Latest / The Trauma Therapist / Getting High Acuity Mental Health Care Right with Dr. Caroline Fenkel, DSW, LCSW

Transcript

Getting High Acuity Mental Health Care Right with Dr. Caroline Fenkel, DSW, LCSW · The Trauma Therapist

• 0:00
  Speaker 1: Welcome to the Trauma Therapists Podcast. My name is gaming person.
• 0:04
  Speaker 1: I interview incredible people who've dedicated their lives to helping
• 0:07
  Speaker 1: those who've been impacted by trauma. A big thank you
• 0:11
  Speaker 1: to our sponsors and our guests who are supporting this show.
• 0:15
  Speaker 1: So five four, three, two and one, our folks, welcome
• 0:19
  Speaker 1: back to the podcast. Very excited to happens. My guest today,
• 0:22
  Speaker 1: doctor Caroline Finkel. Caroline, Welcome, Hi, Hi, I'm excited to
• 0:29
  Speaker 1: talk to you.
• 0:30
  Speaker 2: So. Caroline is a leader in high acuity mental health
• 0:33
  Speaker 2: care and the chief clinical officer and co founder of
• 0:37
  Speaker 2: Charlie Health. Doctor Fenkel oversees all aspects of Charlie Health's
• 0:41
  Speaker 2: clinical programming, including the delivery of evidence based care by
• 0:45
  Speaker 2: teams of expert therapists. She's also the head of Charlie
• 0:48
  Speaker 2: Health's industry leading research and Clinical Outcomes Team, which regularly
• 0:52
  Speaker 2: publishes peer reviewed research and insights relating to treating high
• 0:56
  Speaker 2: acuity individuals. Doctor Finkel has over fifteen years of experience
• 1:00
  Speaker 2: it's working with people across all levels of therapy to care,
• 1:03
  Speaker 2: ranging from residential to outpatient treatment. As a former executive
• 1:07
  Speaker 2: director of the Center for Families, Doctor Finkel designed, implemented
• 1:11
  Speaker 2: and stabbed comprehensive clinical programming for high acuity, intensive, outpatient
• 1:16
  Speaker 2: and partial hospitalization programs. Wow sleep any.
• 1:23
  Speaker 3: On Tuesdays?
• 1:25
  Speaker 2: All right? So before we get going, Caroline, share with
• 1:27
  Speaker 2: the listeners where you're from originally and where you are currently.
• 1:31
  Speaker 3: Yeah.
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  Speaker 4: So I am from outside of Philadelphia and I'm currently there,
• 1:37
  Speaker 4: and that's sort of where.
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  Speaker 3: My story all begins.
• 1:41
  Speaker 4: I used to live in Philly, really, so I grew
• 1:44
  Speaker 4: up in the suburbs out on the main line and
• 1:49
  Speaker 4: keep going, keep going.
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  Speaker 3: So I grew up right in Burnmar, so shut up.
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  Speaker 2: I went to the Haverford School.
• 1:58
  Speaker 4: The Harford Boys' School, No, okay. I went to ferent Central,
• 2:02
  Speaker 4: so right down the street.
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  Speaker 3: Yep, that's so funny.
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  Speaker 2: Went to Baldwin.
• 2:08
  Speaker 4: Okay, I love it, look at you guys.
• 2:10
  Speaker 2: And then I went to what was at the time
• 2:15
  Speaker 2: Philadelphia College of Art exactly. Yeah.
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  Speaker 4: Yeah, anyway, I took a film I took a film
• 2:21
  Speaker 4: class there that I love very Yeah.
• 2:23
  Speaker 2: So where are you now? You're outside?
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  Speaker 4: Yes, yeah, so I'm in I'm in the Malvern area,
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  Speaker 4: so stayed there.
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  Speaker 2: Yeah all right, all right, So let's intense amazing bio.
• 2:37
  Speaker 2: How did it all start for you?
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  Speaker 4: It all started at I'm sure a school that you've called,
• 2:44
  Speaker 4: which which you've heard of, called Gladwyn Elementary, of which
• 2:50
  Speaker 4: I started to have some pretty significant signs and signals
• 2:54
  Speaker 4: that I was not learning the way that other kids
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  Speaker 4: were learning, and was sent to a school for kids
• 3:02
  Speaker 4: who don't read very good a nice Zoolander quote right there.
• 3:06
  Speaker 4: And when I did just felt like really different, you know,
• 3:11
  Speaker 4: and round peg square hole always felt like I.
• 3:14
  Speaker 3: Was too much.
• 3:15
  Speaker 4: Nobody could really handle the energy, the lack of focus,
• 3:20
  Speaker 4: the struggle around attention, And by the time that I
• 3:25
  Speaker 4: had I was able to mainstream despite many people telling
• 3:30
  Speaker 4: my parents that I.
• 3:31
  Speaker 3: Should not mainstream.
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  Speaker 4: They ended up putting me at friend Central, like I said,
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  Speaker 4: and I did okay, but I got very, very addicted
• 3:40
  Speaker 4: to drugs and alcohol. So by the time that I
• 3:42
  Speaker 4: was nineteen, I had crashed and totaled my car and
• 3:47
  Speaker 4: let's stop the trauma dump. Let's stop the trauma dump.
