Lyn Lake Psychotherapy & Wellness’s Drop-In Program: A Low Barrier, Free Service to the Community

Every Wednesday from 1-3 pm, individuals trickle into the small waiting room at Lyn Lake Psychotherapy and Wellness’s Lyndale Ave and Lake St. location.  Some of them have forms in their hands that require a signature.  Some of them are there just to talk to someone.

The difference between these clients and others who show up in Lyn Lake’s waiting room is that these individuals have no appointment.  They come in to make use of Lyn Lake’s free drop-in program.  And the therapists that work with them are taking time out of their day to do so on a volunteer basis.  Since November 2018, when the drop-in program began, Lyn Lake Psychotherapy and Wellness has served 81 people.

“We are trying to create low barrier access to good quality mental health care” states Jade Erickson, a therapist at Lyn Lake and the founder of the drop-in program.  There are many forms and barriers to accessing health insurance, good health care and housing.  We wanted to have a program where those who do not have insurance or who have difficulty getting to structured appointments can have a good experience in seeking mental health assistance and to have help accessing housing, Jade explains.

Many individuals that utilize the drop-in program are seeking housing or hoping to stay in subsidized housing.  In order to get funds for housing and living expenses, required forms need to be filled out and signed by a licensed health professional.  Lyn Lake makes it easy for those seeking services to jump through the hoops and complete the necessary forms.

However, not all that use the drop-in services are experiencing homelessness.  Many people come who are uninsured, or who just need someone to talk to.  Volunteers at LynLake will provide brief therapy and often many of these people will continue as long-term clients.

Research has shown that having a positive experience with a healthcare clinic will result in a higher likelihood of that person accessing care in the future and increased positive outcomes. And because there are often barriers to getting help, many individuals without permanent housing and who have chronic psychiatric and/or physical conditions, have a tough time getting the help that they need.   Many times, people need an address to get a job, apply for health insurance and to gain access to healthcare.

Homelessness in Minnesota has been on the rise with a 10% increase since 2015.

In 2018, Wilder conducted over 4,000 interviews with adults and unaccompanied youth in temporary shelters and non-shelter locations such as encampments, and other drop in services.  Following are a summary of the findings.

• “More of the homeless population are living outside of formal shelters.
• African Americans, American Indians and youth who identify as LGBTQ are over-represented amount the homeless population.
• Nearly 30% are employed
• The majority have a chronic mental or physical condition.
• Homelessness is often associated with adverse childhood conditions.
• Violence and abuse often continue over the lifetime especially among women who experience homelessness.
• And the availability of affordable housing is a critical issue.”

When I asked whether the basic mission for the program was connected to helping these clients become more self-sufficient, Jade corrected me and said, self sufficiency was a subjective term.  No one can determine what that means for someone else.  The drop-in clinic was created because “housing and healthcare are basic human rights,” adds Jade.  The drop-in program reflects this underlying mission by creating low/no barriers to assist individuals who are experiencing homelessness with the process of getting housing. Affordable housing is at such a crisis that many cities such as Minneapolis and St. Paul are forming long term plans to address this issue.  Studies have shown that housing is integral to positive outcomes in health and mortality for this population.

“We all walk around and we forget that everyone has their own journey”, Jade explains.  It is so easy for many of us to shove the issue of homelessness aside because many of these individuals live in the shadow of our awareness: we often do not have direct connection to individuals who are experiencing homelessness.

Even our language describing the challenges they face can be problematic.  For example, I was gently corrected when I used the term, “the homeless” instead of “people who are experiencing homelessness”: an important difference in language if you think about it.  One where the former labels those individuals as if their housing situation is their whole identity compared to a temporary challenge they are experiencing.  They, of course, are human beings first.  And through the lens of viewing each person as unique individuals, they have their own stories.

Resources

1. HousingLink-https://www.housinglink.org/
2. Minnesota Department of Human Services-https://mn.gov/dhs/partners-and-providers/program-overviews/housing-and-homelessness/
3. Community Emergency Assistance Program-http://www.ceap.org/wp-content/uploads/2014/10/CEAP-Resources-Homelessness.pdf
4. Hennepin County: Coordinated Entry Homeless Assistance-https://www.hennepin.us/coordinated-entry
5. Adult Shelter Connect-https://www.simpsonhousing.org/adult-shelter-connect-simpson-shelter/

