --> 00:30:21.880
it even sneaks up on you yourself. And because we
549
00:30:22.000 --> 00:30:24.839
do have so many in our network that are either
550
00:30:25.039 --> 00:30:28.799
students going through school and studying for boards and burning
551
00:30:28.839 --> 00:30:31.400
in at both ends there, or those that are in
552
00:30:31.480 --> 00:30:35.519
practice and trying to grow their business, I think, in
553
00:30:35.559 --> 00:30:37.759
my experience anyway, burnout is one of those things that
554
00:30:37.880 --> 00:30:41.440
is kind of sneaky because you don't see it coming,
555
00:30:41.559 --> 00:30:45.440
and usually by the time you realize that you're burned out,
556
00:30:46.119 --> 00:30:50.200
you're definitely there.
557
00:30:58.960 --> 00:31:01.960
That wraps up Part two of our conversation with doctor
558
00:31:02.039 --> 00:31:06.440
Carolina Shander. In this episode, doctor Shander gave us practical
559
00:31:06.480 --> 00:31:12.039
ways to think about communication, patient agency, burnout, referral conversations,
560
00:31:12.440 --> 00:31:14.400
and the emotional realities.
561
00:31:13.880 --> 00:31:15.559
That can show up during recovery.
562
00:31:16.720 --> 00:31:19.359
One of the biggest takeaways is that providers do not
563
00:31:19.680 --> 00:31:22.839
have to have all the answers, and they don't have
564
00:31:22.920 --> 00:31:26.480
to become mental health professionals to support the whole person
565
00:31:26.519 --> 00:31:30.440
in front of them. But they can get curious, they
566
00:31:30.480 --> 00:31:32.880
can ask better questions, they can listen for the way
567
00:31:32.920 --> 00:31:38.359
patients talk about pain, identity, fear, worth, and recovery, and
568
00:31:38.519 --> 00:31:42.359
they can build relationships with trusted mental health professionals so
569
00:31:42.400 --> 00:31:45.960
that when a patient does need additional support, there's already
570
00:31:46.039 --> 00:31:50.400
a pathway available. We also talked about something that matters
571
00:31:50.440 --> 00:31:54.799
deeply for clinicians themselves, and that's the need to create small,
572
00:31:55.000 --> 00:32:00.799
consistent moments of recovery, not just big vacations or dramatic resets,
573
00:32:01.200 --> 00:32:05.680
but the daily practices that help providers stay grounded, emotionally available,
574
00:32:06.079 --> 00:32:09.559
and able to continue doing meaningful work without burning out.
575
00:32:11.000 --> 00:32:15.319
Doctor Shander also reminded us that words matter. The way
576
00:32:15.359 --> 00:32:19.480
we deliver difficult news, describe pain, discuss progress, and frame
577
00:32:19.519 --> 00:32:23.880
a patient's future can either increase fear or help create
578
00:32:23.880 --> 00:32:27.920
a sense of agency and possibility. A big thank you
579
00:32:28.000 --> 00:32:30.759
to doctor Carolina Shander for sharing such a thoughtful and
580
00:32:30.839 --> 00:32:35.319
practical perspective on the connection between mental health, performance, recovery,
581
00:32:35.680 --> 00:32:39.440
and clinical care. As always, thanks for listening to the
582
00:32:39.480 --> 00:32:43.519
Factor podcast. If this conversation was helpful, be sure to
583
00:32:43.519 --> 00:32:46.559
share it with a colleague, coach, or provider who works
584
00:32:46.559 --> 00:32:50.359
with athletes, high performers, or any patients that are navigating
585
00:32:50.440 --> 00:32:53.680
pain and recovery. Be sure to check out the show
586
00:32:53.720 --> 00:32:57.480
notes for additional resources that we discussed today, as well
587
00:32:57.519 --> 00:33:02.160
as to access any special promotion from our sponsors or partners.
588
00:33:03.160 --> 00:33:06.440
Until next time, keep learning, keep refining your systems, and
589
00:33:06.519 --> 00:33:09.559
keep raising the standard of care. We'll see you then.
590
00:33:14.000 --> 00:33:15.920
Hey guys, if you like what you heard today, I
591
00:33:16.039 --> 00:33:19.599
encourage you to visit our website at Factor hyphenstore dot
592
00:33:19.599 --> 00:33:25.759
com that's spelled fa k tr hyphenstore dot com to
593
00:33:25.799 --> 00:33:28.359
find out more information about all that we have to offer.
594
00:33:28.559 --> 00:33:30.920
We have a variety of online offerings as well as
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00:33:30.920 --> 00:33:34.319
our hands on Factor Rehab System course scheduled in cities
596
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around the globe. Be sure to also check out our
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event calendar and bookmark any of these upcoming live webinar
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00:33:40.000 --> 00:33:41.119
dates coming up in the.
599
00:33:41.079 --> 00:33:42.839
Near future so you can join us live.
600
00:33:42.960 --> 00:33:45.400
And of course, the biggest compliment we can receive is
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for you to help us spread the word to your friends,
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colleagues and classmates. You'll find all the important links, as
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well as info about our sponsors in the show notes,
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so be sure to check those out.
1
00:00:01.800 --> 00:00:04.599
Welcome to The Factor podcast, where we talk about the
2
00:00:04.639 --> 00:00:07.400
stuff they didn't teach you in school, how to grow
3
00:00:07.440 --> 00:00:10.640
your practice, refine your clinical skills, and get better results
4
00:00:10.679 --> 00:00:13.560
for your patients. We're here to help you navigate the
5
00:00:13.599 --> 00:00:17.199
real world challenges of being a healthcare provider, from delivering
6
00:00:17.280 --> 00:00:20.160
top notch patient care to running a business that doesn't
7
00:00:20.239 --> 00:00:23.000
run you into the ground. Whether you're fresh out of
8
00:00:23.000 --> 00:00:26.600
school or scaling your practice, we're diving into effective, cutting
9
00:00:26.719 --> 00:00:30.600
edge treatments to get patients better, faster. We'll also talk
10
00:00:30.640 --> 00:00:33.560
about business strategies and tactics to help you work smarter
11
00:00:33.679 --> 00:00:37.600
and not harder, and the mindset shifts required to thrive
12
00:00:37.679 --> 00:00:40.119
as a top performer in your field so you can
13
00:00:40.119 --> 00:00:43.399
build a career you love without burning out. If you're
14
00:00:43.439 --> 00:00:46.960
ready to learn what works and what doesn't from leading experts,
15
00:00:47.000 --> 00:00:51.600
industry innovators, and respective clinicians across a wide range of specialties,
16
00:00:51.920 --> 00:00:54.520
you're in the right place, my friend. Let's dive in.