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  Speaker 2: Hang on here. So you were having, the way you
• 3:54
  Speaker 2: put it, was interesting, you were having difficulty, your challenges
• 3:57
  Speaker 2: learning the way other kids learned. Yeah, okay, obviously or not?
• 4:02
  Speaker 2: Maybe not. I mean, you're clearly intelligent. Was, was there
• 4:07
  Speaker 2: like a processing disorder thing here? And did they say,
• 4:14
  Speaker 2: or you need some tutoring.
• 4:17
  Speaker 3: Yeah.
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  Speaker 4: I went to uh the Rosemont Plaza, which is where
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  Speaker 4: they have multiple specialists.
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  Speaker 3: And you know, interventionists.
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  Speaker 4: Uh, and sat and did I think an eight hour
• 4:28
  Speaker 4: battery of testing and out popped. You know, this diagnosed
• 4:31
  Speaker 4: these two diagnoses ADHD and dyslexia, and then sort of
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  Speaker 4: a treatment plan from there. You should send her to
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  Speaker 4: this school, and she should be in these different classes,
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  Speaker 4: and she should be with these types of teachers and
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  Speaker 4: these types of students.
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  Speaker 3: But yeah, I don't.
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  Speaker 4: I was not reading or comprehending fluently until I was
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  Speaker 4: about eleven.
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  Speaker 3: I mean I was.
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  Speaker 4: It was a pretty significant issue.
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  Speaker 2: So middle school, high school? Are you still struggling in
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  Speaker 2: high school?
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  Speaker 4: Yeah? So, you know middle school. I went to this,
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  Speaker 4: like I said, this special school. My parents sat down
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  Speaker 4: with like a dozen different psychologists and specialists who said,
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  Speaker 4: whatever you do, do not send her, do not mainstream her.
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  Speaker 4: And thankfully they both said, let's do it. We're going
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  Speaker 4: to do it anyway.
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  Speaker 3: Which you know, a lot of the research and literature.
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  Speaker 4: Shows that if you mainstream a kid who's maybe not
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  Speaker 4: doing very well, if you bring them to that place
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  Speaker 4: of the bar, they'll step up to that bar. And
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  Speaker 4: I'm lucky enough that that happened. But I wasn't socially
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  Speaker 4: doing well. And so what I learned very quickly my
• 5:42
  Speaker 4: freshman year was like, if I want to make friends,
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  Speaker 4: I bring a lot of drugs and alcoholic parties and excuse.
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  Speaker 2: Me, socially weren't doing well because why I.
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  Speaker 4: Think it was like a fish out of water, you know,
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  Speaker 4: Like I just I feel like I got a lot
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  Speaker 4: of messages as a child, which you know, is like
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  Speaker 4: that's where a lot of trauma comes from, right, is
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  Speaker 4: these messages that you get and whether they're implicit or
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  Speaker 4: they're explicit.
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  Speaker 3: I just got a lot of messages that.
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  Speaker 4: I'm too much, I'm too loud, I'm you know, too
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  Speaker 4: obsessive to all of these things. And what I found
• 6:20
  Speaker 4: was like when I was drinking or using, I was
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  Speaker 4: I was just duller and that made people like me more,
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  Speaker 4: you know, whereas before it felt like I was like
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  Speaker 4: it was sort of like a magnet, like people would
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  Speaker 4: kind of step away from me, do you know what
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  Speaker 4: I mean?
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  Speaker 2: What age are we talking about now? Seventeen?
• 6:40
  Speaker 3: Yeah?
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  Speaker 4: Started at fourteen, ended I ended up getting sober at nineteen, so.
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  Speaker 2: Drinking for a few years. Yeah, okay, how do things
• 6:51
  Speaker 2: unfold such a you realize there's an issue going on
• 6:56
  Speaker 2: or a problem going on.
• 6:59
  Speaker 4: Yeah, So things unfold with my parents catching me a
• 7:04
  Speaker 4: couple times, and I ended up going to an intensive
• 7:09
  Speaker 4: outpatient treatment program, which is what we started at Charlie Health.
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  Speaker 4: And I happened to also meet my co founder there,
• 7:16
  Speaker 4: who is our CEO.
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  Speaker 3: And in that.
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  Speaker 4: I think I learned very quickly like I had this.
• 7:26
  Speaker 4: We have alcoholism that runs in our family pretty bad.
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  Speaker 4: So I learned like I'm already predisposed to this, and
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  Speaker 4: I learned that this was probably going to be a problem.
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  Speaker 4: And I remember thinking to myself, I want to just see,
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  Speaker 4: like I want to do a science experiment and see
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  Speaker 4: whether or not this is actually going to be a problem.
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  Speaker 4: So I left that IOP and very quickly relapsed into this,
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  Speaker 4: and that's how I ended up in this dui driving
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  Speaker 4: back from Philadelphia off the Schoogle Expressway at the Gladwyn
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  Speaker 4: exit at two am on a Tuesday night. I like
• 8:00
  Speaker 4: to say it was a Tuesday night because like that
• 8:02
  Speaker 4: means that your drug use must be pretty bad. If
• 8:04
  Speaker 4: you're like getting high and drunk on a Tuesday night. Yeah,
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  Speaker 4: it was pretty tough.
