Latest / The Inspired Stories Podcast / Breaking Barriers in Mental Health: Dr. Barbara J. Brown's Mission for Accessible Care | Healthcare Series

Transcript

Breaking Barriers in Mental Health: Dr. Barbara J. Brown's Mission for Accessible Care | Healthcare Series · The Inspired Stories Podcast

0:04
Welcome to another edition of the Inspired Stories podcast,
0:08
where leaders share their experiences so we can learn from
0:11
their successes and be inspired by how they've overcome
0:14
adversity. My name is Anthony Cotispodi and
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today's guest is Doctor Barbara J Brown.
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Barbara is a licensed Clinical Community Psychologist who has
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been practicing for over 3 decades and is the Founder CEO
0:28
of Capitol Hill Consortium for Counseling and Consultation,
0:33
otherwise known as CCCC. This large private group mental
0:37
health practice in the greater Washington, DC region is
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celebrating it's 15th year and employs over 80 staff that have
0:45
served thousands of children, adolescents and adults through
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the years. Doctor Brown has received both
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local and national recognition for her company's contributions
0:55
to the community. ccccwhichcanbefound@ccccmentalhealth.com
1:01
was founded in 2009 as a mental health group private practice
1:06
dedicated to providing high quality, accessible and
1:10
culturally responsive psychotherapy, psychological
1:13
assessment and testing for children, adolescents and
1:16
adults. They also provide training for
1:19
pre and post doctoral psychologist, including an
1:22
American Psychological Association accredited
1:25
internship. A new clinical and community
1:28
professional development program for early career, social work,
1:31
counseling and marriage and family counselors launched in
1:35
fall 2023 with the ambition of becoming a national model for
1:39
clinical and community focused mental health practice.
1:43
Now before we get into all that good stuff, today's episode is
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AD back benefitsagency.com. Now back to our guest today, the
2:15
founder of Quad C Doctor Barbara Brown.
2:18
I appreciate make making the time to Share your story today.
2:21
Thank you. Thank you for having me today.
2:24
So, Barbara, tell us what first drew you to the field of
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behavioral health? Oh, that was fortunate.
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In in my high school I was provided an opportunity to take
2:39
psychology and my professor was both a minister and taught us
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psychology. And so I really was introduced
2:49
to it through a spiritual component, but also a way of
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healing people. So learned about Jungian dream
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psychology and primal screen therapy and I was hooked in
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terms of just, you know, being fascinated by studying human
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behavior, so. And so from there, what inspired
3:08
you to first start your own practice?
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So I had never planned to start my own practice.
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I really, when I went to Boston University for my grad school in
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clinical and community psychology, I intended to just,
3:24
you know, serve the community. So I, I started running
3:29
well-being a psychologist as well as being an administrator
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for various programs that were based in the community, the
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hospital, outpatient treatment programs, government, government
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clinic as well. And so the reason and
3:50
universities, I'm sorry, I worked at universities.
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So I had a lot of different kinds of experiences, but it was
3:58
really the fact that there were glass ceilings there for a black
4:03
woman, as well as just the bureaucracy, the level of
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bureaucracy, that led me to start my own practice.
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And how has that evolved over the years?
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I mean, you started probably just was it a a one woman show,
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did you? I started a solo practice.
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I had a mentor who was very good, Doctor Joyce Berry, who
4:27
was excellent and really taught me the business of private
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practice that they don't tell you about in school.
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And so I built my private practice successfully.
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And then I decided to join with some partners and we had a
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psychiatry component, a psycho educational component in
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psychology. And we started a group practice,
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family assistance in coping with trauma and stress that lasted 11
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years. And my partners grew wary of, of
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having a private practice and, and the struggles of it.
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And so they departed still good friends and colleagues.
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But I decided to then shift to Capitol Hill Consortium for
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counseling consultation because we had a small number of, we had
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about 8 clinicians working for us then.
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And really I wanted to make sure that it became a group practice
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that everyone could basically join and own their portion of
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could show their expertise. So that's why the term
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consortium of really coming together of like minded people.
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We developed our, our mission statement and really started
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attracting, you know, people who were like minded in, in the area
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of working to provide services regardless of ability to pay.
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And so we took public and private insurances and just
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really had a wide swath of people, you know, age, I was
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joke and say age 3 to 83 and, you know, providing all sorts of
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services in terms of psychotherapy for individuals,
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groups, families, couples. And then the psychological
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testing spans the the variety of psycho educational testing,
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personality assessment, neuro psych assessment, cognitive
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assessment and intelligence testing.
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So we have all of that. And so how do most people find
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their way to you? Are they finding you online or
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or you know they have to come through like a primary care
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physician for a referral? Things have evolved over the
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years because we we've just become very well known by all
6:57
sorts of practices. So we get a lot of our patients,
7:01
our clients, from our current clients, they refer their family
7:05
and friends. We get a lot from insurance
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companies, we get a lot from doctors, physical doctors in the
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area, hospital settings. You know, we, we are pretty well
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known at this point. What are some of the most common
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conditions that are presenting themselves?
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So the garden variety anxiety and depression and, you know,
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stress management. But I think we also are well
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known for our trauma work and that can range from emotional
7:41
neglect to physical and sexual abuse.
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And we do have some veterans also who come back and need help
7:52
for Post traumatic stress disorder.
