Welcome to she persisted I'm your host Sadie Saxton a 19 year
old from the Bay Area studying psychology at the University of
Pennsylvania. She persisted is the Teen Mental
Health podcast made for teenagers by a team in each
episode. I'll bring you authentic
accessible and relatable conversations about every aspect
of mental Wellness. You can expect evidence-based,
Tina, proof resources, coping skills, including lots of DBT,
insights and education. In each piece of content, you
consume, she persisted It offers you a safe space to feel
validated and understood in your struggle.
While encouraging you to take ownership of your journey and
build your life worth living. So, let's dive in this week on,
she persisted often I'll hear from young people but I don't
need a therapist. I have friends and my response
to that is that friends are wonderful.
That really important. I want you to have them and I
want you to talk to your friends about the important things in
your life, but your friends are just that they're your friends,
your This is there to be supportive of you but also push
on you at times and therapy. May be uncomfortable at times
but you need an objective outside person who can tell you
what it is. Hello, hello and welcome back to
she persisted. I am so excited for this
episode. This is one of my most highly
requested topics. It's something I'm constantly
getting questions about via email and DM's at on the
question submission form, which is parents that are looking for
guidance on how to find their team.
Teen treatment. And then, for teens, what to
expect from that process. So we've brought in an expert.
Today's guest is dr. Justin Mo hat.
He is an internationally recognized harvard-trained,
double board certified psychiatrist.
He specializes in anxiety, OCD, and tic disorders and childhood.
Adolescence, and emerging adulthood, he is an expert in
complex case, formulation, and medication management and works
heavily on the treatment side of things, he worked at a treatment
program, so he answered all of my questions about To expect and
what to know if you are navigating this process, both is
apparent and the Teen. So, for parents what to look for
in treatment programs. What questions to ask them?
What are the non-negotiables? What are the things that are
nice to have tips to get your teen to be an active participant
and to be motivated to get treatment especially when
they're not necessarily motivated it initially and how
to approach the treatment process.
So like what can you expect from quote-unquote getting treatment
and then for teens, what can you expect when you are pursuing
intensive treatment? What Justin wishes that teens
were aware of when they start treatment in a bunch of myths
that he wanted to debunk. So if there are any anxieties,
you have about this experience, we debunk all of those.
So this is an amazing conversation.
It really fills a need that I haven't touched on before and
she persisted which are these questions that teens and parents
have from an expert perspective? So I'm so excited about this,
you are going to love it. So with that, let's dive in.
Thank you so much for coming on, she persisted today.
I'm so excited to have you on the show.
We're going to talk about some of my most frequently asked
questions and I know this episode is going to be such a
resource for so many people. So thank you for sitting down
with me. Yeah, I'm happy to be here.
I'm very flattered that you asked me, of course, of course.
Now I am very excited to pick your brain about all things teen
treatment, and get the Adolescent perspective, and the
parent perspective because it really does feel like a black
box almost until you're within the treatment world.
You're like, I don't know what to expect.
Like what's the difference between IOP and Intensive
treatment and residential and there's no set path.
So hopefully with this conversation we can provide a
little bit of clarity and lesson certainty for any families that
are navigating this. You said that so well, I think
that so much of our field is exactly that a black box and
people spend days on the internet, trying to search.
They get word of mouth. And somebody says, oh, this
person is really good, you should go see them but they have
no idea if that person is good for what they need, and one
person can be really good at one thing.
Not know anything about another thing.
And so, you know, I think we've been working very hard in the
places that I've most recently been been at to try and create
systems that are more transparent and easy to navigate
and to help families through that process.
Absolutely. So I'm thinking we split this
between advice for parents and advice for teens because the
questions are very different for teens.
It's more like anxiety of what is this going to be like and
what is this process like? And for it's a lot of the times.
It's like, how do I find a treatment program or what can I
do to support my teen? So to start with parents, I love
to get your thoughts on what the typical treatment trajectory.
Looks like, obviously everyone's experience is very different.
I always am. Like my 14 months and treatment
are probably something. No one else will ever experience
because everyone goes a different route but there are
some things that I think are similar with looking for
programs and maybe going from a more outpatient setting to a
more inpatient These common theme.
So I'd love to kind of understand what steps families
typically go through when they are navigating teen mental
health treatment. Well, I think that families
often start with complete confusion and the idea where to
begin. And then, you know, I think some
families find their way to some sort of mental health provider,
but I also think that the best resource for most families as a
star Eating place is their primary care physician.
