65. Therapy 101: Your Guide to Teen Treatment feat. Lindsay Fleming LPC
Today I am joined by Lindsay Fleming, LPC a Chicago-based therapist working to help individuals take baby-step their way to understanding & normalizing mental health.
Lindsay's TikTok: https://www.tiktok.com/@lindsay.fleminglpc
Lindsay's Instagram: https://www.instagram.com/lindsay_fleminglpc/
Lindsay's Website: https://www.lindsayfleminglpc.com/
Lindsay And I Cover The Following Topics…
+ Lindsay's path to becoming a therapist
+ Different types of therapy including inpatient, outpatient, IOP, PHP, and more!
+ How to know if therapy is right for you
+ What to expect when going to therapy for the first time and how to make sure your therapist is a good fit
+ Common things teens want support on in therapy and topics to consider discussing
+ So much more!
Mentioned In The Episode…
+ https://www.therapistaid.com/
+ https://www.additudemag.com/
Episode Sponsors
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🛋This week's episode is sponsored by Teen Counseling. Teen Counseling is an online therapy program with over 14,000 licensed therapists in their network offering support with depression, anxiety, relationships, trauma, and more via text, talk, and video counseling. Head to teencounseling.com/shepersisted to find a therapist today!
About She Persisted (formerly Nevertheless, She Persisted)
After a year and a half of intensive treatment for severe depression and anxiety, 18-year-old Sadie recounts her journey by interviewing family members, professionals, and fellow teens to offer self-improvement tips, DBT education, and personal experiences. She Persisted is the reminder that someone else has been there too and your inspiration to live your life worth living.
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Sadie: Welcome to she persisted. I'm your host Sadie Sutton. Every Friday, I post interviews about mental health dialectical behavioral therapy and teenage life. These episodes break down my mental health journey, teach skills to help you cope with life and showcase testimonials from individuals, including teens, just like you.
Whether you've struggled yourself or just want to improve your mental fitness. This podcast is your inspiration to live a life you love and keep persisting This week on she persisted.
This week's DBT scale is the fast scale. So when you're in an interpersonal interaction and you want to prioritize yourself to respect, maintain your own values, your views your opinion of yourself in that interaction, this is the skill you use. So this acronym stands for fair apology free. Stick to values and truthfulness.
So you stay fair to yourself. You don't over apologize for the situation, any emotions you're having. You are sticking to your values, whatever those are and you're being truthful to the situation. So doing these four things. Things allows you to maintain your values, maintain yourself, respect and not leave the interaction, feeling like you over compromised.
You let yourself get too far away from your original point of view. And the reason I'm choosing this skill is because when you are asking for help and getting support, you are looking out for your own mental health, your own self-respect, you are looking out for you. So this seemed perfect for this week.
So that is the fast scale. I will also link a longer episode all about the fast scale in today's description. So let's dive into it.
Hello everyone.
And welcome back to another episode of she persisted. If you're new here. Welcome. Hello, my name is Sadie. I'm an 18 year old from the bay area and a senior in high school, but I'm about to graduate next week. And I'm an incoming freshmen at the university of Pennsylvania where I'm going to be studying psychology to hopefully one day become a clinical psychologist.
So this episode is a really, really good one. This is your resource. If you are a teenager looking to explore therapy, understand it, better, know what your options are, educate yourself and kind of get a feel for what it's like.
So before we dive into this amazing, amazing episode, and I tell you a little bit more about the guests, we are going to do our Q and a. So first question is, tell me more about how animals helped in your treatment. So. If you'd asked me this about two years ago, when I was right in the middle of it, I would be like, I just miss my dog.
Like, that was all, that was the only impact of animals in my treatment. There was horse therapy at the therapeutic boarding school I attended, but I really wasn't that into it. I really thought that I just like, didn't like animals other than my own dog. And so in the past year, it's been really interesting.
I have become obsessed with dogs. Of course, just like everyone. I love my dogs, but I've really just enjoyed. Seeing other dogs around, out and about the sounds so weird as like approaching this, like it's a big confession that I liked dogs know. But yeah, I really have grown to like the physical comfort of animals and not ever gonna, I think go anywhere down like the rodent path, but dogs, cats are fine.
Love a good love, a good pet snuggle his whole answer that question. Next question. How are you feeling about being finished with high school? It has not hit me yet. I keep being like, oh, I have a couple more weeks of school. I have time to make up these assignments. No school's next week. My first final is, or graduation is next week.
My first final is tomorrow. Like the deadlines are coming up, people I was writing a little like article today for my friend. Who's interviewing me for our high school, like senior profiles and the newspaper at our school. And I was kind of had this moment where I was like, oh my gosh, like four years ago, I didn't think I was going to graduate high school.
Now, here I am. Going to the university of Pennsylvania. I have the podcast. I've not only gotten to graduation, but I've thrived in my life. Looks completely different. Like going into high school, I was so miserable. So depressed, struggling so much. So just looking at how much I've changed and I'm in the same spot.
Like I'm living in the same room that I was four years ago. My family is like the same. Like all of these sayings are identical to what they were like four years ago. And yet I've done all this incredible, amazing work to change my belief systems and my relationships and my mindset and my habits and my skills.
And it's just very surreal. So eight, it hasn't totally hit me yet. And I'm really excited. I'm really happy. I am ready for the summer. I have so many good things podcast wise. I just cannot wait for that. I haven't had the time to be able to dive into, because I've been really stressed out about school and finals.
So like I was doing daily tech talks that went down on my to-do list. I skipped an episode last week because school. Well, something that I really needed to focus on. Like all of these things are like just my schedule. I'm going to have so much more time to dive into these projects and creative things that I love.
And then moving to college and bring you guys bringing you guys along for all of that. And that segues right. Perfectly into the next question, which is when are you moving to college? And the answer is, let me look at my calendar.
So my move in day is August 25th. So that is a Wednesday. So maybe we'll go up like the day before just to make sure we can like have time to like go to CVS and get shampoo and all that kind of stuff. But that's when I'm moving. So. I'm going to bring you guys along on Instagram for all of the fun things like dorm room decorating, what I'm packing, what classes I'm taking.