7:56
What are you finding are some of the more effective types of
7:59
treatment for, whether it's PTSD or other types of trauma,
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neglect, physical abuse? So we, I, I personally have a
8:11
psychoanalytic psychodynamic background and so I blend that
8:15
with cultural features and you know, we're an integrative
8:20
setting. So we have cognitive behavioral
8:22
therapy, we have the the range. So, but for trauma in
8:27
particular, what we do, I think that's different from other
8:30
agencies is we do evidence based work, but we will go into the
8:37
root, we really try to get to the root of the the core issue
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and that takes time. And so I, I didn't have a phase
8:49
specific kind of treatment. I'll do an initial assessment
8:54
and find out basically, you know, not only what happened,
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but also a lot about any patterns that are recurring in
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the person's life that are indicative of attachment issues
9:08
that may have happened that often happen because of the
9:11
trauma with other people. I assess for ego strength to see
9:16
how how well people can tolerate going in and dealing with the
9:21
trauma directly. And usually I find that people
9:24
need better coping skills. And so before we go deep.
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And so we have a dialectical behavior treatment that we also
9:36
do to help with coping skills. And so that's often mixed with
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the supportive psychotherapy, getting to know the client,
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client, building a trusting relationship, helping them with
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coping skills. And then we can go further into
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the trauma in terms of the impact that it had on the
9:56
individual. You don't always need to discuss
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all of the trauma, but it is important to discuss the effects
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of the trauma and especially on the person's sense of self and
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from that and helping people understand that this is
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something that happened to them, it is not them.
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It helps them get that distance so they can see that and go
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through the the grieving in some way of, of the self that was
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lost because of the trauma and then starting to rebuild a sense
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of self in a different way apart from the trauma, the trauma
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happened. But at the end of therapy, you
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want people to be able to put it on whatever shelf they want.
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That they have control of it. It doesn't have control over
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them. And from that, they're free to
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then start building their life in a new way.
10:54
Couple of things I want to go into a little bit deeper there.
10:57
What does it look like when you assess for ego strength?
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Is it sort of a a series of multiple choice questions you're
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taking people through? Is it sort of more of like a gut
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feel that you get from being in somebody'd presence?
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Well, again, having a psychoanalytic background, I'm
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always looking for defenses that people use.
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And so I find that when we get closer to discussing what
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happened, people will do all sorts of things to defend
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themselves from from it. Some people will use denial
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initially and sometimes you don't hear about the trauma
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until months after a person starts treatment because they've
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blocked, they've tried to block it out.
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Other people use humor. It's it's like they are telling
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you a story and you know, they'll use humor as if it's as
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a deflection of some of the true feelings.
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Other people have more serious, you know, defenses.
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And I've worked with people with dissociative personality
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disorders and all sorts of coping mechanisms.
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So I've heard stories before, and I'm kind of curious to know
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how common this is that somebody experiences rather significant
12:20
trauma and then completely blocks out that it had happened
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until something triggers later in life that brings this sort of
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back to the surface. Is this more like TV and movie
12:34
kind of scripts or is this like a real thing that happens
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somewhat commonly? It's a common reaction because
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you know, people are trying to survive and again, taking them
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to thriving is a different story.
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So they will, I see it a lot in rape victims that, you know, it
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will just be shut down and really won't come out until
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much, much later. And it will be triggered by, you
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know a date or a person or you know any association could just.
13:16
Something that who knows how in the brain has sort of sparked a
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connection that causes them to sort of re remember this.
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Right. But then they often try to
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suppress it again, you know, the goal of any defense is
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repression. We don't that that doesn't
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happen. It's somewhere, it's somewhere
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it's coming out in some way front way or sideways.
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And and often again, it's affecting people's relationships
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with one another. You made the point that they
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don't always have to face all the trauma.
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What do you mean by that? I mean that we don't have to get
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into all the details of the trauma.
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We need to know who was the perpetrator and come to terms
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with who the perpetrator was. The closer the perpetrator, the
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more complicated the relationships are.
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So, you know, stranger anxiety is easier, or stranger
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perpetration is in a lot of ways easier to deal with than someone
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you you know and you're connected with, especially in
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the family. Yeah.
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Then you said sort of, you know, as you're kind of taking them
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through this process, at some point you get to the point where
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it's time to work on rebuilding the sense of self.
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What does that process kind of look like?
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So first, it starts with a lot of compassion for the self in
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terms of, and there are many techniques to kind of separate,
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you know, the what is commonly called the inner child, you
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know, the younger self that was hurt from the self that is
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starting to be able to be a caregiver of that part of you.
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And so viewing that person, that self with compassion, as opposed
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to what often has happened is they've condemned like it's
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somehow the, the victim's fault, you know, somehow their fault.
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And so after you shift that to something that was done to you,
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then rebuilding first again, it's really helping that self
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come along and be re parented by yourself.
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So they're they're no longer a they're not viewed negatively.
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They're help. They you have to take them
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wherever they were hurt and then help them come back to the
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present and reshape relationships.
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So lots of trust building first in your own self, trusting
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yourself and then gradually trusting others.
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A lot of the clients that I work with go from individual therapy
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with me and then they go into group therapy.
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OK. That's sort of like a like a
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graduation process. Right.
16:37
Yeah. So are you still practicing
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quite a bit, I mean. Actually.
16:43
Clinicians like it seems like. You actually, I have replaced
16:47
myself. You know, when I said that, I
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said, oh, I'm not doing this, you know, so much anymore.
