Head Inside Mental Health
Todd Weatherly, Therapeutic Consultant and behavioral health expert hosts #Head-Inside Mental Health featuring conversations about mental health and substance use treatment with experts from across the country sharing their thoughts and insights on the world of behavioral health care.
Head Inside Mental Health
Dr. Sarah Anderson, Transforming Mental Health Treatment with Occupational Therapy
In this episode we interview Dr. Sarah Anderson, professor at Midwestern University and mental health occupational therapist, who unveils the powerful intersection of neurodiversity and recovery in this intriguing conversation.
With neurodivergent individuals making up a significant portion of those struggling with addiction, Dr. Anderson's expertise couldn't be more timely. She explains how ADHD, autism, and other neurocognitive differences affect executive functioning – impacting impulse control, emotional regulation, and the very skills needed for successful recovery. "Substance use often helps with coping," she notes, especially when we understand how a person's brain uniquely processes information and responds to their environment.
Dr. Anderson champions a treatment approach that integrates sensory processing assessments into addiction and mental health treatment. Through her work at Scottsdale Providence Recovery Center and her private practice, she demonstrates how simple environmental modifications and personalized tools dramatically improve outcomes. From creating sensory-friendly spaces to developing individualized systems for time management, her methods honor neurodiversity and help clients embark on a journey of discovery for personal values. Her approach offers a framework for sustainable change that extends far beyond the treatment setting for long-term success.
Whether you're a mental health professional seeking innovative approaches, someone in recovery looking for more effective strategies, or simply interested in understanding neurodiversity better, this conversation offers invaluable insights. Discover how the subtle yet powerful adjustments in how we approach mental health can transform lives when we honor each person's unique neurological makeup.
Hello folks, thanks for joining us on Head Inside Mental Health, featuring conversations about mental health and substance use treatment with experts, advocates and professionals from across the country sharing their thoughts and insights on the world of behavioral health care. Broadcasting on WPVM 1037, the voice of Asheville Independent Commercial Free Radio, I'm Todd Weatherly, your host consultant and behavioral health expert, and with me today is somebody I got the pleasure to meet very recently, dr Sarah Anderson. Dr Sarah is a licensed and practicing occupational therapist with over a decade of experience. She owns and operates a group practice in Scottsdale, arizona, and serves as adjunct faculty member and the occupational therapy department at Midwestern University. Prior to transitioning into private practice full-time, dr Sarah spent several years as a core faculty member and professor at Midwestern, where she is deeply involved in teaching mentorship. She earned her post-professional doctorate in occupational therapy from AT Still University in 2019, her master's degree in occupational therapy from Midwestern University in 2014, and bachelor's in kinesiology from the University of Minnesota in 2012.
Speaker 1:As an occupational therapist, dr Sarah specializes in mental health, with a focus on trauma, anxiety, adhd, autism and addiction recovery, supporting individuals from adolescence through adulthood. Her therapeutic approach is grounded in neurofirming and trauma-informed care, drawing from advanced training in polyvagal theory, attachment theory and the biopsychosocial model. She is especially passionate about developing programs that promote emotional intelligence, stress management and self-regulation in ways that honor each individual's neurodiversity and lived experience. And I met her because she does a lot of work for a program out there Scottsdale Providence, and their residential treatment, php and IOP program and I was super, you know, I was like wow, we got to get on the show so that you and I can nerd out together. Yeah, you're talking about how you're using, you know, the approach that you have and an occupational therapy approach. And then you and I also started talking about cognitive remediation with regard to dealing with individuals now in recovery from substance use. How did you tell me about the journey from kinesiology to here, supporting the individuals that you support there at Scottsdale Providence and in your private practice? Where did that?
Speaker 1:tell me about that journey.
Speaker 2:Yeah. So when I was getting my bachelor's at the University of Minnesota, I thought I wanted to be a physical therapist and I hated chem and physics and all of those really hardcore science classes. And in the midst of, you know, questioning my life choices, I had this intro to kinesiology course and they had an OT come in and in my mind I thought that that's what PT was. Ot has more of a stronger mental health component to it, and some OTs are hand therapists and some OTs work in neuro rehabilitation. Obviously, my specialty is mental health, so it's a little bit different. And so in that moment I knew that I wanted to go into occupational therapy.
Speaker 2:And then, my sophomore year of college, I had an uncle who fell from a deer stand hunting and he sustained a C2, c2, his cervical vertebrae. He had a spinal cord injury at a C2 level and so, along with the in the spinal cord injury, he also sustained a TBI, and so my dad's family is very close. And so, you know, in the midst of all of that, I got to experience, you know, like, who were the professionals working with him? And I got to connect with the OT and I just saw there was so much value in that. So when I got into Midwestern and he needed both.