I am positive that we'll do like a moving blog or a first week at Penn blog. Or even just like some kind of like short highlights. So you guys can see that process. But yeah, I'm really, really excited. The next question was, what universities did you apply to? So if you listened to my college applications episode, which I'll link in the description, I only applied to U Penn, UNC chapel hill and university of Oregon.
And I only heard back from university of Pennsylvania and university of Oregon because you, Penn was my early decision school. And so if you're familiar with the college application process, your early decision school is a binding offer. So if you get in You go there, you agree to withdraw all your other applications from other schools.
So I submitted my application for that in November and found out like end of December. So I didn't hear back from UNC yet because theirs came out in January. The normal deadline for college applications was like January that's when you submitted all of them. So I didn't get to apply to the rest of my schools, but I had a list of about 15 plus schools that I was planning to apply to had early decision not worked out for me.
So, yeah, and the last question is the thing you're most looking forward to moving to college.
Okay. All the things to be completely honest. My high school has been such a weird experience, three different high schools, three different States. COVID so all of the things were not normal during my high school experience. So being able to have a normal college experience cannot wait being in Philly.
Cannot wait. I already looked up so many amazing restaurants moving in and like having my parents had moved me and can't wait, decorating the dorm room. Can't wait. Like all of these things, I just am so excited for classes cannot wait to get back into the back to school mood and note taking and all of these things that I just really enjoy.
So really everything. I just cannot wait for it to happen and to be there. And, and again, we go back to these details of me feeling like. No. When I say insecure, it's not insecure about myself, but not like I have, like, I'm not like I'm out of control. That's what I mean. So like being like, what if I can't get everything for my dorm room and time, like that is what makes me nervous, which is such an odd, random thing.
So let me know if anyone else moving to college is having like weird anxiety is like that. But kind of proud of myself for like, recognizing that that's because I feel out of control and unsupported, but it's good that that's like how that's coming out and it's not like, I'm like, I'm on the other side of the country.
I'm out of control. It's like how I afford my body wash. And I'm, I'm working, I'm going to have a job. I'm doing social media management and college and podcast production assistant stuff. And so it's not like I'm going to college and. Not having a plan for this. It's just like those feelings make me nervous about having them.
Okay. With that being said, what an introduction folks,
you can expect a lot of me being all over the place. In this episode, I was so excited to record with Lindsay. So there was just like those nerves.
And there were so many things that I wanted to talk about and I was like, oh my gosh. Yes. Okay. Can relate to that. That was an amazing point. Now, can we follow up in three different directions? Like that was the vibe of this episode. I'm so just warning you, I. It it's a moment, but this week's guest is Lindsay Fleming.
You might recognize her from tick-tock and Instagram. She has her BA in psychology at the university of Iowa and her master's in counseling from the Chicago school of professional psychology. As you'll hear in this episode, she worked in a partial hospitalization program. She worked in inpatient.
So I found Lindsay on Tik talk at, at Lindsay dot Fleming LPC. And she's both her name, L I N D S a Y. So if you're looking her up on Tech-Talk, that's her username, but she has an amazing community of over 450,000 people following her. And she does the most amazing short content about being an adolescent therapist, working with teens, understanding teen ADHD, depression, talking to parents like everything. Teen mental health is her tech talk page. So I just absolutely fell in love with her content. I knew I had to get her on the podcast because we are so in line. So this has been almost six months in the making you guys would just so exciting.
But with that being said, all of her information, her website, her talk, your Instagram, you name, it will be in the description today. And let's dive into it.
Thank you so much for joining me today on she persisted. I'm so excited to have you here.
Lindsay: Thank you for having me. I'm excited to be here. I mean, you are doing the work that I talk about, right?
Talking about the hard stuff, being a resource for others, and really putting yourself out there, being vulnerable in a way that other people can learn from you. So I think I am just honored too, for you wanting to me to be here. Excited.
Sadie: Yeah. So giving listeners, a little bit of an idea of how you became a therapist, what your current practice is like, who you're working with.
So they understand who they are, whose perspective
Lindsay: they're getting. So. I became a therapist because I struggled a lot growing up and I knew I wanted to work. I love working with children and teens. Like I knew that's what I wanted to do and I'm dyslexic. So I struggled with school a lot. It was not my forte.
And I really struggled with spelling and grammar and some of the more nitty gritty stuff really came at my competence. So. At first, it was like, Oh, I want to be a teacher. And then I was like, there's no way I'm going to be able to be a teacher if I don't know where to put a comment in a sentence. And that just proves to anyone out there.
I graduated grad school and I still struggled to know where to put a comment in a sentence. So not every all day. Yeah. So essentially I was like having panic attacks in middle school. I did not know what they were. My mom didn't know what that they were. She was like trying to help me. And we just were very lost and I saw this field where we could help people and they wanted to be there.
Like I went to a few therapists didn't they. Weren't a good fit. And so I want, I was like, there has to be a way that we can reach people. So I went to grad school and grad school. I had one of those aha moments of like, I really hope I like this considering it. Yeah. But I did. And as soon as I come in first kind of fell in love with it.
I'm like, this is I'm so happy and grateful that I chose this career path. And even in my personal life, it has done wonders. So that's where I, when I became a therapist and then where I'm at. And so I started working at a children's hospital, the inpatient psychiatric unit. And so that is kids who we feel cannot be safe at home.
And so they'll come to our unit and they'll, it's just stability. So they're just there until we think they're stable and they can keep themselves safe and then we will send them into another program or home. So I started there. I moved to a partial program, so that's a little lower level. You're there during the day, but you get to sleep at home and you go home on the weekends and really helping teens and kids get through their day and helping them practice the skills in time.
And then while I was working there, I interned and worked at a few private practices and was felt ready to start my own practice. So I started my own practice in the town, actually that I grew up in and I love being able to give back to the community. And now I'm currently fully in private practice and have left the hospital and doing some social media
Sadie: stuff.
Love it. It's it's so interesting to hear from your perspective, because for so much of my journey, it was like on the other side and I did the inpatient, I did the outpatient, I did the. And so to kind of totally hear what it's like from a career path and then what I'm hoping to do. It's just so awesome to hear and, and very inspiring.