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I do supervise people, but no, I'm not in the day-to-day.
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I had to step away actually right after the pandemic or
17:01
during the pandemic in some ways to start taking care of the
17:05
business that that one of the questions that you have for me
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is about difficulties in the pandemic really, really, really
17:13
changed the business so. Let's hear more about that then.
17:17
Sure. So, you know, the first thing
17:21
was just like we were 100% in person and in the space of a
17:26
weekend, you know, we had been talking about telehealth, but we
17:30
had not planned anything, any time frame.
17:33
But when I think it was March 18th came, we, you know,
17:39
basically said we've got to, we've got to do something else.
17:42
So we went from 100% in person to 100% remote in a weekend.
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And without even, you know, losing any clients, clinicians,
17:53
you know, set just setting it all up to to succeed.
17:58
And that's with about 1000 clients a week.
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Wow. Yeah, it was just.
18:03
At the flip of a switch you had to do it and so was there was
18:06
there a platform that you guys could go to?
18:09
Were you just using Zoom or like how did?
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You no, we hadn't even, we hadn't even started with that.
18:14
We, we, we had been looking at platforms and so we chose a
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platform. I think we were with Bayland at
18:21
that point, but we had to do we were not integrated.
18:25
We had Zoom separate, we had, you know, billing separate, we
18:30
had all of that. Now we've integrated all of
18:32
that. But at the time it was just
18:34
like, what can we, what can we do quickly and HIPAA compliant
18:39
in, in HIPAA compliant way and getting all the clients to sign
18:43
this new telehealth form. So.
18:46
Now, a lot of businesses that I talked to as they went through
18:49
the pandemic, there were times where they're like, I don't know
18:51
if my business is going to survive.
18:53
I'm going to guess that wasn't the case.
18:55
For. You we were overloaded, right?
18:57
Yeah, we grew. We, we grew I think 3 or 4 times
19:01
larger. I mean, it was just amazing.
19:03
And I kept hiring clinicians and we were all remote and for that
19:09
two year period, so and. How were you finding clinicians?
19:15
They were finding us. I mean, we always advertise, but
19:19
people resonate with the mission and, you know, to to be able to
19:24
give back to everybody and to really make mental health
19:29
accessible. And as you can imagine, a lot of
19:33
people were really hurting during the pandemic, especially.
19:36
We did a lot of work with frontline people, too.
19:40
The physicians especially, they were, they were having such a
19:44
hard time. It's such a scary time for them.
19:46
Yeah. I'm kind of curious, you know,
19:49
if somebody who had a front row seat to sort of mental health
19:53
picture pre COVID, during COVID and now that you know, we've
19:57
kind of come out of that. What?
20:00
What sort of how, how would you sort of describe the trajectory,
20:04
the curve, if you were to kind of describe it in in a big
20:07
picture term? I think it really depended on
20:13
your ability to adapt to different circumstances.
20:17
And some people adapted pretty well and took advantage of it.
20:22
And some people adapted very poorly or they didn't adapt.
20:26
And, you know, the mental health crisis, as you know, got so much
20:31
worse with young people. A lot of anxiety, just anxiety
20:38
on its deepest level, it's, it's not having control.
20:43
And none of us really had control over that period of
20:47
time. And so you just had to, as I
20:50
said, adapt or be anxious a lot, depressed, isolated people who
20:58
were in relationships during that period of time that were
21:03
positive, you know, got a lot out of that time together.
21:08
People who were having difficulties or ran into
21:12
difficulties, You know, there were a lot of breakups during
21:15
that period of time. We don't know, I don't know the
21:19
extent of domestic violence that was occurring without any
21:24
outlets. You know, people, if kids were
21:28
not going to school, people weren't going to work, what were
21:31
the outlets? So I I would imagine a lot of
21:35
negative things happen as well that we don't even know about.
21:39
Now that we're on the other side for the most part, what are you
21:44
seeing? Is there a recovery?
21:46
Are people still struggling? I think people are recovering.
21:52
I know that a lot of mental health programs started as a
21:56
result. A lot of funding started coming
21:59
into mental health as a result. We are in the school system now
22:06
that was one of the grants that we we got after the pandemic to
22:11
help the kids and and kids, kids need need help.
22:15
But I and the suicide rate, I'd never seen kids that young, I
22:21
mean very young, be very serious about suicide.
22:24
You know, they just the loss of hope, the loss of, you know,
22:30
wherewithal to keep going. So.
22:34
How young are we talking? Depression, I saw kids as young
22:37
as six. And before the pandemic, there
22:43
were some kids who were talking about it, but they weren't
22:46
serious. These kids were serious.
22:49
Yeah. So the need for family support
22:54
is also great. I always think that I, I have
22:57
always thought since I was a sociology and psychology major
23:01
at Wellesley, that the family has got such a burden on it to
23:07
carry forth all these things for, for the human condition.
23:13
And it's too much. We don't have enough support, I
23:15
don't think, in the United States.
23:17
But when families became isolated like that, and it was a
23:21
matter of who had resources and who didn't, it just got much
23:25
worse. And if the family, if the adults
23:28
can't support the children, the children can't support
23:32
themselves. It's it's really, they try, but
23:36
it takes a toll, always takes a toll 'cause they they're not
23:39
allowed to be kids. You know, there was a lot of
23:42
debate going through COVID about, you know, should we
23:45
isolate? Should we night isolate?
