Wellspring of Hope: Whole-Person Recovery for Girls and Their Families, with Dr. Marcy Russo and Sara Osborne

ABOUT THE EPISODE:

As a mom of four boys, I confess to knowing very little about raising girls. But my guests today have an intimate understanding of the specific emotional needs and experiences of adolescent girls, young women, and gender diverse individuals grounded in decades of therapeutic work.

Dr. Marcy Russo and Sara Osborne advocate for a whole-person approach to residential treatment for many of the most common mental and behavioral health issues -- anxiety, depression, trauma, eating disorders -- and the substance use disorders that sometimes result.

In this episode we'll discuss the perfect storm of issues, from Covid to social media, that has left so many young women feeling they cannot navigate social expectations or develop healthy, supportive relationships. We also talk about the use of relational and somatic therapeutic tools to help girls find authenticity and self-understanding for long term wellness and recovery. 

EPISODE RESOURCES:

• Wellspring website
• Angelus House website

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Transcript

Sara: 0:02

All parents just want their kids to be happy. You know, they just want their, their kids to be happy and healthy and this is a place to start that healing and start to figure out what those root causes are. It's not one single thing that causes somebody to struggle the way that our clients do. It's not just your parenting. It might not be your parenting at all.

Brenda: 0:33

Welcome to Hope Stream, a podcast where you'll hear interviews, conversations, and encouraging words for parents of teens and young adults who struggle with substance misuse and mental health. I'm Brenda Zane, your host, and a fellow parent whose child struggled. I'm so glad you're here. Take a deep breath and know you're not doing this alone anymore. Hey friend, it's really good to be back with you today. You may or may not know this, but my husband and I have four boys together. We're like a small version of the Brady Bunch, but with all boys. And they range in age from 18 to 27. So it goes without saying that I have a lot of experience with the male species. What I don't know anything about is raising girls, clearly. So I loved having the chance to sit down with two brilliant women who are experts in girls mental health and the treatment of things like anxiety, depression, self harm. Behavioral and personality disorders and eating disorders. Dr. Marcy Russo and Sarah Osborne and I spent some time recently talking about a whole person centered approach to mental health and substance use treatment and the way they approach treatment and specialized education needs specifically for adolescent girls and young adult female identifying individuals at Wellspring, which is located in Bethlehem, Connecticut. Dr. Russo joined the Wellspring Foundation as the clinical director earlier this year in 2024, and in this role, she's responsible for the oversight of therapeutic and clinical services offered across all of their programs, their therapeutic school, and their outpatient services. Dr. Russo has worked for over two decades in both private and non profit healthcare facilities and hospitals. She's worked collaboratively with school and state partners to provide care across all levels of community and congregate care settings and has experienced developing programs and mentoring and supervising teams of clinicians. Her training includes work with trauma, grief, life transitions, adjustments, and emergency behavior responses. Dr. Roosta received her master's degree and her doctorate of philosophy. In clinical psychology from the New School for Social Research in New York City and her bachelor's of science from Central Connecticut State University. She maintains an adjunct faculty appointment at the University of Connecticut teaching in a psychology department at the Waterbury campus. and is also the owner of her own private practice called Pathways. Sarah Osborne is a licensed professional counselor and a licensed alcohol and drug counselor and serves as a psychotherapist and assistant director of Angela's House. which is Wellsprings Residential Treatment Program for young adult women and gender diverse individuals who are 18 and over. Sarah is an EMDRIA certified therapist who has extensive training in addressing issues related to complex trauma and co occurring mental health and substance use disorders across the lifespan. She received her master's degrees in applied community psychology and in clinical mental health counseling. Thank you. Even if you're like me and you have a boy, or many boys, you'll still get a lot from this conversation where we talk about the importance of having time in treatment for young people to really peel back the onion and figure out why they're having the struggles they are, whether that is with relationships or substances or unhealthy patterns like self harm. We also talk about the role of parents. And how our own fears and hesitations to dig deep into issues can hamper our kids healing process. It is such a robust conversation and I'm grateful for Dr. Russo and Sarah for spending this time with me on such important topics. So, let's jump in. Welcome Dr. Marci Russo and Sarah Osborne. I am very excited to have a conversation with you today about, well, about a lot of things, but especially your treatment of girls, I think is really special. I think boys tend to get a lot of Time and space and energy in this, and obviously girls struggle too. So I'm, I'm thrilled to talk with you about that. I know that's your special population. So welcome to the podcast. Thank you.