Okay. So diving right in into it, like I told you, my goal for this episode is for it to be your, you know, being the listeners resource for finding therapy as a teen. So just starting off. Super basic exploring that option. How do you know if you might want to get therapy, it might be a resource that would be helpful to you.
How do you even decide if that's something that you should pursue you want to pursue or before you even get further into the process? Just kind of that first step.
Lindsay: Yeah. Well, my first point that I say is, I think we could all benefit. From having a safe space where we reflect on herself. So we work on ourselves now to know like, okay, do I need a friend?
Do I need just kind of a check in or do I need therapy? I'd like to bring it to the fact that I think teens are struggling a lot more than they used to in the past. And we know that by the numbers, suicide rates have tripled. In the past 10 years, anxiety and depression is raising 70%. So we know our teens are struggling and.
What I've done, I've done all these workshops. Right. And I try to get like the cutting edge soften, like we're going to do, what's like new and exciting. And every time when I give them a survey at the end, I'm like, what did you take? What was your biggest takeaway? What did you love about this workshop?
They say, I did not know other teams. We're feeling the same way as I was. So I think there's such a silent suffering going on for teens right now. And then this is, this research is before COVID. So I, I have not seen the newest research that I can only imagine that people and we're still in that survival phase right now.
So as things go back to normal and as we in the fall go back to school, I think we're going to be seeing a lot of teens really struggling and. My biggest thing is I would rather a teen come in and say, Hmm, sometimes I'm feeling nervous, or I don't know if I'd need this and we can work on that now, instead of them getting into crisis mode, and now we've been suffering for years and just didn't know how to ask for help.
They didn't know they needed help. So I love that you're asking these questions. The biggest piece to know if you're thinking that you need help, it's probably assignments and you can always go to them therapists and it's their job to assess and tell you like, you know what? I think you could, you know, have this space, call me if you need me.
Right. Or you could, they could say, you know, I think we could do like every other week, I think you need to come in every week for a little bit and then we'll see how you're feeling. So I think anytime is a good time to make an appointment, talk to your physician, go in and. Find a therapist who can assess if you need therapy or not.
That's why we call it an intake process where they're seeing if you need therapy and what kind of therapies would be a good fit. Yeah.
Sadie: So, so many directions that I kind of want to go off with this, just to kind of lay it out. I want to talk about how to find a therapist. I kind of want to also talk about what therapy looks like, because if you haven't experienced it before, that's a big question, Mark.
For a lot of people, you're like, do you want to sit here? And like, they tell me what's wrong with me or do I have to tell them everything that's ever happened? So kind of those two directions first talking about how do you find a therapist? I think there's different approaches. You could be like parents find me someone.
You could be more hands-on, but it's a very overwhelming process. There's DBT, CBT psychotherapy, different specialties. How do you approach that?
Lindsay: Yes, there is a lot and a lot of letters, right? I guess it's a lot with, they're like, there's all these letters. And even after people's names, like, should I get a social worker?
Should I go to a counselor? Should I go to a psychologist? What's a psychiatrist, like so many different words that make it really hard to understand. So starting out with, how do we find a therapist? I am a full-on believer in that we're all. Social workers, psychologists counselors, whatever it is, we are all trained to do therapy.
Right. And I feel like it's more of, who's a good fit for you and who the clinician is. So my number one thing is. Seeing, what do you want out of therapy? So if we're struggling with anxiety, that's important to know if you feel like you're worrying a lot more, if you feel like you've had some trauma, and you're trying to process that if you feel like you're feeling really down in low mood and depression.
So the number first thing is thing like. What am I struggling with? What do I want out of therapy? Then we can go into law. And some people don't know that's okay too. I don't know. I just don't feel like myself. That's okay. That's a good place to start. And then how do we find it? I'd worry less about the credentialing.
So are they a social worker? They counselor, they psychologist and I would focus more on. What they're like, if you think they would be a good fit for you. So that, that being said, do you want to look at like their bio's? You want to have questions ready to ask them? And it's always
Sadie: okay. I will tell you all the details.
Lindsay: And it's always okay to like go to one and be like, Oh, this is not my cup of tea. This is not me the
Sadie: episode. I totally want to ask you how to break up with a therapist. That's totally overwhelming. Yes,
Lindsay: it is. It is really hard. It is really hard. But some places that you can go to look for therapists, the number one thing is you can go to your physician.
So when you go to your physical for the year, they should have people that they recommend for therapy. Another option is the school. The school should have a list of places that they recommend that they, they work with and that they trust online there's things like psychology today. And some other places that you can look at my biggest thing though, personally is like, Personal referrals because then, you know, people who've gone to them or they know someone who's gone to them.
And that is what I've seen work the best for referral basis. But I know since you don't feel comfortable telling people they're going to therapy and that's totally okay. But I've had, like, my clients asked me for a referral for their friend where I'm like, I won't see your friend. Exactly.
Sadie: I was like, I love my therapist, but I sent any of my friends to her.
That would be so awkward, but she would give great recommendations for other people that they could see. And so totally leaning on those resources. Great test.
Lindsay: Exactly. And the side note, like that's why therapist shouldn't see siblings, because like, if you come to me and you're telling me about you and your sister got in a fight, they're like, you're going to, I'm going to be biased, right.
I'm not going to feel safe and you'd be worried what I'm thinking and what they're telling me. So it's really important to find a therapist, healthy boundaries. And I can go into, you want me to go into some questions you could
Sadie: ask? Yeah, of course, before that, I also really want to touch, I love what you said about siblings.
And I think as a teen, when you're approaching the therapy process, I mean, your parents are taking to appointments. They're paying for this with their insurance. And a lot of ways, it feels like it's not necessarily a hundred percent in your control. And this resource is for you. This is your therapist.
It's not your parents' therapist. It's not your siblings again, it's for you. And so feeling 100% comfortable with that relationship and your therapist will help set those boundaries with being like, okay, your parents are asking every single session, what we talk about, but like, I can't tell them that it's not going to happen, but again, it's, it's for you.
It's your, your individual to your person. And so, yeah. As a team that's possible to have that resource and, and create that great relationship, which is one of the most amazing things about therapy as a team. And I also think a misconception and a barrier for teens trying to get treatment as well.