Articles

1. “A Systematic Review of Evidence on the Links Between Patient Experience and Clinical Safety and Effectiveness”. Doyle, Cathal, Lennox, Laura, Bell, Derek. BMJ Open Journal Vol 3 Issue 1 (2013). https://bmjopen.bmj.com/content/3/1/e001570
2. Wilder Research-Minnesota Homeless Study 2018. http://mnhomeless.org/minnesota-homeless-study/homelessness-in-minnesota.php
3. “Characteristics and Trends Among Minnesota’s Homeless Population: Initial Findings from Face-to-Face Interviews Conducted in 2018. http://mnhomeless.org/minnesota-homeless-study/reports-and-fact-sheets/2018/2018-homeless-characteristics-fact-sheet-5-19.pdf
4. “How Health and Homelessness are Connected-Medically” Hayashi, Seiji. The Atlantic Monthly. (Jan. 25 2016). https://www.theatlantic.com/politics/archive/2016/01/how-health-and-homelessness-are-connectedmedically/458871/

Gratitude + Mourning = Happiness?

Author: Sharon Burris-Brown

“Both mourning and gratitude are daily necessities to lead a healthy life” Pam Winthrop Lauer

I heard this quote today in a workshop and of all the content I heard there, I found that this statement gave me the most pause as food for thought.   In Positive Psychology, the attitude of gratitude is a major tool to increase the ratio of positive thoughts to negative ones.  Positive Psychology believes that you can retrain your brain to boost your happiness quotient and one of those strategies is to learn the discipline of expressing gratitude each day.

The magic of living a life filled with gratitude has been widely discussed—in self-help books, in blogs, on Facebook.

However, creating a daily practice of mourning has not.  We mourn when we experience a loss, but who wants to intentionally go back to those losses in our lives to evoke mourning and sadness on a daily basis?  I can tell you that in my therapy office, my clients are looking to avoid feeling sad—at all costs.  It is even challenging for us to allow ourselves to mourn when we do experience a clear loss.  Our culture pressures us to put our sadness aside so we can be productive.

So, is adding mourning to your daily practice of gratitude a happiness booster?  Well…maybe not—if your belief is that happiness means getting rid of challenging emotions.

Mourning

Most of us know that mourning is sadness and grief about the death of a loved one. However, I see this as a limited definition.  I see complicated grief in almost every client I see.  And many may not have had a death to contend with.  There are so many losses small and large that we all face.  From not getting the mark on a test we hoped for to losing a family member—whether it be from death or from abandonment.

You may say, the poor grade is not something to mourn about, it is simply a disappointment.  But who can tell someone else that this is not significant in their world of losses especially if they have not had to experience and handle losses in the past. This experience may feed into worry about self-identity and fear that future opportunities may be closed off because of a poor grade.

Mourning is really about the loss of or fear of the loss of a specific future or a sense of self as much as sadness about the loss of a particular individual. And we can grieve about something that was never experienced—such as having a warm, trusting and loving relationship with a parent and/or sibling.

Complex Grief

When loss piles on top of loss, unaddressed grief can grow large and become the primary issue.  Many of us place a time limit on our sadness and because the feelings are so uncomfortable, we push them away.  Our culture does this as well.  Friends and family may be attentive for a period of time, but then, after awhile, they move on.  Judgment from others can be directed towards us about long it is taking us to “snap out of it”.  Because we still feel all the feelings that come with mourning, we tell ourselves that there is something wrong with us.  We get angry and frustrated at ourselves. And the self-judgment and blame, over time, can turn inward and distort our perception of who we are.

So, mental health has a lot to do with what we acknowledge and allow into our day to day experience—such as those challenging feelings that can arise from accepting the losses in our lives.

Making Mourning a Daily Practice

We all have feelings that come up every day.  We may not connect our emotions to mourning a loss, but underneath it all, when we have intense reactions to situations, there is usually a loss somewhere in the background.  It could be a need that is not being met or had not been met when we were young that is impacting our lives and our reactions now.

Check in with yourself.  Make times during the day to check in to how you are feeling.  It takes 30 seconds.

Observe. Simply notice the feelings that come up without trying to control, push away or judge them.  Pretend that you are watching yourself and observe any feelings or thoughts.

Connect to Your Body. Notice where the feeling is in your body.  Get to know the physical language of your emotions.

Name it. Simply name your feelings.

Get Curious.  What might be behind your feelings?  Notice when you are feeling self-judgment too.  If you are used to beating yourself, those negative thoughts will come up.  This is part of your process too.  And often, the tendency to criticize your feelings is a symptom of complex grief.

So many of us equate happiness with the belief that we need to feel joy, contentment and uplifting feelings all the time.  Self-help books discuss how optimistic people who can see all experiences from a positive spin are healthier and more successful.  We are inundated with messages of how to be happy so it is no wonder that people feel threatened with challenging emotions that arise.  And they are uncomfortable to experience!  However, what I see in my therapy room are individuals who have had to push aside their sadness and grief and are now realizing that they are unable to feel joy either.  They have numbed out.