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  Speaker 2: So you have these experiences, things are happening to you,
• 8:20
  Speaker 2: You're suffering some kind of severe consequences. At what point
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  Speaker 2: are you do you go to college?
• 8:29
  Speaker 4: Yeah, So once the DUI happened, it was off to
• 8:32
  Speaker 4: rehab detox and then.
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  Speaker 3: Another three rehabs.
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  Speaker 4: So I did them like concurrently due to insurance and
• 8:39
  Speaker 4: things like that. So the first rehab that I went to,
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  Speaker 4: I was in there with fourteen year old who are
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  Speaker 4: using heroin IVY, so it was very I was nineteen
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  Speaker 4: just getting out going, you know, using alcohol mostly, so
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  Speaker 4: really tough because I just again it felt really really lonely,
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  Speaker 4: and like loneliness was such a common feeling. And then
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  Speaker 4: the next reap that I go to, I was with
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  Speaker 4: forty year old alcoholics and again just lonely, not feeling good.
• 9:13
  Speaker 4: And then thankfully, by the third treatment program, I ended
• 9:16
  Speaker 4: up with other twenty year olds and I was finally
• 9:19
  Speaker 4: able to see like, wow, like you can get sober,
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  Speaker 4: Like I could get sober and have fun. One of
• 9:25
  Speaker 4: the first things that I did when I got out.
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  Speaker 4: When I got to this it was technically a Halfway
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  Speaker 4: House is. They invited me to go to a Halloween
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  Speaker 4: party and there were two hundred young people two hundred
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  Speaker 4: this was two thousand and seven, who were in their
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  Speaker 4: early twenties, dancing like crazy people, completely sober, and I
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  Speaker 4: remember thinking, Wow, I really think I can do this.
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  Speaker 4: And that really was the precipice for Charlie Health because
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  Speaker 4: we know that when you're in there with other people
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  Speaker 4: who look and sound like you, who you can hear
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  Speaker 4: the words me too.
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  Speaker 3: I've been there. I know what that's like.
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  Speaker 4: It's so healing, right, But when you're with other people
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  Speaker 4: who are perhaps very different than you, especially when you're
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  Speaker 4: struggling with things like trauma and things like you know,
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  Speaker 4: alcohol use, et cetera, you feel lonely and you feel othered.
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  Speaker 4: So that was sort of how things unfolded for me,
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  Speaker 4: sobriety wise.
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  Speaker 2: All right, So I want to dig into Charlie Health
• 10:20
  Speaker 2: and how that started, but first, so elaborate more on
• 10:26
  Speaker 2: what it was like and how it helped you realizing
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  Speaker 2: being with these like peoplelike people like like minded people
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  Speaker 2: or your age group. What was talk to us about
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  Speaker 2: that more?
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  Speaker 4: Yeah? I mean, so when I was with like these
• 10:45
  Speaker 4: fourteen year olds who likely will never be able to
• 10:49
  Speaker 4: necessarily like use drugs or alcohol again because they were
• 10:53
  Speaker 4: using heroin and like they were detoxing, and they were
• 10:57
  Speaker 4: so dependent on their parents. And then to be with
• 10:59
  Speaker 4: these four year olds who had lost their children or
• 11:02
  Speaker 4: their husbands for like, for this it was so like, ugh,
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  Speaker 4: like I don't even know where how that feels, you know,
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  Speaker 4: round peg, square hole, And so to be with these
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  Speaker 4: twenty year olds, like for me, I just I wanted
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  Speaker 4: to just have fun, and it was hard for me
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  Speaker 4: to imagine a world where.
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  Speaker 3: I'm in my early twenties.
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  Speaker 4: I'm not even like I I celebrated my twenty first
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  Speaker 4: birthday sober, you know, and what did I do that day?
• 11:29
  Speaker 4: I went skydiving in the morning, and then I went
• 11:31
  Speaker 4: to Atlantic City to gamble that night, you know. And
• 11:35
  Speaker 4: it just is like that was like what I wanted.
• 11:37
  Speaker 4: I wanted to feel the feeling of being able to
• 11:40
  Speaker 4: have fun early in your twenties, and everybody around me
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  Speaker 4: wanted that feeling too, Whereas the forty year olds would
• 11:47
  Speaker 4: have no interest, right, like that's not what's something that
• 11:49
  Speaker 4: they have to put together their family. So what I
• 11:52
  Speaker 4: thought too was really neat was when I ended up
• 11:56
  Speaker 4: with these.
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  Speaker 3: Girls in this halfway house.
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  Speaker 4: I also would talk to them a little bit about
• 12:01
  Speaker 4: my story, and they would share very similar sentiments, whether
• 12:04
  Speaker 4: it was that they were but bullied, right, like the
• 12:07
  Speaker 4: feeling of bullied and the feeling of I have a
• 12:09
  Speaker 4: learning disability and I can't read and other people, you know,
• 12:12
  Speaker 4: those are very similar feelings. So I was able to
• 12:15
  Speaker 4: really relate to them, and that made me feel less
• 12:17
  Speaker 4: alone and connected.
• 12:19
  Speaker 2: All right, so let's talk about Charlie health. Where were you?