You have a trusted relationship with that person.
Theoretically, they know you, they know your family.
They are essentially mandated at this point to be screening for
things, like depression and anxiety in kids and depending
where you are sometimes they are screening for suicidality and
self-harm. So that's a really good starting
place because even if they aren't going to be the people to
deliver any sort of intervention or care.
No, the community. And they will typically have
trusted people that they know to work within the area.
And they also will know things like, how long does it take to
get in typically to somebody. And, and frankly, a lot of
primary care, doctors can treat some things.
And so, you may not need to wait to get into a child mental
health. Clinician to start something and
then you can move forward with things like outpatient, treat
ya, which typically that first step, I'm going to Put at just a
plugin for kind of early identification of challenges.
The kids are having because the earlier we can get in there and
this is again where pediatricians and primary care.
Doctors can be Sookie, the easier it is to intervene and
make a difference. And so if you need Outpatient
Treatment then the next step is identifying a local therapist or
psychiatrist and that's I think another place where families get
confused. Like do we need a psychiatrist?
Do we need a therapist? Do we need a psychiatrist who
does therapy because that's an option.
Exactly. Yeah.
People by virtue of maybe their own history or just the
community, they live. In think that you know, you have
to have a psychiatrist that does everything and I think in
different parts of the country there are different models of
treatment. I worked for a long time in the
Northeast where that model of one psychiatrist doing
everything is more common in lots of the country, dad Is not
typical and and I would say that, what's more important than
somebody whose credentials is their experience.
And how much time they spend doing this, you can have a
highly trained psychiatrist. You went to medical school, did
residency, Fellowship work. So their first patient, they
just the another, yeah. Or you're not their first
patient but they don't really do therapy very much.
And you really want a therapist, who does what you need them to
do every day. 2% and even just the demographics of do, they
work with teens or is their Target demographic normally
adults? Because those challenges that
you're experiencing are probably really different or are they
more experience? Was navigating anxiety versus
depression. Like all of these are different
Specialties and things to kind of keep an eye out for and I
love what you mentioned about pediatricians because that's
exactly where I started my journey.
I've said that on the podcast so many times, like one into my
pediatrician appointment, they did the depression screening and
I was like, all of those, all of the above, Of is happening.
And then from there, I went to a psychiatrist and worked with
other people but it really is a great first step and like you
mentioned being able to be aware of things that maybe aren't
going. So well, really early on in the
process and then make shifts and get resources.
And the other great thing about having your pediatrician clued
in, as every single time you go in for their annual there,
checking up on how things are going, how are things going with
medication? Or how are things going with
meeting with a therapist? What are your responses to these
questions? Since looking like compared to a
year ago, whereas if you meet with a psychiatrist one time but
then you just completely fall off that train and never go and
return to those appointments. The pediatrician is at least
following up in a consistent way.
Absolutely. Yeah.
So for parents that have received the recommendation that
their teen might benefit from an intensive Mental Health Care
Program, whether it's a residential or a longer-term.
Program where they're looking Beyond just their, their local
psychiatrists and therapists or pediatrician.
Like, we mentioned, what things do you look for in a treatment
program whether it is non-negotiables, whether its
staff, whether it is different types of therapy, things that
are nice to have. But when you are looking at a
program, what things are? Are you keeping an eye out for
to make sure that it's a great fit for a patient?
Yeah, maybe it's my first thought, which doesn't really
answer. Your question is just what are
all those different levels? Yeah cause I think we don't even
know that but I imagine your listeners have heard, what these
different levels of care are over time.
So I think the first thing is figuring out, what level do you
need, right? So everything from regular
outpatient care to intensive Outpatient Treatment and or
intensive treatment programs, which might be like two to three
days a week for a couple hours at a time up to sort of half-day
program. Alms to partial Hospital
programs that are essentially the school day, 5 days a week to
residential treatment, which is kind of longer term, but
voluntary, treatment and unlocked places, and then
inpatient treatment being the highest level of care.
But your question about what to look for.
If a couple big things that I really wish families would hear.
One is just because a place is the most expensive place.
Doesn't mean it's the best place, and just because it's in
the most beautiful setting doesn't mean.
Horses doesn't mean it'll be the best as far as this has an ocean
view has like, I think families can easily get romanced by some
of that because it's so scary to have your child go away
somewhere. So to say okay well the place is
really expensive. It looks really nice.