Sara: 5:26

Great to be here. Yes. Thank you for having us.

Brenda: 5:28

Yeah. It's always nice to talk with the people who are really in the day to day with families. I know that you have a big family emphasis at Wellspring, not just for the kiddos. I love it when I hear like families are required to be part of the process. So why don't each of you just give us a quick. You know, bio, not really bio, but just, you know, a little bit of background. How did you get to where you are today? And what was that path like for you so that we have some of that, and then we'll dive in. You want to start us off Marcy? Sure.

Marcy: 6:03

Well, I'm a clinical psychologist. I have been for the past 25 years and I've always really been attracted. to working with families that need really intense support in just the behavioral health field. So I've worked with families that have pretty significant mental health and substance abuse challenges that come really from all walks of life and that live in all places on the planet. on the earth, actually, or specifically here in Connecticut. I've spent most of my adult career in behavioral health here in Connecticut. I'm a relatively new to Wellspring. I've been here since January. And what really drew me to Wellspring is its rich and intense history. In relational and family work and providing both residential care, but also outpatient and therapeutic day services, therapeutic, educational day services to adolescence. And as you mentioned, we primarily serve girls here on our adolescent campus in Bethlehem, and we have a young adult. Program called the Angelus House that we serve young adult gender diverse females right down the street. Also here in Bethlehem

Brenda: 7:17

That's awesome. I love that and Sarah. What about you? How did how did you end up in this gig?

Sara: 7:24

Yeah, so I've been working in the mental health field for right around 10 years I'm a licensed professional counselor and a licensed alcohol and drug counselor in the state of Connecticut I'm also a certified EMDR practitioner which is a specific type of therapy used for trauma and PTSD, but also for other, you know, co occurring disorders, anxiety, depression, addiction. You know, it kind of is a, is a special type of therapy that can be helpful across the board. As far as my personal journey, it actually started Here at Wellspring, my very first job in the mental health field was in 2014. After I completed my bachelor's, I moved back to Connecticut with my parents and took a per diem position in our children's program as just kind of a per diem milieu staff member. And I worked in that per diem capacity for about four years before going on to do community based work. Uh, more recently, I spent about eight and a half years working primarily in addiction with the Medicaid population at a community agency, residential outpatient prevention, kind of the whole spectrum, before I found my way back to Wellspring in October. So I've been here a little over nine months in this clinical role and jumped at the opportunity to return because it's a special place and I think there's something very special about it. Similar to what you were talking about before with so many larger agencies, larger, kind of, kind of big, corporation might not be the right word, but big corporation approaches to mental health. I think there's something really special in an agency that has a really deep rooted soul and is a smaller agency that maybe does something really well and has a staff and a leadership and just a whole approach to that. It's just all on the same page and really passionate about what we do. So, you know, I think if you spoke to, to most Wellspring staff, a lot of them have either been here for really long or they came back when they had the chance.

Brenda: 9:27

Wonderful. Yeah, I do. We were talking about that. Just the sort of the trend in the industry today is, you know, This like private equity firms buying up these very small family operated, you know, owner operated programs, which in itself isn't bad. But then when all the staff turns over and then all of a sudden there's five more houses. or whatever, you know, you just think, Oh man, that, that one on one really special, small on purpose, doing that kind of work, it gets a little lost. So that's why I just like to highlight. And I think it's important for parents to know that's a good question to ask, right? If you're looking for a place for your young person, Ask about staff retention. How long has your, you know, what is the average tenure of your staff? But just appreciate so much what you're doing and how you do it there. Maybe you could give us a little bit of a glimpse of what are families struggling with when they end up talking with you. So a family either is thinking about coming to Wellspring or they're, they've arrived there, their daughter is with you, or their young person is with you. What are they typically

Marcy: 10:44

Yeah, I think most often on our main campus with our adolescents, it often is a school struggle. Our adolescents are having a very difficult time settling in and functioning and maintaining their school performance in their regular, in their home school district. And they're needing some extra care and some extra support. to not only support their functioning at school, but then also their functioning at home. So we get a lot of adolescents that are experiencing some significant issues with anxiety, depression, maybe even some self harming behaviors. and relational difficulties. It might be in relation to their parents, in relation to authority figures in their life, or even just really in relation to their peers, just really struggling and maintaining some good, healthy functioning in those areas. Many of our adolescent girls as well, too, have tried other less lower levels of care. They've maybe tried some intensive outpatient programs. They may have been in and out of the hospital, um, for mental health difficulties or, or substance use. And, um, they're really looking for an experience that can help them. Help, you know, that the family rather is really looking for an opportunity to help that adolescent really settle down and begin to function a little bit better in school with their academic performance and and their behavior and relationship with others and really most importantly be able to become to a place where they could do some deeper work. And I know we'll talk a little bit about that because, you know, we spend a lot of time here trying to really reach and understand the true essence of a person, to really understand where their mental health difficulties originate from, really holistically what they might be wanting to change about themselves, think, think about themselves, and how they want to be able to operate more. Really productively and efficiently in the world.

