Getting Help That Actually Fits!

WEBVTT
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Hello and welcome to Why Am I Like This, a podcast for those who didn't get enough hugs as a child.
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I'm Laura Wood and I'm a trauma therapist.
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And I'm Michaela Beaver a Psychiatric Practitioner.
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So, Michaela, why are we doing this podcast?
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I'm so glad you asked.
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We all have patterns fully understand.
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Ways your ads, your feet, skills that seems to show up no matter how hard we try to do that.
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On this podcast, we explore our past experiences, relationships, and nervous systems who we are today.
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Together, we all wonder about at some point why am I like this?
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And more importantly, how can we understand ourselves a little bit more about this?
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Today, we are talking about basically how to get help when we need it.
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So we're trying to answer the following question.
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What type of treatment is out there?
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What is functional medicine?
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And when do I know or how do I know what's right for me?
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So, what are some common barriers that you hear when it comes to like getting help?
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Yeah, I love this.
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I think, you know, when we were thinking about this episode, I think one of the big things that I was thinking about is really who do I go to for how?
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So often people come to me as one, they're not really sure what it is I am or what I do as a psychiatric or practitioner.
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They might be looking for therapy.
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Um, and they're just not really sure what credentials are needed or what credentials they should be looking for when they're looking for care.
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Yeah, I hear that a lot.
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Like, what's the difference between a psychologist and a psychiatrist?
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Or what's the difference between a psychiatrist and a psych MP?
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Or what's the difference between a therapist and a counselor or psychologist, right?
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Like, I don't think that it's really clear or common knowledge, like what the actual credentials are and what they do.
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Yeah, exactly.
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And so I think like it's important for people to kind of understand the different degrees and different things that they should be looking for, so that that will help remove that barrier of like, who do I go to?
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Um, and so you know, traditionally psychiatric nurse practitioners are really gonna be more like in that psychiatrist realm where mostly we're just doing medication management.
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However, I think it's confusing sometimes because I do some psychotherapy, which is not very common.
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Some providers do, but not, but most of them are really just like 15-minute med checks, get them in, get them out.
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Where at CoreSelf we do 30-minute med checks, and we're always thinking about how we can it provide skills, not just pills, right?
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I didn't make it up, but um, I think it's Dr.
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Eamon that I heard say that.
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But so, you know, we're trying to incorporate different modalities of care alongside um, you know, trying to support people with medications because there, you know, obviously is a role where people do you need medications long term or you know, just even for short term till they can stabilize.
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Yeah, I think you know, people who I've seen like requests or whatever online for people who are looking for, they want to have their med provider and their therapist be the same person.
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And that's like barely a thing, right?
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Like you personally, if you're seeing Michela Beaver, like then you are gonna be able to get that, but you're not gonna get that if you're seeing anybody else, right?
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Like you're um most of the time your med provider and your therapist are two different people.
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Yeah.
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But I do think that, you know, we're trying to grow our NPs here at Course Health too, so that they can practice in much of the same pattern.
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But ultimately, even myself as a therapist in a therapist role, you know, I'm doing uh most of the time I'm doing more time-limited psychotherapy, you know, like where it's like, hey, let's try seven sessions and let's make sure, let's let's get you an introduction, let's build some knowledge about, you know, what why are we having anxiety?
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Let's connect some dots, let's help you understand what's going on with your nervous system, let's provide some coping skills, and then let's see where we're at.
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If we're making progress and things are going well, then maybe we'll continue more sessions.
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Or maybe at that point I'll realize that like it's a little bit outside of my scope to continue, you know, providing that psychotherapy and that we maybe need to be looking at a different modality of care that might be a better fit for them because different problems need different tools.
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For sure.
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And lots of therapists practice lots of different modalities, right?
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So when you're doing therapy, you're doing CBT, right?
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I do a little bit of CBT and I do, I have done a little bit of EMCR.
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It's not my main thing.
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I'm testing the waters, but yeah, um, I do that.
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And then I do talk a little bit about like internal family systems stuff with parts work at times, you know, introducing the concepts in there.
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Um, and so I I'm pretty eclectic.
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Yeah.
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Yeah, I think I'm eclectic too in my therapy approach, right?
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Like I'm trained in EMDR, I'm trained in uh structural dissociation, I have um a working knowledge of polyvagal theory, a working knowledge of like um interpersonal neurobiology, sort of the nervous system work and attachment and um and that you know, safe connection and therapeutic relationship.
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Like that's a lot of the time my focus.
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And so um, so what I love though is that you're taking different areas, different types of therapy, and you're working those together around a specific person, right?
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So it's not like, okay, I only do this.