17
00:00:58.799 --> 00:01:01.640
Welcome back to the Factor podcast, where we bridge the
18
00:01:01.640 --> 00:01:06.319
gap between rehabilitation performance and real world clinical practice. I'm
19
00:01:06.359 --> 00:01:10.120
your host, Jessica Riddle, and today we're continuing our conversation
20
00:01:10.280 --> 00:01:15.120
with doctor Carolina Shander, licensed psychologist and certified mental performance
21
00:01:15.159 --> 00:01:20.560
consultant who specializes in sports and performance psychology. In Part one,
22
00:01:20.680 --> 00:01:24.879
we talked about the whole human behind the athlete, how identity,
23
00:01:25.000 --> 00:01:30.599
mental health, relationships, rest, recovery, and performance are all deeply connected.
24
00:01:31.400 --> 00:01:35.280
We also discussed why trust matters when integrating mental health
25
00:01:35.280 --> 00:01:40.319
support into sports medicine and performance environments. In Part two,
26
00:01:40.760 --> 00:01:44.959
we'll move into the practical side of that conversation. Doctor
27
00:01:45.000 --> 00:01:48.519
Shander shares how healthcare providers can broach the topic of
28
00:01:48.599 --> 00:01:53.120
mental health support with patients without making them feel dismissed, judged,
29
00:01:53.560 --> 00:01:56.799
or like their symptoms are all on their head. We
30
00:01:56.840 --> 00:02:01.560
also talk about agency, patient buy in, injury recovery, career
31
00:02:01.719 --> 00:02:06.200
ending injuries, burnout, and how providers can use curiosity and
32
00:02:06.319 --> 00:02:10.759
better questions to understand what is really happening beneath the surface.
33
00:02:12.199 --> 00:02:18.080
This episode also includes an important conversation for healthcare providers themselves,
34
00:02:19.000 --> 00:02:22.759
especially those of you who are high achieving, deeply empathetic,
35
00:02:23.159 --> 00:02:27.360
and constantly giving of yourself. In practice, Doctor Shander will
36
00:02:27.360 --> 00:02:32.840
offer practical insight into recognizing burnout, building small moments of recovery,
37
00:02:33.000 --> 00:02:36.800
and creating rituals that help providers reset their own nervous
38
00:02:36.800 --> 00:02:40.639
systems between patients and at the end of each day,
39
00:02:41.879 --> 00:02:46.080
whether you work with athletes, active individuals, performers, or patients
40
00:02:46.080 --> 00:02:51.000
that are navigating pain, injury, stress, or identity shifts, this
41
00:02:51.159 --> 00:02:54.599
conversation is a reminder that healing is rarely just about
42
00:02:54.639 --> 00:02:59.680
the issue. It's about the person attached to it. Let's
43
00:02:59.680 --> 00:03:02.479
get in and depart two of my conversation with doctor
44
00:03:02.599 --> 00:03:03.520
Carolina Schander.
45
00:03:15.039 --> 00:03:17.639
Well, and I've heard time and time again from providers,
46
00:03:17.960 --> 00:03:20.319
especially those that are a little bit more seasoned in practice,
47
00:03:21.039 --> 00:03:24.520
that sometimes even a patient you've been seeing for a while,
48
00:03:25.120 --> 00:03:28.680
you have to ask questions multiple ways sometimes to get
49
00:03:28.680 --> 00:03:33.560
the true answer. And it's so funny because even being
50
00:03:33.560 --> 00:03:38.159
a patient myself, I realize that sometimes it's hard for
51
00:03:38.199 --> 00:03:42.319
me to articulate, well, it hurts he but it's like,
52
00:03:42.879 --> 00:03:45.680
where does that really hurt? Or where's that coming from?
53
00:03:46.199 --> 00:03:50.599
Or sometimes I know, especially for chiropractors, for pets, for
54
00:03:50.680 --> 00:03:53.639
people who are treating kind of the whole person from
55
00:03:53.639 --> 00:03:57.039
a physical standpoint, people forget to tell them things. Oh yeah,
56
00:03:57.319 --> 00:03:59.759
I forgot to tell you I had this car accident
57
00:03:59.840 --> 00:04:02.599
to weeks ago, or I broke this thing in the past,
58
00:04:02.680 --> 00:04:06.080
and it's bothered me ever since then. So I think
59
00:04:06.199 --> 00:04:07.879
there is a lot to be said, as you mentioned,
60
00:04:07.879 --> 00:04:11.960
for kind of like being very observant and kind of
61
00:04:12.639 --> 00:04:15.560
picking up on cues and picking up little subtleties that
62
00:04:16.360 --> 00:04:19.279
sometimes are not things that are at the forefront of
63
00:04:19.279 --> 00:04:21.319
people's mind when they're speaking to you about their pain,
64
00:04:21.399 --> 00:04:23.959
but certainly are things that if you have an awareness
65
00:04:24.000 --> 00:04:27.000
of what to look for, you certainly can see differently
66
00:04:28.120 --> 00:04:32.399
when it comes to being in the office with that
67
00:04:32.480 --> 00:04:35.720
patient having that visit. Let's say I'm a provider and
68
00:04:35.800 --> 00:04:39.120
I've noticed some things that you've mentioned are kind of
69
00:04:39.160 --> 00:04:42.600
those not necessarily red flags to where I think they
70
00:04:42.600 --> 00:04:45.759
need immediate help, but those kind of yellow flag things
71
00:04:45.800 --> 00:04:47.839
to where it's like, this person could really benefit from
72
00:04:47.839 --> 00:04:53.480
speaking to someone. How do I broach that topic without
73
00:04:53.800 --> 00:04:57.839
number one, making them think that I'm doing that because
74
00:04:58.079 --> 00:05:00.720
I don't feel like I can help them, and then
75
00:05:00.959 --> 00:05:04.639
I potentially set them up to lose trust in me
76
00:05:04.759 --> 00:05:08.879
and my ability to treat them. And or how do
77
00:05:08.959 --> 00:05:12.439
I broach that topic in a way that doesn't offend
78
00:05:12.519 --> 00:05:15.160
them or have them think, oh, you think it's just
79
00:05:15.240 --> 00:05:18.480
all in my head. It's such a delicate dance right,
80
00:05:18.600 --> 00:05:20.519
especially when those physical symptoms.
