1 00:00:00,200 --> 00:00:04,200 Welcome to she persisted I'm your host Sadie Saxton a 19 year 2 00:00:04,200 --> 00:00:07,100 old from the Bay Area studying psychology at the University of 3 00:00:07,100 --> 00:00:10,400 Pennsylvania. She persisted is the Teen Mental 4 00:00:10,400 --> 00:00:13,800 Health podcast made for teenagers by a team in each 5 00:00:13,800 --> 00:00:15,400 episode. I'll bring you authentic 6 00:00:15,400 --> 00:00:18,300 accessible and relatable conversations about every aspect 7 00:00:18,300 --> 00:00:21,600 of mental Wellness. You can expect evidence-based, 8 00:00:21,600 --> 00:00:25,100 Tina, proof resources, coping skills, including lots of DBT, 9 00:00:25,100 --> 00:00:28,300 insights and education. In each piece of content, you 10 00:00:28,300 --> 00:00:31,700 consume, she persisted It offers you a safe space to feel 11 00:00:31,700 --> 00:00:33,800 validated and understood in your struggle. 12 00:00:34,000 --> 00:00:36,400 While encouraging you to take ownership of your journey and 13 00:00:36,400 --> 00:00:40,900 build your life worth living. So, let's dive in this week on, 14 00:00:40,900 --> 00:00:43,900 she persisted often I'll hear from young people but I don't 15 00:00:43,900 --> 00:00:48,300 need a therapist. I have friends and my response 16 00:00:48,300 --> 00:00:50,700 to that is that friends are wonderful. 17 00:00:50,700 --> 00:00:53,200 That really important. I want you to have them and I 18 00:00:53,200 --> 00:00:56,000 want you to talk to your friends about the important things in 19 00:00:56,000 --> 00:00:59,600 your life, but your friends are just that they're your friends, 20 00:00:59,700 --> 00:01:02,900 your This is there to be supportive of you but also push 21 00:01:02,900 --> 00:01:08,300 on you at times and therapy. May be uncomfortable at times 22 00:01:08,300 --> 00:01:12,200 but you need an objective outside person who can tell you 23 00:01:12,200 --> 00:01:15,200 what it is. Hello, hello and welcome back to 24 00:01:15,200 --> 00:01:17,100 she persisted. I am so excited for this 25 00:01:17,100 --> 00:01:18,900 episode. This is one of my most highly 26 00:01:18,900 --> 00:01:21,100 requested topics. It's something I'm constantly 27 00:01:21,100 --> 00:01:24,200 getting questions about via email and DM's at on the 28 00:01:24,500 --> 00:01:27,600 question submission form, which is parents that are looking for 29 00:01:27,600 --> 00:01:30,100 guidance on how to find their team. 30 00:01:30,200 --> 00:01:32,600 Teen treatment. And then, for teens, what to 31 00:01:32,600 --> 00:01:35,800 expect from that process. So we've brought in an expert. 32 00:01:35,800 --> 00:01:38,100 Today's guest is dr. Justin Mo hat. 33 00:01:38,200 --> 00:01:40,800 He is an internationally recognized harvard-trained, 34 00:01:40,800 --> 00:01:42,600 double board certified psychiatrist. 35 00:01:42,600 --> 00:01:47,300 He specializes in anxiety, OCD, and tic disorders and childhood. 36 00:01:47,300 --> 00:01:49,900 Adolescence, and emerging adulthood, he is an expert in 37 00:01:49,900 --> 00:01:54,100 complex case, formulation, and medication management and works 38 00:01:54,100 --> 00:01:56,900 heavily on the treatment side of things, he worked at a treatment 39 00:01:56,900 --> 00:02:01,300 program, so he answered all of my questions about To expect and 40 00:02:01,300 --> 00:02:03,700 what to know if you are navigating this process, both is 41 00:02:03,700 --> 00:02:06,600 apparent and the Teen. So, for parents what to look for 42 00:02:06,600 --> 00:02:09,300 in treatment programs. What questions to ask them? 43 00:02:09,300 --> 00:02:11,200 What are the non-negotiables? What are the things that are 44 00:02:11,200 --> 00:02:15,000 nice to have tips to get your teen to be an active participant 45 00:02:15,000 --> 00:02:17,500 and to be motivated to get treatment especially when 46 00:02:17,500 --> 00:02:20,200 they're not necessarily motivated it initially and how 47 00:02:20,200 --> 00:02:21,600 to approach the treatment process. 48 00:02:21,600 --> 00:02:25,400 So like what can you expect from quote-unquote getting treatment 49 00:02:25,400 --> 00:02:29,100 and then for teens, what can you expect when you are pursuing 50 00:02:29,100 --> 00:02:31,900 intensive treatment? What Justin wishes that teens 51 00:02:31,900 --> 00:02:34,700 were aware of when they start treatment in a bunch of myths 52 00:02:34,700 --> 00:02:37,600 that he wanted to debunk. So if there are any anxieties, 53 00:02:37,600 --> 00:02:40,400 you have about this experience, we debunk all of those. 54 00:02:40,400 --> 00:02:42,500 So this is an amazing conversation. 55 00:02:42,800 --> 00:02:46,100 It really fills a need that I haven't touched on before and 56 00:02:46,100 --> 00:02:49,200 she persisted which are these questions that teens and parents 57 00:02:49,200 --> 00:02:52,400 have from an expert perspective? So I'm so excited about this, 58 00:02:52,800 --> 00:02:56,200 you are going to love it. So with that, let's dive in. 59 00:02:56,400 --> 00:02:58,600 Thank you so much for coming on, she persisted today. 60 00:02:58,600 --> 00:03:00,100 I'm so excited to have you on the show. 61 00:03:00,200 --> 00:03:02,900 We're going to talk about some of my most frequently asked 62 00:03:02,900 --> 00:03:05,400 questions and I know this episode is going to be such a 63 00:03:05,400 --> 00:03:08,100 resource for so many people. So thank you for sitting down 64 00:03:08,100 --> 00:03:10,200 with me. Yeah, I'm happy to be here. 65 00:03:10,200 --> 00:03:13,800 I'm very flattered that you asked me, of course, of course. 66 00:03:13,800 --> 00:03:17,200 Now I am very excited to pick your brain about all things teen 67 00:03:17,200 --> 00:03:19,900 treatment, and get the Adolescent perspective, and the 68 00:03:19,900 --> 00:03:23,600 parent perspective because it really does feel like a black 69 00:03:23,600 --> 00:03:26,200 box almost until you're within the treatment world. 70 00:03:26,200 --> 00:03:27,800 You're like, I don't know what to expect. 71 00:03:27,800 --> 00:03:30,600 Like what's the difference between IOP and Intensive 72 00:03:30,600 --> 00:03:33,600 treatment and residential and there's no set path. 73 00:03:33,600 --> 00:03:35,700 So hopefully with this conversation we can provide a 74 00:03:35,700 --> 00:03:39,600 little bit of clarity and lesson certainty for any families that 75 00:03:39,600 --> 00:03:42,500 are navigating this. You said that so well, I think 76 00:03:42,500 --> 00:03:46,600 that so much of our field is exactly that a black box and 77 00:03:47,100 --> 00:03:50,600 people spend days on the internet, trying to search. 78 00:03:50,900 --> 00:03:53,400 They get word of mouth. And somebody says, oh, this 79 00:03:53,400 --> 00:03:55,500 person is really good, you should go see them but they have 80 00:03:55,500 --> 00:03:58,700 no idea if that person is good for what they need, and one 81 00:03:58,700 --> 00:04:00,000 person can be really good at one thing. 82 00:04:00,200 --> 00:04:02,600 Not know anything about another thing. 83 00:04:02,600 --> 00:04:06,900 And so, you know, I think we've been working very hard in the 84 00:04:06,900 --> 00:04:11,000 places that I've most recently been been at to try and create 85 00:04:11,000 --> 00:04:13,900 systems that are more transparent and easy to navigate 86 00:04:14,000 --> 00:04:17,500 and to help families through that process. 87 00:04:17,700 --> 00:04:20,399 Absolutely. So I'm thinking we split this 88 00:04:20,399 --> 00:04:24,000 between advice for parents and advice for teens because the 89 00:04:24,000 --> 00:04:25,900 questions are very different for teens. 90 00:04:25,900 --> 00:04:28,300 It's more like anxiety of what is this going to be like and 91 00:04:28,300 --> 00:04:31,200 what is this process like? And for it's a lot of the times. 92 00:04:31,200 --> 00:04:34,200 It's like, how do I find a treatment program or what can I 93 00:04:34,200 --> 00:04:38,500 do to support my teen? So to start with parents, I love 94 00:04:38,500 --> 00:04:42,600 to get your thoughts on what the typical treatment trajectory. 95 00:04:42,600 --> 00:04:45,900 Looks like, obviously everyone's experience is very different. 96 00:04:46,000 --> 00:04:48,400 I always am. Like my 14 months and treatment 97 00:04:48,400 --> 00:04:51,000 are probably something. No one else will ever experience 98 00:04:51,000 --> 00:04:54,100 because everyone goes a different route but there are 99 00:04:54,100 --> 00:04:56,200 some things that I think are similar with looking for 100 00:04:56,200 --> 00:04:59,100 programs and maybe going from a more outpatient setting to a 101 00:04:59,100 --> 00:05:01,200 more inpatient These common theme. 102 00:05:01,200 --> 00:05:05,200 So I'd love to kind of understand what steps families 103 00:05:05,200 --> 00:05:08,600 typically go through when they are navigating teen mental 104 00:05:08,600 --> 00:05:11,900 health treatment. Well, I think that families 105 00:05:11,900 --> 00:05:17,600 often start with complete confusion and the idea where to 106 00:05:17,600 --> 00:05:20,400 begin. And then, you know, I think some 107 00:05:20,400 --> 00:05:24,100 families find their way to some sort of mental health provider, 108 00:05:24,100 --> 00:05:29,700 but I also think that the best resource for most families as a 109 00:05:29,700 --> 00:05:32,800 star Eating place is their primary care physician. 