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261: Adapting New Ways of Doing Things in Private Practice Because of Difficult Circumstances
I’m hoping 2021 will be a new year of great experiences and opportunities after what we went through in 2020. Today’s show covers one specific way that clinicians have had to adapt to new ways of doing things because of difficult circumstances. Join us to learn more.
Roseann Capanna-Hodge is an integrative and pediatric mental health expert. She’s the founder and director of the Global Institute for Children’s Mental Health and Dr. Roseann and Associates. Roseann had a simple idea during the pandemic about doing therapeutic activities via Zoom and telehealth sessions. This realization led to her writing the first-ever book on the subject. She’s here to share about her book, its inspiration, and the mental shifts that have become necessary.
www.sellingthecouch.com/session261
Transcript:
Melvin:
Hello, welcome to session 261 of selling the couch; Happy New Year. I hope that you are doing well. It's so good to be back with you. With the way 2020 was I'm really hoping that 2021 would just be a new year, year of new opportunities and new experiences and new podcasts episodes. This is my wish for all of us because I feel like I shared this toward the end of last year in our community.
But I felt like one is just how resilient we have all been in the midst of all of what's happened with the pandemic and even as I'm recording this right now we're in mid-November. And here in Philly, we are about to go into a second modified lockdown and trying to navigate all of this and so even I, I'm hoping when this episode releases that we'll just be in a different space, that there will be vaccine ready and that distribution channels and all that stuff will have been figured out and navigated through and all of those different things.
Today's podcast session is a special episode. My guest is Dr. Roseann Capanna-Hodge. Roseann is a integrative and pediatric mental health expert. She's the founder and director of the Global Institute for Children's Mental Health, as well as Dr. Roseann and Associates.
Roseann had a simple idea during the midst of this pandemic, which is many of us are doing zoom sessions and using various other online platforms to do telehealth, and how do we do activities in a zoom session? So she did a quick search on Amazon and discovered that there weren't any options out there, and so she decided to create the first ever book on Teletherapy, therapeutic activities, and we're actually talking about the process of creating this book, where her inspiration came from, and some of the mental shifts that Roseann had to really consider and own in the midst of this pandemic.
Roseann was actually super busy; as you'll hear on this podcast. She actually wrote four books in the midst of this pandemic, which is just an amazing feat. So we'll get right to today's podcast session. Here's my conversation with Dr. Roseann Capanna-Hodge.
Hey, Roseann, welcome to Selling the Couch.
Roseann:
Well, thank you for having me Melvin.
Melvin:
I'm so grateful that Christy connected us; shout out to Christy.
Roseann:
We love Christy.
Melvin:
We do. We really do love Christy. Selling the Couch would not function and exist without Christy's editing. So thank you Christy, for connecting us and Roseann, I'm really excited for our conversations. You are doing so much in the world and including creating the first ever book on Teletherapy therapeutic activities. You've been busy.
Roseann:
I have been busy Melvin during what I call my Corona creative period, I wrote four bucks.
Melvin:
Oh my Gosh! That's crazy.
Roseann:
Yeah, and I did a bunch of other things including; getting a podcast of my own, which is how we both know Christy.
Melvin:
Yeah, absolutely. I wanted to ask you; maybe we can even start there. With this pandemic, I feel like a lot of clinicians when it happened, it was almost like you got sideswiped right?
Roseann:
Absolutely!
Melvin:
How in the world did you find the energy to write four books and do a podcast in the midst of something that's just so chaotic and uncertain?
Roseann:
Yeah, we all have different superpowers, and I think one of my absolute superpowers is really thriving during points of crisis. I'm one of those people like I can visualize being an undergrad, and somebody got in a motorcycle accident literally right in front of me. Like 15 feet away from me, and everybody was totally immobilized and I remember looking and thinking, why isn't anybody moving? And I just sprung into action and helped him and I just have that ability to future think, think about what needs to happen and take action.
So during this time, I think like all of us, all the therapists in the world, we thought, “Okay, just going to be like four to eight weeks, and we'll all be back at work.”
Melvin:
I remember those early posts even in the selling the couch Facebook community like, “Yeah, we'll do our quarantining for like, three, four weeks, and we'll be good.”
Roseann:
Yeah, I said to myself during this time, when do I have time off? I have a large practice with many therapists, and we do a lot of Neurofeedback, and I do a boatload of media, and I was on an airplane or driving into New York City a minimum of once a week. Sometimes I'd be in L.A in New York, and then seeing clients in between in the same week.
And literally up until March 5th, that was what was happening. And when I had time off, I knew when the pandemic started, I said to myself, “Oh, they're saying a couple weeks,” I said, “This is got to be at least four weeks” My sort of prediction was eight, we went to closing our Center for 10 and we were able to open up on May 20th.
I knew during this time, after the four weeks, I was like, “When we come back to work, it will not be the same.” And I had said, I have worked with a lot of special needs parents and we work with people of all ages, but our specialty really is kids with ADHD and do a lot of work with PANS and PANDAS and autism, all of these things that are common today.