In reality, having a rich, satisfying life means becoming friends with discomfort.  We can’t have the joy without accepting that life is full of losses and, consequently, all of the sadness, anger, confusion that will come up from our grief.

Articles

1. https://www.health.harvard.edu/healthbeat/giving-thanks-can-make-you-happier
2. https://www.scientificamerican.com/article/shades-of-grief/

Seeking Therapy? How to Get Started

The other week, my husband and I were invited to dinner with some friends.  During the course of the discussion, they mentioned that all of their grown kids were either in therapy or considering it.  They wondered whether this was a parenting success or a parenting failure.  Both of them are in the mental health field.

The fact that going to therapy could be considered a parenting failure is an example that speaks to the question at the heart of this.  Does going to therapy equate failure somehow?  What I see in my office are people who come to an, often, reluctant conclusion that they just can’t deal with their troubles by themselves.  When the conclusion truly is—therapy is one resource they can employ to help them sort things out.  And that the ability to ask for help–taking time out for themselves for self-care—is an act of strength that they perhaps do not know they have.

As of 2016, 43% with any identified mental illness in the U.S. have not sought out services from a therapist in the past year. For those with serious and persistent mental illness, 64.8% sought out a therapist within that past year.

More and more of us have become savvy about doing our online research.  We search for what we think is wrong with us or for our diagnosis and we look into different treatments to determine what would be best.  But research really has shown that one of the most important factors for a positive outcome is the relationship between therapist and client, or the quality of the therapeutic alliance.

Finding a therapist with whom you feel comfortable and connected can be a barrier in it of itself.  Who wants to start over again and again until you find the right person? And when beliefs such as “I should be able to handle my problems myself” or “there must be something wrong with me if I need to talk to a therapist” may be circulating in the back of your mind, the process can seem daunting.

However, here are some steps that you can take before starting therapy and during the first couple of sessions that can get you started on the right foot.

Before the first session

Ask for a brief phone consultation so you can get a sense of how you might feel in the session with this therapist.  First impressions do not always match up, but you can determine whether a therapist is open to taking the time to talk to you.

Here are some questions to ask:

• What are the therapist’s credentials/ licenses?
• How much expertise does this therapist have in working with the issues you are experiencing?
• What are the therapist’s approaches to working with these issues and have they been proven effective?
• What are the fees and is the therapist an in-network provider for your insurance plan? Make sure you also check with your insurance because many providers can only give you an estimate of what is covered.

Therapy goals 

I have always heard, “start with the end in mind” when embarking on a large task.  Often, we come into therapy just knowing that we feel bad and we want to feel better.  We may not know why we feel lousy and how we can start to feel better.  And that is normal.  However, as a clinician, I always ask my clients what their therapeutic goals are and to help them expand and get clear on what feeling better looks like for them. However, the clearer you can be about what your goals are in therapy, the better.

Here are some questions you can ask yourself as you are getting started:

• What are your symptoms and how are they getting in the way of full functioning and thriving in your life?
• What would you like to be able to do in your life that you have a difficult time doing or are unable to do now?
• Imagine finishing therapy, how would you know that your therapy was successful? How would you know that you feel done?

What to expect from your therapist

The first few sessions are about getting to know you: how you see your life, your issues, your symptoms, your strengths–both your internal and external resources.  Your therapist should ask you about what you are hoping for from therapy and from the therapeutic relationship.  He/she/they may ask you about your past therapy experiences (if any) and what made them successful or not.

Your therapist may also initiate a conversation about the role of the therapist and mutual expectations.

Ultimately, you want your therapist to be a deep listener and to be able to get you.  You need to believe that your therapist, at the heart, understands you, has hope and faith in your ability to heal and grow even when you do not.

Take an active role

I let my clients know that I am led by them.  Their role is to come into therapy prepared to talk about what is important to them.  I also let my clients know that what happens in between sessions is more important than what occurs within our sessions.  My clients’ lives are where they experiment with new routines, push themselves a bit past their comfort zones and basically try things out that may help them move forward in their healing.

I feel honored when my clients share the details of their lives with me, feel safe enough to be vulnerable with me.   I take it seriously and I feel awed at the strength and resources I see in my clients every day.  Seeking therapy signifies some level of hope and trust that healing is possible. At some time in our lives, we all could use someone outside of our friends and family to sit beside us as we grieve, to bear witness to all that we have done to address our challenges and to help provide a wider lens with which to view our experiences.

Articles

1. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198542/
3. https://www.apa.org/helpcenter/choose-therapist