110 00:05:32,900 --> 00:05:35,700 You have a trusted relationship with that person. 111 00:05:35,800 --> 00:05:38,200 Theoretically, they know you, they know your family. 112 00:05:38,300 --> 00:05:42,400 They are essentially mandated at this point to be screening for 113 00:05:42,400 --> 00:05:46,100 things, like depression and anxiety in kids and depending 114 00:05:46,100 --> 00:05:50,000 where you are sometimes they are screening for suicidality and 115 00:05:50,000 --> 00:05:52,900 self-harm. So that's a really good starting 116 00:05:52,900 --> 00:05:56,500 place because even if they aren't going to be the people to 117 00:05:56,800 --> 00:05:59,900 deliver any sort of intervention or care. 118 00:06:00,200 --> 00:06:03,000 No, the community. And they will typically have 119 00:06:03,000 --> 00:06:06,300 trusted people that they know to work within the area. 120 00:06:06,300 --> 00:06:09,600 And they also will know things like, how long does it take to 121 00:06:09,600 --> 00:06:13,800 get in typically to somebody. And, and frankly, a lot of 122 00:06:13,800 --> 00:06:17,000 primary care, doctors can treat some things. 123 00:06:17,000 --> 00:06:19,800 And so, you may not need to wait to get into a child mental 124 00:06:19,800 --> 00:06:22,600 health. Clinician to start something and 125 00:06:22,600 --> 00:06:26,700 then you can move forward with things like outpatient, treat 126 00:06:26,700 --> 00:06:30,600 ya, which typically that first step, I'm going to Put at just a 127 00:06:30,608 --> 00:06:36,000 plugin for kind of early identification of challenges. 128 00:06:36,000 --> 00:06:39,000 The kids are having because the earlier we can get in there and 129 00:06:39,000 --> 00:06:41,300 this is again where pediatricians and primary care. 130 00:06:41,300 --> 00:06:46,300 Doctors can be Sookie, the easier it is to intervene and 131 00:06:46,300 --> 00:06:50,100 make a difference. And so if you need Outpatient 132 00:06:50,100 --> 00:06:55,100 Treatment then the next step is identifying a local therapist or 133 00:06:55,100 --> 00:06:57,900 psychiatrist and that's I think another place where families get 134 00:06:57,900 --> 00:06:59,700 confused. Like do we need a psychiatrist? 135 00:07:00,100 --> 00:07:03,300 Do we need a therapist? Do we need a psychiatrist who 136 00:07:03,300 --> 00:07:05,900 does therapy because that's an option. 137 00:07:06,200 --> 00:07:07,200 Exactly. Yeah. 138 00:07:07,400 --> 00:07:12,100 People by virtue of maybe their own history or just the 139 00:07:12,100 --> 00:07:14,700 community, they live. In think that you know, you have 140 00:07:14,700 --> 00:07:18,800 to have a psychiatrist that does everything and I think in 141 00:07:18,800 --> 00:07:21,800 different parts of the country there are different models of 142 00:07:21,800 --> 00:07:23,500 treatment. I worked for a long time in the 143 00:07:23,500 --> 00:07:26,600 Northeast where that model of one psychiatrist doing 144 00:07:26,600 --> 00:07:30,600 everything is more common in lots of the country, dad Is not 145 00:07:30,600 --> 00:07:35,000 typical and and I would say that, what's more important than 146 00:07:35,000 --> 00:07:37,400 somebody whose credentials is their experience. 147 00:07:37,500 --> 00:07:40,600 And how much time they spend doing this, you can have a 148 00:07:40,600 --> 00:07:43,500 highly trained psychiatrist. You went to medical school, did 149 00:07:43,500 --> 00:07:47,900 residency, Fellowship work. So their first patient, they 150 00:07:47,900 --> 00:07:51,400 just the another, yeah. Or you're not their first 151 00:07:51,400 --> 00:07:54,300 patient but they don't really do therapy very much. 152 00:07:54,300 --> 00:07:58,000 And you really want a therapist, who does what you need them to 153 00:07:58,000 --> 00:08:03,000 do every day. 2% and even just the demographics of do, they 154 00:08:03,000 --> 00:08:05,800 work with teens or is their Target demographic normally 155 00:08:05,800 --> 00:08:07,500 adults? Because those challenges that 156 00:08:07,500 --> 00:08:10,100 you're experiencing are probably really different or are they 157 00:08:10,200 --> 00:08:13,000 more experience? Was navigating anxiety versus 158 00:08:13,000 --> 00:08:14,800 depression. Like all of these are different 159 00:08:14,800 --> 00:08:18,500 Specialties and things to kind of keep an eye out for and I 160 00:08:18,500 --> 00:08:21,000 love what you mentioned about pediatricians because that's 161 00:08:21,000 --> 00:08:22,900 exactly where I started my journey. 162 00:08:23,200 --> 00:08:25,500 I've said that on the podcast so many times, like one into my 163 00:08:25,500 --> 00:08:27,900 pediatrician appointment, they did the depression screening and 164 00:08:27,907 --> 00:08:30,800 I was like, all of those, all of the above, Of is happening. 165 00:08:30,800 --> 00:08:32,900 And then from there, I went to a psychiatrist and worked with 166 00:08:32,900 --> 00:08:36,299 other people but it really is a great first step and like you 167 00:08:36,299 --> 00:08:40,299 mentioned being able to be aware of things that maybe aren't 168 00:08:40,299 --> 00:08:41,900 going. So well, really early on in the 169 00:08:41,900 --> 00:08:44,700 process and then make shifts and get resources. 170 00:08:44,700 --> 00:08:48,700 And the other great thing about having your pediatrician clued 171 00:08:48,700 --> 00:08:51,000 in, as every single time you go in for their annual there, 172 00:08:51,000 --> 00:08:55,000 checking up on how things are going, how are things going with 173 00:08:55,000 --> 00:08:57,500 medication? Or how are things going with 174 00:08:57,500 --> 00:08:59,900 meeting with a therapist? What are your responses to these 175 00:08:59,900 --> 00:09:01,400 questions? Since looking like compared to a 176 00:09:01,408 --> 00:09:05,000 year ago, whereas if you meet with a psychiatrist one time but 177 00:09:05,000 --> 00:09:09,000 then you just completely fall off that train and never go and 178 00:09:09,000 --> 00:09:12,300 return to those appointments. The pediatrician is at least 179 00:09:12,300 --> 00:09:14,300 following up in a consistent way. 180 00:09:15,200 --> 00:09:16,700 Absolutely. Yeah. 181 00:09:17,300 --> 00:09:21,700 So for parents that have received the recommendation that 182 00:09:21,700 --> 00:09:26,600 their teen might benefit from an intensive Mental Health Care 183 00:09:26,700 --> 00:09:29,900 Program, whether it's a residential or a longer-term. 184 00:09:30,000 --> 00:09:33,200 Program where they're looking Beyond just their, their local 185 00:09:33,200 --> 00:09:35,500 psychiatrists and therapists or pediatrician. 186 00:09:35,500 --> 00:09:38,900 Like, we mentioned, what things do you look for in a treatment 187 00:09:38,900 --> 00:09:42,800 program whether it is non-negotiables, whether its 188 00:09:42,800 --> 00:09:45,800 staff, whether it is different types of therapy, things that 189 00:09:45,808 --> 00:09:48,100 are nice to have. But when you are looking at a 190 00:09:48,100 --> 00:09:51,700 program, what things are? Are you keeping an eye out for 191 00:09:51,900 --> 00:09:54,900 to make sure that it's a great fit for a patient? 192 00:09:55,200 --> 00:09:57,800 Yeah, maybe it's my first thought, which doesn't really 193 00:09:57,800 --> 00:09:59,100 answer. Your question is just what are 194 00:09:59,100 --> 00:10:02,000 all those different levels? Yeah cause I think we don't even 195 00:10:02,400 --> 00:10:06,500 know that but I imagine your listeners have heard, what these 196 00:10:06,500 --> 00:10:08,700 different levels of care are over time. 197 00:10:08,800 --> 00:10:13,300 So I think the first thing is figuring out, what level do you 198 00:10:13,300 --> 00:10:16,000 need, right? So everything from regular 199 00:10:16,000 --> 00:10:20,200 outpatient care to intensive Outpatient Treatment and or 200 00:10:20,200 --> 00:10:22,900 intensive treatment programs, which might be like two to three 201 00:10:22,900 --> 00:10:29,500 days a week for a couple hours at a time up to sort of half-day 202 00:10:29,500 --> 00:10:31,300 program. Alms to partial Hospital 203 00:10:31,300 --> 00:10:34,900 programs that are essentially the school day, 5 days a week to 204 00:10:34,900 --> 00:10:38,000 residential treatment, which is kind of longer term, but 205 00:10:38,000 --> 00:10:41,600 voluntary, treatment and unlocked places, and then 206 00:10:41,600 --> 00:10:44,600 inpatient treatment being the highest level of care. 207 00:10:44,700 --> 00:10:47,200 But your question about what to look for. 208 00:10:48,000 --> 00:10:51,700 If a couple big things that I really wish families would hear. 209 00:10:51,700 --> 00:10:54,800 One is just because a place is the most expensive place. 