• 12:23
  Speaker 2: How did that come about?
• 12:26
  Speaker 3: Yeah?
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  Speaker 4: So I decided to go into the career of social work.
• 12:37
  Speaker 4: It was after I had taken an elective essentially at
• 12:42
  Speaker 4: a college and I just loved it. I thought that
• 12:46
  Speaker 4: it was really neat, and the idea that I would
• 12:49
  Speaker 4: going at my master's or like even today, I'm like,
• 12:51
  Speaker 4: I have a doctorate, Like does anybody know that? How
• 12:54
  Speaker 4: did I do that? Like I must have tricked somebody
• 12:57
  Speaker 4: out there, you know, But like the idea of like
• 13:00
  Speaker 4: going to get my masters, etc.
• 13:02
  Speaker 3: It was just so it was so overwhelming.
• 13:05
  Speaker 4: And when I decided to put my mind to it
• 13:08
  Speaker 4: and do it, which being the person that's too much
• 13:10
  Speaker 4: and a little bit more of that like Founder Energy,
• 13:14
  Speaker 4: I ended up going and doing this and seeing in
• 13:18
  Speaker 4: social work so much is about how can you fight
• 13:23
  Speaker 4: systemic issues that are impacting those who need and are
• 13:28
  Speaker 4: desperate for mental health treatment. And it made me incredibly
• 13:32
  Speaker 4: you know, focused on marginalized populations.
• 13:36
  Speaker 3: The jobs that I happened to get after that, however,
• 13:39
  Speaker 3: were that of.
• 13:40
  Speaker 4: Commercial insurance, and were that of these programs that only
• 13:45
  Speaker 4: had a certain number of spots in them and therefore
• 13:48
  Speaker 4: had waitless so it was not affordable and not accessible.
• 13:55
  Speaker 4: One of the programs that I built, which you mentioned
• 13:57
  Speaker 4: at the beginning, is this program called Center for Families,
• 13:59
  Speaker 4: and that program was incredible, but again wait list and
• 14:03
  Speaker 4: you owed a lot of money oftentimes, right you had
• 14:06
  Speaker 4: these max out of pockets and we only take commercial
• 14:08
  Speaker 4: and and I loved running it, and I wanted something more.
• 14:14
  Speaker 4: When we had.
• 14:17
  Speaker 3: COVID. What happened was I.
• 14:20
  Speaker 4: Transitioned and I had several of these like Center for
• 14:22
  Speaker 4: Families and outpatient programs throughout the country over from being
• 14:26
  Speaker 4: in person to virtual overnight.
• 14:28
  Speaker 3: It was like twenty four.
• 14:30
  Speaker 2: If you created this, you founded that too.
• 14:35
  Speaker 4: Yeah, it was part of a bigger program, but yes,
• 14:37
  Speaker 4: like found was able to start up a couple of
• 14:40
  Speaker 4: those those sites.
• 14:41
  Speaker 2: Yeah, Jesus.
• 14:44
  Speaker 4: So when COVID hit, we I remember ending up like
• 14:49
  Speaker 4: crying myself to sleep.
• 14:50
  Speaker 3: I mean, you remember what this was like. It was
• 14:52
  Speaker 3: like so scary.
• 14:53
  Speaker 4: Everybody was so terrifying, And I thought, tomorrow's the day
• 14:57
  Speaker 4: that I'm not going to have any of our clients
• 14:59
  Speaker 4: are going to to show up. There's no way that
• 15:01
  Speaker 4: they're going to jump onto a zoom for five hours.
• 15:03
  Speaker 4: Like it's just not happening. Now, I've hired all of
• 15:06
  Speaker 4: these people, and the people that I hire, I'd consider
• 15:08
  Speaker 4: them to be my family.
• 15:09
  Speaker 3: I mean, these are people that.
• 15:10
  Speaker 4: Like I've convinced to join and and now here I am,
• 15:13
  Speaker 4: and I'm gonna have to lay them off. I've got
• 15:14
  Speaker 4: all this fear. I'm filled with fear going to sleep.
• 15:18
  Speaker 4: And we opened up the zoom and we had one
• 15:21
  Speaker 4: hundred percent participation, one hundred percent, and.
• 15:25
  Speaker 3: We had better outcomes.
• 15:26
  Speaker 4: Over several weeks, I started to see that the outcomes
• 15:29
  Speaker 4: were changing.
• 15:29
  Speaker 3: Why were they changing.
• 15:30
  Speaker 4: Because we solely treated adolessence and parent participation in treatment
• 15:35
  Speaker 4: is the single largest indicator for positive outcomes. But parents
• 15:39
  Speaker 4: don't show up to treatment. Why because of shame and blame,
• 15:43
  Speaker 4: but also because of inaccessibility. I might have two jobs,
• 15:47
  Speaker 4: I can't do it. But what we would do is
• 15:49
  Speaker 4: we would say, hey, guy, is mom around And Guy
• 15:52
  Speaker 4: would say, yeah, Mom's around, she's in the next room.
• 15:54
  Speaker 4: Because it's COVID and we're all in the freaking house, right,
• 15:57
  Speaker 4: we're all doing work from home. And mom would step
• 16:00
  Speaker 4: and I would say, hey, guy hurt himself last night.