Lindsay: And I wonder for you, like, I've been finding a lot of making too, even been in therapy before don't really understand the rules around what parents can now.
What they should know. We
Sadie: should definitely touch on that. I think the number of times that I've heard it from like everyone, I think I like maybe know most of them, but it's totally also a misconception that, that they'll just tell people. Thanks. So first we'll do questions to ask your therapist when you're doing that intake meeting and then the kind of rules of therapy of how, how things are your, your business and no one else's and, and kind of diving into that.
Lindsay: So some questions that I would have ready for your therapist is number one, asking them there, who do they work with? So if this person normally sees a bunch of seven year olds and you're 17, Probably not going to be the best fit, but they're hearing what they're seeing is
Sadie: fidget toys out there, but maybe emotionally might not be the right level.
Exactly.
Lindsay: They will. They will have all the coloring books, everything you want, but they might not understand intricate relationships and what's going on with T so definitely you want to ask them the population they're working with. Another good question to ask them is how do they work? So for me, I.
Really utilize client focus. So meaning that I feel like it's me and the client together working together. It's not me like a teacher being like, here's your homework. This is what you need to do, do this by next week. I really want to empower them to take control of their life and they know themselves fast.
So asking them, what's their approach. How do they, what does therapy normally look like with them? Can tell you a lot about the therapist. And what I would say to that, if a client asks me is what I usually say is I love utilizing things you like. So if you tell me you want you like to write instead of talk, I'll do the first 10 minutes and you're journaling.
And then I can pull from that. After you write, if you like to do art projects, I can bring in art. So really finding someone who is. Thoughtful and taking the time. So you can learn a little bit about a therapist and you ask them, what would it look like with you?
Sadie: So before we dive into what therapy is like, I think it's also important to touch on these different types of therapies.
We kind of talked about finding a therapist, but I think another thing that's a big question, Mark in the air is there's group therapy. We talked a little bit about potential hospitalization, full hospitalization. So kind of what are these different options? Who are they for? And even kind of. Before that point, if someone goes to therapy, are they going to be immediately slotted into all of these different things?
Or are they safe to go in and talk to someone and not have to fully commit to five years of a treatment protocol?
Lindsay: Yeah, so there's so many, and I hope there will be more and there's, there's so many different types right now that we think about. So what we call outpatient, right? We'll start with that. So outpatient therapy is we're looking at that once a week, once every other week therapy.
For an hour session, another option is group therapy. So that looks like even less pressure of the one-on-one conversation. So you're with people around your age, were dealing with the similar things as you, and it's more of a collaborative group. You hear from other people you support each other and the one-on-one therapy, that's where we're creating goals.
Like what do you. Struggling with what do you want help with? And then we work every week to try to understand and move towards those goals. If it feels like once a week is not enough, you're still struggling a lot. What we might move towards is what we call an IOP and IOP is intensive outpatient therapy.
And now a lot of times it's more of a conversation with the client. I think people get fearful when they hear like, Oh, intensive outpatient. I'm like, that's scary. And really what it is is it's just trying to give you the support you need. So you'll be able to go to this program for. We started at like four days a week or three days, depending on what your knee you need.
And you do group work and individual therapy with the psychiatrist who does the one who does the medications, and it really is supposed to help give the wraparound services. And usually that's after school
Sadie: hours. And they have great snacks, guys, overwhelming, lots of breaks. I did puzzles all the time.
It's totally relaxed teens, your age. And so even though this, it is this idea of being intensive, there's again, that relief that other people are in the same position. They're there to be a resource and they make it accessible to teens and not overwhelming. So having been in that, in that step as well, which is something which I don't think as many teens is navigated, not scary, not overwhelming.
It's it's a great resource.
Lindsay: And I think you bring up a good point too, like intensive therapy to me, does it mean, Oh, we're talking about our feelings the whole time. It also means forcing us to practice calming skills and just socializing. And so I think that, you know, even
Sadie: in more time intensive, rather than emotionally overwhelming.
Yeah.
Lindsay: Yeah. That's a really good way to put it. And I think even in individual therapy, people. Sometimes if I start like just chatting, they're like, don't, we only need to be talking about feelings and how doing, we also need to like, build a relationship and I can learn a lot about you by what your interests are in what is going on in your life, other than just how anxious did you feel this week?
Oh,
Sadie: totally. I find myself regularly being like you to my therapist, you have to see this tech talk. It was so funny. I was laughing for like 45 minutes and she's like, Oh my God, love it. I've sent some of your therapy take talks to her multiple times. She loves them. So kind of all worlds colliding, but there's a lot of really casual elements that I don't think you would expect going into it, but they want to hear about this stress who like, and we'll talk about what is therapy like, and kind of talking about things, teens bring to the table, but again, reinforcing it.
Not this overwhelming. You're put in this situation where everything has to be spilled immediately. It's, it's a relationship. It's a process.
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So back to diving into outpatient and more intensive often.
Lindsay: So we have the outpatient that we talked about. We have an IOP intensive outpatient, and then we can look at like a partial program.
So it, a partial program is, is again I just talked about a little bit earlier in the podcast. It's. Where we're looking, you're there for during the day. So you're in there like a school day and then you're able to go home after and on the weekend. It really, what we're looking at is you throughout your day.
So we're able to help you if you're having suicidal thoughts or if you're having if you're feeling really low or feeling really nervous or. It's hard to get to school for refusal. We'll see a lot of that there, where we're able to, where maybe you can keep yourself safe, but you're constantly struggling with these thoughts or these behaviors.
So it
Sadie: feels like school too. It's like, you're not learning what you would be learning in school, but we would set in different. You could call them classes or groups, or we would learn about how to cope ahead for a situation. What are we would do like fun little parties. If everyone had full attendance.
That week and we would do like tie together. And you're, you're getting up. You're going somewhere during the day and you're learning about totally different skills than you would be at school, but the environment is pretty similar. The different therapists that comes in come in, it's almost like different teachers.
And so a familiar environment, nothing too crazy. But different content that you're learning.
Lindsay: Exactly. And we had it in my partial program and our were where you did do schoolwork. So some of my. Teens are like Lindsey, how, what I'm going to fall. So behind in school, it's like, there is literally a specific teacher
Sadie: there to help you
Lindsay: advocate for what you need in the school
Sadie: setting.