210 00:10:54,800 --> 00:10:57,900 Doesn't mean it's the best place, and just because it's in 211 00:10:57,908 --> 00:10:59,900 the most beautiful setting doesn't mean. 212 00:11:00,100 --> 00:11:03,800 Horses doesn't mean it'll be the best as far as this has an ocean 213 00:11:03,800 --> 00:11:09,500 view has like, I think families can easily get romanced by some 214 00:11:09,500 --> 00:11:12,300 of that because it's so scary to have your child go away 215 00:11:12,300 --> 00:11:14,100 somewhere. So to say okay well the place is 216 00:11:14,100 --> 00:11:16,200 really expensive. It looks really nice. 217 00:11:16,300 --> 00:11:19,600 That doesn't necessarily mean high quality Care. 218 00:11:19,700 --> 00:11:21,400 Yeah. The other thing I would say is 219 00:11:21,500 --> 00:11:25,500 be wary of programs that promise everything if you look at their 220 00:11:25,500 --> 00:11:28,400 materials and they say they basically treat everything under 221 00:11:28,400 --> 00:11:29,900 the Spectrum with evidence-based. 222 00:11:30,000 --> 00:11:33,300 Treatments. And it's highly unlikely that 223 00:11:33,300 --> 00:11:35,800 they really are that specialized in all of those different 224 00:11:35,800 --> 00:11:38,500 things. I much prefer to have a program 225 00:11:38,500 --> 00:11:42,500 that says, we do this and this very well and this is our 226 00:11:42,500 --> 00:11:45,400 modality. You want to ask them what 227 00:11:45,400 --> 00:11:48,600 modalities of treatment they use and they should be able to 228 00:11:48,600 --> 00:11:52,000 answer. That clearly is an easy example, 229 00:11:52,000 --> 00:11:56,100 which is I often see patients who say that they've been 230 00:11:56,100 --> 00:11:59,500 getting cognitive behavioral therapy for their anxiety. 231 00:12:00,100 --> 00:12:03,200 But it's not getting better and it's not helping and I ask them. 232 00:12:03,200 --> 00:12:06,400 Well what are you doing in your therapy and it turns out that a 233 00:12:06,400 --> 00:12:11,000 largely what they're getting is supportive Psychotherapy with 234 00:12:11,400 --> 00:12:16,300 some sort of instruction on how to do deep breathing and maybe 235 00:12:16,300 --> 00:12:21,000 some psycho education on, not avoiding anxiety-provoking 236 00:12:21,000 --> 00:12:25,700 situation, not to CBT, not getting full fledged CBT and 237 00:12:25,700 --> 00:12:29,700 they're not getting the core key treatment to CBT which is 238 00:12:29,700 --> 00:12:33,300 exposed Bossier therapy. So you want to educate yourself 239 00:12:33,300 --> 00:12:36,300 ahead of these conversations about your kids diagnosis and 240 00:12:36,300 --> 00:12:38,300 what the best treatments are for that. 241 00:12:38,500 --> 00:12:41,900 And then ask very pointed questions about it. 242 00:12:42,100 --> 00:12:44,200 What are those questions that you would ask? 243 00:12:44,200 --> 00:12:48,200 If you could give like 325 that they could bring to their intake 244 00:12:48,200 --> 00:12:49,300 meeting? They're on the phone? 245 00:12:49,300 --> 00:12:50,900 They're screening these programs. 246 00:12:51,300 --> 00:12:54,500 What would you ask? That's a really hard question to 247 00:12:54,500 --> 00:12:57,300 answer simply because I think it's so dependent on what a 248 00:12:57,300 --> 00:13:02,100 particular young person is. But those questions. 249 00:13:02,500 --> 00:13:06,500 So what if we said, like a teen is struggling a bully, like, use 250 00:13:06,500 --> 00:13:09,900 me at Tina, struggling with depression, self-harm has tried 251 00:13:09,900 --> 00:13:12,700 outpatient inpatient at home, the recommendation is 252 00:13:12,700 --> 00:13:15,200 Residential Care. History of self-harm suicidal 253 00:13:15,200 --> 00:13:18,600 ideation and have tried outpatient DBT and then 254 00:13:18,600 --> 00:13:22,300 intensive outpatient. But as far as residential, what 255 00:13:22,300 --> 00:13:24,900 the recommendation is, we know, we don't know. 256 00:13:24,900 --> 00:13:26,900 Do we need a DVT intensive program? 257 00:13:26,900 --> 00:13:29,600 Do we need like a therapeutic boarding school for residential? 258 00:13:30,000 --> 00:13:31,200 So, the next step is residential. 259 00:13:31,200 --> 00:13:33,300 The background is depression, anxiety. 260 00:13:33,300 --> 00:13:36,200 Those behaviors. So, what questions would you ask 261 00:13:36,200 --> 00:13:39,600 different residential programs? Well, I think the first thing 262 00:13:39,600 --> 00:13:42,400 I'd want to know given the history are describing as 263 00:13:42,400 --> 00:13:46,400 whether the program and I would sort of start with an open-ended 264 00:13:46,400 --> 00:13:48,300 question. Knowing what I want the answer 265 00:13:48,300 --> 00:13:49,200 to be. Yes. 266 00:13:49,200 --> 00:13:52,000 So my question would be, you know what modality of treatment 267 00:13:52,000 --> 00:13:56,000 do you use in your program? And listen to what I say? 268 00:13:56,000 --> 00:13:58,300 And what I would want them to say is that they use a 269 00:13:58,300 --> 00:14:01,600 combination of dialectical You're all therapy and cognitive 270 00:14:01,600 --> 00:14:07,300 behavioral therapy and that they sort of address safety concerns 271 00:14:07,300 --> 00:14:09,100 first. And so the first treatment would 272 00:14:09,100 --> 00:14:13,900 probably be DBT and then when safety is off the table, then 273 00:14:13,900 --> 00:14:15,900 you can work on the depression and the anxiety. 274 00:14:15,900 --> 00:14:20,500 Yeah, that's really helpful for sure to kind of just have those 275 00:14:20,500 --> 00:14:24,400 exact labels of what to listen for and ask that open-ended 276 00:14:24,400 --> 00:14:28,600 question because I mean it's so crazy that you even have to 277 00:14:28,600 --> 00:14:31,400 think about how these things. These are marketing and kind of 278 00:14:31,400 --> 00:14:34,000 see through, when they're like, oh, we offer everything. 279 00:14:34,000 --> 00:14:35,800 And it's like, well what do you really offer? 280 00:14:35,900 --> 00:14:38,200 And when you said that, it reminded me of this marketing 281 00:14:38,200 --> 00:14:41,200 strategy, where it's when things advertise themselves, as like 282 00:14:41,200 --> 00:14:43,900 the Cheesecake Factory where they offer anything and 283 00:14:43,900 --> 00:14:45,700 everything you could possibly ever want to eat. 284 00:14:45,700 --> 00:14:48,400 But nothing on the menu, is really that great. 285 00:14:48,400 --> 00:14:51,000 And so you can think of trigger programs that way or if they're 286 00:14:51,000 --> 00:14:54,000 offering anything and everything to possibly be treated. 287 00:14:54,100 --> 00:14:56,700 They're probably not going to be that great at all of those 288 00:14:56,700 --> 00:14:58,900 different things. So to listen, for those key 289 00:14:58,900 --> 00:15:01,800 terms is super Pull rather than going in and being, like, do you 290 00:15:01,800 --> 00:15:04,000 offer DBT? Because my parents did that one 291 00:15:04,300 --> 00:15:06,300 we were looking for therapeutic boarding schools in a 292 00:15:06,308 --> 00:15:08,400 therapeutic boarding. School was like, yes, of course 293 00:15:08,400 --> 00:15:11,700 we do, but then once I went there that did not offer DVT, 294 00:15:12,400 --> 00:15:14,000 right? Well, you know, and I think 295 00:15:14,000 --> 00:15:16,900 specifically with DBT I would want to know in this is very 296 00:15:16,900 --> 00:15:21,500 kind of technical but our number are your therapist DBT certified 297 00:15:21,500 --> 00:15:25,200 with behavior tag? Yeah, yearly DBT therapist. 298 00:15:25,200 --> 00:15:30,000 Do you provide full Fidelity DVT and because anyone can say They 299 00:15:30,000 --> 00:15:33,300 do anything. They may do DVT, informed 300 00:15:33,300 --> 00:15:36,200 treatment and in some situations that might be appropriate. 301 00:15:36,200 --> 00:15:38,500 But if you're talking about residential care, and you're 302 00:15:38,500 --> 00:15:41,900 talking about, chronic sort of self-injury and depression, you 303 00:15:41,900 --> 00:15:46,400 really want that full Fidelity? Yeah, and it's also so helpful 304 00:15:46,400 --> 00:15:50,200 to remember that a lot of these different evidence-based 305 00:15:50,200 --> 00:15:54,000 treatments are proven to be evidence-based under very 306 00:15:54,000 --> 00:15:57,300 specific conditions. So, like with DBT, you're doing 307 00:15:57,300 --> 00:15:59,800 a very specific, six-week course of learning. 308 00:16:00,000 --> 00:16:02,800 During a certain number of skills with your therapist 309 00:16:02,800 --> 00:16:06,500 working in tandem with a certain number of other therapists and 310 00:16:06,500 --> 00:16:09,700 you are approaching your challenges in therapy with a 311 00:16:09,700 --> 00:16:12,400 very specific hierarchy. And you're also meeting with a 312 00:16:12,400 --> 00:16:15,500 psychiatrist, like all of these details are very clearly laid 313 00:16:15,500 --> 00:16:17,300 out. And that is what is shown to be 314 00:16:17,300 --> 00:16:19,800 effective. The idea of like me on the 315 00:16:19,808 --> 00:16:22,400 podcast when I teach you a DBT skill it's not what's 316 00:16:22,400 --> 00:16:24,600 evidence-based to heal depression. 317 00:16:24,700 --> 00:16:27,100 Like it's just a fun thing that might make you feel a little bit 318 00:16:27,100 --> 00:16:29,500 better to accumulate some positives in your life. 319 00:16:29,600 --> 00:16:32,100 But It's that like super set criteria. 