Brenda: 12:48

Yeah. And Sarah, I'm sure with your, you know, sort of expertise in the addiction and substance side, those, the, the school struggles often go hand in hand with that, right? Because it's such a, I'll say good in air quotes way for the, the kids to try to find ways to cope and to fit in and to deal with a school system that may not be working for them. Talk a little bit about what you're seeing, Sarah, in the substance use area with your teens and adolescents.

Sara: 13:18

Yeah, and especially here at Angelus where we have the young adults, it's quite similar. A typical client profile is somebody who maybe has been able to, to complete a couple years of college, but just is really struggling to, to maintain that and is seeing a lot of just mental health maybe bubble up that they thought they've been managing for a while, but are just not able to do that. Again, maybe somebody that has tried a lot of different outpatient or IOP or different things. Absolutely. types of less intensive treatment and it's just not meeting the need. You know, when we think about addiction, you know, a craving is It's, it's, it's a yearning, it's, it's an attempt to meet a need that's not being met. And a lot of times these needs are at that basic level of relationships. You know, it's isolation, it's detachment, it's feeling less than or not feeling you can connect or get the support you can. And so you reach for these outside. Substances are these outside, these, these behaviors that maybe, maybe help for a little while, but over time are destructive and, and really aren't the way that you want to be living your life. So there is that overlap. And I think what is really important about what we do share with the whole person healing is that there's traditionally been a focus on separating. mental health and addiction, and for the longest time our systems were set up that way. You either went to, you know, a 30 day rehab, but if you had mental health, some rehabs would say, no, we don't do mental health, and mental health would say, oh, no, we don't do addiction, but they go hand in hand. You can't separate the two. You know, that's at the core of it is a person who is struggling with something really deep rooted and chicken or the egg, it doesn't, it doesn't matter. And so that's where that whole person healing, it's really important to meet that need and to, to make that relationship deep. to cover all the bases in treatment.

Brenda: 15:15

Yeah. I think there's a lot of focus on behavior modification, right? Of like, just stop doing that. Like just stop smoking wheat all day and then everything would be fine. And you know, as you start to peel back the onion, you realize, Oh, actually that's probably not true. So maybe talk a little bit about that whole person healing. I think it's so important to understand because yeah. As a parent listening, somebody might be like, but wait a minute, I thought I needed to call a 30 day rehab. Like, what's wrong with that? So talk a little bit about that and help us understand why that's so important.

Marcy: 15:53

Well, I think it's just one quick thing, and then I'll let Sarah really do the prime area of that particular question. But you know, you said something, Brenda, in terms of peeling back the onion. And, uh, you know, that's really important. I think that that's one thing that I think is a major drawback for a short term program is there are often some very helpful behavioral things that are put into place and some very helpful immediate coping skills that help stabilize a person. But we're of the belief here, unless you really truly peel back that onion and begin to really understand why you might be driven towards some of these behaviors, why you might be using a particular habit or substance or. It's just a ongoing behavior in your life. That's really where, that's where the jackpot is. That's really where understanding that and correcting that is going to really produce those long term gains. Yeah, Sarah, do you want to

Brenda: 16:47

expand a little bit on that?

Sara: 16:49

Yeah, I think, you know, you hear a lot from, you You know, some of the, the people that we work with, if it was as easy as that to just stop, you know, if it was as easy as just stop drinking or stop smoking weed, you know, I would, oh my gosh, you know, I would have done that, you know, years ago, but it's not that easy. It's, it's something deeper. It's, it's something, and especially in, you know, You know, some of the societal things that our young people deal with today, the disconnection through media, you know, we've seen a huge impact of COVID on clients that we work with, you know, we, we are wired as human beings to connect and to be in relationship and to you. To be with each other. And so, when there's barriers put up, whether it's something outside or it's something inside of me that holds me back from connecting to somebody else, that's just going to continue to, you know, hold me back from, From being successful and from having the life that I want to lead, you know, we get a lot of clients that feel hopeless or feel a lack of direction, you know, just just wanting a meaningful life. You know, I just want meaning. I just want purpose, you know, but there's that that deeper issue that needs the time. It needs the really deep work to be addressed.