23:47
Should we mass? Should we social distance?
23:48
Should we come back together? And, you know, early on, I was a
23:52
big proponent of now let's lock down, let's mask, let's
23:55
separate, let's do as much as we can to prevent death.
24:00
Having now come through and hearing stories like yours as
24:03
well as many others, I think the big part that I discounted was
24:08
the mental and emotional suffering that would come from
24:12
being isolated like that. You know, for me, it was just,
24:15
hey, if we can just stay apart long enough, we'll get some
24:17
vaccines, you know, like we'll, we'll make it through this, you
24:21
know, because when somebody, when somebody passes away, you
24:24
know, there's no undoing that. There's no bringing them back.
24:27
But the the part that I so heavily discounted was this
24:30
component of human suffering that went with being, you know,
24:35
physically disconnected from each other.
24:38
And I think we all did. I, I, you know, it was just how
24:41
do you, how do you stay safe during this very scary period?
24:44
And with people dying at such high rates, it's like I'd rather
24:49
stay home, right? How has your mission evolved
24:55
sort of through COVID and and post COVID?
24:58
I think we're just really trying to find resources, you know,
25:04
more and more resources to bring to people.
25:08
And insurance, again, taking insurance isn't always the
25:12
easiest path. You know, a lot of businesses,
25:17
psychologist, therapist in general, went into self pay
25:21
practices because of some of the issues with insurances, managed
25:27
care. I always say I, I started the
25:30
field and I had my first private practice in the 80s before
25:35
managed care existed. And so just seeing, seeing it
25:41
now and how it's evolving and how much control people who are
25:47
not the therapists or are not the providers have over our
25:55
practice is just not the best. Sort of right.
26:00
People who aren't trained and aren't seeing the patients or
26:04
making decisions on what level of care they should have access
26:07
to. And yes.
26:09
Yeah, yeah. It's a challenging situation for
26:11
sure. Are are there, I mean, you talk
26:14
about being able to accept, you know, people across different
26:17
abilities to pay are there, you know, if you take donations, is
26:21
there like a nonprofit component to this so you can serve people
26:25
who. Well, so most people can get
26:30
Medicaid or if they can't get that, they can get the public,
26:37
you know, the commercial insurances through their, their
26:40
work and through the, the healthcare like we use DDC,
26:45
Healthlink, you know, the Affordable Care Act allows that.
26:49
So we mainly go through that. There is a low fee component.
26:54
If people can't pay, we can have a sliding scale.
26:59
I tend to come from the point of view that people should in order
27:04
to be accountable for the value of the the work.
27:09
If they can't, if they're not paying Medicaid, then you need
27:12
to show up to your your meetings.
27:15
But if you can pay, then even a small amount is important for
27:19
people to to value it. Great.
27:23
You've grown to what, 80 clinicians now?
27:27
Over 80 clinicians. Yeah, we have.
27:29
We have 8080 clinicians and including our our trainees so.
27:35
And we've just touched on already how your role has sort
27:38
of changed. You're not practicing like you
27:41
used to. Do you miss that?
27:43
Has has that been a difficult transition for you?
27:46
I think that it was. I mean, after doing it, as long
27:50
as I've done it, I think that it was OK to transition.
27:54
I still have lots of, lots of experience to rely on, but I, I
28:00
keep in touch with it through the, the training.
28:02
I, I am now the director of training in addition to being
28:06
the CEO. And so I meet regularly with all
28:11
of the trainees and students that we have.
28:15
And we, I love it because I'm, that's like, my new passion is
28:21
to help the, the next generation take over.
28:25
So. So we touched on telehealth a
28:27
little bit and you went from 100% in person to, you know,
28:30
100% remote. Now I'm gonna guess what was
28:35
that now you're hybrid. Yeah.
28:37
So like what percentage is in person versus remote?
28:42
And do you, what are the sort of the differences that you see
28:45
between being able to deliver the care remotely versus in
28:49
person? So we're about 25% in person
28:54
now, I would say 75% remote and that's in large part because the
29:00
clinicians prefer it, but also the clients have adapted to it
29:05
and really, really like it. We found that our no show rate
29:09
went way down with telehealth and people could make it on time
29:15
and stay the whole time going back to work even there's more
29:19
flexibility from their jobs and being able to do in do both in
29:26
person as well as remote work, you know, during their their
29:30
lunch breaks. So it's really helped.
29:35
I think we were all therapists were surprised that we were the
29:40
more resistant ones to starting telehealth.
29:43
And but once we started it, we love it.
29:47
You can do a lot more, a lot more than you think in terms of
29:54
reading non verbals, reading, you know, being in interaction
29:57
just like we are today. You know, you can tell how
30:01
someone's feeling. You can tell all of that.
30:05
I do think it's more difficult with children.
30:08
It's hard to there are some play more and more play therapy
30:12
techniques that you can do online that are are are digital,
30:19
but allow some of the same thing that you can get in person where
30:23
it's more interactive. But I still you know that and
30:27
psychological testing again, the field has adapted to the need
30:33
and so there are testing things that you can do that are have
30:37
manipulatives that you can use online as well.
30:40
But by and large, we still like prefer the play therapy in
30:44
person and the testing in person.