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And so if you come to me, this is what you're gonna get.
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Yeah.
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Well, I'm I mean, I think it makes sense that I do what I do because I learned a lot of things from you.
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So we do a lot of the same things.
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That's fair.
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Um and our therapists though, too, like talking about core self specifically, we have um ART, which is accelerated resolution therapy, we have EMDR, we have child-centered play therapy, we have Santray therapy, we have IFS, the internal family systems, right?
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So, like, um, and then of course your skills-based therapies like CBT and DBT.
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Um, and those, those are really like CBT and DBT, I think about those as like preparation for trauma work.
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So, in a trauma-focused system, which we tend to be, um our our thought process is in phases, right?
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So the first phase of treatment is usually um that preparation and stabilization.
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And that comes with a lot of CBT and DBT skills, like riding the wave of emotion, um, naming your emotions, recognizing your thoughts and how they can, you know, they contribute to your emotional experience and which contributes to your behavior and vice versa, right?
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So um, so all of those things kind of working together.
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And then with EMDR, ART, um Sandray and play therapy for kids is bringing in those um safety mechanisms.
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That's why I think about it.
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It's like we're establishing safety and treatment and we're establishing safety within ourselves, within that nervous system before we're moving into phase two of trauma work, which is really that memory work.
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I think a lot of people come in and say, like, oh, I just want to do EMDR.
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And what do they think that means?
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Right?
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They think that means reprocessing a traumatic memory.
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But we know it's a lot more than that.
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Yes.
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I mean, I'm pretty sure that that's what I thought it was for the longest time, too.
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Right.
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And so I think that that's where like we're training our NPs as well to be really good at helping with the stabilization part of the work.
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And when you know, that that really pairs nicely with medications because, you know, a lot of times that's where polypharmacy comes in, is where we're trying to solve problems with with pills and medication when it's like, you know, the the best research says that cognitive behavioral therapy for insomnia works better than any trazodone out there.
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But it doesn't, it doesn't work overnight.
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And so we need to kind of complement the things that we're doing so that we can, you know, ensure that people get the best outcomes.
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Yeah, where it's not one or the other, it's both.
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So medication can be really helpful in stabilization because it can help take a lot of the severity level down from the symptoms.
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So if I'm experiencing like severe depression and a medication can help me lift my mood enough to where I can start showering every day and I can start eating, you know, every day and I can start sleeping a little bit better, those things are going to contribute to my stabilization and healing before I can get into like what caused my depression in the first place, which could have been a traumatic experience from early childhood, um, you know, maybe like severe experiences of like neglect and um unsafety or abuse, those can contribute to lifetime uh prevalence of depression.
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So I can't work on that stuff if I can't get out of bed.
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Right.
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Well, and sometimes it's just your brain chemistry, that's why you're like this.
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Mm-hmm.
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Yeah.
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Sometimes our brain chemistry just is a little bit different genetically, right?
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Like, you know, for example, if there's a family with a lot of, you know, maybe they have depression and anxiety in their family, it's very likely that your brain is going to have depression and anxiety when you experience stressors and when you experience those triggers and that epigenetic, the environmental triggers kind of turn on that epigenetic feature that releases this genetic uh component that you normally maybe didn't see before, but then suddenly your life got hectic and really hard, and now that's how your brain is responding.
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Yeah, absolutely.
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I think that that's 100% true.
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I think that, you know, it's a it's a it's a combination of different mechanisms that are leading people to have the struggles that they're having.
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It's not just environment, it's not just genetics.
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Um, and sometimes just like, you know, catching that someone has undiagnosed and treated ADHD can really impact anxiety and depression.
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I think like I heard someone say that um women who seek care are more likely to get diagnosed with anxiety and depression rather than ADHD.
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Because we're not, you know, one, it's I think maybe more common and normalized that we're hyper purple.
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Like, you know, we talk a lot, so then like that gets overlooked a little bit.
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Oh, she's just chatting, you know, but then they kind of like don't, you know, focus in on how much anxiety is is driving this the ADHD to perform, right?
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Like it's I'm really working 10 times harder and you don't know it, but like I'm stressing and worrying over these things so much, and that's what's keeping my performance, you know, adequate.
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So you're not seeing me fail.
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And so that, you know, there's there's lots of different reasons why um supporting someone from a like a complex, you know, system overview where you're looking at like the root causes and kind of conceptualizing all the things is going to be really helpful for creating a good treatment plan.
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Yeah, and a good treatment plan includes physical health and mental health, right?
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Like we have to think about how this person is interacting with their nutrition in the world, with their sleep in the world, with their um quality of like exercise and activity, um, all of those things really contribute to our mental health.