And there are so many of them combinations that can be made. I took an entire semester off of my. Freshman year I was on a medical leave, which you, same thing that happens. If you've got a really intensive surgery, you had a big accident for my mental health. And I went to residential treatment and recovered all those credits.
I'm going to the university of Pennsylvania next year. So it works out. It'll be okay. Even if you need, need a lot of mental health support, there's a system in place to help you get back on track, recover these credits when you're only focused can be your emotional. Stability. And you don't have a lot of resources beyond that.
So it'll be okay in the moment. It's very overwhelming another barrier for teens, but these are experts. They know what they're doing to help you get back on track and reenter your life more effectively.
Lindsay: Exactly. And then now they're at, so then the next, like a higher level of care would be an inpatient psychiatric unit.
So that is when we're looking at someone who really likes. Their parents don't feel safe, or we don't feel that the hospital deems that they, so essentially what happens is you have to go to the emergency room and in the emergency service, social worker comes and meets. You talks to you. They make a decision on if they feel like you can't, if you may feel like you can't be safe at home to go to inpatient unit.
And I think a lot of people get really fearful of this because of. Media because it's unknown. Like we don't really know what it looks like.
Sadie: Dark history in the mental health industry we've come so far, but there's also that a lot of that, that still is a lot of stigma. I know when I went to McLean, that was what girl interrupted was about.
It was that hospital. It wasn't a Sila before, and I was going to be so bad. This is going to be a disaster. Totally not what it's like. There w I'll let you finish your, your spiel on inflation and then add. But yeah, again, there, it makes sense why those anxieties are there and those fears, we hear more about that than we do of what it's really like.
And for privacy reasons too. No, one's going to be like, here's my weekly blog of inpatient. That's not a thing. So it totally makes
Lindsay: sense. Yeah. So in inpatient unit, you're you sleep there? It's the average stay is like five days, three to five days. Now it's gotten shorter over the time, over time. But essentially they're there just to.
Help you feel stable and when you feel stable and they, the team thinks that you're stable, they will transition you again to one of those lower levels I was talking about. And now if you're someone who it feels like we're in and out of inpatient units or things, aren't really clicking and you're still really struggling.
That's when we might move to a residential program, which I know that you can speak on too, but that's where it's a little bit longer term. And trying to help you in a, instead of going through all these different programs in one space and giving you a lot of support.
Sadie: Totally and inpatient, just like outpatient, similar things where you're lots of groups during the day, lots of learning different things, but you're getting out of crisis mode and it's a lot of, it's a lot of wearing your PJ's.
It's a lot of movie watching a lot of cafeteria meals. Your parents can come and visit you so you're not totally alone. Everyone is. So compassionate and my experience, you have great teams of nurses and doctors and social workers and people that just want to help you. And again, it's not 24 seven therapy.
They'll let you sleep, eat, do your thing and bring your books, read whatever you want to do to kind of get out of that crisis space. So even though it is more time intensive yeah. It's, you're not going to be completely emotionally overwhelmed because that purpose is to get you out of that crisis place and get back to your environment or get to a new environment that will help you eventually get out of that place.
So, I think amazing breakdown, something that's so confusing if you haven't been in treatment before, so it's super helpful. So what is therapy like something that you wouldn't always know unless you've been in therapy? So super big question. Mark brings lots of anxiety.\ I think it makes sense to first talk about what to expect when you go to your first therapy session, and then we can go more into what are common things that teens want to talk about. And what are things that could be helpful to talk about? So first you make your appointment. You're ready to go. What do you expect to expect what's going to happen?
Lindsay: Yes. The first session is very boring. That's what I tell them. Like right. When I have someone come in, I'm like, this is going to be the most boring session that you are a part of. It's really history collecting. Right. So I'm trying to learn about you. That's the first session. And I think some fears that I hear a lot of is like, what do I say?
What if there's an awkward silence? What if, like, what if, what if I don't want to share yet? And as a therapist, I know people aren't telling me everything in the first session, I'm a stranger staring at you asking you questions that you don't even tell your parents or your friends. So, yeah, totally feel like you're on pace.
Some of some people tell me everything. Some people are very like closed off and that's okay. It's all part of your process and your process going to look different than other people's. So the first session that was a lot of history, collecting questions like. What were your, what are your grades? What are we, what's it like with your friends?
What's your relationship with your family? What's the history of you struggling with your thoughts or behaviors? And it's a lot more of just me trying to see what, what you look like in your environment. And assess how you're feeling and where you think you sh you are struggling. So as someone comes in, they tell me all this information, then together we'll make a plan of what is the biggest thing that you feel like is impacting you.
And let's start there and start working at that through the next session.
Sadie: And totally, like you just said, it's what are you, what do you want to work on? It's not like your parents told me your grades are bad. How are we going to do this? It's going to be, so what do you want out of this? What are you hoping to change or improve or shift?
And I think for me, a lot of times my parents would big. You really got to work on this and I'd go into therapy and be like, My parents are so annoying. I really want, like, how do I get the navigate this? What can I do to like, make this conversation more effective? So again, it's your resource. It's not your parents.
It's not your friends. It's not your teachers. It's for you. So what are some things that you hear all the time that teams want to work on in therapy? Common things that they're like, this is my focus. For anyone who's kind of at a loss. And I was like, I don't know. I want some help, but I don't know what direction to go.
As far as that, what are, what are some common things?
Lindsay: My first thing usually that I work with is just getting to know her feelings, because I think we talk a lot about what happens to your body physically during puberty. We don't talk about what happens emotionally,
Sadie: feel more sensitive, not helpful.
Lindsay: So I navigate that.
Right. And I do a lot with, with people just like let's first learn about yourself, where you're at. Who you want to be. It's so confusing in your teen years, you're supposed to try on these different hats and see like, is this who I am? Is this where I want to be? You are supposed to take risks. So I teach teens how to take healthy risks cause it is a part of growing.
Right. And so what I'm hearing so many teens come in though, is. A lot of low mood, a lot of lack of motivation, a lot of pressure feeling so much pressure, whether it's social pressure, academic pressure body image, pressure, performance, I'm just hearing so much fear of making mistakes of living life of I'm not enough.