That doesn't necessarily mean high quality Care.
Yeah. The other thing I would say is
be wary of programs that promise everything if you look at their
materials and they say they basically treat everything under
the Spectrum with evidence-based.
Treatments. And it's highly unlikely that
they really are that specialized in all of those different
things. I much prefer to have a program
that says, we do this and this very well and this is our
modality. You want to ask them what
modalities of treatment they use and they should be able to
answer. That clearly is an easy example,
which is I often see patients who say that they've been
getting cognitive behavioral therapy for their anxiety.
But it's not getting better and it's not helping and I ask them.
Well what are you doing in your therapy and it turns out that a
largely what they're getting is supportive Psychotherapy with
some sort of instruction on how to do deep breathing and maybe
some psycho education on, not avoiding anxiety-provoking
situation, not to CBT, not getting full fledged CBT and
they're not getting the core key treatment to CBT which is
exposed Bossier therapy. So you want to educate yourself
ahead of these conversations about your kids diagnosis and
what the best treatments are for that.
And then ask very pointed questions about it.
What are those questions that you would ask?
If you could give like 325 that they could bring to their intake
meeting? They're on the phone?
They're screening these programs.
What would you ask? That's a really hard question to
answer simply because I think it's so dependent on what a
particular young person is. But those questions.
So what if we said, like a teen is struggling a bully, like, use
me at Tina, struggling with depression, self-harm has tried
outpatient inpatient at home, the recommendation is
Residential Care. History of self-harm suicidal
ideation and have tried outpatient DBT and then
intensive outpatient. But as far as residential, what
the recommendation is, we know, we don't know.
Do we need a DVT intensive program?
Do we need like a therapeutic boarding school for residential?
So, the next step is residential.
The background is depression, anxiety.
Those behaviors. So, what questions would you ask
different residential programs? Well, I think the first thing
I'd want to know given the history are describing as
whether the program and I would sort of start with an open-ended
question. Knowing what I want the answer
to be. Yes.
So my question would be, you know what modality of treatment
do you use in your program? And listen to what I say?
And what I would want them to say is that they use a
combination of dialectical You're all therapy and cognitive
behavioral therapy and that they sort of address safety concerns
first. And so the first treatment would
probably be DBT and then when safety is off the table, then
you can work on the depression and the anxiety.
Yeah, that's really helpful for sure to kind of just have those
exact labels of what to listen for and ask that open-ended
question because I mean it's so crazy that you even have to
think about how these things. These are marketing and kind of
see through, when they're like, oh, we offer everything.
And it's like, well what do you really offer?
And when you said that, it reminded me of this marketing
strategy, where it's when things advertise themselves, as like
the Cheesecake Factory where they offer anything and
everything you could possibly ever want to eat.
But nothing on the menu, is really that great.
And so you can think of trigger programs that way or if they're
offering anything and everything to possibly be treated.
They're probably not going to be that great at all of those
different things. So to listen, for those key
terms is super Pull rather than going in and being, like, do you
offer DBT? Because my parents did that one
we were looking for therapeutic boarding schools in a
therapeutic boarding. School was like, yes, of course
we do, but then once I went there that did not offer DVT,
right? Well, you know, and I think
specifically with DBT I would want to know in this is very
kind of technical but our number are your therapist DBT certified
with behavior tag? Yeah, yearly DBT therapist.
Do you provide full Fidelity DVT and because anyone can say They
do anything. They may do DVT, informed
treatment and in some situations that might be appropriate.
But if you're talking about residential care, and you're
talking about, chronic sort of self-injury and depression, you
really want that full Fidelity? Yeah, and it's also so helpful
to remember that a lot of these different evidence-based
treatments are proven to be evidence-based under very
specific conditions. So, like with DBT, you're doing
a very specific, six-week course of learning.
During a certain number of skills with your therapist
working in tandem with a certain number of other therapists and
you are approaching your challenges in therapy with a
very specific hierarchy. And you're also meeting with a
psychiatrist, like all of these details are very clearly laid
out. And that is what is shown to be
effective. The idea of like me on the
podcast when I teach you a DBT skill it's not what's
evidence-based to heal depression.
Like it's just a fun thing that might make you feel a little bit
better to accumulate some positives in your life.
But It's that like super set criteria.
That is shown to be evidence-based.