320 00:16:32,100 --> 00:16:33,700 That is shown to be evidence-based. 321 00:16:33,700 --> 00:16:36,700 So you have to make sure that the treatment programs are using 322 00:16:36,700 --> 00:16:39,000 that set criteria. That is been proven to be 323 00:16:39,000 --> 00:16:41,900 effective and not just like pulling little ideas from here 324 00:16:41,900 --> 00:16:43,900 and there to try and support people. 325 00:16:44,500 --> 00:16:47,700 There's a really interesting and important research study, that 326 00:16:47,700 --> 00:16:52,800 was done several years ago. Now, comparing sort of 327 00:16:52,800 --> 00:16:58,300 psychoeducation, like providing education about cognitive 328 00:16:58,300 --> 00:17:03,500 behavioral therapy. Yeah, you doing full-fledged 329 00:17:03,500 --> 00:17:06,900 cognitive behavioral therapy to medications? 330 00:17:06,900 --> 00:17:09,500 Trying to look at what's realistic for primary care. 331 00:17:09,500 --> 00:17:13,000 Doctors to do, right? They can't do a CBT session in 332 00:17:13,000 --> 00:17:15,099 there. 10. 15 minutes with? Yeah. 333 00:17:15,099 --> 00:17:17,700 Well, they're like also checking to make sure you can like, bend 334 00:17:17,700 --> 00:17:20,700 your knee correctly. Like let's check the nose. 335 00:17:20,800 --> 00:17:24,500 Let's do some exposure therapy, nugget nation, and does that 336 00:17:24,500 --> 00:17:27,400 move you do? And unfortunately it was not as 337 00:17:27,400 --> 00:17:29,800 effective as which is what you would. 338 00:17:29,900 --> 00:17:32,500 Expect but but I think that that's often what happens. 339 00:17:32,500 --> 00:17:34,900 People provide a little education about CBT but they 340 00:17:34,908 --> 00:17:38,600 don't really do yeah. Fall series with exposure. 341 00:17:38,600 --> 00:17:42,300 Yeah. If there were two to three 342 00:17:42,300 --> 00:17:45,400 non-negotiables that you would want to make sure we're at a 343 00:17:45,408 --> 00:17:48,400 treatment program for parents to look for whether it's like a 344 00:17:48,408 --> 00:17:51,400 psychiatrist on staff or a certain evidence based 345 00:17:51,400 --> 00:17:54,000 intervention. Maybe it's like a number of 346 00:17:54,000 --> 00:17:56,000 patients or how long the treatment facility has been 347 00:17:56,000 --> 00:17:57,700 open. A certain like accreditation. 348 00:17:57,700 --> 00:18:00,200 There's so many different potential things but You to 349 00:18:00,200 --> 00:18:03,200 choose some non-negotiables. We were like at the very minimum 350 00:18:03,200 --> 00:18:05,900 a program should have this. What would that be? 351 00:18:06,100 --> 00:18:08,500 Yeah, and you're speaking to some really tricky things 352 00:18:08,500 --> 00:18:11,100 because state-by-state the regulations are on residential 353 00:18:11,100 --> 00:18:14,600 treatment are widely varying. So residential can be fully 354 00:18:14,600 --> 00:18:19,700 accredited or regulated, but depending on the state and the 355 00:18:19,700 --> 00:18:23,200 size of the program that can be vastly different Yang for. 356 00:18:23,200 --> 00:18:27,200 This is making your listeners, very anxious as I'm saying it. 357 00:18:27,200 --> 00:18:30,400 But I know I just released literally as a record - the 358 00:18:30,400 --> 00:18:32,600 episode that went out this week is about the troubled teen 359 00:18:32,600 --> 00:18:35,600 industry, so luckily there's going to be some time before 360 00:18:35,600 --> 00:18:38,300 this episode comes out. But like in that episode, an 361 00:18:38,300 --> 00:18:40,300 example of what accredited, a program was. 362 00:18:40,300 --> 00:18:43,200 How many toilets they had? And the ratio to students. 363 00:18:43,500 --> 00:18:46,600 So, that's it. There's some discrepancy here on 364 00:18:46,600 --> 00:18:50,300 what accreditation means. Absolutely, I mean, honestly, I 365 00:18:50,300 --> 00:18:54,500 think the, the most important things from my perspective are 366 00:18:54,700 --> 00:18:58,900 that they involve family and that's for a couple reasons. 367 00:18:58,900 --> 00:19:03,200 One is If you are a program that doesn't communicate with 368 00:19:03,200 --> 00:19:06,600 parents, that doesn't involve parents and family in treatment 369 00:19:06,800 --> 00:19:10,800 and you're doing this sort of bubble of something with a kid. 370 00:19:10,800 --> 00:19:12,700 And then you say, okay, we're done and you send them home, and 371 00:19:12,700 --> 00:19:15,800 you've never done anything to change the environment. 372 00:19:16,300 --> 00:19:20,600 Then you're setting everyone up for failure and some sense. 373 00:19:20,600 --> 00:19:25,100 So, I think number one for me, is that family is very involved 374 00:19:25,100 --> 00:19:28,800 in the treatment in whatever way is possible that maybe virtual 375 00:19:28,800 --> 00:19:32,000 because the family Can be where the kid is at but that it is 376 00:19:32,000 --> 00:19:35,700 built into the program and it's not just will check in once a 377 00:19:35,700 --> 00:19:41,200 week for an hour or you call us if you have right yeah you'd be 378 00:19:41,200 --> 00:19:44,700 surprised what can happen out there so I think that's really 379 00:19:44,700 --> 00:19:47,300 critical. I think that again 380 00:19:48,000 --> 00:19:51,400 evidence-based treatments but not every evidence-based 381 00:19:51,400 --> 00:19:54,800 treatment Under the Sun. So you know for instance for a 382 00:19:54,800 --> 00:20:00,100 kid who has depression who has self injury, has a lot of And 383 00:20:00,100 --> 00:20:05,200 regulation difficulties a no-go would be if they didn't have a 384 00:20:05,208 --> 00:20:07,300 true DBT program. Yeah. 385 00:20:07,500 --> 00:20:10,600 If you have a kid who has obsessive-compulsive disorder or 386 00:20:10,600 --> 00:20:14,300 a severe anxiety disorder, you want a program that is an 387 00:20:14,300 --> 00:20:19,500 exposure based cognitive behavioral therapy program and 388 00:20:19,700 --> 00:20:22,400 they should be able to talk to you about what that action 389 00:20:22,600 --> 00:20:26,300 really looks like and how they deploy that you want 390 00:20:26,300 --> 00:20:28,900 evidence-based treatments for the thing that your child is 391 00:20:28,900 --> 00:20:31,600 struggling. And you can even ask them, like, 392 00:20:31,600 --> 00:20:34,600 oh, can you send the the research that supports this 393 00:20:34,600 --> 00:20:37,100 intervention that you're using? I remember, I asked my 394 00:20:37,400 --> 00:20:40,600 therapeutic boarding school that one time after I left and they 395 00:20:40,600 --> 00:20:43,400 sent me a paper talking about how nature can be good for 396 00:20:43,400 --> 00:20:47,200 mental health was like, okay, but this is not what I, my 397 00:20:47,200 --> 00:20:50,600 parents signed up for when they were like, we'd like a long-term 398 00:20:50,800 --> 00:20:53,400 transitional program that can help her like maintain mental. 399 00:20:53,400 --> 00:20:58,100 Health continued to maintain DBT skills and not be depressed and 400 00:20:58,100 --> 00:21:01,600 suicidal like they were not. Optimizing for exposure to 401 00:21:01,600 --> 00:21:04,300 Nature. So ask them if they can send you 402 00:21:04,500 --> 00:21:07,300 studies that support this intervention and the Adolescent 403 00:21:07,300 --> 00:21:09,400 population and show good results. 404 00:21:09,400 --> 00:21:11,100 And you don't have to read the entire study. 405 00:21:11,100 --> 00:21:13,900 We're not like, please spend all your time reading 12 studies. 406 00:21:14,100 --> 00:21:16,700 But if they can't provide that, that's immediately like red 407 00:21:16,700 --> 00:21:18,200 flag. Yeah. 408 00:21:18,500 --> 00:21:21,300 And I think the other thing is you want transparency. 409 00:21:21,300 --> 00:21:25,000 So if you're getting any sense that there are sort of skirting 410 00:21:25,000 --> 00:21:27,900 around questions and then are not giving you very clear 411 00:21:27,900 --> 00:21:32,600 answers, I would be really wary. Yeah, I think that this may be 412 00:21:32,600 --> 00:21:36,200 hard and you may not get a satisfactory answer, but it's 413 00:21:36,200 --> 00:21:40,900 worth at least asking what their internal quality kind of 414 00:21:40,900 --> 00:21:43,900 processes. And if they have any data or 415 00:21:43,900 --> 00:21:46,500 statistics on the success of. Yeah. 416 00:21:47,200 --> 00:21:49,800 Absolutely. And they should be able to 417 00:21:49,800 --> 00:21:51,200 produce something. Yeah. 418 00:21:51,800 --> 00:21:54,900 From the professional standpoint should parents have to sign over 419 00:21:54,900 --> 00:21:58,200 their custody when their child gets mental health treatment 420 00:21:59,200 --> 00:22:01,800 Shit's it, while you can tell by my answer. 421 00:22:01,900 --> 00:22:03,700 Like what? That's a thing. 422 00:22:04,700 --> 00:22:07,800 No, absolutely, yeah. Not a standard of care. 423 00:22:07,800 --> 00:22:11,300 And I have to remind people of that because like, I, my parents 424 00:22:11,300 --> 00:22:14,100 found the most amazing DBT program in Boston. 425 00:22:14,100 --> 00:22:17,000 And then four months later, I also went to program Montana. 