I'm not good enough. I'm not far enough in life. Compare. And I like to say the thing about social media is instead of. How it used to be, where you compare yourself to your neighbors, they're the kids in your class. You guys are comparing yourselves to people, to a whole world, literally of people putting out filtered and best highlight reels of their lives.
And you're a lot of people aren't saying like, look at this, look at this. This is all the stuff that I'm not included in. So I'm just hearing a lot of negative self-talk and a lot of comparison.
Sadie: I think another fear that comes with therapy is that you'll be judged touching on that. You go to therapy.
You're like this happened. I, whether you feel like you, you made a mistake, you feel like you're, you're sharing these really vulnerable things that you're not good enough. The soft you're having that can be really overwhelming. These interactions you might feel guilt about. Are you going to be judged if you go to therapy?
Lindsay: I think that what I love about therapist is we did a lot of work on ourselves and understanding ourselves and not judging ourselves about our mistakes about ourselves and our lives. And we hear and do this all day. So you are not going to be judged. All I do is I really just want to understand. What's going on and what you're thinking and be there for you.
We care about our clients. If I'm with a client that I feel like I'm not clicking with and it's not working, I will refer them to another therapist. Like that's my, my obligation as a therapist to do, to make sure that if it's a good fit. So I know so many people are fearful of being judged and that goes back to this whole.
Fear of making mistakes and comparison aspect where that is. Absolutely not what it's like in a therapy room. And if it feels like that, try different therapists. Yeah. Yeah. Really. It's a space where you should be able to be your authentic self and explore who you are. Without the fear of being judged. I think we got to work on it when people first come in because of the social norms of that, like watch what you say, what should you do?
People are judging you, but in the therapist's room, it takes a lot for someone to say something that I haven't heard before, especially teenagers. You've never. Lindsey. They're like, I just, I know I don't, I don't want to tell you this, but they'll say something I've heard like three times that obviously in the moment, I'm like, Oh, thank you for telling me that what's been really hard, but I'm like, I wish you knew that is so common.
And you are carrying this burden. Like this is so bad I'm having these thoughts are, this is so bad that I did this thing where. I'm like you could have told me that three weeks ago. Totally,
Sadie: totally. And so I loved what you said about taking healthy risks as a teenager. I think that's another thing is that again, your parents are somewhat involved in this therapy process.
There's this fear of judgment. And, and you're talking about things, behaviors that you kind of worry. For some individuals getting in trouble for if you're taking these healthy risks, you're you might be talking about romantic relationships. Well, we'll talk next about what are like the rules of therapy and how that can be shared.
But I think that's another fears. If you go to therapy, it'll be like, you can't do any of these things. You're going to get up at 6:00 AM every day and meditate and think about your emotions all day. And this is how it's going to work to feel better. So what. Is that is that kind of stereotype true.
That you're going to be told what you can and can't do and all that kind of stuff. I'm
Lindsay: going to be very thoughtful about this and say that I'm going to preface this with, there are a million amazing therapists out there. They're like any profession. There are some that are not good. Like I'm just going to be blanket on it, like common.
It is. I think it's always great to, I know we'll get into this later. Ask your therapist what. Their rules are around informing your parents of things. I think too, what, I hear a lot of teens talking to me about with coming out and gender and thinking about just some topics that are, maybe they're fearful of their family's opinions on.
I just say like, I just want to be very clear, like making sure you feel comfortable with your therapist and asking them and gaining their trust, and then being able to share some more of the stuff that you're fearful of your parents knowing with that also comes healthy risks around. Drinking drugs, sexuality, like becoming sexually active.
This is a space where your therapist is supposed to be there again to help you help you navigate that world. And so if you are with a therapist who trust in you, not with them and you take the time. To get to know them. Then I definitely feel like it's different than talking to a parent. And that's what surprises teens a lot.
They're like, Oh my gosh, I thought you were going to tell me, like, I shouldn't be doing this. And I'm like, no, I'm not going to do that very much. Therapists take like an educational approach. Like here's the risks, you know, the risks. Yeah. Make a choice. And then we talk about that choice. So if you were like, Oh my gosh, I was drinking and I.
Drank too much. And I embarrassed myself. I'm not going to be like, Oh my gosh, last week I told you we shouldn't be drinking. I'm going to say like, what do you think about that choice? Like what let's talk about it. How did we get to making that choice? Is that, where can we learn from this? Is there something you can change in the future when you are at a party?
So I think keeping, I think being mindful of the fact of. Making sure it's a therapist that you align with, and then you can feel comfortable talking about more of those healthy risks that we were speaking on.
Sadie: Totally. I think that's something that's so important to remember and definitely something that scares a lot of people.
Vulnerability is really overwhelming and especially in therapy, when you're talking about all these things, and I think once you get through those first couple of sessions, you'll really be able to see that. It's it's a totally different dynamic and relationship than you've probably experienced in the past.
And even just in those moments, taking those healthy risks of telling someone those emotions that you're feeling you're, you're practicing the muscle of vulnerability. You're working on these skills that you're doing in therapy and so all around helpful in your journey.
This week's episode is sponsored by teen counseling. I can not tell you guys how many DMS texts emails I get from teens, parents, even friends asking, how can I find a therapist? How can I enroll in therapy? How can I find a therapist for my team? How do I tell my parents? I want to go to therapy.
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So no matter what level of support you're looking for, they got you. You're going to go to teen counseling.com, she persisted. You'll fill out a quick survey about what your goals are for therapy, whether that's improving your mental health during the pandemic. Working on your relationship with your parents, improving self esteem, whatever it is, they'll match you with therapists that fits your needs.
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So rules of therapy HIPAA is something that people are not always aware of.
So you're a team getting therapy. W can your parents know things? Can they ask things, can your teacher call you up and be like, what's happening in these sessions? What is that like?
Lindsay: So with HIPAA, if you're a teenager, the only time your therapist really should be telling your parents anything is when you're a danger to yourself or someone else.
So we're looking at if you're having suicidal thoughts and then we just have to create a safety plan and like really the only time they should be bringing your parents in is if you Are were fearful of harm. Right. And in my
Sadie: experience still kind of have that be a conversation with you. They'll be like, I'm worried about this.