So you have to make sure that the treatment programs are using
that set criteria. That is been proven to be
effective and not just like pulling little ideas from here
and there to try and support people.
There's a really interesting and important research study, that
was done several years ago. Now, comparing sort of
psychoeducation, like providing education about cognitive
behavioral therapy. Yeah, you doing full-fledged
cognitive behavioral therapy to medications?
Trying to look at what's realistic for primary care.
Doctors to do, right? They can't do a CBT session in
there. 10. 15 minutes with? Yeah.
Well, they're like also checking to make sure you can like, bend
your knee correctly. Like let's check the nose.
Let's do some exposure therapy, nugget nation, and does that
move you do? And unfortunately it was not as
effective as which is what you would.
Expect but but I think that that's often what happens.
People provide a little education about CBT but they
don't really do yeah. Fall series with exposure.
Yeah. If there were two to three
non-negotiables that you would want to make sure we're at a
treatment program for parents to look for whether it's like a
psychiatrist on staff or a certain evidence based
intervention. Maybe it's like a number of
patients or how long the treatment facility has been
open. A certain like accreditation.
There's so many different potential things but You to
choose some non-negotiables. We were like at the very minimum
a program should have this. What would that be?
Yeah, and you're speaking to some really tricky things
because state-by-state the regulations are on residential
treatment are widely varying. So residential can be fully
accredited or regulated, but depending on the state and the
size of the program that can be vastly different Yang for.
This is making your listeners, very anxious as I'm saying it.
But I know I just released literally as a record - the
episode that went out this week is about the troubled teen
industry, so luckily there's going to be some time before
this episode comes out. But like in that episode, an
example of what accredited, a program was.
How many toilets they had? And the ratio to students.
So, that's it. There's some discrepancy here on
what accreditation means. Absolutely, I mean, honestly, I
think the, the most important things from my perspective are
that they involve family and that's for a couple reasons.
One is If you are a program that doesn't communicate with
parents, that doesn't involve parents and family in treatment
and you're doing this sort of bubble of something with a kid.
And then you say, okay, we're done and you send them home, and
you've never done anything to change the environment.
Then you're setting everyone up for failure and some sense.
So, I think number one for me, is that family is very involved
in the treatment in whatever way is possible that maybe virtual
because the family Can be where the kid is at but that it is
built into the program and it's not just will check in once a
week for an hour or you call us if you have right yeah you'd be
surprised what can happen out there so I think that's really
critical. I think that again
evidence-based treatments but not every evidence-based
treatment Under the Sun. So you know for instance for a
kid who has depression who has self injury, has a lot of And
regulation difficulties a no-go would be if they didn't have a
true DBT program. Yeah.
If you have a kid who has obsessive-compulsive disorder or
a severe anxiety disorder, you want a program that is an
exposure based cognitive behavioral therapy program and
they should be able to talk to you about what that action
really looks like and how they deploy that you want
evidence-based treatments for the thing that your child is
struggling. And you can even ask them, like,
oh, can you send the the research that supports this
intervention that you're using? I remember, I asked my
therapeutic boarding school that one time after I left and they
sent me a paper talking about how nature can be good for
mental health was like, okay, but this is not what I, my
parents signed up for when they were like, we'd like a long-term
transitional program that can help her like maintain mental.
Health continued to maintain DBT skills and not be depressed and
suicidal like they were not. Optimizing for exposure to
Nature. So ask them if they can send you
studies that support this intervention and the Adolescent
population and show good results.
And you don't have to read the entire study.
We're not like, please spend all your time reading 12 studies.
But if they can't provide that, that's immediately like red
flag. Yeah.
And I think the other thing is you want transparency.
So if you're getting any sense that there are sort of skirting
around questions and then are not giving you very clear
answers, I would be really wary. Yeah, I think that this may be
hard and you may not get a satisfactory answer, but it's
worth at least asking what their internal quality kind of
processes. And if they have any data or
statistics on the success of. Yeah.
Absolutely. And they should be able to
produce something. Yeah.
From the professional standpoint should parents have to sign over
their custody when their child gets mental health treatment
Shit's it, while you can tell by my answer.
Like what? That's a thing.
No, absolutely, yeah. Not a standard of care.
And I have to remind people of that because like, I, my parents
found the most amazing DBT program in Boston.
And then four months later, I also went to program Montana.