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I heard somewhere that um exercise can like 20 minutes of exercise a day can be as effective as an SSRI on depression.
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And so if you're let's say you're like, well, yeah, but I'm depressed, so I can't exercise, okay, start that SSRI and then get into the exercise routine.
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And then potentially, you know, your brain can work itself out and get um get a little bit more balanced, and then you know, you can adjust from there with under the care of your physician.
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Like I think it's really important to recognize that not all mental health conditions are permanent, long-term, forever things.
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A lot of stuff can be healed, right?
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Yeah, absolutely.
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I think that that goes back to the why am I like this whole pre premise is because we developed thoughts about ourselves in childhood, you know, when our brain wasn't really fully developed.
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And those things, those thoughts hang around and they impact us as adults.
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Yeah, yeah.
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And like trauma can be healed, PTSD can be healed.
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We can, and when I say healed, what I mean by that is that you could take that assessment and not meet criteria for the disorder.
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Like for diagnostic purposes in the mental health field, we're looking at the DSM 5 and or the DSM 5 TR is the most recent manual, but it's the diagnostic and statistical manual and it contains a list of all the mental health disorders.
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And within each disorder is a cluster of symptoms.
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So those symptoms that are occurring in you are caused by a variety of things and are exacerbated by a variety of things.
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So if we address some of the causes, address some of the stressors, address some of the things that are exacerbating the symptoms, then we can be symptom free.
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And then in which case we no longer meet the criteria for that particular diagnosis.
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So when people go, you know, think about mental health, a lot of things they're like, well, if I have a mental health disorder, like that means I'm gonna be on meds the rest of my life.
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And that's not always true.
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It's not always true.
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Sometimes it is true, and you know, that is okay too, right?
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It doesn't mean that we failed, it just means that that is how we're gonna function our best.
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And really in the end, that's what matters the most.
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But if we can try to get people off of medicines, that's medicine that's always, you know, an ultimate goal, which makes me think of like what you were saying about like, you know, focusing on different components of their health is really important.
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You know, talking about sleep, you know, sleep is one of the biggest things that people come to get care for, right?
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That that's the thing that drives them here because they're they're they're really struggling with not being able to sleep at night.
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Um, nutrition is huge, you know, there are definitely um things that impact the brain and the body, and your gut is a huge one.
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I know we've talked about that on here before, you know.
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But if your gut isn't sending good signals back to the brain, it's feeding it information that we're not okay.
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And so we wanna, you know, when when we have leaky gut, we're having things cross the blood brain, the gut barrier and the blood brain barrier both that shouldn't be there.
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That's making us have inflammation.
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We know that inflammation is a really big trigger for depression.
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And so, you know, part of what we want to do is help with that functional psychiatry piece of things where we're we're not just you know focusing on um mental wellness, but we're we're focusing on whole person wellness and we're looking at you know optimizing our labs, like our vitamin D, you know, do we have the MTHFR gene mutation?
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What does that mean?
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And how do we, you know, help you manage that?
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And you know, one of the the big things is that, you know, thinking about the dopamine and the reward system, which it plays into a lot of different things, getting out of bed in the morning, right?
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And so making sure that we have the ability to make enough dopamine is important, and so some of those rate limiting things are impacted by our nutrition.
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And so if we can look at that and support our nutrition, then we can feel our best really.
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Um, and that supports the the talk therapy and it also supports the medication management, you know, because if we're just, you know, sometimes meds work better when you take a B complex, for example, right?
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You have the MTHFRG mutation.
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Um, in certain cases, that could be something that would improve an outcome.
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Yeah.
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So when a person is looking for care and they are feeling like, okay, I don't know what's best for me, like, where do I start?
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What it sounds like is you could start with something like um functional psychiatry, like functional medicine, to kind of understand a lot of like what's going on in the body and how that's affecting the brain, and then pair that with something like psychotherapy, where you can then stabilize your capacity for um for experiencing contentment and calm and increase your ability to regulate your nervous system and then potentially work through some of that trauma or some of that, um, some of those causal issues, get to the root cause of things, and then all of that stuff is working together for your best health.
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Yeah, absolutely.
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You know, I think that um traditional um, you know, care often treats the the smoke, right?
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Like we're seeing a lot, we're we're just managing symptoms, right?
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We're because that's what the TSM looks as a collection of symptoms equals a diagnosis, right?
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And so we're just trying to treat symptoms.
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And I think that that the same could be said about some of the different types of therapy modalities, right?
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And in in your trauma work, you're treating fire, right?
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You're trying to look for the fire, trying to put out the fire so that we can also take care of the you got to take care of the smoke sometimes first, right?