426 00:22:17,000 --> 00:22:20,200 And when they were like, okay, sign over 51%, my parents were 427 00:22:20,200 --> 00:22:23,000 like, okay, like they're very smart people, they knew what 428 00:22:23,000 --> 00:22:25,900 they're talking about and yet some of these again it's a black 429 00:22:25,900 --> 00:22:29,300 box like from the outside, you would like, oh well my Is living 430 00:22:29,300 --> 00:22:32,300 there for a year. So maybe they would need 51%, 431 00:22:32,300 --> 00:22:36,300 but they don't that's it. Myth, not offend or it shouldn't 432 00:22:36,300 --> 00:22:39,300 be should not be a thing. Today's episode is brought to 433 00:22:39,308 --> 00:22:42,500 you by teen counseling. Teen counseling is better helps 434 00:22:42,500 --> 00:22:45,800 online Therapy Program for teens, they have over 14,000 435 00:22:45,800 --> 00:22:48,500 licensed therapist within their Network and they offer support 436 00:22:48,500 --> 00:22:51,800 on things like depression, anxiety, relationships, trauma, 437 00:22:51,800 --> 00:22:54,300 and so much more. You guys know that there are P 438 00:22:54,300 --> 00:22:56,100 was a huge part of my mental health Journey. 439 00:22:56,100 --> 00:22:58,700 It's a resource that was absolutely essential for. 440 00:22:58,800 --> 00:23:02,200 Or me to recover maintain my mental health, improve, my 441 00:23:02,200 --> 00:23:05,500 emotion, regulation distress tolerance, all of the things. 442 00:23:05,900 --> 00:23:09,200 So if you would like to try meeting with a therapist or find 443 00:23:09,200 --> 00:23:11,200 a new therapist to meet with, you can go to teen 444 00:23:11,200 --> 00:23:14,700 counseling.com. She persisted, they offer talk 445 00:23:14,700 --> 00:23:16,900 text and video counseling all from your home. 446 00:23:16,900 --> 00:23:18,400 So no need to be on a super long. 447 00:23:18,400 --> 00:23:22,100 Wait list to find a therapist. They will also meet you exactly 448 00:23:22,100 --> 00:23:24,600 where you're at, with what level of support you're looking for. 449 00:23:24,600 --> 00:23:28,400 So, to check out teen counseling can go to teen counseling.com 450 00:23:28,900 --> 00:23:32,000 She persisted to find a therapist that meets your needs 451 00:23:32,000 --> 00:23:34,200 today. The last question I wanted to 452 00:23:34,200 --> 00:23:39,300 ask from the parents perspective is so many and this is hard to 453 00:23:39,300 --> 00:23:40,900 answer. Because when I get asked this, 454 00:23:40,900 --> 00:23:42,900 I'm like, I don't even know what to tell you. 455 00:23:42,900 --> 00:23:46,500 Because the question is, how can I get my teen to want to be 456 00:23:46,500 --> 00:23:49,600 motivated to make changes and want to get better when they're 457 00:23:49,600 --> 00:23:52,100 like, not wanting to go to treatment, which was exactly 458 00:23:52,100 --> 00:23:55,300 where I was at. And I think my most recent 459 00:23:55,300 --> 00:23:58,000 response is just be there to support your child, explain to 460 00:23:58,000 --> 00:24:00,000 them that you to see them feel better. 461 00:24:00,000 --> 00:24:02,600 And then the professionals are the one that can help cultivate 462 00:24:02,600 --> 00:24:05,500 that willingness and help provide some Hope on how things 463 00:24:05,500 --> 00:24:07,600 can shift. That's a lot to ask of a parent 464 00:24:07,600 --> 00:24:09,000 be like, let's get your kid from. 465 00:24:09,300 --> 00:24:13,000 Absolutely not wanting to make any changes to be so motivated 466 00:24:13,000 --> 00:24:16,700 and engaged in treatment, but for a parent who's like, I know 467 00:24:16,700 --> 00:24:19,400 my kid needs help but they are just so not at the point of 468 00:24:19,400 --> 00:24:22,900 being motivated to do that. Do you have any advice or 469 00:24:22,900 --> 00:24:26,100 validation or wisdom that you can kind of offer because it's 470 00:24:26,100 --> 00:24:29,100 so common. In this process I feel Like I 471 00:24:29,100 --> 00:24:31,800 just want to ask you the question back, because yeah. 472 00:24:31,800 --> 00:24:35,900 Do you think that if I knew the answer to that? 473 00:24:35,900 --> 00:24:39,500 I would be the world's most famous. 474 00:24:41,900 --> 00:24:45,200 Yeah. I think ultimately where I see 475 00:24:45,200 --> 00:24:50,400 it fall apart is when it becomes a tug-of-war and if parents can 476 00:24:51,700 --> 00:24:56,800 Brian not take the bait so to speak and not have it turned 477 00:24:56,800 --> 00:25:03,600 into a war about it and come from a place of compassion and 478 00:25:03,800 --> 00:25:08,400 validation and not that that's going to be immediately 479 00:25:08,400 --> 00:25:12,400 successful, but you're going to start moving the needle. 480 00:25:12,400 --> 00:25:18,700 If it just becomes know, you need to do this and it becomes a 481 00:25:18,800 --> 00:25:22,300 sort of butting of heads then. You're not going to get 482 00:25:22,400 --> 00:25:25,600 anywhere. I mean, I do think that I've 483 00:25:25,600 --> 00:25:29,300 certainly been in situations where for variety of reasons, a 484 00:25:29,300 --> 00:25:33,000 young person often at substance-related is just not in 485 00:25:33,000 --> 00:25:35,800 a place to make a good decision for themselves. 486 00:25:35,800 --> 00:25:39,600 And so parents have had to make really difficult decisions to 487 00:25:39,600 --> 00:25:43,100 sort of send their kids away against their will and sometimes 488 00:25:43,100 --> 00:25:46,000 that ends up going well because they get clean and the kid gets 489 00:25:46,000 --> 00:25:49,300 perspective and sees things and from a different way, sometimes 490 00:25:49,300 --> 00:25:51,200 it doesn't. So I do. 491 00:25:51,400 --> 00:25:52,600 Billy. You got to a place where it's a 492 00:25:52,608 --> 00:25:58,600 shared decision making process. And I think as therapists we try 493 00:25:58,600 --> 00:26:01,700 and use motivational enhancement motivational interviewing 494 00:26:01,700 --> 00:26:05,800 strategies to kind of help young people and parents, sometimes 495 00:26:05,800 --> 00:26:09,300 get to a place where they can see that the benefits of doing 496 00:26:09,300 --> 00:26:14,700 something outweigh the fears that they have to get the young 497 00:26:14,700 --> 00:26:18,600 person to realize that because I often feel like when a kid is 498 00:26:18,600 --> 00:26:21,800 refusing to do something, it's not because they I just don't 499 00:26:21,800 --> 00:26:25,100 want to do it, it's because they've lost hope that anything 500 00:26:25,400 --> 00:26:28,400 can hundred percent difference. And so what you're really coming 501 00:26:28,400 --> 00:26:31,000 up against this hopelessness more and it comes out as 502 00:26:31,000 --> 00:26:35,700 oppositional kind of defiant Behavior or even fear. 503 00:26:35,700 --> 00:26:37,600 I remember I was like tooth and nail. 504 00:26:37,600 --> 00:26:40,700 I will not do a sleep study. Goes already in residential 505 00:26:40,700 --> 00:26:43,600 treatment, I'd agreed all these things but it came to the sleep 506 00:26:43,600 --> 00:26:46,800 study for some reason I was anxious and I'm like this is 507 00:26:46,800 --> 00:26:49,600 where the hammer is coming down. I'm not going. 508 00:26:49,800 --> 00:26:52,600 So it's kind of unraveling that Being like what's behind that 509 00:26:52,600 --> 00:26:56,000 because I mean any kid who's really struggling? 510 00:26:56,000 --> 00:26:59,100 Like if they knew that on the other side was happiness and joy 511 00:26:59,100 --> 00:27:01,300 and stability. Of course, they would get to 512 00:27:01,300 --> 00:27:04,500 that point but there's just not always a clear path forward. 513 00:27:04,700 --> 00:27:07,900 And so I love that perspective of trying to see what is going 514 00:27:07,900 --> 00:27:10,800 on beneath the surface and seeing beyond that like 515 00:27:10,800 --> 00:27:14,500 opposition if you will. Yeah, I really believe in 516 00:27:14,600 --> 00:27:19,000 compassion and an in that is sort of self-compassion I think 517 00:27:19,000 --> 00:27:26,000 parents have to give them Self sort of some Grace and some 518 00:27:26,000 --> 00:27:28,700 sense of like, this is a really bad situation and I may not 519 00:27:28,700 --> 00:27:32,600 always have handled it, well, but I can do things differently, 520 00:27:32,600 --> 00:27:36,200 going forward, and not just get stuck in a rut. 521 00:27:36,400 --> 00:27:39,300 Yeah. And so much self-validation 522 00:27:39,300 --> 00:27:42,700 because I can't even imagine what it's like as a parent to 523 00:27:42,700 --> 00:27:46,000 see your child struggle so much and feel like, you don't know 524 00:27:46,000 --> 00:27:49,300 how you can help them and whether it's guilt or shame or 525 00:27:49,300 --> 00:27:51,100 just its sadness, that's a lot to go. 526 00:27:51,300 --> 00:27:54,100 As a parent, let alone as a child. 527 00:27:54,100 --> 00:27:58,200 And so I feel like I completely that was lost on me when I was 528 00:27:58,200 --> 00:28:01,600 going through this process, how how hard this was for my parents 529 00:28:01,600 --> 00:28:04,400 and how I wasn't the only one that was struggling in this 530 00:28:04,400 --> 00:28:07,700 process that it really does take a toll on the whole family and 531 00:28:07,700 --> 00:28:10,600 so resources for parents to because it's not an easy 532 00:28:10,600 --> 00:28:13,000 journey. I also think that this process 533 00:28:13,000 --> 00:28:18,000 can go better if this comes back to family-focused treatment. 