30:48
I'm going to guess, especially in a heavily congested area like
30:52
the DC area where you guys are, that, you know, not having to
30:56
drive across town or you know, flight traffic is, is probably a
31:01
big reason that both clinicians as well as patients are taking
31:04
to this and a big reason why the no show rate has dropped.
31:08
Yes, and you know the pay payment for parking and all of
31:12
that that that goes along with the commute.
31:15
So it is much easier. So are you able to employ
31:19
clinicians who live in different parts of the country then?
31:22
Does that give you sort of more flexibility in hiring?
31:24
It does, but we try to do that very carefully.
31:27
It's because, you know, again, the one thing about being in a
31:33
remote world is trying to connect.
31:36
And we do find that when we do have in person, you know, get
31:40
togethers there, there's a different feel to it than just
31:43
seeing each other on Zoom. So we prefer to have people that
31:48
we know. But having said that, we've had
31:51
clinicians who have been with us and then have moved to other
31:55
locations and we feel very comfortable with employing them
31:59
because we know them. And if someone has been
32:01
recommended to us by one of our clinicians, then that that
32:06
helps. But otherwise, it's really
32:08
screening and just really having at least three interviews and
32:12
really making sure there's a good connection and that our
32:16
values are the same and our practices are, you know, just
32:20
again, excellent and ethical and, and life changing.
32:25
How do you, Barbara, how do you ensure that across such a big
32:30
workforce that is geographically spread out?
32:33
I mean, even for, you know, most of the folks I get are still
32:35
kind of in the same physical region, but you're not in person
32:38
together, all of you all the time.
32:41
I would imagine that presents some challenges.
32:43
Yeah, it, it certainly does, especially in terms of feeling
32:47
people feeling really connected. But we do have several things in
32:51
place. Again we have supervision for
32:54
people who are not yet fully licensed, so licensed graduate
32:58
workers or again our pre doctoral or post doctoral
33:04
trainees. But then we also have peer
33:08
consultation and peer groups that that are are, I would love
33:13
everyone to be in them, but not everyone has has the time.
33:17
But we know we can contact each other as needed for consultation
33:23
and especially on issues where there's liability.
33:27
You want to have a second opinion?
33:30
We also have a, a unique thing called challenging case
33:34
presentations. And so twice a month, people can
33:38
come, anyone can come and present a case that they're
33:41
having a challenge with and we'll we'll discuss it as a
33:43
group. Your team has been described as
33:48
experienced, multicultural, multidisciplinary.
33:52
Why is the diversity component so important in providing
33:58
effective mental health services?
34:01
I think we want to be representative of our society
34:07
for a few reasons. I, I also think it's, we're good
34:12
role models for other practices in terms of really looking at
34:17
diversity as a strength, but also we have a lot of variety in
34:22
terms of, of who people can relate to.
34:25
And so because I started the company, we have a lot of people
34:30
coming and asking for a black female therapist.
34:36
We, some of our male therapists don't get it filled at the same
34:40
rate as the female therapist because even men, and this has
34:44
been throughout my career, often men, when they're coming in this
34:48
vulnerability, they want to see women as opposed to men.
34:52
But we value our men in our practice as very much.
34:57
And even though there are fewer of them than there used to be
35:00
when I started, women were the the minority instead of the
35:05
majority when I started in practice.
35:08
But now it's the reverse. I mean, yeah, you talked about
35:12
in the beginning of the interview sort of the glass
35:14
ceiling that you were running into, I'm gonna guess some
35:17
combination of, you know, being African American, some
35:19
combination of being a woman. Have you seen both of those sort
35:24
of glass ceilings kind of disintegrate or do you think
35:29
they're still very much that? No, I didn't know to Pollyanna.
35:33
Not not there yet. Huh?
35:34
OK. No, I will tell a story of we
35:38
had because our practice had been very successful in keeping
35:45
people out of the hospital who had a lot of complex trauma.
35:50
We were asked to, we were on the preferred list for as providers,
35:55
one of two in DC at that, at that point, anyway, we were
36:00
asked to join a group and it's, I think it was myself and maybe
36:06
one other female and of this large group and everyone else
36:10
were, were males, white males. And when I, I was asked to come
36:17
back to GW to help out, they were having some issues there.
36:22
And so I came, I went back there and I had someone else take over
36:26
the practice for a little bit, even though I was still with the
36:29
practice, but I was just doing a side thing and helping GW.
36:34
Anyway, I sent him to the same meeting I had been going to for
36:41
a year and he was a white male and he got invited out to this,
36:48
you know, old Boy Network to enhance the practice that I had
36:53
never been invited to. And I was like.
36:55
Nobody ever brought it up even. Nope.
36:58
And I said, huh, this is something.
37:03
So no, it exists. And I'm in, I'm in a, I'm in a
37:07
lot of female business groups as a result, ones that are just
37:16
strictly for, for black women like the Bow Collective, Black
37:21
owners and women Collective. But I'm in the women presidents
37:25
organization, women elevating women, just a lot of things
37:30
where you get validation, you get colleagues who who want to
37:36
help you so. And these groups that you're a
37:40
part of, is this more business development or is this more of
37:47
sort of engaging with the community?
37:49
I mean, community empowerment seems to be central to your
37:52
mission, right? Yes, so a lot of it, some of the
37:56
groups are both and in terms of business development is, is
38:03
their primary goal. But I'm like with the one of my
38:06
newest ones is women, the women's business collaborative
38:11
and I'm in a special group, you know, the women of purpose.