And so I wrote my first book was, It's Gonna be OK! And I worked on that, and then we've two books to support that book. And then June happened, and I said, “Wow, people really aren't coming back to in person.” And I was surprised on that. I thought, “Okay, people are going to come back in person.” I knew Teletherapy was here to stay and we've been doing Teletherapy for 10 years at our center in Ridgefield, Connecticut.
But I didn't realize that almost nobody was going to come back in person, and then we really have very high level training at our center. Everybody gets a least one supervision a week. Some people we do ERP. So there's ERP supervision. We do EFT tapping, we have supervision for that, we do group supervision and all the new clinicians have to have at least one supervision on their own a week for like the first two years.
So we're really serious about supporting therapists and blossoming them. And so I started to get worried; what were my therapists doing? Did they have enough activities? And I started doing what all the other therapists were doing; scrolling on their phone, checking the Amazon, looking for a book on Teletherapy activities.
I remember this so vividly; it was a Wednesday night was late June, and I'm sitting in my hot tub and I put in Tele, and then mental health activities came up, and then it just dawned on me, there wasn't a book. So I said, I'm going to write this book; and I wrote it in 31 days, it's 420 pages and I just came very fast at writing and also done a boatload of Neurofeedback. So my brain works really fast.
I started with wanting to support my own therapist, and then I realized that like therapists Melvin, during this pandemic, they all are feeling like they just got out of grad school because nobody was trained for Teletherapy.
Melvin:
Yeah, and I think many people are like, yeah, it's a new skill set. A lot of folks I think, what we talked about earlier they’re dealing with their own emotions, and then the practical things. Like a lot of therapists are, for example, caregivers or parents, and they're trying to navigate changes on multiple levels and on multiple systems.
Roseann:
Absolutely! And practical like, before we started Melvin had me do a tech check, and a lot of therapists that regardless of age may not have the comfort level with technology, and just even that was a barrier then supporting your clients’ technology. There were a lot of hurdles to face.
I think people now are in their stride with that, like everybody knows zoom now or different platforms that you're using, I use the HIPAA compliant version of zoom and have always have. And then, like you said Melvin, people who are like feeling their own raw emotions; we've been on a roller coaster during this whole pandemic, not just with COVID, but with many other issues.
Melvin:
Yeah, absolutely! I wanted to shift a little bit and the question is actually about mental shifts. So I totally did not do that on purpose. But what do you think like a mental shift is that a clinician needs in working with kids and teens because you said that's like a big part of the population in an office versus a Telehelp, so like mentally, what's the shift they need?
Roseann:
For those of us that work with kids and teens, we all know that a requirement is actually really enjoying kids and teens and thinking they're fun. So it's the same in Teletherapy. I think the first mental shift that all therapists need to have in Teletherapy, is that they absolutely can be a rock star teletherapist, and they can be as good in Teletherapy as they were in person. And I think that's the first, aha, because I think that I've met a lot of therapists who are like, wow, it's just not as effective, and that's not the truth.
We know, through the research that it is. And just like everything else, there needs to be in terms of efficacy in therapy, there are so many factors, but the client motivation, and the skill set and experience of the therapist is another huge factor. So the shift that needs to happen, and I'm basing this on being in a lot of Facebook groups with therapists is, we need to shift back to therapeutic activities.
I think a lot of people jumped in to tell us therapy, and not knowing what to do, are overusing activities for engagement. I see therapists doing Minecraft with kids, still playing Scrabble on the regular and just different things; and why?
I think it's because they didn't have a resource and that's why I wrote this book, which is like literally dozens and dozens and dozens of activities that are therapeutic and just ridiculously easy to use. You get this book, you open it up. But they also can go to their own toolkit and just look what I did is, I modified solid therapeutic activities to be done in a really either visual and or tactile kinesthetic way on they need to get creative, Melvin and I think some people really are.
Melvin:
Yeah, I think absolutely. I would say the vast majority of clinicians are quite creative. Again, I feel like this was such a unique time where there was like, such a profound grief around whether it's having shut down an office or try to think about things differently and all of the different other stressors that have come with this pandemic. But to your point, I feel like so many clinicians now, like we really are blossoming and emerging…
Roseann:
Blossoming for sure.
Melvin:
Yeah, even yesterday, I wrote this post in the community, just about like, “Hey, guys, I know we've been doing telehealth for a number of months, can you share what your office space looks like? And what tech are you using? And what's not working? What’s working?” And it's just some of the stuff like that our colleagues are creating. It's just absolutely beautiful.
Roseann:
Yeah. I think like you brought up, Melvin some grief points, but I think one of the biggest grief points that I hear from therapists is that, even though they're bracing teletherapy, they feel isolated.
And we have two therapists in my office that are like, “I got to see people in person.” They do different kinds of things. One works with a lot of really littles and so that presents us a different challenge. And she's great in teletherapy. But I know both the therapists what it is for them, is they need the interaction with us, the office staff, me, our Neurofeedback staff. So, everyone's got to do what's right for them, but therapists, you're right, like they're getting into technology now. They're putting up beautiful backgrounds and getting great lighting. I love all that stuff.