• 16:03
  Speaker 4: I wanted to let you know, is there any way
• 16:05
  Speaker 4: that you can help us to remove the sharp knife
• 16:07
  Speaker 4: whatever it is that's going on in his home, so
• 16:11
  Speaker 4: you know, and oh my gosh, changed outcomes tenfold. And
• 16:15
  Speaker 4: suddenly I realized and this was the key. You know
• 16:18
  Speaker 4: that we always like talk about this idea of Pennsylvania
• 16:21
  Speaker 4: and how we have Philadelphia, we have Pittsburgh, right, and
• 16:24
  Speaker 4: we have like this in between section and that in
• 16:27
  Speaker 4: between section is there's no quality treatment there. I mean,
• 16:32
  Speaker 4: these adolescents think to yourself, the nearest school is an
• 16:36
  Speaker 4: hour away, the nearest emergency room is two hours away.
• 16:39
  Speaker 4: I mean, it's horrible, you're just And I remember admitting
• 16:43
  Speaker 4: a client and I could cry talking about this. We
• 16:45
  Speaker 4: admitted a client who had been in and out of
• 16:47
  Speaker 4: a psychiatric unit major trauma. You couldn't even imagine horrible trauma,
• 16:52
  Speaker 4: has never seen a therapist that's like, has ever seen
• 16:56
  Speaker 4: a therapist consistently, And we admitted him and we were
• 17:00
  Speaker 4: able to take them because we were virtual and it
• 17:02
  Speaker 4: was COVID, and I just remember thinking, this is it,
• 17:06
  Speaker 4: this is the answer. You want to help systemically solve
• 17:09
  Speaker 4: all of mental health across the country.
• 17:11
  Speaker 3: You turn it virtual.
• 17:13
  Speaker 4: You give individuals the access that they deserve to have
• 17:18
  Speaker 4: high quality treatment, high quality group therapy where they can
• 17:21
  Speaker 4: see other people who look and sound like them, that
• 17:24
  Speaker 4: they can hear the words me too. And we make
• 17:26
  Speaker 4: it so that way it's affordable. We take Medicaid, and
• 17:29
  Speaker 4: we take commercial insurance, and we take everything we have
• 17:34
  Speaker 4: a right now, we have a grant arm at Charlie
• 17:37
  Speaker 4: Health where if you don't have insurance, we're going to
• 17:38
  Speaker 4: make sure that you can get in. So that's how
• 17:42
  Speaker 4: it started. It started with that and me calling my
• 17:44
  Speaker 4: co founder Carter, who I was working with at the time,
• 17:47
  Speaker 4: and saying, you know, I think.
• 17:48
  Speaker 3: We got to do this. I think that this would
• 17:50
  Speaker 3: really help a lot.
• 17:53
  Speaker 2: And you treat adolescents specifically, So.
• 17:58
  Speaker 4: We started by treating adolescens and young adults. Today we
• 18:04
  Speaker 4: treat eight to sixty four. Okay, so we really kind
• 18:08
  Speaker 4: of helped we broaden that that range pretty significantly, And
• 18:13
  Speaker 4: a lot of that was all based on need. We
• 18:15
  Speaker 4: were getting parents that were calling us that We're saying,
• 18:17
  Speaker 4: I have a nine year old and I have nowhere
• 18:18
  Speaker 4: to send them, and we're like.
• 18:20
  Speaker 3: All right, we're going to do this.
• 18:21
  Speaker 4: We need to do it because this is what's needed
• 18:23
  Speaker 4: across the country.
• 18:24
  Speaker 2: You know, let's just for the time purposes here, let's
• 18:30
  Speaker 2: focus on the adolescence because I happen to love that
• 18:33
  Speaker 2: group population. What is your philosophy on how you work
• 18:38
  Speaker 2: with them? How you when you started this, what did
• 18:41
  Speaker 2: you think or feel needed to be incorporated into treatment
• 18:45
  Speaker 2: for them?
• 18:47
  Speaker 4: Yeah, adolescence is also my favorite.
• 18:51
  Speaker 3: It's my passion.
• 18:53
  Speaker 4: I love them so much, mainly because they're very malleable, Right,
• 18:58
  Speaker 4: You're able to really make some true ching is, especially
• 19:00
  Speaker 4: with their parents if their parents are engaged. So the
• 19:04
  Speaker 4: first thing that I think of whenever I think of
• 19:06
  Speaker 4: treating adolescence is getting them out of their heads and
• 19:09
  Speaker 4: into their bodies.
• 19:11
  Speaker 3: So what does that look like? It looks like saying
• 19:13
  Speaker 3: to them, let's go for a walk.
• 19:14
  Speaker 4: Why don't you go ahead and put in headphones and
• 19:17
  Speaker 4: we can go for a walk. It looks like, let's
• 19:19
  Speaker 4: talk a little bit about where that feeling is in
• 19:21
  Speaker 4: your body. It looks like, hey, why don't we talk
• 19:24
  Speaker 4: a little bit more about how we can do a
• 19:26
  Speaker 4: yoga pose or a box breathing.
• 19:29
  Speaker 3: And that for us.