Brenda: 18:08

Right. The 30 days. I agree with Marcy. I think there's, there's definitely a benefit to having that time out, right? Like getting certain substances out of the system, all of that, some, some groundwork laid, but it's often, you know, what I see is with our families is this cycle of 30 days. Okay. Things are better. Young person comes home, couple weeks later, they're right back into the same old patterns and, and that's where eventually you realize, okay, there's something bigger going on here. We've got to go a little bit deeper and to have the expertise and the support, not just with the substance use, but on that mental health side. to say what's going on. And, and I have to imagine, and I talk with a lot of people about this kind of perfect storm of COVID, like young people and COVID and social media, and how that's really playing a big part in, you know, These young folks not feeling like they have direction or purpose or feeling so like I'm not doing enough and then getting to a place of overwhelm and I'd be curious to hear if you're seeing this as well. Just this overwhelm of like, now I'm basically just going to stay in my room. Like I can't go to school. I can't. You know, I just, I'm kind of paralyzed. What are you seeing around that dynamic? We're

Marcy: 19:37

seeing a lot of that actually, a lot of really dysfunction and, and not really being a, being prepared to be able to understand and participate in just the social reciprocity of relationships. I think there's two things in terms of this real expansion of social media and And so, even so video conscious, I think in terms of how much kids time kids are spending online, of course, is taking that focus of themselves outward from the internal, moving away from the internal of thinking, Who am I and what are my hopes and what are my desires and dreams and focusing it so much more on on the outward. What do I look like? Oh, how's my hair? What am I dressing as? Because that's what we're visually seeing constantly. And then the second part of that is that's what we're not only visually seeing consciously, but that's where society is also placing its emphasis right now. Rather than being true and honest with yourself, really more focused on what kind of image are you portraying out there. What kind of image are you putting out there? How are you making connection with another person is usually how are you commenting on their status or this, this, that, and the other. So it really has, I think, not only disconnected people from their intuitive selves, And that many individuals that are coming to care for us no longer really trust their own intuitive thoughts, intuitive, you know, desires or behaviors, but also are really, really hard on themselves because once we start comparing ourselves to others, then there never is a perfect match between self and other and it does really open up the opportunity for a lot of self defeat, self defeating thoughts and processes. So we are seeing a lot of that certainly with both our adolescents and our young adults.

Brenda: 21:48

Hey there, are you feeling stuck in a cycle of drama and arguments with your child, worried sick about their substance use? I have been there and I want you to know there's hope. This podcast is just one piece of the curated and trustworthy resources and solutions we offer for parents. We recognize you need emotional support and a solid plan for moving forward, making positive change in your family. So in addition to connecting with other parents and feeling like part of something bigger, we also teach you practical skills and strategies to dial down the drama and diffuse those heated moments. We step you through the evidence based craft approach, a game changer that can help you invite your child to accept help without resorting to tough love or waiting for rock bottom. We have so much more than the podcast waiting for you. Head over to HopeStreamCommunity. org to tap into all of our resources and become part of the HopeStream family in our private online community. Remember, you're not alone in this. We're doing it together. Now let's get back to the conversation. So I have four boys, so I don't know a lot about raising girls. I don't know a lot about what girls go through. And I know that is a big emphasis for you, especially in the adolescent program. Talk a little bit about why and how, how is treatment different from girls? I used to think it was just like, there would be, you know, girls are over here and boys are over there just so that they don't mingle. Cause that can, especially with teens, that can cause a lot of problems, but I think it's more than that. I imagine it's more than that. And Sarah, you mentioned trauma and I know a lot of young girls have endured a lot of trauma. So bring me up to speed on the girl factor. It is just an area that I'm not, I'm not super informed of. You know,

Sara: 23:52

when we work with our clients, we talk about big T and little T trauma. And so big T trauma is some of the, the more obvious traumas, you know, you experienced a natural disaster, you experienced an assault, you experience, you know, a war zone, something that's quite obviously traumatic, but then there's the little T traumas that are things that can compound over time and, and create the same issues. And I think those are, those, those come for our clients. Female identifying clients as, you know, expectations from the outside, being expected to look a certain way, to act a certain way, to present a certain way, like we were talking about, and if I'm feeling less than, and I don't have the tools to communicate that, that's going to compound over time and impact my sense of self.