What do you think about bringing your parents in to create this resource? It's not like you're going to show up one day and both parents are sitting there ready to dive into it. You'll be part of this conversation. And they'll be like, I'm thinking about bringing this up with your parents. What do you think?
Super transparent, super open. This is your person again.
Lindsay: Yes, they, they should be in your corner. Again, like you said, my clients are not. My client, my clients are not my client's parents, my client, wasn't a client. And I think that some people tell me, well, I'll know, my mom will Walmart. Like if I go to therapy, she's gonna have to know what's going on in the room.
And what I say to that is we usually talk about that. I've made rules of parents before. We're like, listen, I will give you a, after talking to my client first, I talked to my teen client. I'm like, okay, You're telling me, mom is going to grill you with questions or demand that I tell her things. So let's come up with a plan.
And usually what that would look like for me is. Is it okay if I tell them on generally what we're working on, and then she is not allowed to ask you questions about therapy at all on the way home ever. And usually parents, then it comes their anxiety of like you're in a room with an adult and I don't know what's going on.
And if I'm able to say we're working on worries. Right. So if you tell me. Oh, my gosh, Lindsay, like this happened, this drama and this with my boyfriend, I'm not going to go out and tell your mom mother's details. Feminist say we worked on relationships and how to communicate and how to handle when things aren't great.
And that allows the parent to understand, okay, you're working on stuff. I'm in the know, I know if something is going on and it allows the child, the ability to not worry about all these questions they're going to receive, or if I'm telling their parents something different. I always say. It's up to my clients.
If, if they want to be there every time I talk to their parents, I allow that. So I really allow my clients to be the ones to say, like to lead it if we're bringing
Sadie: parents in. Totally. And I think another great kind of I don't, I wouldn't say resource, but another thing you can lean on that is less vulnerable.
It's something that is more societal. It societaly acceptable. If your parents like what's going on in therapy, school stress. It's overwhelming. It's something we all deal with. You're not getting into those relationships or emotions, but it's still something that you probably will talk about at some point in therapy.
It's something that you're building skills around anyways. So kind of coming up with a list of things that you would be okay, just rattling off, even if you're not getting into the details, whether at school stress, you were like, I'm trying to figure out what I want to do in college, or I'm trying to figure out okay.
What I might want to do in the future, who I want to become and all that kind of stuff. So figuring out what are some options of things you can disclose that you feel comfortable with, and if you don't feel comfortable at all, your therapist will help you learn how to set those boundaries, because that's exactly what their puppy is there to do.
So we talked about therapists are not always the right fit. It's a relationship. Just like anything. You're not going to vibe with everyone. It's not going to be perfect in every single relationship. And it shouldn't be forced in therapy because that's just not how relationships work. So you go to therapy.
Is there a certain number of sessions you should do before you decide? If so?
Lindsay: Yeah, I think just like relationships or there can be some red flags and again, You're allowed to have an opinion and ask your therapist questions and. Especially this year, I've been talking way more about systemic issues. I've been talking way more about racial trauma.
And when we're looking at sessions with a therapist, if you feel like they are invalidating you a lot, that's kind of a red flag. If you are feeling uncomfortable, that's a red flag. If you. Feel like you asked, like they're telling your parents things and that's, again, we just talk about that loud, legally that therapists can get in trouble for that.
And it's not just like, Oh, it's good for therapists. Like that's legally our obligation.
Sadie: No, you're not. Can't happen.
Lindsay: If you're really feeling like it is not a good fit, I would say give it three to five sessions. If at, at, around that time you're still like, like all these red flags are popping up and you're not feeling comfortable.
Then I would definitely say it's time to move on. And sometimes it is just like the person, like I'm a very bubbly, talkative person and that doesn't work for everyone. So people need someone who's just calm. Yeah. And way more of a listener and less like interactive. And that's okay. So again, if some, if that's what you need, if that's the fit that you need, that's great.
You should find that we are providing you a service. You are the person in charge, and if you feel like you're not getting enough out of it, or you're not feeling comfortable, then it is it's your choice to definitely look elsewhere. I've had clients who are like Lindsay. You're great. I think you're awesome.
I just feel like I need someone else and that's okay. That happens to everyone. So just making sure that you can advocate for yourself.
Sadie: Totally. And so what is the process of, I guess, breaking up with the therapist, do you send an email, do you dump it on your parents to do, do you go into the session and do you have that conversation?
How would you approach that? That kind of switching therapists process.
Lindsay: My community. If anyone on here is for my fellows, my take talks, I love the saying like baby stops. Like I always say that things are even anxiety loves to be big and scary. Right. And thinking this like, Oh my gosh, I have to break up with my therapist.
That's so scary when you break it down into smaller parts, it's like, okay, I've decided that I don't want to see this person anymore. If it's someone that you've only seen for three to five sessions and email is totally fine. And just, I think will give you wording of just saying like, I feel statements, right?
So. You know, and you keep it cause like, I feel thankful for our time together and I am ready to move on. So thank you for our sessions. I will not be needing any more sessions in the future and that's it. And like just very short, clear, concise. That's all you need. If there's someone you've been seeing for like six months a year, Again, you can email them.
That's totally fine. It's really what you feel comfortable with. I think it's a good growing behavior to try to do it in person, but I know some people tell me, like, that's just too scary and that's okay. Because the important thing is that you get your needs met. So if you're like, Nope, email is what I'm going to do, that's fine.
Maybe let's make it a little bit. More lengthy, like thank you for your time. And I loved working with your, I appreciated working with you.
Sadie: I love that we covered these topics. I really improved my ability to recognize emotions, something like that. Yeah, yeah,
Lindsay: yeah. Yeah. Just keep it, throw in a little, a few sentences of
where you think you've grown. But then if you want to do it in person, you could just say. Again, like, I feel like I've outgrown these sessions. Like this is like you just said, these are the things that have been super helpful and I'm ready to try something different. And when we were talking earlier about the different types of therapy, that's another approach as well.
So if you're doing all this CBT therapy, which is cognitive behavioral therapy, like. When you think about it, that's really good for someone, for some people, but if you have a trauma or different things, like that's not as helpful. So you want to be doing more trauma informed therapy. DVT is really good for people who struggle with suicidal thoughts and people who struggle with feeling in crisis a lot.