Speaker 1:He needed PT and OT oh, he needed everything Right Like he needed. He needed across the board.
Speaker 2:Yes, and he did not live very long after the injury because it was so significant. I think Chris passed maybe four gosh, no, not even. It was probably like a year and a half to two years after. And so even the midst of seeing like the grief and all of that, and he also was highly intoxicated at the time of the fall. And so you know, alcoholism runs in my family.
Speaker 2:I am no stranger to mental health and addiction and so I've always had like a love and passion for that. My grandparents, my dad's parents, are, you know, like they made an active choice when they were young to kind of remove themselves from some like generational trauma. And so you know, like I always think like they made that choice for all of us future generations to have a different life. And so I'm like, I know, right, like looking through the disease model of addiction or the biopsychosocial or the learning model, there's so many components to addiction. So when I got to Midwestern I fell in love with the mental health classes. My professor at the time was Dr Katina Brown. She is a world-renowned occupational therapist. She's written all the mental health textbooks, she's written the research textbooks and she's also the editor of Willard and Spackman, which is like the main book of OT, and so I was so fortunate to have her as a professor. She later became a colleague once I started teaching at Midwestern. Her as a mentor, she really facilitated, like, my confidence in becoming a mental health OT and a professor and I think it was her love and passion that further drove me to have such a love and passion for mental health OT.
Speaker 2:When I got out of school I did not start in mental health. Only about 2% of us at the time worked at mental health in mental health. Now only about four and a half percent work in mental health. We are like a very it's like a tiny little niche, and so I started in home health pediatrics. But again, I love like the family dynamic stuff, like you know how family systems work and the mental health components of working with kids who had, you know, cerebral palsy and autism and Down syndrome, and you know what the parents were experiencing.
Speaker 2:Then I transitioned and worked for a day school for the deaf in Phoenix, arizona, and also working at a school where you know I think it was like 5% of the kids' families learned sign language. Part of it was accessibility to learn right Resources, time. All of that, though you know being at the school and seeing kids you know go home essentially to homes where there was more language deprivation but also seeing all of those other factors that contribute to it. It wasn't just that the parents didn't want to right there's. It's so complex and I fell in love with that piece and looking into some of you know the trauma that some of the kids experienced and how that affected their ability to engage in school. And then after that, in that time, I decided to go back and get my doctorate. I had so many questions that didn't have answers?
Speaker 2:And I wanted to be a part of that process of how can we do more when we haven't figured that out yet, like what that looks like. And so at that time I got an offer from Midwestern to come on part time and be a faculty member and so I left my full time job for a part time job and then probably a month later I got hired on at Child Health, which is a childhood advocacy center. So the kids that come there have pretty substantial trauma and so I did that for a while and that time of my life was just really incredible, being completely immersed in mental health. It was hard as a mom Now I could never go back and work in that environment. It was just, it was a lot, but I learned a lot.
Speaker 2:And then I became um, then, kind of like when the pandemic hit, I transitioned into full-time and then, you know, it was fairly like a year ago, I transitioned to part-time and then I grew my practice and it really boomed. And then in November of last year I stepped down as like a official, like full faculty member, but I still adjunct and help out and I do a lot of guest lecturing at different universities in the Valley. Cause again mental health. Ot is so rare. It's so rare, not, there's not a lot of it.
Speaker 1:That's why I was like we got to talk about this, yeah.
Speaker 2:And so, yeah, and you know, kind of at the same time I got connected with someone at SPRC and they're like would you want to do OT work, or why don't you come and meet the owners? And so I sat down with Alex and Dan and I'm like I want to be in here, like I love being a clinician, I love aspects of research. It's really fun and it's really great. And then there's other aspects that are not my favorite, like the nitty gritty details.
Speaker 1:You know the brutal hours of nitty gritty details.
Speaker 2:My brain doesn't work that way. So the clinical piece I love so much and so so, yeah, so now I have the practice and then we have a contract with SPRC and so you know we get a.
Speaker 1:We can have a variety of things that we do that really um, the and the reason why the, the people that I invite to the show are, you know, they're passionate about something. A lot of times they're offering something unique or they're offering something that's instrumental in care. And you're right, the, the use of ot and mental health is pretty rare. I don't see it a lot and when, when I you know, came to visit you at scottsdale providence and sat there on campus and you came in and gave your piece, I'm like, oh, because you see it a lot in the developmental delay population, the kids with very significant disorders who are struggling with kinesiology kinds of challenges and PT kinds of challenges, but in their long-term care, ot has to be a part of it.