• 19:31
  Speaker 4: At Charlie Health, we call that our integrative hour where
• 19:34
  Speaker 4: we have music therapy and art therapy and yoga therapy,
• 19:38
  Speaker 4: and really it's focused on this idea of how can
• 19:43
  Speaker 4: we start to help individuals sort of step away from
• 19:50
  Speaker 4: dissociating from their body. Right, So much of the work
• 19:53
  Speaker 4: that we do as trauma work where you're trying to
• 19:56
  Speaker 4: individuals are oftentimes trying to separate themselves from their body,
• 20:00
  Speaker 4: and so it's like, how can we integrate that? And
• 20:03
  Speaker 4: that's really the first thing that comes to mind. The
• 20:05
  Speaker 4: second is, you don't have family therapy with an adolescent.
• 20:10
  Speaker 3: You're you're in a situation.
• 20:11
  Speaker 4: Where you're not going to have great outcomes unfortunately. So
• 20:14
  Speaker 4: the goal is to encourage the family to show up
• 20:17
  Speaker 4: as much as possible.
• 20:20
  Speaker 2: And of course that family could be many things or
• 20:23
  Speaker 2: defined many ways.
• 20:24
  Speaker 3: Right, definitely.
• 20:25
  Speaker 2: Yeah, So Okay, so this getting into the body family therapy,
• 20:32
  Speaker 2: what other aspects are important in your mind for them?
• 20:36
  Speaker 4: Yeah, Like I said, I think that loneliness is the
• 20:41
  Speaker 4: biggest epidemic that we have throughout the country. It's what
• 20:47
  Speaker 4: oftentimes leads to suicide, it's oftentimes what leads to depression,
• 20:52
  Speaker 4: it's oftentimes what leads to anxiety. So the big question
• 20:55
  Speaker 4: for us has always been how can we increase connection
• 21:00
  Speaker 4: to other human beings. So many adolescents are feeling an
• 21:05
  Speaker 4: incredible amount of loneliness and what there's this big sort
• 21:10
  Speaker 4: of paradox right, which is but they're on social media,
• 21:13
  Speaker 4: so they're connecting so much to influencers and to other people. Well,
• 21:16
  Speaker 4: actually that's increasing the loneliness in a lot of ways.
• 21:21
  Speaker 4: And so a big part of what we do at
• 21:24
  Speaker 4: Charlie Health is we match all of our clients to
• 21:29
  Speaker 4: different groups that are specific for them, where that's running
• 21:32
  Speaker 4: the right curriculum for them, but it's with the right peers,
• 21:35
  Speaker 4: and it's with an individual facilitator who's the right.
• 21:38
  Speaker 3: Fit for them.
• 21:39
  Speaker 4: And we do that based on the one hundred thousand
• 21:42
  Speaker 4: other clients that we've treated, so we're able to archetype
• 21:46
  Speaker 4: them and put them into groups so that way they
• 21:47
  Speaker 4: feel less alone.
• 21:49
  Speaker 2: So is that like a mentor relationship.
• 21:52
  Speaker 4: So all of our yeah, I mean you could look
• 21:55
  Speaker 4: at it in that way because a lot of our
• 21:57
  Speaker 4: groups are made up of individuals who have been at
• 22:00
  Speaker 4: Charlie Health for a few weeks and then people who
• 22:02
  Speaker 4: just came in. So there is a little bit of
• 22:05
  Speaker 4: mentorship that can happen there for sure, But our groups
• 22:08
  Speaker 4: are really about, you know, this idea of taking six
• 22:11
  Speaker 4: individuals and putting them into a group where they can
• 22:14
  Speaker 4: have a shared experience and they can talk about what
• 22:18
  Speaker 4: it is that they've been through, how they've gotten through it,
• 22:21
  Speaker 4: or how they have not gotten through it. And here
• 22:23
  Speaker 4: again those words just me too, I know it. That's
• 22:26
  Speaker 4: like when I did that, this is what I did,
• 22:28
  Speaker 4: and this is what worked, you know, and being able
• 22:31
  Speaker 4: Also a big part of groups is about put the
• 22:34
  Speaker 4: pulling portion. So it would be like, hey, guy, you
• 22:36
  Speaker 4: mentioned that you were going to talk to your mom
• 22:37
  Speaker 4: about something serious last night.
• 22:39
  Speaker 3: How did that go?
• 22:40
  Speaker 4: And I will tell you that intervention can be so
• 22:45
  Speaker 4: key for a person who thinks I'm going to end
• 22:47
  Speaker 4: my life and nobody will notice, and now you have
• 22:50
  Speaker 4: somebody in group noticing you.
• 22:52
  Speaker 2: Huge like accountability almost exactly. Yeah. Yeah, So bigger picture,
• 23:03
  Speaker 2: Charlie health is what type of treat How long is
• 23:06
  Speaker 2: the treatment? Obviously not impatient? Yeah, or do you have
• 23:10
  Speaker 2: an impatient.
• 23:11
  Speaker 4: No, it sits between in patient and outpatient. So it's
• 23:16
  Speaker 4: something called intensive outpatient programming and a lot of people
• 23:20
  Speaker 4: don't know about it, which is so sad because it's
• 23:23
  Speaker 4: really there's a huge dearth of this across the country
• 23:26
  Speaker 4: where essentially, and I just want you to think about this, guys, Sorry,
• 23:29
  Speaker 4: I have to go into a tangent for one minute.