81
00:05:21.439 --> 00:05:24.240
No, it's it definitely is a delicate dance. And I
82
00:05:24.279 --> 00:05:27.800
even find myself a delicate conversation too, whether it's with
83
00:05:27.879 --> 00:05:30.279
coaches or even parents that are sending their kids into
84
00:05:30.319 --> 00:05:33.480
my office. But a big part of what you just
85
00:05:33.519 --> 00:05:35.680
said right before this is like how do we get
86
00:05:35.759 --> 00:05:37.759
curious about the person that's on our table or in
87
00:05:37.759 --> 00:05:40.120
their office? And so I use that kind of same
88
00:05:40.240 --> 00:05:42.839
lens of if you know the person sitting on your
89
00:05:42.839 --> 00:05:47.639
table is prone to maybe feeling helpless, or maybe it's
90
00:05:47.680 --> 00:05:52.000
prone to feeling like they're a problem, right, Like suggesting
91
00:05:52.120 --> 00:05:56.319
seeing an additional practitioner may feel really difficult and may
92
00:05:56.360 --> 00:06:00.720
feel really scary and unwelcomed. And so I think what
93
00:06:00.759 --> 00:06:05.920
I recommend to practitioners is to first get their understanding of,
94
00:06:06.000 --> 00:06:09.199
like what do they think about mental health or a
95
00:06:09.199 --> 00:06:12.839
sport performance person? Have they ever had experience with anybody?
96
00:06:13.160 --> 00:06:15.720
What do they know about it? And then offer your
97
00:06:15.759 --> 00:06:19.040
own kind of understanding of like, hey, like I've been
98
00:06:19.360 --> 00:06:21.720
talking about this, or I've been reading about this, or
99
00:06:21.759 --> 00:06:24.480
I know this person that kind of offers this kind
100
00:06:24.519 --> 00:06:27.240
of support. Do you know anybody who's done that before?
101
00:06:27.519 --> 00:06:31.000
Or even talk about other athletes that are really in
102
00:06:31.079 --> 00:06:33.759
the news space that have talked about it frequently. There's
103
00:06:33.800 --> 00:06:36.199
a lot of women's soccer players currently talking about their
104
00:06:36.199 --> 00:06:38.839
mental health and the challenges that they went through throughout
105
00:06:38.879 --> 00:06:42.040
their years of performing and playing, or people who have
106
00:06:42.079 --> 00:06:44.560
come back from injury and have utilized those kinds of
107
00:06:44.639 --> 00:06:48.120
resources being able to just showcase, like, hey, that might
108
00:06:48.160 --> 00:06:51.680
be something that would be worthwhile, but no worries if not,
109
00:06:51.879 --> 00:06:54.040
just want to put that out there, that can be
110
00:06:54.120 --> 00:06:57.560
an additional person on your team to help support you.
111
00:06:58.120 --> 00:07:00.000
I'm definitely not going to be the catch all beyond
112
00:07:00.199 --> 00:07:02.240
the savior in any way of shape or form, But
113
00:07:02.639 --> 00:07:04.800
can I be a part of the team that.
114
00:07:04.720 --> 00:07:07.199
Can help support that athlete or that person on that table.
115
00:07:07.560 --> 00:07:10.519
Most people are a lot more willing to hear that
116
00:07:10.560 --> 00:07:13.279
somebody is going to be just another part of the
117
00:07:13.360 --> 00:07:16.680
system versus being somebody that's going to either fix it
118
00:07:16.720 --> 00:07:19.040
all or do it all, or be the thing that's
119
00:07:19.120 --> 00:07:22.319
going to change everything, because we may not be offering
120
00:07:22.319 --> 00:07:25.600
that as maybe a potential option. And then another kind
121
00:07:25.600 --> 00:07:29.240
of aspect or component for me at least, is this
122
00:07:29.319 --> 00:07:31.680
kind of like backdoor approach of like, hey, have you
123
00:07:31.720 --> 00:07:35.879
ever thought about incorporating something else into your practice or
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into your sport to amplify your performance, because a lot
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of the times we get people coming in here and
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saying like, oh, I want to be a better free
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throw shooter, or I want to be a better quarterback,
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I want to have better focus, and then we end
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up also being able to build up their confidence and
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their worth and how they see themselves in relationships. And
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so sometimes that approach also works too to give them, hey,
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you might learn something about this, that or the other,
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and once they get into our office, we realize maybe
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it's a little bit more than that. Absolutely well.
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And I can only imagine too, when you have an
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athlete who has had an injury, maybe one that is
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a career ending or a sport ending injury. And as
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you mentioned earlier, like so much of an athlete's identity
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can be wrapped up in being this thing. We as
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humans always tend to label ourselves in one way or
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another because there's there's safety and there's comfort in that,
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especially if that's something that has been your identity for
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so long. And I would imagine that when an athlete
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is at that place where they've had a catastrophic so
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to speak injury that it's like, Okay, I'm not going
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to be able to be this thing anymore. How do you,
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as a mental health professional kind of help guide them
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through figuring out who they are after that? Like, maybe
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you're not this anymore, but that doesn't mean that you
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can't become something different or that there's so much more
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to you than just this one.
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Thing you asked one of my favorite things, I think
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because a big part of also my research in school
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was about transition out of sport and athletes who are
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experiencing a career ending injury. I mean, it's devastating. First
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of all, there's a ton of shock and then grief.
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So we typically work with that first and be able
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to process, understand, and make meaning out of what's happening.