And when they were like, okay, sign over 51%, my parents were
like, okay, like they're very smart people, they knew what
they're talking about and yet some of these again it's a black
box like from the outside, you would like, oh well my Is living
there for a year. So maybe they would need 51%,
but they don't that's it. Myth, not offend or it shouldn't
be should not be a thing. Today's episode is brought to
you by teen counseling. Teen counseling is better helps
online Therapy Program for teens, they have over 14,000
licensed therapist within their Network and they offer support
on things like depression, anxiety, relationships, trauma,
and so much more. You guys know that there are P
was a huge part of my mental health Journey.
It's a resource that was absolutely essential for.
Or me to recover maintain my mental health, improve, my
emotion, regulation distress tolerance, all of the things.
So if you would like to try meeting with a therapist or find
a new therapist to meet with, you can go to teen
counseling.com. She persisted, they offer talk
text and video counseling all from your home.
So no need to be on a super long.
Wait list to find a therapist. They will also meet you exactly
where you're at, with what level of support you're looking for.
So, to check out teen counseling can go to teen counseling.com
She persisted to find a therapist that meets your needs
today. The last question I wanted to
ask from the parents perspective is so many and this is hard to
answer. Because when I get asked this,
I'm like, I don't even know what to tell you.
Because the question is, how can I get my teen to want to be
motivated to make changes and want to get better when they're
like, not wanting to go to treatment, which was exactly
where I was at. And I think my most recent
response is just be there to support your child, explain to
them that you to see them feel better.
And then the professionals are the one that can help cultivate
that willingness and help provide some Hope on how things
can shift. That's a lot to ask of a parent
be like, let's get your kid from.
Absolutely not wanting to make any changes to be so motivated
and engaged in treatment, but for a parent who's like, I know
my kid needs help but they are just so not at the point of
being motivated to do that. Do you have any advice or
validation or wisdom that you can kind of offer because it's
so common. In this process I feel Like I
just want to ask you the question back, because yeah.
Do you think that if I knew the answer to that?
I would be the world's most famous.
Yeah. I think ultimately where I see
it fall apart is when it becomes a tug-of-war and if parents can
Brian not take the bait so to speak and not have it turned
into a war about it and come from a place of compassion and
validation and not that that's going to be immediately
successful, but you're going to start moving the needle.
If it just becomes know, you need to do this and it becomes a
sort of butting of heads then. You're not going to get
anywhere. I mean, I do think that I've
certainly been in situations where for variety of reasons, a
young person often at substance-related is just not in
a place to make a good decision for themselves.
And so parents have had to make really difficult decisions to
sort of send their kids away against their will and sometimes
that ends up going well because they get clean and the kid gets
perspective and sees things and from a different way, sometimes
it doesn't. So I do.
Billy. You got to a place where it's a
shared decision making process. And I think as therapists we try
and use motivational enhancement motivational interviewing
strategies to kind of help young people and parents, sometimes
get to a place where they can see that the benefits of doing
something outweigh the fears that they have to get the young
person to realize that because I often feel like when a kid is
refusing to do something, it's not because they I just don't
want to do it, it's because they've lost hope that anything
can hundred percent difference. And so what you're really coming
up against this hopelessness more and it comes out as
oppositional kind of defiant Behavior or even fear.
I remember I was like tooth and nail.
I will not do a sleep study. Goes already in residential
treatment, I'd agreed all these things but it came to the sleep
study for some reason I was anxious and I'm like this is
where the hammer is coming down. I'm not going.
So it's kind of unraveling that Being like what's behind that
because I mean any kid who's really struggling?
Like if they knew that on the other side was happiness and joy
and stability. Of course, they would get to
that point but there's just not always a clear path forward.
And so I love that perspective of trying to see what is going
on beneath the surface and seeing beyond that like
opposition if you will. Yeah, I really believe in
compassion and an in that is sort of self-compassion I think
parents have to give them Self sort of some Grace and some
sense of like, this is a really bad situation and I may not
always have handled it, well, but I can do things differently,
going forward, and not just get stuck in a rut.
Yeah. And so much self-validation
because I can't even imagine what it's like as a parent to
see your child struggle so much and feel like, you don't know
how you can help them and whether it's guilt or shame or
just its sadness, that's a lot to go.
As a parent, let alone as a child.
And so I feel like I completely that was lost on me when I was
going through this process, how how hard this was for my parents
and how I wasn't the only one that was struggling in this
process that it really does take a toll on the whole family and
so resources for parents to because it's not an easy
journey. I also think that this process
can go better if this comes back to family-focused treatment.