• 23:31
  Speaker 2: No, I love it.
• 23:32
  Speaker 4: Imagine for a moment that you get into a car
• 23:34
  Speaker 4: accident and you are in the ICU. You would step
• 23:39
  Speaker 4: down from the ICU to the hospital. Then you would
• 23:42
  Speaker 4: go from the hospital down.
• 23:43
  Speaker 3: To a rehab.
• 23:44
  Speaker 4: Then your rehab would take you down to a physical
• 23:46
  Speaker 4: therapist where you would go seven days a week, then
• 23:48
  Speaker 4: six days a week, then five days a week, right,
• 23:51
  Speaker 4: and they would be following your symptoms. We don't do
• 23:55
  Speaker 4: that at all in mental health care, not even a little.
• 23:59
  Speaker 3: What do we do have?
• 24:00
  Speaker 4: Somebody who goes into a psych unit and then they
• 24:04
  Speaker 4: may or may not end up in a partial or
• 24:06
  Speaker 4: an IOP and then they go down to once a
• 24:08
  Speaker 4: week therapy.
• 24:10
  Speaker 3: It's crazy.
• 24:11
  Speaker 4: I mean in one day, imagine for a minute that
• 24:14
  Speaker 4: you were in the ICU and the doctor came in
• 24:16
  Speaker 4: and he pulled out your like your IV and pulled
• 24:18
  Speaker 4: out your breathing tube and was like okay, So in
• 24:21
  Speaker 4: one week from now, a nurse will visit you for
• 24:23
  Speaker 4: one hour and you're.
• 24:24
  Speaker 3: Like, I'm sorry, what, Like, it's unacceptable.
• 24:27
  Speaker 4: So Charlie Health is trying to solve that continuum of
• 24:30
  Speaker 4: care issue and allow it so that way, if somebody
• 24:33
  Speaker 4: is in a psychiatric unit, they can come to Charlie
• 24:36
  Speaker 4: Health and appropriately step down it's about ten to twelve weeks.
• 24:40
  Speaker 4: And if they're in an outpatient program, which there are
• 24:43
  Speaker 4: so many outpatient therapists that have a client that they're like.
• 24:45
  Speaker 3: I don't want to send in the emergency room.
• 24:47
  Speaker 4: That's traumatizing, it will be horrible, you know, And I
• 24:51
  Speaker 4: know that they need more than once a week therapy,
• 24:53
  Speaker 4: they can step them up to Charlie Health.
• 24:57
  Speaker 2: You know, imagining people me, You're amazing, and I'm listening.
• 25:02
  Speaker 2: I'm imagining people listening to this and going, I want
• 25:06
  Speaker 2: to work for this woman. What type of people do
• 25:08
  Speaker 2: you do you hire? What do you look for?
• 25:13
  Speaker 4: So the first thing that came to my brain was flexibility.
• 25:16
  Speaker 4: It's the number one thing, right.
• 25:18
  Speaker 3: Because here's the deal.
• 25:19
  Speaker 4: We're trying to redefine what mental health treatment looks like
• 25:23
  Speaker 4: in this country. So what that means is if somebody
• 25:26
  Speaker 4: comes in and rigidly is like, well, wait a minute.
• 25:29
  Speaker 4: Individual sessions are supposed to be one hour, but I
• 25:31
  Speaker 4: need you to go an hour and a half with
• 25:33
  Speaker 4: a client because this is a client that's really traumatized
• 25:35
  Speaker 4: and they have a lot going on. We're going to
• 25:37
  Speaker 4: ask you to do that and you have to be
• 25:39
  Speaker 4: okay with that, right. So I think flexibility is something
• 25:43
  Speaker 4: that I look a lot for. I love therapists who
• 25:48
  Speaker 4: are really open to like learning.
• 25:52
  Speaker 3: Right.
• 25:52
  Speaker 4: We have all these different learning platforms at Charliehealth, so
• 25:56
  Speaker 4: we have like at least four hour and a half
• 25:58
  Speaker 4: long trainings every month. I mean, we just have some crazy,
• 26:01
  Speaker 4: really cool things that we do. We have something called
• 26:03
  Speaker 4: Charlie Theater where we do role plays, and Charlie University
• 26:07
  Speaker 4: where we like, you know, present research is very cool.
• 26:11
  Speaker 4: So I love having therapists who are flexible, who are
• 26:14
  Speaker 4: willing to learn. And then I really, you know, and
• 26:18
  Speaker 4: I'm not just saying this because I'm on this podcast,
• 26:20
  Speaker 4: but we need it. We do a screening around being
• 26:24
  Speaker 4: trauma informed, right, It's something that's crucial to the work
• 26:27
  Speaker 4: that we're doing. These are very high acuity individuals. These
• 26:31
  Speaker 4: are individuals that are coming with very high depression scores,
• 26:34
  Speaker 4: very high anxiety frequently, are suicidal frequently, have major substance
• 26:38
  Speaker 4: use issues, and we're taking all of them.
• 26:41
  Speaker 3: Which is like a little risky, right.