534 00:28:18,000 --> 00:28:21,800 If treatment along the way isn't about a kid, Being in a room 535 00:28:21,800 --> 00:28:25,900 with a therapist and then getting a report out or not from 536 00:28:25,900 --> 00:28:28,900 the therapist afterward like really incorporating family into 537 00:28:28,900 --> 00:28:31,500 everything that's done from a treatment standpoint. 538 00:28:31,500 --> 00:28:36,300 That's what we try and do at our Center is have family at the 539 00:28:36,300 --> 00:28:38,700 core of everything that we're doing. 540 00:28:38,700 --> 00:28:40,600 Like in our partial Hospital program. 541 00:28:40,800 --> 00:28:44,400 We have one day a week where the entire family is required to be 542 00:28:44,400 --> 00:28:46,900 there. Yeah, I love that and it's not 543 00:28:46,900 --> 00:28:49,300 just a family meeting each week with the therapist. 544 00:28:49,300 --> 00:28:51,100 It's a whole day where the family is getting deep. 545 00:28:51,300 --> 00:28:55,600 New skills. And so, yeah, no. 546 00:28:55,600 --> 00:28:57,500 I asked my parents a couple of weeks ago. 547 00:28:57,500 --> 00:29:01,200 I was talking to some parents about, like, advice for teens 548 00:29:01,200 --> 00:29:03,400 and supporting your teen. And before I gave the talk, I 549 00:29:03,408 --> 00:29:05,100 was like, okay, parents? What are the advice? 550 00:29:05,100 --> 00:29:08,000 This is your chance to throw some advice for parents that are 551 00:29:08,000 --> 00:29:10,200 going through it. And the one advice was that if 552 00:29:10,200 --> 00:29:13,300 this works so much better, if the parents learn the skills, 553 00:29:13,300 --> 00:29:16,500 alongside the teen, because if anything, it doesn't hurt for 554 00:29:16,500 --> 00:29:19,300 you both to get more skillful and for you both to be more 555 00:29:19,300 --> 00:29:23,100 effective in the relationship. And that you also just are able 556 00:29:23,100 --> 00:29:26,200 to empathize on another level. You have the shared experience 557 00:29:26,200 --> 00:29:29,500 of navigating, this and my parents, and I are now big DBT, 558 00:29:29,500 --> 00:29:31,400 nerds, whatever, we're navigating, anything. 559 00:29:31,400 --> 00:29:34,100 Or I have some into my mom's like a bring out the dear, man. 560 00:29:34,200 --> 00:29:39,900 I'm like, I know I've learned this also olya and, and the 561 00:29:39,900 --> 00:29:41,800 Apple doesn't fall far from the tree, right? 562 00:29:41,800 --> 00:29:47,100 So if you're asking an anxious parent to do exposure therapy 563 00:29:47,100 --> 00:29:51,100 with their anxious kid, and the parent is so anxious. 564 00:29:51,300 --> 00:29:52,800 They can't do it. You're not going to get 565 00:29:52,800 --> 00:29:54,600 anywhere. So you have to teach everyone 566 00:29:54,600 --> 00:29:58,200 these skills to get any movement, 100%. 567 00:29:58,200 --> 00:30:01,500 So for teens, I think one of the biggest things that I remember 568 00:30:01,500 --> 00:30:04,800 is just how daunting of and experience this is, it's so 569 00:30:05,300 --> 00:30:08,000 anxiety-provoking because a lot of the times, you don't know 570 00:30:08,000 --> 00:30:10,000 what to expect. And once you get there, I feel 571 00:30:10,000 --> 00:30:12,100 like it's better because you're in it with other teams like 572 00:30:12,100 --> 00:30:15,300 you're not alone in this day. It's a very, a lot of times a 573 00:30:15,300 --> 00:30:18,500 very welcoming experience. Tons of teens have been through 574 00:30:18,500 --> 00:30:21,100 this process so they know how to orient people. 575 00:30:21,200 --> 00:30:24,400 And do the little tour and introduce you to other kids or 576 00:30:24,400 --> 00:30:28,300 teens, probably not kids, but it's very anxiety-provoking to 577 00:30:28,300 --> 00:30:30,700 know that you're going to be going to a program or an 578 00:30:30,700 --> 00:30:34,000 outpatient program or therapy session, but not know what that 579 00:30:34,000 --> 00:30:36,900 looks like or what to expect. So if you could give just some 580 00:30:36,900 --> 00:30:40,300 basic pointers of what to expect, whether it's like, you 581 00:30:40,300 --> 00:30:43,300 can probably expect to on the first day kind of go through, 582 00:30:43,700 --> 00:30:46,900 why you're here and what's happened this far and maybe it's 583 00:30:46,900 --> 00:30:50,300 you lorient to, like, what your family system is like, or you, 584 00:30:50,300 --> 00:30:51,600 you probably will learn. Skills. 585 00:30:51,600 --> 00:30:55,000 But just kind of providing a little bit of insight into what 586 00:30:55,000 --> 00:30:57,100 goes on again. And this like black box of a 587 00:30:57,100 --> 00:31:00,100 world that teens often times haven't had any experience with. 588 00:31:00,500 --> 00:31:02,200 I think the first thing would be to say what it is. 589 00:31:02,200 --> 00:31:05,300 Not right? I think a lot of teams are 590 00:31:05,300 --> 00:31:07,600 thinking that if they go to Residential Treatment, it's 591 00:31:07,600 --> 00:31:11,100 going to a locked hospital. I Googled McClain, and it was 592 00:31:11,100 --> 00:31:15,500 like, Asylum from the 1800s and I was like great, perfect. 593 00:31:16,800 --> 00:31:21,000 Well, terrified and that's not what residential treatment is. 594 00:31:21,300 --> 00:31:25,900 And not what intensive Outpatient Treatment is and 595 00:31:26,500 --> 00:31:28,300 there is a place for inpatient treatment. 596 00:31:28,300 --> 00:31:34,100 But if your family is trying to get you help in a voluntary way 597 00:31:34,100 --> 00:31:40,400 at a specialized program, it's going to be an unlocked unit. 598 00:31:40,500 --> 00:31:44,700 It's going to be everyone's there voluntarily it's going to 599 00:31:44,700 --> 00:31:47,800 be again if it's the right program it's going to be kids 600 00:31:47,800 --> 00:31:49,600 your age, right? So that's a thing. 601 00:31:49,800 --> 00:31:54,100 I mean hopefully is a A program that has commingled kids of all 602 00:31:54,100 --> 00:31:57,300 different ages, that's another that regulation should prevent, 603 00:31:57,300 --> 00:31:59,900 but yeah, I think you're not going to be asked to strip down. 604 00:31:59,900 --> 00:32:02,200 You're not going to be asked to be in Scrubs. 605 00:32:02,200 --> 00:32:05,800 You're not going to have all of your worldly belongings taken 606 00:32:05,800 --> 00:32:09,400 away from you. You know, they are going to want 607 00:32:09,400 --> 00:32:12,400 to understand what's bringing you in. 608 00:32:12,400 --> 00:32:15,100 They're going to want to understand if there are safety 609 00:32:15,100 --> 00:32:17,800 concerns, depending on why you're going into treatment. 610 00:32:17,800 --> 00:32:20,700 But even if you're going in for something that's not about 611 00:32:20,700 --> 00:32:23,700 self-harm, Are more suicidality, they're going to be asking you. 612 00:32:23,700 --> 00:32:27,000 Those questions are going to want to know, they genuinely are 613 00:32:27,000 --> 00:32:29,600 going to want to try and understand what the path has 614 00:32:29,600 --> 00:32:34,800 been to get you to that place, and to come up with goals and 615 00:32:34,800 --> 00:32:38,300 targets for treatment lawyer. And if safety is a primary 616 00:32:38,300 --> 00:32:40,700 concern, they're going to spend a lot of time on that first day. 617 00:32:40,700 --> 00:32:46,100 Assessing safety, coming up with safety plans and trying to sort 618 00:32:46,100 --> 00:32:50,000 of identify in the program. What are the resources that you 619 00:32:50,000 --> 00:32:52,600 can use? You're feeling unsafe. 620 00:32:52,700 --> 00:32:55,400 Hmm, it's so many questions that you're asked. 621 00:32:55,400 --> 00:32:57,800 Initially again, like you're emphasizing, it's such a 622 00:32:57,800 --> 00:33:00,800 collaborative process and I like your brought in and the 623 00:33:00,800 --> 00:33:05,000 treatment protocol is 100% laid out like this is being adjusted 624 00:33:05,000 --> 00:33:08,300 based on what your needs are. So, even the safety plan, like 625 00:33:08,300 --> 00:33:10,900 what has been helpful for you in the past, with coping, with 626 00:33:10,900 --> 00:33:14,300 urges, or when you get anxious, what skills do you like to use 627 00:33:14,300 --> 00:33:17,800 and really making sure this is going to be effective for you 628 00:33:17,800 --> 00:33:21,000 and I would say other random things that come to mind. 629 00:33:21,100 --> 00:33:23,200 Is like there's lots of activities probably lots of arts 630 00:33:23,200 --> 00:33:24,800 and crafts. Like lots of different ways to 631 00:33:24,800 --> 00:33:26,500 express what you're experiencing. 632 00:33:26,700 --> 00:33:29,400 It feels very much like being at a new school because you're 633 00:33:29,400 --> 00:33:32,700 thrown into a new environment with other teens and you're all 634 00:33:32,700 --> 00:33:34,900 just kind of like getting to know each other and and 635 00:33:34,900 --> 00:33:39,000 introducing yourselves so much TV watching a movie watching. 