Like they do a lot of. Really great mindfulness techniques and crisis management and communication stuff. So too, that could be the other piece of what this therapist is providing has been enough. And now you want to try something different. Totally.
Sadie: Okay. So your we've talked about first, what is therapy?
What to expect? What are the different types of therapy, how to switch therapists? Kind of wrapping it up what are your favorite resources for teens? We've talked about finding therapy. If that's an option for you, if someone is already in therapy or if they are going to pursue that option or they're not ready for it, what are some other ways that teens can improve their mental health, get support, all of that kind of stuff.
Yeah.
Lindsay: So my number one thing is obviously we're on social media. And so I do think that social media can be a great resource for people. My only reminder is. Don't believe ever, don't take everything for face value. Right? So if you're looking following someone, who's an advocate, that's great. And that can be super helpful reminding yourself that they're not licensed, but that doesn't mean that their stuff can't be really impactful and important.
Even myself like everyone, no one should be just taking what I post for face value and being like, Oh, this is factual. Like this is it. We really want to be mindful if we're using the internet, that we are checking credentials and. And second guessing what people are putting out,
Sadie: being a critical consumer.
Lindsay: I think that's very important, but, and again, both can be true. Right?
Great people on social media, it can be super helpful and we just need to pay attention to what we're intaking and do our research. If you find like, Oh my gosh, this is what I feel like. I totally relate to this doing research and understanding more. So social media, I think is great following some people if you are not ready to go to therapy, but you're looking for ways to feel better.
Social media currents. Keep me on the social media path, unfollow, anyone who doesn't make you feel good about yourself, follow people who do make you feel good about yourself. You can always go back and follow those people again, hiding people from your timelines. If you just got in a huge fight with your friend, and you're no longer friends going and looking at their Snapchat location, going and looking at their story is not going to be helpful.
So setting up boundaries for yourself. Making sure like the calm app there's apps that can be super, super helpful, practicing some mindfulness, practicing journaling, writing, how you feel like those are some really good resources. There's a thing called therapist, a.com. I really liked therapist aid.
They have so many psycho-education so information on what is depression? What is anxiety in anyone with ADHD? There's something. Called attitude with two DS. That's really good for ADHD. And there's some Chad with CDs or which is really good for ADHD. And they have like what it's like as a teen to have ADHD.
So those are some resources that I really like. That's out there.
Sadie: What are your thoughts on crisis chat crisis call lines. Is that something for teens in the moment that you are like, yeah, this is great. Use this resource or you're like, lean on people around you lean on teachers, family, friends, all of that kind of stuff.
Lindsay: If you are in crisis, the number one thing would be to try to tell an adult who will listen and take it seriously. It doesn't have to be your parents. It can be an uncle. It can be older sibling. It can be a cousin. But I think the number one thing is letting someone know in even saying it out loud can cause a little bit like that release.
So I definitely think that is like my first recommendation. And if that is not school, teachers are great too. If you feel really close to a teacher, the school social worker, so a psychologist, if you have one, I'm your counselor. I think crisis lines are great. I think again, it's. It's a great resource there.
So if you are feeling like you don't have anyone else to talk to, crisis lines are really good. If I have any clients who go into crisis, I always make sure that they have crisis hotline numbers in their phone. But my number one thing would definitely be to tell someone that totally.
Sadie: So I want to hear before we wrap up your top three favorite mental health tips slash recent obsessions of sorts for you.
And it can be anything, whether it's like a beauty product, a book you're loving a movie, a habit, whatever it is that you're loving, what are your top three?
Lindsay: Number one would be taking walks, I think getting outside in some aspect. So I laugh with my clients if they want. And you can ask your therapist
Sadie: to do that too.
No wording with my therapist before. So all the things, all the things, there are so many ways they can meet you where you're at.
Lindsay: So movement. I really, really love to move. I think that's been great. I'm a big advocate for the same three self positives. Every day I make my fiance do it sometimes too. I love it.
And he like thinks I'm joking. And I'm like, no, really that you like about yourself. And he's like, Oh, why am I engaged to a therapist? No, but I think that's super helpful to, to force yourself, to remind yourself why you love yourself, because we're so fixated on what do I need to get better at? What am I doing wrong?
Taking time to say, what do I really love about me is super important. So those are me too. And then my third one, which is not really related directly to, Oh, this mental health scale is I've been really trying to take care of my hair. And so I've been doing a lot of like asking my followers and trying to engage with them a bit more about how do I take care of parts of me.
So I got into skincare and tried to start doing that. And now I'm working on my hair a little bit, so I love
Sadie: it. I'm always, I have the thinnest hair and then I also struggled with trick for awhile. So if you ever get the thickening, your hair tips, let me know. Okay. I need them. But I love it.
I think this is one of my favorite episodes and something that any team can relate to and use and resonate with and so much value, so much information and really just the perfect team therapy resource.
So thank you so much for joining me. Thank you
Lindsay: for having
Sadie: me. Of course. , last thing, where can people find you?
Where can they find you on social media online? All of that.
Lindsay: So you can find me on Ted talk at Lindsay Fleming LPC in on Instagram. My podcast is being revamped and it should be coming out like end of June, early July, hopefully fingers crossed. So I will have a podcast hopefully coming out soon, but for now, those are the places you can find me.
So it's. Lindsay dot Fleming, LPC and Lindsay underscore Fleming LPC on Instagram.
Sadie: And then I'll update this description when the podcast comes out. So if people listen to this months down the line, they can find it as well. Thank you again so much for sitting down with me and having this discussion so much fun and an amazing resource course.
Thanks for having me.
In case you skipped the end to recap, Lindsay and I discussed. Her path to becoming a therapist, all sorts of different levels of treatment. Outpatient, inpatient, partial hospitalization, intensive outpatient group therapy, individual therapy, family therapy. How to talk to your parents about seeing a therapist, common things that teens bring to therapy, what to expect in therapy, how to break up with your therapist and so much more right.
This is your resource as a teen on all things therapy and getting therapy as a teen. So I hope you enjoyed this episode.
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