• 26:43
  Speaker 4: We want to make sure that people are feeling good
• 26:45
  Speaker 4: about that risk as well, and we want to make
• 26:48
  Speaker 4: sure that they're really trained and skilled and feel prepared
• 26:50
  Speaker 4: to go into it.
• 26:52
  Speaker 2: As we kind of wind down here, Caroline, I mean again,
• 26:56
  Speaker 2: you exude this passion, But what do you feel you're
• 27:02
  Speaker 2: bringing to this work? You just said we want to
• 27:06
  Speaker 2: redefine mental health in this space. What are you bringing
• 27:12
  Speaker 2: to this? Is it your passion? Is it this flexib
• 27:17
  Speaker 2: But what is it?
• 27:19
  Speaker 3: What am I bringing or what is Charlie Health bringing you?
• 27:21
  Speaker 2: You first, you me?
• 27:26
  Speaker 4: The first thing that comes to mind for me is
• 27:29
  Speaker 4: is I bring a very intense passion and open mindedness
• 27:34
  Speaker 4: to how we can utilize data science and how we
• 27:38
  Speaker 4: can utilize AI to help individuals to get the care
• 27:43
  Speaker 4: that they need.
• 27:45
  Speaker 3: And I think.
• 27:45
  Speaker 4: That that for me, And obviously this is only something
• 27:49
  Speaker 4: in the past couple of years, but ultimately, when I
• 27:53
  Speaker 4: think about how I can help to move the needle forward,
• 27:56
  Speaker 4: I think about how can we do this at scale?
• 27:59
  Speaker 3: Right?
• 27:59
  Speaker 4: Like, how can we actually help every single person we
• 28:02
  Speaker 4: say Charlie's throughout the world, like people who are struggling,
• 28:06
  Speaker 4: and we say our clients are all Charlie.
• 28:08
  Speaker 3: So how can I help.
• 28:09
  Speaker 4: Every single Charlie throughout the country who is struggling today?
• 28:14
  Speaker 4: At scale? And I think that what I bring is
• 28:17
  Speaker 4: that idea of big picture motion and how do we
• 28:22
  Speaker 4: scale with the with the data that we have implementing
• 28:25
  Speaker 4: AI to ensure that we're doing it efficiently.
• 28:29
  Speaker 3: Does that make sense?
• 28:30
  Speaker 2: It does? I love it. I mean it feels correct
• 28:33
  Speaker 2: me if I'm wrong, But we'll let me ask you this.
• 28:37
  Speaker 2: Does Does this come from when you had your own
• 28:41
  Speaker 2: experiences getting healing?
• 28:46
  Speaker 3: Yeah?
• 28:47
  Speaker 4: I mean I think every person that works at Charlie Health,
• 28:51
  Speaker 4: every person I think that's in this field. Frankly, it's
• 28:55
  Speaker 4: either them or it's a family member or a friend
• 28:57
  Speaker 4: that get into this. But my experience with feeling like
• 29:02
  Speaker 4: a fish out of water from the moment that I
• 29:05
  Speaker 4: walked into first grade until the moment that I ended
• 29:09
  Speaker 4: up in two rehabs, until the moment that you know
• 29:13
  Speaker 4: that I ended up in a doctorate program, sober, but
• 29:17
  Speaker 4: feeling like what.
• 29:18
  Speaker 3: Am I doing here? Why did these people really? That feeling?
• 29:22
  Speaker 4: I want to decrease for every single Charlie throughout the country,
• 29:26
  Speaker 4: because that's not a feeling that we should ever have
• 29:28
  Speaker 4: to feel. We should be able to feel like we're
• 29:30
  Speaker 4: part of our tribe, like we have found the people
• 29:33
  Speaker 4: that we love and that care about us just for
• 29:35
  Speaker 4: who we are, not for what we do, but for
• 29:37
  Speaker 4: who we are, and that's my ultimate you know goal there.
• 29:44
  Speaker 2: Awesome, Caroline, You're amazing. I mean you are, Seriously, it's
• 29:50
  Speaker 2: it's you're so freaking inspiring. Seriously, Jesus, how.
• 29:55
  Speaker 3: Do people.
• 29:58
  Speaker 4: Yeah, Charlie how at the dot com? And Caroline Finkel,
• 30:03
  Speaker 4: I don't know there's LinkedIn?
• 30:04
  Speaker 3: I think you Okay, okay.
• 30:07
  Speaker 2: We'll have all those linked up here at the show
• 30:09
  Speaker 2: notes page at the Trauma Therapist to podcast Pounds dot com.
• 30:12
  Speaker 2: Love to have you back at a later date, but
• 30:15
  Speaker 2: thank you. You know what it is you know what
• 30:17
  Speaker 2: it is, Caroline. It's you coming on here and being
• 30:20
  Speaker 2: willing to share your story and be vulnerable. People not
• 30:27
  Speaker 2: only connect with that, but it inspires them so many ways.
• 30:33
  Speaker 2: So and not everyone does that. So I appreciate, appreciate you.
• 30:38
  Speaker 3: Thank you, guys. This was This was lovely.
• 30:40
  Speaker 4: I love spending time with you.
• 30:42
  Speaker 3: Let's get it again.
• 30:42
  Speaker 2: In touch, Take care,