636 00:33:39,000 --> 00:33:41,800 Most times you don't, if there's not a lot of time like scrolling 637 00:33:41,800 --> 00:33:44,700 on Tick-Tock or on your phone. So when you're doing an activity 638 00:33:44,700 --> 00:33:47,000 at night, you're watching a show together or doing a movie. 639 00:33:47,000 --> 00:33:50,100 And so it's not all just there be 24/7. 640 00:33:50,100 --> 00:33:54,200 It's lots of Activities routines that again would transfer after 641 00:33:54,200 --> 00:33:57,100 you leave treatment and you're reminding me. 642 00:33:57,100 --> 00:33:59,600 That one of the other big barriers I hear from some kids 643 00:33:59,600 --> 00:34:01,800 about going to residential treatment is falling behind in 644 00:34:01,800 --> 00:34:03,200 school. Yeah. 645 00:34:03,400 --> 00:34:07,100 And trying to reassure kids that school is a part of treatment 646 00:34:07,100 --> 00:34:10,400 when you're in residential care. So you will be doing school and 647 00:34:10,400 --> 00:34:12,800 you don't need to worry that you're going to come out and 648 00:34:12,800 --> 00:34:16,300 have to repeat a grade. No no yeah 100% And even me I 649 00:34:16,308 --> 00:34:19,000 took a medical leave of absence for one year but I did the 650 00:34:19,000 --> 00:34:20,900 summer semester caught up on things. 651 00:34:21,100 --> 00:34:23,600 I was on track. I was able to apply to college 652 00:34:23,600 --> 00:34:27,300 the world continued to go round. And I think it's such a reminder 653 00:34:27,300 --> 00:34:29,900 that without your mental health, you really don't have anything. 654 00:34:29,900 --> 00:34:33,300 You're not able to pursue your education or these interests are 655 00:34:33,500 --> 00:34:36,600 a career because your mental health is such a foundation. 656 00:34:36,600 --> 00:34:39,300 And so yeah, very very important reminder. 657 00:34:39,300 --> 00:34:41,199 Is there anything? You wish that teens would be 658 00:34:41,199 --> 00:34:45,300 aware of when pursuing mental health treatment, any myths or 659 00:34:45,400 --> 00:34:48,900 things that they knew going into treatment that people want them 660 00:34:48,900 --> 00:34:51,000 to get better? That it's a very collaborative. 661 00:34:51,199 --> 00:34:53,800 Anything that you will re like. I wish they came in day one and 662 00:34:53,800 --> 00:34:58,900 this was just an understanding. I mean ultimately I wish in this 663 00:34:58,900 --> 00:35:01,200 is really for kids who are maybe not sold on treatment. 664 00:35:01,200 --> 00:35:03,900 There are there are young people who come in asking for 665 00:35:03,900 --> 00:35:06,400 treatment. Like yeah, we have that first 666 00:35:06,400 --> 00:35:09,400 appointment and ask the parents, you know, like why are you here? 667 00:35:09,400 --> 00:35:12,900 Like, some kid brought me here. Yeah, if they're our best but 668 00:35:12,900 --> 00:35:17,900 for the kids who aren't at that place is a wish they understood 669 00:35:17,900 --> 00:35:19,800 that. I am not an agent of their 670 00:35:19,800 --> 00:35:21,000 parents. Yeah. 671 00:35:21,100 --> 00:35:22,800 Yeah. Yeah, I think their parents are 672 00:35:22,800 --> 00:35:25,300 really important partners and really important people in their 673 00:35:25,300 --> 00:35:26,800 lives. And we're going to want to 674 00:35:26,800 --> 00:35:31,500 involve them but I'm not here to do the bidding of your parents. 675 00:35:31,500 --> 00:35:35,100 I'm here to help you and figure out what's causing used to 676 00:35:35,100 --> 00:35:39,300 suffering and struggling and trying to effect change so that 677 00:35:39,300 --> 00:35:43,100 you can lead your best life. And I often say to kids, if I 678 00:35:43,107 --> 00:35:46,000 think they have a sense of humor, the, in the first visit 679 00:35:46,000 --> 00:35:49,000 that my real main goal is that I never see them again. 680 00:35:49,200 --> 00:35:53,500 Yeah. Yeah like Not here to take your 681 00:35:53,500 --> 00:35:55,600 money. I'm not here to sort of see you 682 00:35:55,600 --> 00:35:58,000 forever. I'm not here just to put you on 683 00:35:58,000 --> 00:35:59,900 medication. In fact, I'm only going to put 684 00:35:59,900 --> 00:36:03,600 you on medication if it is really indicated and necessary 685 00:36:03,700 --> 00:36:07,200 and that your best interests are sort of like The Guiding Light, 686 00:36:07,200 --> 00:36:12,200 the true north of tree and gets really hard to understand that 687 00:36:12,200 --> 00:36:14,500 and feel that when you're in a dark place. 688 00:36:14,500 --> 00:36:20,300 Yeah, I also love the the way of thinking about it of like if you 689 00:36:20,300 --> 00:36:22,500 have a therapist, You're a psychiatrist, who's in your 690 00:36:22,500 --> 00:36:24,300 corner and truly working with you. 691 00:36:24,600 --> 00:36:27,100 You could suddenly have this highly trained professional to 692 00:36:27,100 --> 00:36:29,300 help you Advocate and get things from your parents. 693 00:36:29,300 --> 00:36:31,600 If you're like I want them to validate me more or I wish that 694 00:36:31,600 --> 00:36:33,900 they would stop getting mad at me for not cleaning my room. 695 00:36:34,000 --> 00:36:37,100 You have this person who has been highly educated and can be 696 00:36:37,100 --> 00:36:39,100 like from a therapeutic perspective. 697 00:36:39,100 --> 00:36:42,100 We really do think that asking about the room being cleaned 12 698 00:36:42,100 --> 00:36:44,000 times. A day is not great. 699 00:36:44,400 --> 00:36:46,500 And you have someone in your corner, you have someone helping 700 00:36:46,500 --> 00:36:48,900 you make these changes in your family relationships. 701 00:36:48,900 --> 00:36:51,200 And it's kind of funny to think about it that way because In a 702 00:36:51,207 --> 00:36:53,200 lot of ways, it's true. You have someone helping set 703 00:36:53,200 --> 00:36:56,400 those boundaries and Advocate and it's a lot more of a skill 704 00:36:56,400 --> 00:37:00,000 set than you on your own. You have you have an objective 705 00:37:00,000 --> 00:37:02,600 outside professional. Yeah. 706 00:37:03,100 --> 00:37:08,400 Is not there to do anything other than try and improve your 707 00:37:08,400 --> 00:37:11,500 life. Yeah, and often I'll hear from 708 00:37:11,500 --> 00:37:16,300 young people but I don't need a therapist, I have friends and my 709 00:37:16,300 --> 00:37:18,700 response to that. I've many different responses to 710 00:37:18,700 --> 00:37:21,500 it but one of them is that friends are wonderful, that 711 00:37:21,500 --> 00:37:23,900 really important. I want you to have them and I 712 00:37:23,900 --> 00:37:26,700 want you to talk to your friends about the important things in 713 00:37:26,700 --> 00:37:30,200 your life, but your friends are just that they're your friends, 714 00:37:30,200 --> 00:37:33,600 your therapist is there to be supportive of you but also push 715 00:37:33,600 --> 00:37:38,300 on you at times and therapy. May be uncomfortable at times 716 00:37:38,300 --> 00:37:43,700 but you need an objective outside person who can tell you 717 00:37:43,700 --> 00:37:48,300 what it is when it's happening and and that you can develop a 718 00:37:48,300 --> 00:37:50,800 rapport with that is a true back. 719 00:37:50,800 --> 00:37:54,700 And Earth and Trust. Yes, absolutely. 720 00:37:55,200 --> 00:37:57,200 I love that. When you have patients come in, 721 00:37:57,200 --> 00:38:00,300 are there any mindsets are approaches or questions asked 722 00:38:00,300 --> 00:38:01,400 that? You're like this is great. 723 00:38:01,400 --> 00:38:04,100 We love to see this. I know when I first got to 724 00:38:04,100 --> 00:38:07,100 residential, I was like, I don't want to be here, my parents that 725 00:38:07,100 --> 00:38:08,800 I have to be here, this isn't going to work. 726 00:38:08,800 --> 00:38:11,000 And then before I actually began, there had to be that 727 00:38:11,000 --> 00:38:14,300 shift of like, okay, I trust you guys to help me. 728 00:38:14,300 --> 00:38:17,300 I know that there is evidence support this, and I want to get 729 00:38:17,300 --> 00:38:18,900 better, and I hope I can get better. 730 00:38:18,900 --> 00:38:20,900 And let's see how this goes. So, is there anything? 731 00:38:21,000 --> 00:38:25,100 Thing like that that's helpful to kind of like do that internal 732 00:38:25,100 --> 00:38:28,400 work as your kind of cultivating that willingness and entering 733 00:38:28,400 --> 00:38:32,600 the therapy world? I mean honestly I think what I 734 00:38:32,600 --> 00:38:37,700 love to hear is an openness to just exploring opportunity and 735 00:38:37,700 --> 00:38:40,100 possibility. You know the idea that in this 736 00:38:40,100 --> 00:38:43,300 is really hard as a teenager I remember well even though it was 737 00:38:43,300 --> 00:38:47,400 a long time ago like that then maybe you don't know everything 738 00:38:47,600 --> 00:38:51,600 and the other to do definitely feel Like you do. 739 00:38:51,700 --> 00:38:56,000 But when a young person comes in and says, really miserable I'm 740 00:38:56,000 --> 00:38:59,300 unhappy or I'm really anxious. I don't want to feel this way 741 00:38:59,300 --> 00:39:04,100 anymore and I want to do whatever it takes to sort of 742 00:39:04,100 --> 00:39:07,700 feel better. That's obviously ideal, but just 743 00:39:07,700 --> 00:39:11,700 an openness to exploring what might be possible, is sort of 744 00:39:11,707 --> 00:39:16,900 music to the ears of solutely. And it's also just, that's a 745 00:39:16,908 --> 00:39:19,600 helpful reminder to have that. How many times in your life, 746 00:39:19,600 --> 00:39:20,900 where you going to have an entire team? 747 00:39:21,000 --> 00:39:24,000 Team of people that are just there to support you and care 748 00:39:24,000 --> 00:39:26,700 for you and want to see you thrive, like there's not many 749 00:39:26,700 --> 00:39:28,600 positions that you're put in there. 