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So you can see the fire.
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But you know, like in functional psychiatry, that's often what we're looking for.
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We're trying to understand, like underneath the mechanics of what's going on, so that we can try to, you know, come up with the best treatment plan.
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Okay, so what does that mean?
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What does that include?
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Like if I were to make an appointment and what would I expect?
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Yeah.
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Well, I think the hard thing is that, you know, a lot of what I do is not functional psychiatry.
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A lot of what I do is integrative psychiatry.
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And so the difference is that most people are wanting to come and talk about supplements and see what other options they might have to treat their symptoms.
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Okay.
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Functional psychiatry actually revolves around digging deeper and looking at the underlying things.
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So it requires a lot of lab monitoring and looking at what's going on with the labs.
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And unfortunately, some of the most impactful labs are not covered by health insurance.
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And so that's where I kind of get a lot of hang up, is that I'm like, hey, we can dig down as deep as you want.
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We can see what the what the underlying cause is here, but you know, that often requires some of these other financial implications.
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And not everybody's able to do that.
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So we do the best we can at trying to work with the labs that we are able to get.
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Um, but it, you know, it doesn't have the same impact as if I could get an organic acid test and maybe see, you know, what's do you have cryptopyrol disorder and different things like that that could be really impacting, you know, the outcome of care.
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Okay.
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So it sounds like one of the biggest barriers to care is going to be cost and is going to be insurance and whether or not it's covered and stuff like that.
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I know I hear that too in my work, like with as a therapist, you know, sometimes insurance doesn't cover the cost of therapy until you meet your deductible.
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Um, so those are things to watch out for when you're selecting your plans, right?
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Like I know this year when I selected my plan, because last year that was how mine was.
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And it was like I had to pay, I had to meet my deductible before I could get my therapy costs covered.
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And I was like, oh, that doesn't make sense.
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Like, I don't want to do that again.
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So I changed my plan.
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So I made sure that behavioral health, mental health was covered at my copay rate before I meet my deductible so that I don't have to pay like thousands of dollars out of pocket.
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So I think people don't realize that like those things are written into their plans and they can select a plan potentially that covers more um more mental health and behavioral health.
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But some of them aren't gonna cover all the labs.
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Like they're most of the time, there's gonna be some labs that you pay out of pocket for.
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But then when it comes to for me, it comes down to like, is this worth it?
00:21:46.480 --> 00:21:48.079
How much am I spending?
00:21:48.079 --> 00:21:55.920
How much time, energy, and effort am I spending on dealing with these symptoms and dealing with this, the consequences of whatever's going on?
00:21:55.920 --> 00:21:59.759
That's what's gonna make it worth it for me to.
00:21:59.759 --> 00:22:04.960
Maybe allocate more resources to my health.
00:22:04.960 --> 00:22:11.839
I think I I don't think that we do a good job in our society of allocating resources to health.
00:22:12.160 --> 00:22:13.680
Yeah, I agree with that.
00:22:13.680 --> 00:22:21.599
But I think that like, you know, it's likened often to throwing darts at a dartboard, you know, and you just have to see what sticks.
00:22:21.599 --> 00:22:25.680
And some people are willing to run, you know, jump through the hoops.
00:22:25.680 --> 00:22:27.839
And sometimes it's still necessary, right?
00:22:27.839 --> 00:22:42.559
There are some things that don't follow the rules, but um ultimately, you know, it's it would be nice to be in a in a position where we could, you know, pick the most impactful things first.
00:22:42.559 --> 00:22:54.559
And sometimes that looks at like doing genetic testing as well, which is also in the state of Arizona, not covered by health insurance, by commercial plans for the most part.
00:22:54.559 --> 00:23:08.720
I mean, sometimes it sometimes it could be, I guess I can't speak for all things always, but I know that um, you know, in other areas like Medicare, Medicaid pay for the genetic testing to be done 100%.
00:23:08.720 --> 00:23:10.640
Oh, that's cool.
00:23:10.640 --> 00:23:11.039
Yeah.
00:23:11.039 --> 00:23:14.079
And so what does the genetic genetic testing tell you?
00:23:14.079 --> 00:23:19.279
It looks at how our body is metabolizing drugs in the liver.
00:23:19.279 --> 00:23:34.079
So looking through it's called the CYP system, and it's helping us try to identify are there barriers to improving or sorry, excuse me, are there barriers to how the medication is getting broken down in the body?
00:23:34.079 --> 00:23:40.240
And so, like most of our psych medications go through the 2D6 pathway in the liver.
00:23:40.240 --> 00:23:46.720
And so, you know, one of our big medications is, you know, Adderall, for example, right?