If treatment along the way isn't about a kid, Being in a room
with a therapist and then getting a report out or not from
the therapist afterward like really incorporating family into
everything that's done from a treatment standpoint.
That's what we try and do at our Center is have family at the
core of everything that we're doing.
Like in our partial Hospital program.
We have one day a week where the entire family is required to be
there. Yeah, I love that and it's not
just a family meeting each week with the therapist.
It's a whole day where the family is getting deep.
New skills. And so, yeah, no.
I asked my parents a couple of weeks ago.
I was talking to some parents about, like, advice for teens
and supporting your teen. And before I gave the talk, I
was like, okay, parents? What are the advice?
This is your chance to throw some advice for parents that are
going through it. And the one advice was that if
this works so much better, if the parents learn the skills,
alongside the teen, because if anything, it doesn't hurt for
you both to get more skillful and for you both to be more
effective in the relationship. And that you also just are able
to empathize on another level. You have the shared experience
of navigating, this and my parents, and I are now big DBT,
nerds, whatever, we're navigating, anything.
Or I have some into my mom's like a bring out the dear, man.
I'm like, I know I've learned this also olya and, and the
Apple doesn't fall far from the tree, right?
So if you're asking an anxious parent to do exposure therapy
with their anxious kid, and the parent is so anxious.
They can't do it. You're not going to get
anywhere. So you have to teach everyone
these skills to get any movement, 100%.
So for teens, I think one of the biggest things that I remember
is just how daunting of and experience this is, it's so
anxiety-provoking because a lot of the times, you don't know
what to expect. And once you get there, I feel
like it's better because you're in it with other teams like
you're not alone in this day. It's a very, a lot of times a
very welcoming experience. Tons of teens have been through
this process so they know how to orient people.
And do the little tour and introduce you to other kids or
teens, probably not kids, but it's very anxiety-provoking to
know that you're going to be going to a program or an
outpatient program or therapy session, but not know what that
looks like or what to expect. So if you could give just some
basic pointers of what to expect, whether it's like, you
can probably expect to on the first day kind of go through,
why you're here and what's happened this far and maybe it's
you lorient to, like, what your family system is like, or you,
you probably will learn. Skills.
But just kind of providing a little bit of insight into what
goes on again. And this like black box of a
world that teens often times haven't had any experience with.
I think the first thing would be to say what it is.
Not right? I think a lot of teams are
thinking that if they go to Residential Treatment, it's
going to a locked hospital. I Googled McClain, and it was
like, Asylum from the 1800s and I was like great, perfect.
Well, terrified and that's not what residential treatment is.
And not what intensive Outpatient Treatment is and
there is a place for inpatient treatment.
But if your family is trying to get you help in a voluntary way
at a specialized program, it's going to be an unlocked unit.
It's going to be everyone's there voluntarily it's going to
be again if it's the right program it's going to be kids
your age, right? So that's a thing.
I mean hopefully is a A program that has commingled kids of all
different ages, that's another that regulation should prevent,
but yeah, I think you're not going to be asked to strip down.
You're not going to be asked to be in Scrubs.
You're not going to have all of your worldly belongings taken
away from you. You know, they are going to want
to understand what's bringing you in.
They're going to want to understand if there are safety
concerns, depending on why you're going into treatment.
But even if you're going in for something that's not about
self-harm, Are more suicidality, they're going to be asking you.
Those questions are going to want to know, they genuinely are
going to want to try and understand what the path has
been to get you to that place, and to come up with goals and
targets for treatment lawyer. And if safety is a primary
concern, they're going to spend a lot of time on that first day.
Assessing safety, coming up with safety plans and trying to sort
of identify in the program. What are the resources that you
can use? You're feeling unsafe.
Hmm, it's so many questions that you're asked.
Initially again, like you're emphasizing, it's such a
collaborative process and I like your brought in and the
treatment protocol is 100% laid out like this is being adjusted
based on what your needs are. So, even the safety plan, like
what has been helpful for you in the past, with coping, with
urges, or when you get anxious, what skills do you like to use
and really making sure this is going to be effective for you
and I would say other random things that come to mind.
Is like there's lots of activities probably lots of arts
and crafts. Like lots of different ways to
express what you're experiencing.