Marcy: 24:39

Yeah, I mean, I think what makes our model unique is what makes it fit so perfectly for, for girls and, and young women is that our model is very relational. And, you know, really everybody needs mutually satisfying relationships with others. It's necessary for our own emotional well being, our own well being. Emotional development, really our own person development, and it's particularly important for girls. Girls move through the world in a very relational way, and they often don't see themselves without having some sort of connection to another, another person. It's unfortunate that all of our girls, that connection to other has gotten disrupted. through their development. Maybe a traumatic exposure that Sarah just spoke of. It might have been it, but it's also gotten maybe disrupted through some of the early attachments that, you know, our girls and our young women have had to early caregivers. So really the work that we do in helping girls to become more. Authentically relate it to themselves and to others is really the reparative work that we do here.

Brenda: 25:57

Do they even recognize that they don't necessarily know themselves or that they are sort of projecting this? I'm just trying to sort of figure out what they would be thinking as they are starting to spend some time with you. What are the things that you're doing to help them to sort of help pull that out of them and to help them see. Oh, maybe I haven't been being really authentic to myself and maybe my relationships have been more surface level. Like talk to me a little bit about what that looks like because I, I would love to be a fly on the wall.

Marcy: 26:33

Yeah. I mean it really runs the gamut and I think Sarah would say that's about the same young adult that she works with every day. We have some very astute. And some very insightful young adolescents and young adults that come to us, and they, they realize that sort of there's a problem. Why, why can't I keep a relationship? Why do I have such horrible relationships with my parents? Gee, I, I really, I, I long and I yearn to, uh, you know, have a connection with something. Or, gee, some folks even say, I think I use substances, or I think I use some of my negative behaviors. As the thing that I'm really connected to because it's the only thing that sort of takes care of me in life. My substance is the only thing that takes my negative feelings away or my abusive friend or my abusive boyfriend is the only one that I feel like truly knows me or truly, you know, supports me. So I think that there are some young people that can recognize that some. And then there's others that come to us because they're doing it for somebody else. My mom is making me be here or my fiance or my boyfriend isn't going to be in a relationship with me if I don't get this under control. And sometimes we have to approach those individuals a little bit differently. And sometimes we have to use ourself as a human to talk with them a little bit about what is it like for us to be in relation to them. Kind of use in the moment, you know, as has everybody, has anybody ever said this to you? Or I notice when we're in connection with each other, this kind of stuff comes up. And usually once we continue to, you know, sort of point that out in an environment that's. Warm and welcoming and supportive, and we do that in a variety of ways through different therapeutic techniques that maybe we'll talk a little specifically about, that that helps, um, an individual begin to identify, yeah, you know what, maybe I do see that in how I'm relating to others, and it increases their curiosity to want to change. A lot of

Sara: 28:47

the clients that come to us talk about, you know, not even knowing what their hobbies are, not even knowing what they enjoy and really not having a sense of self. And when you don't have a sense of your authentic self, that's really scary. And I think for a lot of our clients on some level, they, they do know that they do feel that, but to actually speak that out loud is really scary, which is where the relational model and the longer term treatment can build that trust and build that environment where we can speak the unspoken. You know, there's a lot of, a lot of feelings of shame or a lot of feelings of less than that working with the same team, you know, everybody from your primary clinician down to your support staff, to your program staff, you know, working with the same people for, you know, three, six months in our program, longer in the adolescent program really creates that space where that's possible. Because when we look at even somebody who completes a 30 day program and then has a really great aftercare plan set up. Think of how many times you've changed your providers, how many times you've changed your therapist, how many times you've had to restart your story. And so what we offer here is the chance to tell your story in full. And especially in, you know, a specific technique that comes to mind that we use a lot in our expressive group is, you know, repeated questioning, which is based in, you know, psychodynamic therapy, but that helps you to speak the unspoken and to say things, to say your, your fears and your insecurities and your true self, let your true voice out, especially in front of others. in a, in a group format with your peers, or even just in a session with your therapist, there's so much power and so much relief in that and just naming it. because before we name it and we turn and we face it, it can be huge and overwhelming and we just keep running from it. But as soon as you face something as terrifying and difficult as it is, it becomes smaller or it becomes something that I can now tackle.

Brenda: 30:49

Repeated questioning, that's interesting. I've never heard that. What are some of the other therapeutic techniques, or I know you also have some more somatic practices and things like that. So what are some of those things that you're doing that can help a young person start to peel back those layers?