38:15
And so we really want to make a social impact.
38:18
So it's it's both and the both collective we're working on
38:24
black women empowerment in our society and really building that
38:28
in a financial structure that we don't have enough of.
38:33
So. Barbara, I'm curious, are there
38:35
any new types of therapies or approaches to therapy that
38:41
you're excited to either continue to follow or maybe you
38:45
know, use yourself? Yes, I think the frontier that
38:52
is really in its toddler phase is really neuropsychological,
38:58
you know, just really brain behavior, really understanding
39:02
the brain much better. And some of the techniques that
39:08
are newer, like tapping or EMDR are have a neuropsyche basis to
39:16
them. Neuro biofeedback, you know,
39:18
really trying to help the brain do something different.
39:22
We we used to think, you know, very backward, like the, you
39:26
know, the brain didn't have plasticity, it didn't have a way
39:30
of, of resilience, etcetera. And now we know that's not true.
39:34
We, you, the brain keeps evolving in that nothing has to
39:39
be set in stone. Even though it can be hard
39:42
wired, there's still ways. There are approaches that are
39:46
now being called like bottom bottom up approaches to to pass
39:52
the verbal. The verbal is head down.
39:55
The bottom up approaches are not verbal, but they are effective.
39:59
So explain what tapping in EMDR? So EMDR is uses the bilateral
40:09
parts of the brain to help shift people while they're talking
40:13
about some difficult areas or they're trying to reinforce
40:18
positive coping skills. And so bilateral means that
40:22
you're using, you know, you have the person follow your fingers
40:25
or you know, there's other. You can use your, you can use
40:29
tapping or you can use, but you're using both sides of your
40:32
brain to kind of help. Break up the previously set
40:44
patterns and shift. Sort of like forming new
40:48
pathways in the brain. Yes, that's the that's the idea
40:51
is like when it there, the pathways are always there, but
40:54
when you keep doing the same thing over and over, it just
40:58
it's that's what you automatically go to.
41:01
So just shift it you want to create new pathways.
41:07
I've seen some wearable devices that I don't know neck or head
41:12
area that will deliver like small like electrical
41:16
stimulation. Is that kind of in this same
41:18
field or is that kind of? Hope, I think I, I don't know
41:21
which one that's called 'cause they're a bunch of them coming
41:24
out. But yes, they're trying to, to
41:26
get to different parts of the brain.
41:28
Yeah. Same same kind of idea.
41:31
Yeah, yeah. Barbara, you've been involved in
41:35
mental health advocacy through different published works and
41:39
speaking engagements. What are some of the messages
41:41
that you're most excited to share?
41:45
I always like the normalization issue.
41:50
It's like we all have issues. We believe that the healthiest
41:56
people have been in therapy, have done therapy either by
42:00
themselves, 'cause there are these wonderful self help books,
42:03
or with someone through more guided facilitation.
42:08
And that the joke is that people are in therapy, you know,
42:14
because of other people you know, that they're in touch
42:18
with. But again, the the relationship
42:21
to self is also critical. So I always want to make sure
42:25
that people know that it's OK the whole thing, it's OK not to
42:29
be OK. Before that existed, it was just
42:32
really trying to normalize whatever you're going through,
42:36
we can work through. And it's important to work
42:39
through that self-awareness that you have is important as well
42:45
as, you know, being surrounded by a supportive community.
42:49
Are there any types of treatments, maybe new or
42:52
experimental, that you're kind of you've got an eye on?
42:55
You're like, yeah, that that's probably something people should
42:58
stay away from. No, I, I think because we are,
43:05
you know, some things are tried and true and we know they, they
43:11
work. Other things we are
43:13
experimenting with and we're testing, we're seeing what the
43:17
outcomes are. But you have to, you have to
43:20
experiment because if you don't, you're gonna stay the same.
43:24
And so I, I told, I said, I mentioned primal screen therapy
43:29
with that I was introduced to and in high school.
43:32
No, I don't use that technique. What is it?
43:36
Yeah, basically just releasing. It's basically a cathartic
43:39
release. I think there's lots of ways
43:42
other than that to, to do that. But it's, you know, I, I, I
43:50
think we have to experiment to keep, keep going, you know, and
43:54
see what works. We just have to have good
43:56
handles on it. That's why they have internal
43:59
review boards for any kind of experimentation for research, so
44:05
that we make sure that it's ethical and that it doesn't hurt
44:09
people more than it's helping. Why did you get away from Primal
44:13
Screen Therapy? I I don't think it was I I heard
44:19
it wasn't very effective and and it's too loud.
44:22
It hurt my ears so. Fair enough.
44:26
Yeah. Plus, if we're doing telehealth
44:29
now and I'm in my office taking taking my telehealth visit,
44:34
yeah, I don't want to upset my my Co workers.
44:37
Right, right. Where do you see the future of
44:41
the practice going? Quad C?
44:43
The consortium? What's What's in store?
44:45
I see us expanding. I do am looking, I'm looking at
44:50
diversification in terms of payer types as we've gotten more
44:56
contracts and insurance in some ways is getting more
45:01
bureaucratic in terms of their oversight.
45:06
I just want to have more options.