00:23:46.720 --> 00:23:50.160
And um, going through the 2D6 symptom system.
00:23:50.160 --> 00:23:58.160
So if we have that and it's a slow metabolism of that pathway, then we're gonna have drugs hanging around a lot longer.
00:23:58.160 --> 00:24:04.559
And so then that's where we get a lot of insomnia or different side effects from from the treatments.
00:24:05.119 --> 00:24:05.839
That makes sense.
00:24:05.839 --> 00:24:23.200
So it can tell you what types of drugs are gonna metabolize in your system and how like how that, and then you can predict possibly like what kinds of side effects you might have, or like whether or not that might be the most effective choice, because there's so much out there where it's like, how do I know what's the right one?
00:24:23.440 --> 00:24:24.160
Yeah, exactly.
00:24:24.160 --> 00:24:36.079
I mean, I don't think that I think that it gets misconstrued and like some of them are like color-coded, and it's like, oh, this is you know bad because it's in the red, but really it doesn't mean we can't use those medications.
00:24:36.079 --> 00:24:44.079
Those medications have worked very effectively for some people, but it just means that we may change how we're prescribing them.
00:24:44.079 --> 00:24:56.799
You know, we might go with a much lower dose than normal to start when they're a slow metabolizer, or we know that we need to push that dose to the maximum to get any efficacy because they're a rapid metabolizer.
00:24:56.799 --> 00:25:08.799
And then that's where I usually look at the MTHFR gene mutation, if they have a COMT abnormality, which looks at how much dopamine's in the brain and kind of correlates with that.
00:25:08.799 --> 00:25:13.279
And so then that can lead to um, you know, correlation between symptoms.
00:25:13.279 --> 00:25:18.160
So, like my kid, for example, um, he has the COMT met.
00:25:18.160 --> 00:25:26.880
And, you know, it's very consistent that if he gets on too high of a dose of a stimulant, he has side effects.
00:25:26.880 --> 00:25:30.720
He doesn't tolerate them well because it's just too much for his brain.
00:25:30.720 --> 00:25:41.839
And so, and that it's that is among other reasons why, but um, that is one of the contributing factors to it, and it and we can see that play out in how he responds to medication.
00:25:41.839 --> 00:25:48.720
So it's really interesting to be able to review his genetic tests and be able to try to find a good option for him.
00:25:49.680 --> 00:25:51.279
Yeah, that's really helpful.
00:25:51.279 --> 00:25:56.559
So generally, you come to the appointment, you kind of go through all the options, right?
00:25:56.559 --> 00:26:16.160
Like your provider is gonna, and this is like if you see somebody here with core self, but like anybody should expect to go through options with their provider and get an idea of like, should I do a lab first or should I do a genetic test in order to determine like what's appropriate?
00:26:16.160 --> 00:26:18.799
And like those things are good questions to ask, right?
00:26:19.839 --> 00:26:20.480
I think so.
00:26:20.480 --> 00:26:49.200
I think you know, um, the way that we do things here is we kind of start an intake with just trying to understand what their what their concerns are, and then go through all of the different possi, you know, as you know, the major possibilities of things, kind of get to know what's going on for them socially, emotionally, you know, um, how's school, how's work, you know, how are you sleeping, how are you eating, kind of get the lay of the land before we know how to kind of move forward with how we want to proceed.
00:26:49.200 --> 00:26:52.400
Um, usually an intake takes an hour.
00:26:52.400 --> 00:26:55.759
Um, and then you know, we're we're making a plan.
00:26:55.759 --> 00:27:05.839
And I like to, you know, have like a platter, which I know this is overwhelming for some people, but I'm like, you could you could do this, you could do this, you could do this.
00:27:05.839 --> 00:27:09.759
And I try to break it down into pieces so that they can kind of give me a direction.
00:27:09.759 --> 00:27:11.279
Do you want supplements?
00:27:11.279 --> 00:27:12.079
Do you want meds?
00:27:12.079 --> 00:27:13.039
Do you want therapy?
00:27:13.039 --> 00:27:13.599
Okay.
00:27:13.599 --> 00:27:15.839
Now where should we go from there?
00:27:15.839 --> 00:27:16.160
Right.
00:27:16.160 --> 00:27:18.720
And then then I'm not offering too many choices.
00:27:18.720 --> 00:27:22.000
Sometimes people just want you to tell tell them what you think you should do.
00:27:22.000 --> 00:27:30.079
And in which case I'm always looking for shared decision making, understanding the risks versus the benefits of doing those things as best I can.
00:27:30.079 --> 00:27:34.480
Um, and I think that's how like most of our providers at at CoreSelf are.