It feels very much like being at a new school because you're
thrown into a new environment with other teens and you're all
just kind of like getting to know each other and and
introducing yourselves so much TV watching a movie watching.
Most times you don't, if there's not a lot of time like scrolling
on Tick-Tock or on your phone. So when you're doing an activity
at night, you're watching a show together or doing a movie.
And so it's not all just there be 24/7.
It's lots of Activities routines that again would transfer after
you leave treatment and you're reminding me.
That one of the other big barriers I hear from some kids
about going to residential treatment is falling behind in
school. Yeah.
And trying to reassure kids that school is a part of treatment
when you're in residential care. So you will be doing school and
you don't need to worry that you're going to come out and
have to repeat a grade. No no yeah 100% And even me I
took a medical leave of absence for one year but I did the
summer semester caught up on things.
I was on track. I was able to apply to college
the world continued to go round. And I think it's such a reminder
that without your mental health, you really don't have anything.
You're not able to pursue your education or these interests are
a career because your mental health is such a foundation.
And so yeah, very very important reminder.
Is there anything? You wish that teens would be
aware of when pursuing mental health treatment, any myths or
things that they knew going into treatment that people want them
to get better? That it's a very collaborative.
Anything that you will re like. I wish they came in day one and
this was just an understanding. I mean ultimately I wish in this
is really for kids who are maybe not sold on treatment.
There are there are young people who come in asking for
treatment. Like yeah, we have that first
appointment and ask the parents, you know, like why are you here?
Like, some kid brought me here. Yeah, if they're our best but
for the kids who aren't at that place is a wish they understood
that. I am not an agent of their
parents. Yeah.
Yeah, I think their parents are
really important partners and really important people in their
lives. And we're going to want to
involve them but I'm not here to do the bidding of your parents.
I'm here to help you and figure out what's causing used to
suffering and struggling and trying to effect change so that
you can lead your best life. And I often say to kids, if I
think they have a sense of humor, the, in the first visit
that my real main goal is that I never see them again.
Yeah. Yeah like Not here to take your
money. I'm not here to sort of see you
forever. I'm not here just to put you on
medication. In fact, I'm only going to put
you on medication if it is really indicated and necessary
and that your best interests are sort of like The Guiding Light,
the true north of tree and gets really hard to understand that
and feel that when you're in a dark place.
Yeah, I also love the the way of thinking about it of like if you
have a therapist, You're a psychiatrist, who's in your
corner and truly working with you.
You could suddenly have this highly trained professional to
help you Advocate and get things from your parents.
If you're like I want them to validate me more or I wish that
they would stop getting mad at me for not cleaning my room.
You have this person who has been highly educated and can be
like from a therapeutic perspective.
We really do think that asking about the room being cleaned 12
times. A day is not great.
And you have someone in your corner, you have someone helping
you make these changes in your family relationships.
And it's kind of funny to think about it that way because In a
lot of ways, it's true. You have someone helping set
those boundaries and Advocate and it's a lot more of a skill
set than you on your own. You have you have an objective
outside professional. Yeah.
Is not there to do anything other than try and improve your
life. Yeah, and often I'll hear from
young people but I don't need a therapist, I have friends and my
response to that. I've many different responses to
it but one of them is that friends are wonderful, that
really important. I want you to have them and I
want you to talk to your friends about the important things in
your life, but your friends are just that they're your friends,
your therapist is there to be supportive of you but also push
on you at times and therapy. May be uncomfortable at times
but you need an objective outside person who can tell you
what it is when it's happening and and that you can develop a
rapport with that is a true back.
And Earth and Trust. Yes, absolutely.
I love that. When you have patients come in,
are there any mindsets are approaches or questions asked
that? You're like this is great.
We love to see this. I know when I first got to
residential, I was like, I don't want to be here, my parents that
I have to be here, this isn't going to work.
And then before I actually began, there had to be that
shift of like, okay, I trust you guys to help me.
I know that there is evidence support this, and I want to get
better, and I hope I can get better.
And let's see how this goes. So, is there anything?
Thing like that that's helpful to kind of like do that internal
work as your kind of cultivating that willingness and entering
the therapy world? I mean honestly I think what I
love to hear is an openness to just exploring opportunity and
possibility. You know the idea that in this
is really hard as a teenager I remember well even though it was
a long time ago like that then maybe you don't know everything
and the other to do definitely feel Like you do.