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That's one of the most important parts about transitioning out
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of sport or injury in that kind of career ending
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way is to make meaning from it and understand it
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a little bit more and conceptualize it. Because once we're
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able to experience it and make meaning from it, then we.
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Can actually make choices and do something with it.
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The other part that you talked about of identity, I
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mean athletes typically all so foreclosed on a lot of
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other parts of their identity because they're so committed to
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the sport or their craft. And so it's about building
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those other pieces up too, while managing the grief about
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letting go of the primary one or moving the primary
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identity to a different spot. And I like to talk
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about it that way of you will always be an athlete,
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or you will always be a performer. It's just that
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performer may change shape and look different. Like, for example,
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the way that I see performing and being an athlete
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is I technically have to be an athlete with my
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ten month old and my two and a half year old.
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Every day, I have to figure out how to have
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my energy in a certain place, how to show up
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as my best self despite many circumstances. That may not
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mean I'm sprinting and going off the blocks and swimming
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as fast as I can, but I'm utilizing those same skills.
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And so how do we see the transfer of those
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skills in a way that actually builds confidence and worth
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versus just being like, oh, yeah, you can do other
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things too. You don't have to be an athlete, Because
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the reality is most of the humans sitting in my
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office want to continue to feel like an athlete, So
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how do we build that up and allow them to
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feel also this agency that they can choose how they
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use their athletes self and how they want to see it,
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and how they can transfer it in a way that
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actually feels real to them because they may not identify
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with the fact of using it as a mother. They
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might not they may identify it as like, oh, I
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might actually want to find a different craft that I do.
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Maybe it's I don't know, stock trading, maybe it's baking,
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maybe it's some kind of art. But being able to
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give them the opportunity to explore is also a massive
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part of the work once they get into my office.
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Well, it's something you said there I think is so
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important and I'm curious to hear your thoughts. You mentioned
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that them having the agency to make that choice and
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make that decision. How important do you feel agency is
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to the healing process in general?
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It's like one of the most important parts, right, like feeling.
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And it's so hard because let's say you have you
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tear your acl right or something that you disc bulges
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in your back that never technically will go back to
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where it was before, because that's not how that works, right,
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But feeling like you have agency over what you're healing
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looks like and how much you get to incorporate the
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way that you utilize, whether it's the PTE or whether
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it's like some of these other kind of medical interventions,
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is incredibly valuable, right, not just timing, but who they
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work with and how they work with them. Giving just
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somebody little pieces of choice allows them to feel like, Okay,
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I'm not just I don't have to just do this
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and manage it. But it allows them to feel like
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I get to I have the opportunity to. It's a
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little bit harder when you have like a career ending
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or like life changing injury where your life really does
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no longer look the same, not just about getting back
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to where you were, but more so adjusting to a
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new life completely. That's where it's a little bit harder.
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And then we try and figure out what kinds of
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places of agency they have in other spaces other than
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there may be physical health, but can they change maybe
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even where they work, or like what their schedule might be,
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or even things as simple as like when I get
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up in the morning or when I go to sleep,
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to be able to feel like, no, I don't just
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have to adjust because of my injury, but I'm going
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to adjust also corporate some healing when it comes to
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my injury, but then be able to feel like I
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have a life that I'm building, not just because of
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something that changed.
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Absolutely, and there's an old I don't know how old
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it is, but there's a common saying. You've probably heard
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it too, the physical therapy, physical medicine space and the
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questions always posed, well, what's the best exercise to give
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a patient togrit the patient, and it's the one they'll
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actually do. And I think that really speaks to what
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you were saying about agency, because so many providers are
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frustrated that they will prescribe home exercises. They'll prescribe home
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care to their patients, whether it's an athlete, whether it's
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just your normal.
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Everyday Joe.
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And then the patient comes back in and they're like, well,
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how did your exercise goes? And they're like, I didn't
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have time, all right, I didn't figure it out or whatnot?
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What do you feel like are some fundamental aspects of
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and I know you already mentioned agency, I think is
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a big thing they have to buy in. They have
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to feel like this is something that is their choice
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to do and they're a partner in this. What are
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some ways that you would suggest for healthcare providers to
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get better buy in from their patients when it comes
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to their care plan. I mean from a factor standpoint.
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A lot of our healthcare providers they're very performance minded,
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so they do take into consideration activities of daily living
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that the person already is doing, goals that they have.
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If they're an athlete, they certainly take into consideration the
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sport that they utilize. But and you're sitting down with
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a patient saying, okay, this is what I want you
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to do at home, what are those things that they
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should really have at the forefront of their mind to
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make sure that the patient actually follows through and takes
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responsibility for their care. It's a real question that every
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provider wants to get the answer on.
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Right.
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It's like, what is the one thing I can say
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or the few things I can say to really make
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them understand they have to participate in this. They're not
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just going to come here and get a magic wand
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that I can wave and make.
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It all better. I think I come at a place
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with that from curiosity and transparency. I think the people
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that know me best is I'm pretty direct and so
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like similarly, like if I want somebody to practice imagery
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or some focus or some things that we practice in session,
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and I ask them pretty directly of like, how willing
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are you at this point as much as you know
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from a conscious mind, how willing are you to practice this?
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How also likely are you to practice this? Because this
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is an additional task, right, And so I try to
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understand what it would look like and what kind of
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barriers they are going to be for them, whether it's yeah,
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they have kids, or maybe they have a really tough schedule.
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So what are some places that I can have them
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do their skills or their kind of rehab, not in
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addition to but while they're doing something else, right, So
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that might look like getting curious of like when do
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you have three or four minutes between things that you
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can incorporate this that it's not an additional task but
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just something you do instead. Right, Like I might have
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some breathwork to do for public floor therapy, I could
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do that in my chair right like between clients. And
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so if I were to say, like, oh, I have
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to go do this thing I'm probably not likely to
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do it, but more so of like, Okay, every time
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I take my time and a break, I'm going to
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practice these lifts in my chair. So getting curious about
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like when are they actually able to maybe implement it
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without it being an additional task, and then being really
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curious of what do you think is gonna hold you back?