45:08
So you know, we have self pay components in terms of doing
45:13
psycho educational workshops and we're have a series of webinars
45:19
that we're planning in terms of the training component contracts
45:24
in the schools, contracts with the military and we were open to
45:29
two different kinds of funding. I really, as I said, my passion
45:36
at this point is really the next generation and developing an
45:39
army of therapists that are really well trained and clinical
45:44
and really have the outlook of wanting to help people in the
45:49
community. Not not not just self pay, but
45:52
just really being open and and finding more and more effective
45:58
and faster ways to treat people. Is is the size of the consortium
46:05
unusual? I mean, are most mental health
46:09
practices on the smaller side? Are you a bit of an outlier
46:12
here? We are one of the larger
46:14
practices for sure in the, in the area and that growth as it's
46:21
wonderful, but it has created challenges in terms of keeping
46:24
people, you know, connected. And, but we, we do a pretty good
46:30
job making sure our standard of care is good.
46:33
We do a lot of outcome pieces with clients to make sure that
46:37
they're doing OK. They let us know if they're not
46:39
doing OK and then we help and, and they know that if a
46:44
therapist is not the right fit for them, that they can change.
46:48
But they like the flexibility that they like the choice that
46:52
choices that we have and in the people.
46:55
And because we were one of the first group private practices in
47:01
the area. Again, we're well known.
47:04
We've been around for 15 years, tried and true.
47:08
And so we we see ourselves continuing.
47:11
I do see that, you know, there are a lot of national practices
47:16
at this point that are growing and certainly have knocked on my
47:22
door many times to see if we are interested in selling.
47:28
You know, I, I think that, you know, it's not something that
47:31
I'm looking for because I'm looking for us to grow.
47:35
But again, I, I, I have not found yet someone with the same
47:41
value system as as we have that's looking to to you know,
47:47
expand that service. So I think people say that they
47:51
are committed, but then people will only take certain
47:54
insurances etcetera, so. That was going to be my follow
47:59
up question is where are the disconnects?
48:01
Is it primarily in the forms of payment, the insurance that
48:03
they'll accept? Yes.
48:05
Like they don't want to take Medicaid I'm assuming?
48:08
Many of them don't take Medicaid, but some do.
48:13
Some do, but not the not the large national ones.
48:17
And there's you. You we have to be careful with
48:20
the bureaucracy in Medicaid because you don't want to turn
48:25
off people who really want to help people by over, you know,
48:33
the bureaucracy of it, right? Is there thoughts in your mind
48:38
of expanding geographically from your base now?
48:42
Yeah. Again, we're in the DMV in in
48:47
Virginia, Maryland and DC, But as I said, some of our providers
48:52
who we know who are still licensed here have moved.
48:57
And so there's the possibility of opening up places there as
49:01
well. Barbara, you've got a lot of
49:04
experience in clinical community psychology.
49:10
I'm kind of curious from your perspective, have you developed
49:14
any unique theories or perspectives on people, business
49:19
life in general? You know, being able to have
49:22
helped so many people and now supervising so many people that
49:25
are helping an even broader range of people.
49:27
Are there sort of patterns or things that you've kind of
49:30
identified? I don't think this is new, but
49:35
it, it always amazes me how micro and macro, you know,
49:42
really are the same thing whether you're studying an
49:45
individual studying, you know, a community studying a culture,
49:50
studying, you know, globally. It's, it's human nature does not
49:55
change. Human nature doesn't change.
49:59
That's the science of psychology.
50:03
And so when we're looking at the, the aggression in the war
50:10
and I, I'm always thinking about who the, the leaders are and
50:14
what they're thinking and why they're acting the way they are.
50:17
And you can see it in a family, you can see it in a warring, a
50:22
person who's warring with themselves.
50:25
So it it's that always amazes me that it's the same.
50:29
The micro and the macro is the same, whether it's world leaders
50:32
who are fighting over a piece of turf or it's an internal family
50:37
dynamic that there's friction going on over something.
50:40
Yeah. And so I find that fascinating
50:43
and I want to write more and more about that.
50:46
If I get get a chance I need the time.
50:53
What's something you wish you could teach a younger version of
50:55
yourself, Doctor? To go to Business School or to
51:00
or to go to the Goldman Sachs or, or what are these things at
51:04
a much earlier age? Because a lot of, I mean, I was,
51:08
I didn't go to school to become a businesswoman.
51:11
I went to school to become a psychologist.
51:13
And so I've learned by a lot, making a lot of mistakes and
51:18
going into some of the business development groups has really
51:24
helped. But I an an earlier version I
51:27
would have gone to Business School in addition to this to
51:31
the PhD. You mentioned 1 mentor in the
51:34
beginning of our conversation. Is there anybody else, or maybe
51:38
any books or other podcasts that have been particularly helpful
51:42
in your personal professional development?
51:46
Yeah, when I think of the influences besides, besides my
51:49
father, my father, you know, and my my family or, you know,
51:54
physicians, you know, like my sister's the 4th generation
52:00
physician in the family. So a lot of healing, a lot of
52:02
community work. And then I had social justice
52:06
people in the family who were really, really good at in really
52:12
focused on civil rights opportunities.
52:15
And so those were very early influences.
52:18
But David Satcher, I will say this, when he was the the
52:23
surgeon general and I, I was was it in Carter?
52:28
I think it was when Carter was around.
52:30
I can't, I can't remember exactly, but he influenced me
52:35
in, you know, his saying, you know, there is no health without
52:40
mental health. And I, and for a physician to
52:44
say that in on a national level was so significant in terms of
52:50
validating the role of mental health.