750 00:39:28,600 --> 00:39:32,200 That's the only goal is just to help you be more effective and 751 00:39:32,200 --> 00:39:34,300 happy. And so that's something that is 752 00:39:34,300 --> 00:39:36,900 really amazing about treatment. That sometimes gets lost is 753 00:39:36,900 --> 00:39:40,100 everyone's just there to support you and it's a really unique 754 00:39:40,300 --> 00:39:43,900 experience in that way. The caveat to that would be. 755 00:39:43,900 --> 00:39:47,700 That support doesn't always feel good, 100%. 756 00:39:47,800 --> 00:39:50,300 Yeah, right? Yes, yes, yes. 757 00:39:50,400 --> 00:39:52,400 A good. Our best isn't always going to 758 00:39:52,400 --> 00:39:56,800 just say, oh, I'm so sorry. You feel that way? 759 00:39:57,000 --> 00:39:58,900 Well, you got yourself in this situation. 760 00:39:58,900 --> 00:40:03,200 So pity party is a little others of support, right? 761 00:40:03,300 --> 00:40:06,900 But a good therapist is going to deliver a message to try and 762 00:40:06,900 --> 00:40:10,700 shift your thinking in a way that doesn't lead you to feel 763 00:40:11,200 --> 00:40:14,400 bad about yourself. They challenge you to think 764 00:40:14,400 --> 00:40:17,100 about things differently. Absolutely. 765 00:40:17,600 --> 00:40:21,400 Any last advice for parents navigating this SS. 766 00:40:21,400 --> 00:40:25,000 And then for teens as well, I think on both fronts, the 767 00:40:25,008 --> 00:40:27,500 biggest thing is just ask questions. 768 00:40:27,500 --> 00:40:31,000 Lots and lots and lots and lots of questions and if anything 769 00:40:31,000 --> 00:40:34,400 doesn't feel right asking more questions until it either feels 770 00:40:34,400 --> 00:40:36,300 right or until you say you know what? 771 00:40:36,300 --> 00:40:40,800 This is a no go. I don't know what and you know I 772 00:40:40,800 --> 00:40:45,100 think at some point you also have to trust, right? 773 00:40:45,100 --> 00:40:48,100 So once once you get to a certain place where you feel 774 00:40:48,100 --> 00:40:52,400 like, okay, this person is good where I A lot of struggle is 775 00:40:52,500 --> 00:40:56,400 when we've got a good rapport, but then we come up against 776 00:40:56,400 --> 00:41:00,200 something and it feels like that trust isn't really there. 777 00:41:00,200 --> 00:41:03,300 And then we can take the next step around the treatment 778 00:41:03,300 --> 00:41:07,200 because maybe it takes some risks around some sort of 779 00:41:07,207 --> 00:41:09,000 exposure. I mean, I'm an anxiety disorder 780 00:41:09,000 --> 00:41:12,900 OCD person. So I think a lot about kind of 781 00:41:13,200 --> 00:41:17,200 how to help anxious people including parents tolerate 782 00:41:17,300 --> 00:41:22,000 distress those situations. So questions And lots, and lots 783 00:41:22,000 --> 00:41:25,200 and lots of questions. I remember writing down, like, 784 00:41:25,200 --> 00:41:27,800 literally on a napkin, we went to go get lunch before I 785 00:41:27,808 --> 00:41:31,200 officially start at three East and I was like, what will my 786 00:41:31,200 --> 00:41:33,700 typical day? Look like, which therapists are 787 00:41:33,700 --> 00:41:36,400 my actually meeting with when can I call my friends? 788 00:41:36,400 --> 00:41:38,900 Like those were my questions. My parents were like, so how 789 00:41:38,900 --> 00:41:41,200 does DPT work? Are you actually doing DBT? 790 00:41:41,200 --> 00:41:43,400 What are the different ways that were involved in? 791 00:41:43,400 --> 00:41:47,200 Mine were just so simple, but having that Clarity was really, 792 00:41:47,200 --> 00:41:50,700 really helpful and there's no bad questions. 793 00:41:51,000 --> 00:41:53,500 These are things that probably tons of teens have had questions 794 00:41:53,500 --> 00:41:56,200 about before, then you can even ask the other teams as well. 795 00:41:56,200 --> 00:41:58,200 I remember, that was one of the biggest things on the first 796 00:41:58,200 --> 00:42:01,100 couple of days. Whether it was at IOP or 797 00:42:01,100 --> 00:42:04,500 residential or therapeutic boarding school asking them 798 00:42:04,500 --> 00:42:06,200 questions Bank, okay? But like what is it? 799 00:42:06,200 --> 00:42:09,100 Like when we start going to school or what is the routine on 800 00:42:09,100 --> 00:42:11,500 the weekends or what are your favorite things to do? 801 00:42:11,500 --> 00:42:14,500 And just getting a real feel for what the community is like and 802 00:42:14,500 --> 00:42:18,000 what to expect and everyone has been in the same position before 803 00:42:18,000 --> 00:42:20,800 and so they'll be more than happy to answer those. 804 00:42:21,000 --> 00:42:22,600 Questions. Absolutely. 805 00:42:22,600 --> 00:42:25,300 And if they're not then that tells you something about the 806 00:42:25,300 --> 00:42:27,000 program. How's your percent? 807 00:42:27,400 --> 00:42:28,500 Yeah. Yeah. 808 00:42:29,300 --> 00:42:34,500 If people want to learn more about Ohana or continue to 809 00:42:34,800 --> 00:42:37,400 follow along with all the amazing work you guys are doing 810 00:42:37,400 --> 00:42:39,300 where can they do that? Yes. 811 00:42:39,300 --> 00:42:43,000 So we have a website. So if you go to the Community 812 00:42:43,000 --> 00:42:46,400 Hospital of the Monterey Peninsula, you can navigate to 813 00:42:46,400 --> 00:42:49,100 the Ohana website. If you were to Google Ohana 814 00:42:49,100 --> 00:42:52,600 Monterey, California. You'd get a lot of information 815 00:42:52,600 --> 00:42:55,800 there, you get to our web page, the web pages under construction 816 00:42:55,800 --> 00:42:59,100 because we're very much under construction or a new program. 817 00:42:59,100 --> 00:43:02,100 That's being built. Both literally and figuratively 818 00:43:02,100 --> 00:43:05,100 are building, will not open until next summer. 819 00:43:05,200 --> 00:43:09,300 So our services are still small right now but growing quickly. 820 00:43:09,500 --> 00:43:11,900 And how do you want is planning to have a mental breakdown and 821 00:43:11,900 --> 00:43:15,300 about a year or so you're going to have a great place to go to. 822 00:43:17,100 --> 00:43:20,800 Yeah, we're providing Outpatient Treatment and I owe p and p. 823 00:43:20,900 --> 00:43:25,600 PHP level of care right now and when the new building opens will 824 00:43:25,600 --> 00:43:28,500 be doing all of that and in a larger expanded way, plus have 825 00:43:28,500 --> 00:43:31,800 residential Adolescent Treatment, that will be in a 826 00:43:31,808 --> 00:43:34,200 couple different tracks. But one of those tracks will be 827 00:43:34,200 --> 00:43:37,900 a DBT based residential program is amazing. 828 00:43:37,900 --> 00:43:43,000 I found IOP and PHP programs to be so helpful to really solidify 829 00:43:43,000 --> 00:43:47,500 those DBT skills and really just practice the the skills in the 830 00:43:47,500 --> 00:43:50,500 context of having routine getting up and going somewhere, 831 00:43:50,500 --> 00:43:52,100 rather. Just being in like the 832 00:43:52,100 --> 00:43:54,900 residential setting and so it's amazing to hear that. 833 00:43:54,900 --> 00:43:57,700 That's a resource. If anyone is in Monterey the 834 00:43:57,700 --> 00:44:00,400 links will be in the show notes and thank you so much for 835 00:44:00,400 --> 00:44:02,500 answering all my questions. I know this is going to be so 836 00:44:02,500 --> 00:44:04,500 helpful. Well it was it was great. 837 00:44:04,500 --> 00:44:07,900 It was so nice to see you. Thank you so much for listening 838 00:44:07,900 --> 00:44:09,900 to this week's episode of she persisted. 839 00:44:09,900 --> 00:44:12,300 If you enjoyed, make sure to share with a friend or family 840 00:44:12,300 --> 00:44:14,400 member. It really helps out the podcast 841 00:44:14,600 --> 00:44:17,600 and if you haven't already leave a review on Apple podcast or 842 00:44:17,600 --> 00:44:20,800 Spotify, you can also make sure to follow along at a cheaper. 843 00:44:20,900 --> 00:44:24,000 Persisted podcast on both Instagram and Tik-Tok and check 844 00:44:24,000 --> 00:44:27,100 out all the bonus resources content and information on my 845 00:44:27,100 --> 00:44:29,600 website. She persisted podcast.com, 846 00:44:30,000 --> 00:44:32,600 thanks for supporting, keep persisting and I'll see you next 847 00:44:32,600 --> 00:44:33,000 week.