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Is it time? Is it willingness? Is it that you're
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afraid also that you're not gonna get better? Right? Like
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that's also maybe a barrier at times. And so I
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like to be pretty direct and sometimes clients or patients
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are pretty forthcoming and sometimes they're not, but at least
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it opens up the conversation and the door because maybe
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the first time they come back to you and say, yeah,
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I didn't do them or I forgot, and then you
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ask the question again, I'm like, yeah, we talked about
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this last time, and I'm curious, like, is there anything different,
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Like you said this was a barrier or this was
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gonna be something that was gonna be a challenge.
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Is that what happened?
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Because if so, then like let's get curious and invite
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them to also offer Maybe is it a different exercise
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that doesn't feel as vulnerable or as like shameful, right
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like if I really struggle to do my heel lifts
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or something like that because I feel stupid at practice,
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is there something else that I can do that doesn't
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make me look as silly right in front of my
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teammates or in front of my coaches, or that makes
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me feel strong and capable.
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I know not all exercises make us feel strong and capable.
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But maybe there's another one that can make us feel
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capable that I might do before I do something that's
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really really vulnerable. And so those are the things that
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I would think about. The buy in, though, is for
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us to also remember that if somebody is not willing
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to maybe put in some of the work, all we
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can really do is get curious and understand them and
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offer them the fact that, like, that's okay, and also
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you I want to do this for you at home,
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But how can we together craft a plan that you're going.
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To be actually going to be following.
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And if they don't also being okay without them, maybe
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they're not in the place to implement this help just yet.
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I think that's one of my growth edges throughout the
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last decade has been that sometimes people aren't in the
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place that they're ready to change or to receive support
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and help, that we can just continue to offer, continue
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to either and remind them that I'm here even if
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even if they don't take a ton of action right now.
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The best clinicians aren't the ones who know the most techniques.
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They're the ones who can execute the right system consistently.
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The Factor Rehab System teaches.
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00:19:13.640 --> 00:19:18.119
Made with wondercraft Start Creating today at wondercraft dot Ai.
353
00:19:18.319 --> 00:19:21.799
To guide patients beyond pain relief and into performance optimization.
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00:19:22.640 --> 00:19:25.200
Attending a live, hands on Factor training allows you to
355
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walk away with a system you can run Monday morning.
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Made with wondercraft, Start creating today at wondercraft dot Ai
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00:19:32.359 --> 00:19:33.400
Houston and Buffalo.
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Each is limited to only twenty seats and they're selling fast.
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That's fakt r education dot com now made with Wondercraft.
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I think that's really important too, especially for new providers,
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because when you are the provider, when you are the
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product and the service, so to speak, that's some one
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is coming to that is spending their money, spending their
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time investing in Yeah, I'm sure there's a lot of
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feelings that you as an individual have when a patient
367
00:20:10.960 --> 00:20:13.519
goes to you when you felt like things were going
368
00:20:13.559 --> 00:20:16.880
great and then they just never came back. So I
369
00:20:16.920 --> 00:20:18.880
think that was huge in what you're saying about having
370
00:20:18.880 --> 00:20:23.240
those conversations. Would you recommend that it's better to ask
371
00:20:23.359 --> 00:20:28.759
questions early on about their availability in terms of time
372
00:20:29.079 --> 00:20:31.880
their normal schedule, like, so that you can go ahead
373
00:20:31.920 --> 00:20:35.039
and be proactive about coming up with that treatment plan,
374
00:20:35.599 --> 00:20:39.000
keeping in mind, well, they have multiple kids and they're
375
00:20:39.039 --> 00:20:41.680
often in the car running from place to place, so
376
00:20:41.720 --> 00:20:43.559
that you can incorporate a little bit of that into
377
00:20:43.559 --> 00:20:44.759
the plan from the start.
378
00:20:45.480 --> 00:20:47.880
Yeah, that's actually one of the things I love here.
379
00:20:48.039 --> 00:20:49.920
Doctor don and I have a little kind of like
380
00:20:50.079 --> 00:20:53.799
spreadsheet that's included in our intake paperwork of like their
381
00:20:53.880 --> 00:20:59.440
daily schedule and weekly kind of performance habits, because again
382
00:20:59.480 --> 00:21:02.920
that may not give us the complete details, but gives
383
00:21:02.960 --> 00:21:05.079
us a better understanding of like, yeah, how often are
384
00:21:05.119 --> 00:21:07.000
you sitting, how long are you in the car, do
385
00:21:07.039 --> 00:21:09.759
you have a ton of commuting time? Yeah? How long
386
00:21:09.799 --> 00:21:12.160
are your practices? Are you really active in them? And
387
00:21:12.200 --> 00:21:14.759
so to get some of that information upfront, and then
388
00:21:14.839 --> 00:21:17.160
be able to elaborate in session of what does it
389
00:21:17.200 --> 00:21:19.920
really look like and what's feasible Because again, like I
390
00:21:19.960 --> 00:21:22.720
can know a ton of stuff about imagery, and I
391
00:21:22.720 --> 00:21:24.960
can give them a ton of skills and tools to
392
00:21:25.000 --> 00:21:26.960
work on when it comes to confidence. But if they
393
00:21:27.000 --> 00:21:32.519
only really can focus for thirty minutes each day, okay, wow,
394
00:21:33.160 --> 00:21:35.799
then we're going to be kind of working uphill. And
395
00:21:35.839 --> 00:21:37.799
if I don't know that, I can tell them a
396
00:21:37.839 --> 00:21:39.559
ton of things and that's not going to be really
397
00:21:39.559 --> 00:21:40.559
all that useful to them.
398
00:21:41.119 --> 00:21:43.680
I think that's huge to get that information right from
399
00:21:43.720 --> 00:21:48.119
the get go with their intake information. And I think too,
400
00:21:48.359 --> 00:21:52.920
as you mentioned earlier, having those conversations, being intentional with
401
00:21:53.000 --> 00:21:55.400
your communication and the way you speak to patients is
402
00:21:55.400 --> 00:21:59.279
so important. I know that, especially too when it comes
403
00:21:59.279 --> 00:22:00.680
to the physical metad in space.
404
00:22:01.920 --> 00:22:02.759
Words have an.