52:53
And it wasn't popular at that time.
52:55
He also talked a lot about the, the, the lack of resources in
53:03
the black community in terms of mental health.
53:05
And so those two things were really influential on me.
53:09
I, I, I am just such a fan of his and he has continued his
53:15
work, I think down at Morehouse. I think my Hussein Abdullahi
53:23
Bullhan, who was my first reader for my dissertation on which was
53:27
the first dissertation on violence in black couples in the
53:36
80s, in the early 80s. Anyway, he was a huge influence
53:40
on me. He taught me about the
53:42
psychology of, of oppression. Basically he was one of the
53:47
foremost expert experts on Franz Phenon.
53:52
And So what is that Franz Phenon who was a psychiatrist in, I
53:57
think in Algeria. And so he taught me the
54:01
psychology of oppression. So really putting that together
54:05
with these very Westernized psychoanalytic concepts and the
54:09
psychology of oppression, how do you work together to help people
54:14
free, you know, the individual bonds that they have, You know,
54:19
how do you free them from those? So it was it.
54:24
Those were my biggest influences in my career.
54:29
Doctor David Satcher, if Google is to be believed here, was the
54:32
16th Surgeon General served under Clinton from 98 to 2002.
54:39
Carter would have been quite a few years earlier.
54:41
I was going to say before I started psychology.
54:45
I think I was in diapers back then.
54:49
Doctor Brown, is there maybe something fun or interesting
54:52
that we haven't covered about you?
54:54
Something that maybe most people wouldn't even know about you.
54:59
The first thing that came to mind was I've been in the same
55:02
book club since I moved to DC, basically since 89.
55:07
And we, we get together every month and read and talk and
55:11
gossip and, you know, all sorts of good things.
55:14
But we've been together and that has been a very special, you
55:18
know, bond that I've had with these.
55:21
We call ourselves the Seven Sisters.
55:23
So. I like that.
55:26
Yeah, but there are actually 1010 to 20 of us at any given
55:29
time, but. It's grown beyond the original
55:32
cruel. Yes, I get it.
55:34
I get it. One more question for you,
55:37
Doctor Brown. But before I ask, I want to do 2
55:39
things. Everyone listening today, I know
55:41
that you love today's content. Please hit the Like Share
55:43
subscribe button on your favorite podcast app.
55:45
I also want to let people know the best way to get in touch
55:47
with you or with the Consortium. What would that do?
55:51
So our our main number is 202-544-5440 and again CCCC at
56:03
mentalhealth.com is our website and you can reach us by e-mail
56:09
at support@ccccmentalhealth.com or for business purposes
56:16
business at CCCC mentalhealth.com and you know we
56:23
are reachable. Yeah, we'll have all that stuff
56:26
in the show notes if somebody missed it.
56:27
But last question for you, How do you see the mental health
56:32
care, mental health care space evolving in the next couple of
56:36
years? What do you think?
56:38
Maybe some of the biggest changes that are coming?
56:40
Technology. Technology is going to.
56:44
It's already starting. It's just helping us helping
56:48
physicians and and therapists do what we do faster.
56:54
I think it will help us in our compliance with all of the
56:58
bureaucracy that is coming, the value based care models.
57:03
It will help us so that we can stay focused on our clinical
57:06
work and and helping people. There are gonna be virtual
57:12
agents. There are gonna be lots of
57:15
things coming soon. And so I can't predict it all,
57:19
but I just know that AI is gonna change the game and help people
57:22
scale, help people have access, help people save time, be more
57:28
efficient in our operations. So technology for sure.
57:33
Do you see the AI bots as a threat to what you and your
57:39
colleagues are doing? Do you see it as just a way, I
57:44
mean, if, if an AI bot could do some percentage of what you and
57:50
your staff do, does that feel like a threat?
57:52
Does does that risk replacing somebody?
57:55
I don't, not, not to me, because I do think you're just the human
58:00
element will always be there, that it's just helping us maybe
58:05
expand our workforce in the ways that we need to because there
58:10
aren't enough therapists for all the needs that there are.
58:13
And so I, I don't, I don't see humans being separate from what
58:18
we're gonna do with the technology.
58:22
Do you see like a human therapist using AI to support
58:29
the way that they're delivering care or is it sort of a
58:32
different level of care? Maybe, you know, the somebody
58:36
can't afford a therapist or you know, they can't get into the
58:39
schedule or something. And so they meet with the the AI
58:42
tool today. Do you have sort of a any
58:45
concept of how this might unfold?
58:46
I. Do I do and I have Ndas on some
58:48
things OK. Fair enough.
58:52
Maybe we'll have you back in the in a couple of years as some of
58:54
this is unfolded and you could give us a little peek behind the
58:57
scenes. Yes.
58:59
But yeah, there there's lots of things happening that I think
59:02
are that will enhance our abilities in the field and it
59:06
won't detract from it. OK, well, that's very exciting.
59:09
Sometimes the mystery of it is more fun of knowing what what it
59:13
actually could be. Well, Doctor Barbara Brown, I
59:16
want to be the first one to thank you for sharing both your
59:19
time and your story with us today.
59:21
I'm really grateful. Oh, thank you.
59:23
This was this was a lot of fun. You were a great host.
59:26
I appreciate your kind words, folks.
59:28
That's a wrap on another episode of the Inspired Stories podcast.
59:31
Thanks for learning with us today.