Marcy: 31:07

Yeah, we do have a few somatic practices. We regularly do yoga and different meditation practices with our, with our residents each and every week. And we also have the expressive therapy, as Sarah mentioned. And expressive therapy really allows The opportunity to, to kind of get out of your head sometimes and to get into your body as well, too, whether we're doing some psychodrama or whether we're using art or music or, or, you know, some other type of, of movement to kind of really understand our internal experiences and help us express those internal experiences. We have a really neat land and animal program as well, too. Sometimes, Getting into nature, not sometimes, I'm going to say really getting into nature, always getting into nature, really helps individuals become a little bit more authentic with themselves. We have residents that show up on the first day and they are petrified of our farm animals. And by the last day they're here, they've have fortunately experienced a whole new relationship and a whole new connection. to the animal, which has allowed them to have a whole new connection to themselves. You know, challenging yourself to do something that maybe you haven't done before, or that you're not familiar with, or that you don't know how to take care of another living being and learning how to do that can have really just such transformational outcomes.

Sara: 32:39

Yeah, because I think if you're looking at like whole person treatment, you want a program that offers a diverse set of. interventions of approaches so that you can meet all the needs, you know, because you can't meet all the needs with just one approach. So here at Angelus, we have, you know, the same, the adventure of the land, the animal program art therapy. And then we offer maybe some therapies that more people have heard of like CBT, DBT, EMDR, psychoeducation, along with the expressive therapy. So it's really kind of offering as diverse as possible. A program to someone to make sure that we can tailor it and meet an individual person's needs because each individual person has had a different experience. They might be working on. similar issues or, you know, they might have similar symptoms to somebody else, but their experience is really uniquely their own. So their treatment needs to be able to be uniquely their own as well.

Brenda: 33:37

Right. And I would imagine that even just living in the same space with and, and moving through the each day to day. with other young people is also very therapeutic because they're having to learn how to relate to those people. If you're sharing a room or a chore or something like that, there's no choice but to figure it out. And, and that's what I hear from the parents that I talk with is, you know, they're, they're almost shocked by their kid's inability to really problem solve and do just do some of these things that you would anticipate would be fairly normal. But I think a lot of that growth and that development has been stunted, whether that's from some trauma or the substance use, or it's all usually a combination, right, of all of that. Right.

Marcy: 34:27

Yeah, and we as adults, as their primary caregivers while they're here, they have, uh, our residents have the same opportunity to move through those learning experiences with us who might at times be perceived as an authority figure, or who at the beginning might be perceived as maybe an adult who kind of thinks we know it all, but we don't know it all. But it really offers a really unique opportunity for our adolescents and young adults. Women to not only figure out how to do that with their peers in a residential setting but also how to do that with a caregiver and and then we use that work to translate over to the new relationships or the developing Relationships they're then going to have with their families.

Brenda: 35:15

Yes that whole authoritative figure Issue can, I know just from speaking from experience with my son, it was very difficult to navigate and, and I know you probably, actually, I would love to just hear, and then I want to shift over to talk a little bit more about parents, but what are some of the, and I hate to kind of pathologize people, but what are some of the diagnoses that, That young people are coming to you with. I think it's helpful just to hear because a lot of parents are like, Oh, we just got this diagnosis and now what do we do? And you know, is, is my kiddo too bad or too severe or not bad enough? Like they can't quite figure out what that means.

Marcy: 35:58

Yeah, we definitely see in our, in our adolescent programs, we see most of our young kids are entering and they're having some pretty significant problems around mood. And so we see a really the whole spectrum of mood disorders, including depression and, and bipolar, which used to be referred to as manic depressives. We also see the whole spectrum of anxiety. We have kids that have some pretty significant symptoms and challenges with anxiety, some with some obsessive compulsive behaviors or thoughts. And we also actually see a large number of, of children and certainly young adults that also are struggling. with some of their personality features and structures. So it's not uncommon for us to have residents that are beginning to experience some issues around borderline personality disorder or dependent personality features. And then as well as our Angela's house, we also have residents that are also have some co occurring substance use, whether that be alcohol or marijuana or other substances that they've been using on a regular basis that has significantly interfered with their functioning in relationships. Yeah, so you're seeing, you're seeing a lot. What about eating disorders? Is that fairly common? Yeah, thank you. I forgot about that. Yeah, a very large portion of our population as well too struggles with eating. Absolutely. And, and disordered eating in, in many ways. Some of our residents that might not be at the, the most important. point of their treatment or where they are right now, but have had periods in their life where they've really had some significant disruption in their eating, including previous diagnoses of anorexia. Yeah, and I think