405
00:22:02.680 --> 00:22:07.799
Extreme amount of power over patients, and while as a
406
00:22:07.839 --> 00:22:11.839
profession health care providers, I think are at least a
407
00:22:11.839 --> 00:22:14.680
little more aware now of the power of their words
408
00:22:14.680 --> 00:22:19.839
when it comes to catastrophizing pain or giving specific terminology
409
00:22:20.079 --> 00:22:24.480
or gnostic terms that patients can now go to. Used
410
00:22:24.480 --> 00:22:26.359
to be it was just go to Google and WebMD
411
00:22:26.519 --> 00:22:29.200
and freak themselves out. Now they can have a higher
412
00:22:29.240 --> 00:22:33.119
conversation with GPT or claude and get a full diagnosis
413
00:22:33.279 --> 00:22:36.720
for better or worse, and long term forecast of what
414
00:22:36.759 --> 00:22:41.440
their life could be like. What do you suggest healthcare
415
00:22:41.480 --> 00:22:45.720
providers should keep in mind when it comes to delivering
416
00:22:46.039 --> 00:22:52.599
difficult news or informing a patient about maybe something that's
417
00:22:53.359 --> 00:22:56.279
a little bit more disappointing than what they had hoped
418
00:22:56.359 --> 00:22:59.720
was going to be the prognosis or diagnosis.
419
00:23:00.480 --> 00:23:03.000
Yeah, what can I ask, what is like one of
420
00:23:03.000 --> 00:23:05.680
the harder diagnoses do you feel like to deliver? Because
421
00:23:05.680 --> 00:23:07.799
I can think of maybe their progress as slower, so
422
00:23:07.839 --> 00:23:10.319
their return to play is slower, right, Like, Okay, I
423
00:23:10.359 --> 00:23:13.359
can respond to that, But what diagnoses do you feel
424
00:23:13.359 --> 00:23:14.720
like are the hardest to deliver?
425
00:23:16.079 --> 00:23:20.519
And again, as a non clinician, I can't speak from experience,
426
00:23:20.599 --> 00:23:23.519
but I can say having had a front row seat
427
00:23:23.559 --> 00:23:26.680
for it sometimes I think some of the harder ones
428
00:23:26.920 --> 00:23:31.240
involve things like identity, as you mentioned saying we're going
429
00:23:31.279 --> 00:23:34.000
to have to refer you for surgery now, or if
430
00:23:34.000 --> 00:23:39.480
there's someone who's post injury, post surgery and they're just
431
00:23:39.720 --> 00:23:42.559
never able to get quite back to where they used
432
00:23:42.599 --> 00:23:46.000
to be. Or then for providers that treat a lot
433
00:23:46.000 --> 00:23:50.240
of weekend warriors and former athletes, like, hey, dude, you're
434
00:23:50.400 --> 00:23:53.200
seventy now, your seventy year old body is not going
435
00:23:53.279 --> 00:23:55.720
to work the same way that your twenty five year
436
00:23:55.759 --> 00:23:58.920
old body did. Things like that that can be really
437
00:23:59.000 --> 00:24:02.799
crushing when that is such a core part of their identity.
438
00:24:03.680 --> 00:24:06.279
Okay, that's what That's what I was kind of hoping for.
439
00:24:06.319 --> 00:24:10.880
Because the angle that I typically take right is, first
440
00:24:10.880 --> 00:24:14.119
of all, I take a step back and think, what
441
00:24:14.200 --> 00:24:16.920
is this going to mean for this person taking account
442
00:24:16.920 --> 00:24:19.160
into their identity? Right, So let's say this is a
443
00:24:19.200 --> 00:24:21.640
seven year old human takes a lot of pride in
444
00:24:21.720 --> 00:24:24.839
what they do and they love crushing it, but this
445
00:24:25.000 --> 00:24:27.400
is really starting to brittle their bones, right, or like,
446
00:24:27.480 --> 00:24:31.759
this is really detrimental if I know this about them,
447
00:24:31.920 --> 00:24:35.759
I think about Okay, I have I want to share
448
00:24:35.839 --> 00:24:40.039
with you this information about how your behavior is impacting
449
00:24:40.279 --> 00:24:43.200
your health and kind of look at it from a
450
00:24:43.480 --> 00:24:47.640
this doesn't define you, right, These behaviors are challenging your health,
451
00:24:48.079 --> 00:24:50.359
and I know this means a lot to you. So
452
00:24:50.480 --> 00:24:53.279
let's get kind of curious and creative of what it
453
00:24:53.319 --> 00:24:56.599
would look like to still honor your identities and the
454
00:24:56.640 --> 00:24:59.160
things that matter the most to you, while also keeping
455
00:24:59.200 --> 00:25:01.559
in mind that we have to adjust right the words
456
00:25:01.599 --> 00:25:04.400
of like, there's a whole kind of phenomenon about the
457
00:25:04.400 --> 00:25:07.480
power of yet right or and also the terminology or
458
00:25:07.519 --> 00:25:10.319
words about like we need to adjust, not fix, not stop,
459
00:25:10.480 --> 00:25:12.720
not you're never going to be the same, but more so,
460
00:25:13.240 --> 00:25:17.079
we need to adjust to a new new normal. We
461
00:25:17.160 --> 00:25:20.519
need to identify what's going to be the best path
462
00:25:20.599 --> 00:25:24.559
moving forward given the changes you've experienced, and to have
463
00:25:24.599 --> 00:25:27.640
this kind of almost like openness and idea and almost
464
00:25:27.720 --> 00:25:31.160
again curiosity to what it could look like to change
465
00:25:31.799 --> 00:25:36.039
our behaviors or how we see ourselves despite this really
466
00:25:36.119 --> 00:25:39.079
challenging news, right, Like, if I have an athlete coming
467
00:25:39.079 --> 00:25:41.759
in who's like they have some kind of injury and
468
00:25:41.799 --> 00:25:44.440
they're let's say it's a back injury and they're unable
469
00:25:44.519 --> 00:25:48.640
to return to the field as quickly as they would
470
00:25:48.680 --> 00:25:51.880
like to, I mean, first of all, it's honoring the
471
00:25:51.880 --> 00:25:55.839
fact that like this is really crappy. Is not the
472
00:25:55.839 --> 00:25:58.359
news you want to receive, and honestly, it's not the
473
00:25:58.720 --> 00:26:02.519
news I want to give you either, And what we
474
00:26:02.599 --> 00:26:05.720
need to do is see it as just information and
475
00:26:05.799 --> 00:26:09.519
not something that's defining the next couple steps, because I
476
00:26:09.559 --> 00:26:13.319
think what's really common for high achieving humans and a
477
00:26:13.359 --> 00:26:15.880
lot of people in this planet as we see things
478
00:26:15.960 --> 00:26:18.240
as black or white, like I'm either healed or I'm not,
479
00:26:18.839 --> 00:26:22.240
or I'm cleared to play or I'm not, versus yeah,
480
00:26:22.319 --> 00:26:25.200
I still have these challenges and can I still move
481
00:26:25.240 --> 00:26:27.519
forward in some way, shape or form, even if it's
482
00:26:27.559 --> 00:26:30.319
not the way that I had envision to begin with,
483
00:26:30.680 --> 00:26:34.160
So offering opportunities of maybe healing or growth that's not
484
00:26:34.279 --> 00:26:37.319
maybe just yeah, you're cleared and you're fine, versus like, hey,
485
00:26:37.319 --> 00:26:41.119
you've gotten a lot stronger here, and highlighting the growth
486
00:26:41.119 --> 00:26:44.599
that you've already seen while acknowledging the fact that they're
487
00:26:44.640 --> 00:26:47.720
not where they want to be yet absolutely well.