00:27:34.480 --> 00:27:47.920
Um but I think like, you know, when we're looking at, you know, whether this person should, you know, when you're looking for, you know that you want therapy, for example, right?
00:27:47.920 --> 00:27:50.960
And you're not really looking for medications yet.
00:27:50.960 --> 00:28:07.519
You know, looking for someone who has a degree as a licensed professional counselor or an LPC is really helpful, or someone who has an LISW or LMSW, um, who's pre-licensed or whatever, right?
00:28:07.519 --> 00:28:09.359
Am I missing anything there?
00:28:09.680 --> 00:28:09.920
Yeah.
00:28:09.920 --> 00:28:19.920
So in the counseling world, there's a licensed associate counselor, and those people are are qualified therapists who are practice under supervision.
00:28:19.920 --> 00:28:25.759
And a licensed professional counselor is somebody who is practicing independently without supervision.
00:28:25.759 --> 00:28:38.160
Um, and then in this with these, there's also social workers who practice as therapists, and they're an LMSW, which is practicing under supervision, and an LCSW, which is practicing without supervision.
00:28:38.160 --> 00:28:59.279
So looking for an LAC or an LPC or an LMSW or an LCSW, those are those, those are therapists who are going to be providing you with like the mental health therapy weekly appointments, 50-minute appointments where you're talking through your challenges, making a treatment plan with that therapist to work on specific goals.
00:28:59.279 --> 00:29:13.839
So we think we usually make a treatment plan that has two or three big goals that are related to symptoms or related to behaviors that we don't like about our lifestyle or ourself, right?
00:29:13.839 --> 00:29:38.240
So, like for example, um, you know, if I don't like the fact that I am having trouble sleeping and that I am um overthinking and feeling anxiety, and those are causing me clinically significant distress, like those could be some goals that I would set, like maybe change my sleep pattern, um, reduce my anxiety symptoms, uh, reduce my overthinking.
00:29:38.240 --> 00:29:39.839
Those would be therapy goals.
00:29:39.839 --> 00:29:42.880
And then we would be working towards those goals.
00:29:42.880 --> 00:29:50.720
And a lot of the interventions that we use as therapists are going to come from CBT, DBT, EMDR, all those things that we mentioned earlier.
00:29:50.720 --> 00:30:00.480
And your therapist is going to uh work with you to make sure that they're on track to helping you achieve those goals.
00:30:00.480 --> 00:30:02.880
There's a lot of shared decision making there.
00:30:02.880 --> 00:30:08.400
And um, what's really important in therapy is autonomy and accountability.
00:30:08.400 --> 00:30:16.000
And um really what's happening is we're building your ability to function at your best, right?
00:30:16.000 --> 00:30:23.039
So the therapist isn't like telling you what to do, the therapist isn't giving you all this advice or saying like what you should do.
00:30:23.039 --> 00:30:39.359
The therapist is working with you to help you make the best possible choice and help you make the best, you know, optimize your life in the way that is going to be the best for you based on you know your capacity and also like helping you with symptom reduction.
00:30:39.359 --> 00:30:50.240
So we kind of reduce those symptoms, we identify the cause uh or the root cause, and we modify behaviors and we say, you know, how's that working?
00:30:50.240 --> 00:30:56.480
And um evaluate kind of if if this is effective or not, and then kind of continue to go forward.
00:30:56.480 --> 00:31:06.160
But we update treatment plans at least once a year because you know, um we're we should be achieving those therapy goals as we're working together.
00:31:06.480 --> 00:31:07.839
Yeah, yeah, I love that.
00:31:07.839 --> 00:31:22.160
I think that one of the things that um is the most difficult when trying to get into therapy is that you're so ready, like you're finally ready to like talk and get help.
00:31:22.160 --> 00:31:28.960
And the first like three sessions are really not that most of the time.
00:31:28.960 --> 00:31:40.640
You might be sprinkled in, but you know, you're really looking at like creating that, you know, treatment plan so that you know what how to start and how to move forward.
00:31:40.640 --> 00:31:53.839
And so, you know, I think the the one thing I would say for like therapy barriers would be just like hang in there and know the first like three sessions are gonna be really more like technical, um, not really support-based necessarily.
00:31:54.240 --> 00:31:55.440
Yeah, that's a good point.
00:31:55.440 --> 00:32:02.319
And uh, you know, for us, I like for our intakes to include some tangible things that we can use right away too.
00:32:02.319 --> 00:32:05.119
So we also include what's called psychoeducation.