Sara: 37:39

that can be tricky too, you know, eating disorders, similar to how we talked about before addiction and mental health being siloed, you know, eating disorders themselves are still very much siloed and, you know, it's one of, it's got such a high Co occurrence with substance use in the female population, you know, there's such a high occurrence of disordered eating behaviors in adult women who are also struggling with substance use because Again, it goes back to that, that human need of trying to fill a void or having a need that's not met. So how do I take things from the outside and try to fill that or try to, to feel better? So we certainly take people that have struggled with a wide range of eating disorders. We kind of will consider Anyone who is, is safe, you know, because here, especially here at Angelus, you know, it is an adult program. It's a little bit different, but, you know, we are in rural Connecticut in an unlocked, beautiful old farmhouse with, you know, sometimes, Light staffing, one or two staff on at a time. So the biggest thing we consider when we're looking at prospective clients is, you know, is this a safe place for them? You know, can they be safe in this level of clinical structure? But yet, a little bit unstructured compared to maybe a hospital or an acute psychiatric environment. So it's, it's determining what's safest for the client, but we consider anyone, you know, borderline personality disorder is something that a lot of practitioners are not comfortable diagnosing in adolescents, no matter how clear some of the patterns or some of the traits might be in a younger age, it still is a misconception that either you can't. Make that diagnosis or that you shouldn't, um, but what that does is just delay the treatment that someone needs, you know, and the way that certain diagnoses. Um, you know, it's, it, it's not, it's, there's help here. We've helped a lot of people with a lot of combination of struggles and diagnoses.

Brenda: 39:49

Yeah. The, the idea of, I think sometimes the, just the idea or the word treatment can be very unsettling for parents to think about because they think about the lockdown, you know, facility. And it's really refreshing to hear that, obviously for the right person who is, like you said, safe, that there is a more natural sort of home like environment where that you're, you're not having to deal with that more like cold clinical facility. type place. I saw the pictures and I'm like, I kind of want to come visit you all because it looks really gorgeous. I'd love to shift to parents a little bit. They're a big part of the equation, obviously. It's often just having been through it, it's often really uncomfortable to look at yourself and think, huh, I probably had, Some part in this it's it's really not fun, but it's so important. So I would love to hear how you think about the parent role. I know you do require parents to be involved and maybe any just words of. of wisdom or, you know, encouragement for parents who might be in the thick of it right now.

Marcy: 41:09

Yeah, we have a pretty intensive component for family treatment in our adolescent programs, and, and families have a weekly family session that starts Immediately upon admission and happens each and every week. And we also have an opportunity for Families Monthly to participate in both a parent support group as well as a multi-family group, which is an opportunity to fam for families to all be together and to not only learn from each other, but for them to have a feeling and a sense of who their, their daughter is spending time with. They get an opportunity to meet the other families, to meet the other residents in the house. So, it is really a very important and central piece in our adolescent programs as our home passes and family visits are a very central piece. Our young adult program is really focused on family as it makes sense for each and every young adult. And so, Sarah, you can talk a little bit more, but that piece is really highly individualized for, for each young adult that we're caring for.

Sara: 42:16

Yeah. And you know, here at Angeles, it is a little bit different. These are adult clients, so they do have autonomy in their care as far as refusing certain things. So it's a little bit different than in the adolescent population where we might be able to more strongly require things, but we do strongly encourage some family therapy component, even if at the very least it's, it's towards completion, just to make sure that transition goes well, because. The majority of our discharging young adults are going home, and we need to make sure that that transition is smooth and that, you know, they're, they're set up for the most success. And I think what I would say to parents is that it's not one thing. single thing that causes somebody to struggle the way that our clients do. So it's, it's not, it's not just your parenting. It might not be your parenting at all. You know, it's a combination of things. It's a lot of things that are unexpected or out of control, out of your control. All parents just want their kids to be happy. You know, they just want their, their kids to be happy and healthy. And this is a place to start that healing and start to figure out what those root causes are. Clients are the most successful when they have involvement in their treatment from the people closest to them and the people that are going to continue to be in their lives. and be there for them after our role is done. So as difficult or as scary as it might be for the family to also enter into this process, it sets everybody up for the most success and for the most healing.