488
00:26:47.759 --> 00:26:50.400
And I think it's important to have they say to
489
00:26:50.440 --> 00:26:53.359
have and phrases instead of butt like, instead of just
490
00:26:53.759 --> 00:26:56.759
so much have and like, so that they can see
491
00:26:56.759 --> 00:27:03.319
that while you have this injury, you maybe have this
492
00:27:04.160 --> 00:27:06.599
long term thing that you may have to deal with
493
00:27:06.680 --> 00:27:11.400
moving forward, and you can also still be this thing.
494
00:27:11.960 --> 00:27:12.480
Yeah.
495
00:27:12.720 --> 00:27:14.759
It's not an either or there's not a choice to
496
00:27:14.799 --> 00:27:20.160
be made about one versus another. And I would imagine too,
497
00:27:20.200 --> 00:27:24.240
that that's also one of the things you want to
498
00:27:24.279 --> 00:27:26.839
listen for when it comes to having conversations with patients
499
00:27:26.839 --> 00:27:30.079
throughout their care journey is, as you mentioned before, how
500
00:27:30.079 --> 00:27:32.799
are they speaking, what type of language are they using?
501
00:27:33.319 --> 00:27:37.720
Are they using a lot of negative self talk? Are
502
00:27:37.759 --> 00:27:41.400
they making comments that make you question what kind of
503
00:27:41.400 --> 00:27:44.839
support system they may have outside of your interactions with
504
00:27:44.880 --> 00:27:48.359
them in the et cetera. There's been a lot of
505
00:27:48.440 --> 00:27:52.759
focus in the corporate world lately about burnout and about
506
00:27:53.359 --> 00:27:57.640
the signs of burnout what to look for. I'd imagine that,
507
00:27:57.880 --> 00:28:01.039
much like burnout can happen with people who are high
508
00:28:01.079 --> 00:28:05.519
achievers from a mental and a productivity standpoint at work,
509
00:28:06.200 --> 00:28:08.240
you have the same thing when it comes to dealing
510
00:28:08.279 --> 00:28:13.119
with athletes. If I'm a provider who treats the gamut
511
00:28:13.319 --> 00:28:18.440
of different patient demographics, what are some signs of burnout
512
00:28:18.559 --> 00:28:21.559
that I should look for that can kind of tip
513
00:28:21.640 --> 00:28:25.240
me off to the fact that this may shift or
514
00:28:25.319 --> 00:28:28.279
change my care plan a little bit in terms of
515
00:28:29.599 --> 00:28:33.079
kind of the timing and the sequencing of things, versus
516
00:28:33.480 --> 00:28:36.359
really kind of forcing that patient to slow down a
517
00:28:36.400 --> 00:28:38.359
little bit in some aspect of their life.
518
00:28:39.920 --> 00:28:43.000
Yeah, it's a good question. I mean, burnout can look
519
00:28:43.039 --> 00:28:45.240
a little bit different for different kinds of humans. But
520
00:28:45.279 --> 00:28:49.319
the things that stick out to me is probably their
521
00:28:49.400 --> 00:28:53.160
drive is lower, their excitement to improve is lower, so
522
00:28:53.200 --> 00:28:55.920
they're maybe not talking a lot about what they're doing additionally,
523
00:28:56.119 --> 00:28:58.599
or any of their practices or kind of maybe there's
524
00:28:58.599 --> 00:29:00.920
somebody who watches a lot of tape even other sports,
525
00:29:00.920 --> 00:29:03.279
you see kind of a decrease in that. You might
526
00:29:03.359 --> 00:29:07.480
see some really emotional dysregulation. May not just look like
527
00:29:07.480 --> 00:29:10.400
sadness or anger, but maybe some just like volatility and
528
00:29:11.839 --> 00:29:15.160
variability and how they're showing up in there in your office.
529
00:29:15.200 --> 00:29:17.680
If there's big shifts and changes like that's something to
530
00:29:17.720 --> 00:29:20.799
be paying attention to. Maybe also changes in how much
531
00:29:21.440 --> 00:29:23.839
if you ask, like how much they're sleeping, are they
532
00:29:23.839 --> 00:29:26.559
getting rest, are they feeling like rested? If that is
533
00:29:26.599 --> 00:29:30.759
also happening underneath the surface, you'll see some changes and
534
00:29:31.079 --> 00:29:35.400
how they're able to recover. Also, I mean any kinds
535
00:29:35.400 --> 00:29:38.039
of big shifts and changes in eating habits, and so
536
00:29:38.200 --> 00:29:40.839
paying attention to big weight loss with weight gain, or
537
00:29:40.839 --> 00:29:46.119
even comments regarding nutrition and hydrating, because that is typically
538
00:29:46.400 --> 00:29:48.559
falls by the wayside or is a big product of
539
00:29:49.079 --> 00:29:51.519
some of the burnout too, do I answer.