And then they're really creating a lot more exciting activities that they can use with their clients. But kids, they're very different working with kids and teenagers than adults. Adults are going to come in, I'm going to tell you, I always prefer working with kids to adults. And it's not that way, the majority of therapists work with adults, but kids are open, and they're open to creative things. But they need a lot more in this virtual world because they're doing many of them virtual learning, and then we're asking them to get on and do a virtual session. Again, they need movement. They need a focus on activities that are stimulating that are visual, otherwise, you're just not going to get that same kind of therapeutic growth.
Melvin:
Yeah, right. Absolutely. So really random like, not at all to put you on spot like, what's an example of an activity in the book?
Roseann:
Oh, yeah, you're not putting me on the spot; I could talk about this all day. I have some activities that are coming up on my YouTube channel, Dr. Roseann, that are there and people can just see them. One of the activities that we have is calm my brain and so there's different ways to do it.
So you can use this if you're anxious, if you have OCD, if you have social issues, whatever the issue is, but we know most people are experiencing stress and clinical anxiety at this point. And so its calm R activity is what it's called. And so it's a brain and with my book, you can get PDFs. So you can either email a PDF, or pop it on the screen, or you can draw a brain, and you get into habit of a check in with a kid or a teenager, this is a great activity for a lot of things. And then you can say like, what is the issue.
They can write it, they can draw it, they can put it right on their brain, and I'm huge into a lot of things, but a big part of my work is psychoeducation and really teaching kids teens and their families about what the issue is. I have a lot of psychoeducation sheets in my book as well. Many people come to me, I deal with a lot of complex issues at my center, Melvin, and it's not unusual for somebody, even with a child have seen 10 or 12 other providers. And often they are craving that understanding that psychoeducation.
It’s so important, and we know therapeutically, that when people understand the issue, they're more likely to take action. So this is an activity to bring in psychoeducation about the brain, but it's really for them to connect with their body to understand. So the other part about my book is all the activities have a somatic component to them because I do a lot of work with trauma. I was one of the approved providers with Sandy Hook. So I did a lot of work with Sandy Hook survivors. But long before that, I've been working with trauma sufferers.
It’s important to get people to connect their body. And so that's one of the activities that has the psychoeducation piece, it's got R in there, it's got a kinesthetic and visual part, as well as, it's really, really getting kids to understand their body and be like, “Wow, here's an alert signal. And this means I need to take action.” So that's an activity that I have in the book.
Melvin:
That's really cool. Our time flew. So I wanted to ask you a final question. Just in general, like, how did you come up with these activities? I mean, was this like, I know I've done this, and it was almost like you sat down and wrote it down? Or how did you even compile? I mean, that's a lot of activities in this book?
Roseann:
Yeah. It’s 420 pages. So how did I do it? This is what I do with everything. I wrote my other book, 200 pages, 35 pages of citations; it's going to be okay, really quick, too. But what I do is I do a lot of planning and organizing. So writing itself is ridiculously easy for me. I can bang out writing, but where I spend the bulk of my time is planning. So, what I did is I said, “What are the most common issues facing kids that therapist needs support?” So it's anxiety, it's mood, it's anger, OCD. We have an OCD section in the book, so many people have OCD, we had R and psychoeducation component.
And so then I started with that, and then I just was like, wait a second, we sort of like just a wave where you're like, I did this activity, and this helps. And then we use this and we use that. I've been supervising therapists for well over a decade. I've been a college professor, even working in mental health for 30 years. There's a lot in my brain, and it's super organized. And it just really honestly flowed. And I also interviewed a few of the therapists in my office and was like, wait a second, I know you use this technique. So I did a little picking of the brain and of my favorite colleagues, but really, honestly, it just poured out of me and I know what works.
I think when you deal with really complex cases, you have the best strategies available to you, and they're applicable to the easiest, I should say situations that maybe just need a short term support. But they're also great for challenging cases because in these 30 years, I've been working with kids, cases are challenging now, Melvin, like people have multiple layers younger. So that's how I did it. Started with the need, and I've been often referred to as a walking encyclopedia, and I just got writing.
Melvin:
Did you organize this? Did you use any…
Roseann:
You know what I used? A good old Google Sheet, my friend. And I do a lot of color coding. And then I put Google Docs to it. And I'm going to tell you the next time because book editors, somebody edited it for me. Book editors edit in word. So now I know to make it in word because that was a pain. The hardest part about our book was actually, there's got to be probably 200 supporting graphics. And that was the hardest part.
Melvin:
Oh, I would imagine, like having someone draw this or like what?
Roseann:
We used a graphic design software. And it's in there, you'll see tons of hands out. There's like 200 handouts in this book. Like, it's no joke. This is why we call it the handbook, the therapists handbook for treating children and teens, because it really has a lot of stuff...