00:32:05.119 --> 00:32:14.720
So we might in an intake, we're gonna gather a lot of information, but we're also gonna teach you a little bit about your nervous system and your window of tolerance and like how that is affecting your daily life.
00:32:14.720 --> 00:32:26.559
And like we're gonna talk about what questions I might ask you in the future and why those questions are important and how those the the answers to those questions could lead us down to the road to the root cause of what's going on.
00:32:26.559 --> 00:32:48.400
And so hopefully by the end of your first session um or your second session or your third session, you know, those those information gathering sessions, um, you're feeling like at least you're feeling understood, you're feeling like you have a better understanding of what's happening for you, and you're feeling like you have a really clear path forward and you have some hope.
00:32:48.720 --> 00:32:49.920
Yeah, I love that.
00:32:49.920 --> 00:32:56.960
Do you think that what are other barriers do you see with people like reaching out for therapy?
00:32:58.160 --> 00:33:11.519
Um well, I think because people are afraid that they're not gonna like their therapist, they're afraid to like tell someone everything and like invest their energy into that appointment and then have it not be a good fit.
00:33:11.519 --> 00:33:13.759
So I think that's hard.
00:33:13.759 --> 00:33:21.119
Um, but I know that, you know, the relationship, the therapeutic relationship is really important.
00:33:21.119 --> 00:33:27.200
And it's one of the things that does the most work in a therapy session is that connection that you have with your provider.
00:33:27.200 --> 00:33:37.839
And so when you are meeting someone for the first time, like figuring out if it's a good fit is a really critical aspect of whether or not you're gonna be successful.
00:33:37.839 --> 00:33:56.880
And so I think that scares people to just think about like, I'm gonna go in and I'm gonna be vulnerable and I'm gonna share, like, because when we're experiencing distress constantly, when we're constantly in survival mode, when we're extreme depression, anxiety, overwhelm, OCD, all these things, that's a barrier to our functioning in our day-to-day life.
00:33:56.880 --> 00:34:07.920
And in order to make an appointment, in order to do the research, Google, you know, the therapist powers core self-that's what I was gonna say.
00:34:07.920 --> 00:34:13.280
Go to core self.org and schedule an appointment, but like you have to take time out of your day.
00:34:13.280 --> 00:34:30.719
Like we know as therapists, like that it's a lot, and so we recognize that like you're in a vulnerable position in that moment because you've done all this work, you've put all this energy into getting here, and so we want to make this as safe as possible for you.
00:34:30.719 --> 00:34:32.480
That's really our goal.
00:34:32.800 --> 00:34:34.000
Yeah, I love that.
00:34:34.000 --> 00:34:40.480
And I I'm wondering, like, you know, the fit the free 15-minute consultation, right?
00:34:40.480 --> 00:34:41.519
Like, this is gold.
00:34:41.519 --> 00:34:53.599
And I think that like maybe it doesn't get utilized as as often as it could, but I think from like uh I'm a therapist standpoint, like that's your opportunity to to like decide.
00:34:53.599 --> 00:34:56.159
Do we kind of like like drive?
00:34:56.159 --> 00:34:57.679
Drive, do we do drive?
00:34:57.679 --> 00:35:00.000
Like, are we like are we gonna be a good fit?
00:35:00.000 --> 00:35:03.760
Do we seem like we're on the same page as far as like personalities?
00:35:03.760 --> 00:35:08.079
Or, you know, are you giving me warm feedback when I need warm feedback?
00:35:08.079 --> 00:35:10.559
Or are you too much like, you know?
00:35:10.559 --> 00:35:12.559
And so I think that's a really good opportunity.
00:35:12.559 --> 00:35:23.760
And then I think, you know, from the psychiatric prescriber standpoint, I think that's a really good opportunity to like ask questions and say, like, here's what I'm looking for.
00:35:23.760 --> 00:35:26.400
What do you, what services do you provide?
00:35:26.400 --> 00:35:30.880
And are you going to be someone who can give me what I'm looking for?
00:35:30.880 --> 00:35:34.400
So I think it's a really good resource to use.
00:35:34.639 --> 00:35:35.039
It is.
00:35:35.039 --> 00:35:43.039
And I wasn't even thinking about the 15-minute consult, but that's such a good point because that it like when you're looking for someone, look for someone who offers a 15-minute consult.
00:35:43.039 --> 00:35:47.280
We do, our therapists do, our providers offer a 15-minute consult.
00:35:47.280 --> 00:36:03.280
Um, our NPs and our therapists do, because we want you to not have to do all that, like we want you to be able to experience like what you feel in the moment to see if it's a good fit before you come in for that first appointment, because we know how hard that can be.