540
00:29:51.319 --> 00:29:54.160
Your question, Yeah, No, that's these are all huge like
541
00:29:54.200 --> 00:29:57.000
things to look for because I think so many people,
542
00:29:57.759 --> 00:30:01.680
especially because a lot of the providers that we have
543
00:30:01.799 --> 00:30:06.839
in our network are themselves high achievers. They are giving
544
00:30:06.880 --> 00:30:09.599
of themselves every day. They all went into the profession
545
00:30:09.640 --> 00:30:12.359
to heal and to help people. I think burnout is
546
00:30:12.400 --> 00:30:16.720
one of those things that while sometimes you may think
547
00:30:16.759 --> 00:30:19.480
you know what it looks like and other people, sometimes
548
00:30:19.480 --> 00:30:21.880
it even sneaks up on you yourself. And because we
549
00:30:22.000 --> 00:30:24.839
do have so many in our network that are either
550
00:30:25.039 --> 00:30:28.799
students going through school and studying for boards and burning
551
00:30:28.839 --> 00:30:31.400
in at both ends there, or those that are in
552
00:30:31.480 --> 00:30:35.519
practice and trying to grow their business, I think, in
553
00:30:35.559 --> 00:30:37.759
my experience anyway, burnout is one of those things that
554
00:30:37.880 --> 00:30:41.440
is kind of sneaky because you don't see it coming,
555
00:30:41.559 --> 00:30:45.440
and usually by the time you realize that you're burned out,
556
00:30:46.119 --> 00:30:50.200
you're definitely there.
557
00:30:58.960 --> 00:31:01.960
That wraps up Part two of our conversation with doctor
558
00:31:02.039 --> 00:31:06.440
Carolina Shander. In this episode, doctor Shander gave us practical
559
00:31:06.480 --> 00:31:12.039
ways to think about communication, patient agency, burnout, referral conversations,
560
00:31:12.440 --> 00:31:14.400
and the emotional realities.
561
00:31:13.880 --> 00:31:15.559
That can show up during recovery.
562
00:31:16.720 --> 00:31:19.359
One of the biggest takeaways is that providers do not
563
00:31:19.680 --> 00:31:22.839
have to have all the answers, and they don't have
564
00:31:22.920 --> 00:31:26.480
to become mental health professionals to support the whole person
565
00:31:26.519 --> 00:31:30.440
in front of them. But they can get curious, they
566
00:31:30.480 --> 00:31:32.880
can ask better questions, they can listen for the way
567
00:31:32.920 --> 00:31:38.359
patients talk about pain, identity, fear, worth, and recovery, and
568
00:31:38.519 --> 00:31:42.359
they can build relationships with trusted mental health professionals so
569
00:31:42.400 --> 00:31:45.960
that when a patient does need additional support, there's already
570
00:31:46.039 --> 00:31:50.400
a pathway available. We also talked about something that matters
571
00:31:50.440 --> 00:31:54.799
deeply for clinicians themselves, and that's the need to create small,
572
00:31:55.000 --> 00:32:00.799
consistent moments of recovery, not just big vacations or dramatic resets,
573
00:32:01.200 --> 00:32:05.680
but the daily practices that help providers stay grounded, emotionally available,
574
00:32:06.079 --> 00:32:09.559
and able to continue doing meaningful work without burning out.
575
00:32:11.000 --> 00:32:15.319
Doctor Shander also reminded us that words matter. The way
576
00:32:15.359 --> 00:32:19.480
we deliver difficult news, describe pain, discuss progress, and frame
577
00:32:19.519 --> 00:32:23.880
a patient's future can either increase fear or help create
578
00:32:23.880 --> 00:32:27.920
a sense of agency and possibility. A big thank you
579
00:32:28.000 --> 00:32:30.759
to doctor Carolina Shander for sharing such a thoughtful and
580
00:32:30.839 --> 00:32:35.319
practical perspective on the connection between mental health, performance, recovery,
581
00:32:35.680 --> 00:32:39.440
and clinical care. As always, thanks for listening to the
582
00:32:39.480 --> 00:32:43.519
Factor podcast. If this conversation was helpful, be sure to
583
00:32:43.519 --> 00:32:46.559
share it with a colleague, coach, or provider who works
584
00:32:46.559 --> 00:32:50.359
with athletes, high performers, or any patients that are navigating
585
00:32:50.440 --> 00:32:53.680
pain and recovery. Be sure to check out the show
586
00:32:53.720 --> 00:32:57.480
notes for additional resources that we discussed today, as well
587
00:32:57.519 --> 00:33:02.160
as to access any special promotion from our sponsors or partners.
588
00:33:03.160 --> 00:33:06.440
Until next time, keep learning, keep refining your systems, and
589
00:33:06.519 --> 00:33:09.559
keep raising the standard of care. We'll see you then.
590
00:33:14.000 --> 00:33:15.920
Hey guys, if you like what you heard today, I
591
00:33:16.039 --> 00:33:19.599
encourage you to visit our website at Factor hyphenstore dot
592
00:33:19.599 --> 00:33:25.759
com that's spelled fa k tr hyphenstore dot com to
593
00:33:25.799 --> 00:33:28.359
find out more information about all that we have to offer.
594
00:33:28.559 --> 00:33:30.920
We have a variety of online offerings as well as
595
00:33:30.920 --> 00:33:34.319
our hands on Factor Rehab System course scheduled in cities
596
00:33:34.359 --> 00:33:36.400
around the globe. Be sure to also check out our
597
00:33:36.440 --> 00:33:39.880
event calendar and bookmark any of these upcoming live webinar
598
00:33:40.000 --> 00:33:41.119
dates coming up in the.
599
00:33:41.079 --> 00:33:42.839
Near future so you can join us live.
600
00:33:42.960 --> 00:33:45.400
And of course, the biggest compliment we can receive is
601
00:33:45.440 --> 00:33:47.680
for you to help us spread the word to your friends,
602
00:33:47.799 --> 00:33:50.920
colleagues and classmates. You'll find all the important links, as
603
00:33:50.920 --> 00:33:53.279
well as info about our sponsors in the show notes,
604
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so be sure to check those out.