Brenda: 43:50

It can be, like I said, uncomfortable because you kind of know Oh, as I get in and I do this work and I'm on these family calls and now my child is feeling more free to speak, you know, about really sort of what, what they're feeling and experiencing it. It can be a lot to take in. And so that family work is so important and, and as you were talking about the relational model, you really, if you are not doing that work, and then that young person goes back into the home and they have. I've had those tools and they've learned CBT or DBT or whatever that they've found helpful. And parents are way back here and haven't done the work. That relationship is just so friction filled again. My son went through many programs, so I had the experience of doing it wrong and then doing it better. But it, it is hard. How do you see, kind of what do you see in the families as they move through, like from day one, like you said, you know, you start through maybe a three, six, you know, nine or 12 month process. What are some of the things that you see just to give anyone who's listening an idea of. That growth, like what does that growth look like?

Marcy: 45:12

Yeah, I mean, usually it takes a good, believe it or not, a month or two, usually closer to 60 days, just for an adolescent to and the family to really just settle in, and to learn a little bit about how things go and what to expect and, and to be able to trust the process. And that often is the hardest step because Families, of course, are going to feel is that person, is that therapist going to judge me? Are they going to say that I've done everything wrong? Will I be blamed? Or, right, what will my child say about, you know, what has happened? Will it, you know, You know, and we've had some children, for a variety of reasons, maybe not be so truthful about what has happened in the past and have families have, you know, have had to kind of work through that with families. So, a lot of that stuff definitely happens, you know, at the first part of this day. And I think once adolescents begin to trust, And our staff here, once they begin to trust that therapeutic process and be able to have some knowledge and be able to have some understand the predictability around what's going to happen, then thank goodness, people start sharing and sharing authentically, because really, it's a no blame attitude from any particular situation. You know, and, and it's a no judgment. I mean, our families and our children are not bad and often we hear that they come in with that perspective that they are either bad kids or that something's wrong or, you know, something that they did wrong or something that they did or didn't do. And it's not really about that something's wrong with you. It's really more about finding out the story of what has happened. And understanding that experience and trying to work with both the family and the adolescents and saying, Okay, well, how do we want to go forward? How do you want to rewrite that in terms of what's happened? What does that look like for you going forward? So it's really understanding what unique journey each one of the family has had, and then also co constructing with the family. Where are we going forward? What would you like to see?

Brenda: 47:34

I'm wondering if, just as we wrap up, is there a myth or misperception that you think is out there that you I would love to clear up for folks around either adolescence or mental health, girls, anything that just kind of irks you that you just, you know, if I could give you a billboard that you would put on to say, this is really what I want people to know.

Marcy: 48:01

You know, there's, I think all these things that we. Hear from society to do with our children, right? Don't spoil your kids. Don't be too firm. You know, don't be too inconsistent. Don't, you know, don't provoke your kids. I think that there's all these things that we hear in terms of the do's and don'ts. And I can't tell you really how many of those are just so inaccurate. So I think I'd like people to sort of know that, you know, um, There's an expectation, I think, that parents need to be perfect and need to know what to do in every single situation of whatever their child or adolescent comes home with. And I guess I would try to tell parents is to have a little bit more patience with yourself and don't try to be so perfect. Lovely.

Brenda: 48:56

Anything come to

Sara: 48:57

mind for you, Sarah? Yeah. I think what comes to mind is Not expecting things to be black and white, not expecting to find the one right thing, the one right program, the one right therapy, you know, things are so layered and so nuanced that that can hold us back from seeking what we need at times that just, you know, Just focusing on moving in a healthier direction is really a good place to start. You know, you don't have to have all the answers to at least start. Even when you look at mental health, look at addiction, you know, it's a spectrum. It's not black and white. It's not clear. Because we are human beings and we're so individual, not letting that black and white thinking or wanting to find the one right answer hold you back from just moving forward or moving towards what you in your gut know you need to do.

Brenda: 49:53

Okay, my friend, that is a wrap for today. Don't forget to download the new ebook, Worried Sick. It's totally free. It will shed so much light on positive tools and strategies you can use right now. to start creating those positive conditions for change in your home and in your relationships. It is at HopeStreamCommunity. org forward slash worried. And guess what? We have moved the entire podcast to our website at HopeStreamCommunity. org. So now when you want the show notes or resources, or if you want to download a transcript, just go to HopeStreamCommunity. org and click on podcast notes. And you will find it all there. You can search by keyword, episode number, guest name, and we have created playlists for you, makes it much easier to find episodes grouped by topic. So we're really excited to have that done and hope you like the podcast's new home. Please be extraordinarily good to yourself today. Take a deep breath. You've got this and you are going to be okay. You're not doing it alone. I will meet you right back here next week.