00:36:03.280 --> 00:36:07.199
And there's a lot of therapists and practices out there that offer the 15-minute consult.
00:36:07.199 --> 00:36:08.159
Some don't.
00:36:08.159 --> 00:36:12.480
So if you can get in with a 15-minute consult, I would recommend starting there.
00:36:12.800 --> 00:36:14.880
Yeah, I think it's a low pressure way.
00:36:14.880 --> 00:36:20.960
Like, you know, that's not the time to like share all the details of your situation.
00:36:20.960 --> 00:36:23.119
Just a brief overview.
00:36:23.119 --> 00:36:28.480
Like, I'm feeling anxious, I'm feeling sad, I think I have ADD, ADHD.
00:36:28.480 --> 00:36:31.360
Like, I want, you know, I'm this is what I'm looking for.
00:36:31.360 --> 00:36:33.760
I'm looking for meds, I'm looking for therapy.
00:36:33.760 --> 00:36:43.119
I'm looking for someone who is gonna listen to me, you know, and make me feel heard, not and validated, and not like I'm just a number in their practice.
00:36:43.119 --> 00:36:51.039
That's that's the goal of trying to, unless that's what you're looking for, just a quick like I just want someone to just give me my meds and get out, right?
00:36:51.039 --> 00:36:55.119
In which case, then then you'll get that vibe from the person, hopefully.
00:36:55.599 --> 00:36:56.159
Yeah.
00:36:56.159 --> 00:36:58.079
No, I think that's such a good point.
00:36:58.079 --> 00:37:03.039
Like it's it can be really intimidating to talk to some to meet with someone for the first time.
00:37:03.039 --> 00:37:11.519
Like, you might be worried that you're gonna be judged, you might be worried that you're gonna be um, you know, questioned about like why do you want this medicine?
00:37:11.519 --> 00:37:14.159
Or, you know, there might be like a mat a bad connotation.
00:37:14.159 --> 00:37:18.400
Like, I know people who get nervous about like going and getting treatment and getting care.
00:37:18.400 --> 00:37:30.239
And, you know, it's important to remember that like they're the provider is there for you, like they're there to help you with your goals and help you find relief from your symptoms.
00:37:30.239 --> 00:37:40.719
And they're also the expert in the medication and the expert in, you know, the treatment modality to kind of say, like, you know, this may be a really good fit for you, this may not be a good fit for you.
00:37:40.719 --> 00:37:42.079
So it's a partnership.
00:37:42.079 --> 00:37:47.039
It's not um, like you're the expert on you and they're the expert on the training, right?
00:37:47.039 --> 00:37:50.400
So it's like that partnership is really important.
00:37:50.400 --> 00:37:56.159
You're not um, you know, you're not like less than them.
00:37:56.159 --> 00:38:01.840
Like that it's they're you're as important as they are in that relationship, right?
00:38:01.840 --> 00:38:17.360
Like I think sometimes people can feel like uncomfortable with the power dynamic, and that's something that we try to try not to um to really have is we want you to know that like we're just people too, and we're here to support you and help you.
00:38:17.360 --> 00:38:18.639
That's so true.
00:38:18.880 --> 00:38:19.039
Yeah.
00:38:19.440 --> 00:38:20.079
Yeah.
00:38:20.079 --> 00:38:33.519
And so I wonder, you know, about like the very first day that I'm trying to, you know, look for something online and I'm thinking like what's best for me.
00:38:33.519 --> 00:38:46.400
Um the other thing is like an integrated clinic like CoreSelf or others that offer therapy and medication management in the same place could be really helpful because wherever you start, we're gonna guide you in the right direction.
00:38:46.800 --> 00:38:47.920
Yeah, absolutely.
00:38:47.920 --> 00:38:58.960
I think that that's a good point, and I think that that's what we are looking to develop is just being able to be uh a support for people and helping them feel really comfortable on the journey.
00:38:59.199 --> 00:38:59.679
Yeah.
00:38:59.679 --> 00:39:03.760
Well, I think that's a really good place to leave it today.
00:39:03.760 --> 00:39:05.440
Um, this was really helpful.
00:39:05.440 --> 00:39:13.679
I know that there's a lot of people out there who are worried about you know not knowing where to start, and we may have a better idea now.
00:39:13.679 --> 00:39:19.679
So thank you everyone for listening to Why Am I Like This.
00:39:19.679 --> 00:39:24.159
If you like our show, p lease leave us a rating on your favorite platform.
00:39:24.159 --> 00:39:40.880
Follow the show and share it with friends! This episode was written by Laura Wood and Michaela Beaver, and a special thanks to core self, Benavieri counseling, and active healing psychiatric services for sponsoring our show.