But when a young person comes in and says, really miserable I'm
unhappy or I'm really anxious. I don't want to feel this way
anymore and I want to do whatever it takes to sort of
feel better. That's obviously ideal, but just
an openness to exploring what might be possible, is sort of
music to the ears of solutely. And it's also just, that's a
helpful reminder to have that. How many times in your life,
where you going to have an entire team?
Team of people that are just there to support you and care
for you and want to see you thrive, like there's not many
positions that you're put in there.
That's the only goal is just to help you be more effective and
happy. And so that's something that is
really amazing about treatment. That sometimes gets lost is
everyone's just there to support you and it's a really unique
experience in that way. The caveat to that would be.
That support doesn't always feel good, 100%.
Yeah, right? Yes, yes, yes.
A good. Our best isn't always going to
just say, oh, I'm so sorry. You feel that way?
Well, you got yourself in this situation.
So pity party is a little others of support, right?
But a good therapist is going to deliver a message to try and
shift your thinking in a way that doesn't lead you to feel
bad about yourself. They challenge you to think
about things differently. Absolutely.
Any last advice for parents navigating this SS.
And then for teens as well, I think on both fronts, the
biggest thing is just ask questions.
Lots and lots and lots and lots of questions and if anything
doesn't feel right asking more questions until it either feels
right or until you say you know what?
This is a no go. I don't know what and you know I
think at some point you also have to trust, right?
So once once you get to a certain place where you feel
like, okay, this person is good where I A lot of struggle is
when we've got a good rapport, but then we come up against
something and it feels like that trust isn't really there.
And then we can take the next step around the treatment
because maybe it takes some risks around some sort of
exposure. I mean, I'm an anxiety disorder
OCD person. So I think a lot about kind of
how to help anxious people including parents tolerate
distress those situations. So questions And lots, and lots
and lots of questions. I remember writing down, like,
literally on a napkin, we went to go get lunch before I
officially start at three East and I was like, what will my
typical day? Look like, which therapists are
my actually meeting with when can I call my friends?
Like those were my questions. My parents were like, so how
does DPT work? Are you actually doing DBT?
What are the different ways that were involved in?
Mine were just so simple, but having that Clarity was really,
really helpful and there's no bad questions.
These are things that probably tons of teens have had questions
about before, then you can even ask the other teams as well.
I remember, that was one of the biggest things on the first
couple of days. Whether it was at IOP or
residential or therapeutic boarding school asking them
questions Bank, okay? But like what is it?
Like when we start going to school or what is the routine on
the weekends or what are your favorite things to do?
And just getting a real feel for what the community is like and
what to expect and everyone has been in the same position before
and so they'll be more than happy to answer those.
Questions. Absolutely.
And if they're not then that tells you something about the
program. How's your percent?
Yeah. Yeah.
If people want to learn more about Ohana or continue to
follow along with all the amazing work you guys are doing
where can they do that? Yes.
So we have a website. So if you go to the Community
Hospital of the Monterey Peninsula, you can navigate to
the Ohana website. If you were to Google Ohana
Monterey, California. You'd get a lot of information
there, you get to our web page, the web pages under construction
because we're very much under construction or a new program.
That's being built. Both literally and figuratively
are building, will not open until next summer.
So our services are still small right now but growing quickly.
And how do you want is planning to have a mental breakdown and
about a year or so you're going to have a great place to go to.
Yeah, we're providing Outpatient Treatment and I owe p and p.
PHP level of care right now and when the new building opens will
be doing all of that and in a larger expanded way, plus have
residential Adolescent Treatment, that will be in a
couple different tracks. But one of those tracks will be
a DBT based residential program is amazing.
I found IOP and PHP programs to be so helpful to really solidify
those DBT skills and really just practice the the skills in the
context of having routine getting up and going somewhere,
rather. Just being in like the
residential setting and so it's amazing to hear that.
That's a resource. If anyone is in Monterey the
links will be in the show notes and thank you so much for
answering all my questions. I know this is going to be so
helpful. Well it was it was great.
It was so nice to see you. Thank you so much for listening
to this week's episode of she persisted.
If you enjoyed, make sure to share with a friend or family
member. It really helps out the podcast
and if you haven't already leave a review on Apple podcast or
Spotify, you can also make sure to follow along at a cheaper.
Persisted podcast on both Instagram and Tik-Tok and check
out all the bonus resources content and information on my
website. She persisted podcast.com,
thanks for supporting, keep persisting and I'll see you next
week.