Speaker 1:You know they've got to be able to function in the world and do things and hopefully have a job one day and all these kinds of stuff. And the fact this is where the silo thing happens in mental health care and in all care really is that we get these people and they become really good at doing what they do. It's been largely aimed at a certain population, so they stay there, you know. They kind of don't leave their yard. And the cool thing about you I'm going to compliment you right now is that you have this brilliant insight to be like, wow, this really fits in mental health and addictions care and I want to do this, so you know. My other question for you is how does that, does that look on campus at Scottsdale Province or in your private practice with what I might say are not necessarily traditional OT kinds of clients?
Speaker 1:Yeah, you know you have people who are smart and maybe they've had degrees but they've suffered from an addictions issue. And now they're in front of you and you're like, hey, let's get some alignment going on here, Like, tell me about that, work on a day to day basis. I want to hear a little more about it.
Speaker 2:So I'm always looking at what is the function of behavior, like what is what's going on, yeah, and so most of the clients I see at Scottsdale Providence are neurodivergent, and so for anyone that is unfamiliar with that term, it's an umbrella term, it's not a diagnosis itself but, and depending on the umbrella and model you're looking at, there's a whole host of things that can fall under it.
Speaker 2:But almost always there's agreement upon autism, adhd, audi, hd, which is autism and ADHD, combined epilepsy, other learning disabilities, like things like dyslexia, dysgraphia, dyscalculia.
Speaker 2:Sometimes we pull trauma under there as well, but it's this idea of, you know, having neurocognitive differences, so the way that the brain processes information and how the body responds to it, like what does it do when the brain, like brain, sends a message, and then what happens after, and so that really is what separates, kind of things that fall under that neuro divergent umbrella. And so at Scottsdale Providence I primarily work with people who have those other things going on, and so, from an OT lens, we are inherently a very holistic profession. We are naturally what we call pretty neuroaffirming, where we are honoring individual strength. We're really looking at like function of behavior, versus labeling a behavior good or bad, and then we like extinguish the behaviors Like where is it coming from. Extinguish the behaviors like where is it coming from. And so when I am working with clients who are experiencing addiction and are, you know, in the early midst of early like addiction recovery and they have adhd, right um I'm looking at.
Speaker 2:Of course they do I'm looking at the adhd components that also relate to the addiction, challenges with impulse control, difficulty with self-monitoring of behavior, maybe even just like challenges with dysregulation. So, although it's not in the DSM, a core component of ADHD is significant emotional dysregulation. There's another new term that's kind of been connected with ADHD, again not in the DSM, but many psychiatrists have like acknowledged this is a thing going on, a phenomenon rejection sensitivity, dysphoria, so a high sensitivity to rejection. But we think about what it takes to adult. There's a lot of executive function related for success.
Speaker 1:You're saying you know what, what it does take to adult.
Speaker 2:Yeah, I mean.
Speaker 1:I'm interested. What's your answer to that?
Speaker 2:Yeah, it takes a lot right. Like adulting is really hard. And if you have executive dysfunction, if it's hard for you to plan, to organize, to start a task, to complete that task, to monitor your own behavior, to regulate when you're overstimulated, like it, you're going to have challenges with like adulting. And so many of the individuals I see at Scottsdale Providence have experienced these challenges and so coping. You know, substance use often helps with coping right, especially when we look at the substance of choice and how it impacts the brain and the nervous system right, the central nervous system as well as the autonomic nervous system. And so I'm always looking at function of behavior, like what's going on. Individuals with executive function issues also don't know what to do when they're bored, and sometimes boredom is a common thing that comes up when I'm like what are your triggers for relapse? Boredom?
Speaker 2:And so we look at how do we develop leisure relapse boredom, and so we look at how do we develop leisure, healthy leisure occupations, how do we engage in play more as, like an adult, we adults we forget to play and have fun. But when you struggle to organize and initiate and like whether it's initiate a task, initiate conversation, organize your life, those things are going to be hard. So I'm always looking through multiple models when I'm working with any client to figure out like where's the function of the behavior and how can I support both skill development as well as like systems development in their life, so that life feels easier and they feel successful, they increase confidence, have more of a deeper connection to their own identity and then can experience mental well-being.
Speaker 1:Well, and you know, it sounds to me that part of this process, which is where this crossover is really beautiful in my mind the awareness of my own emotive process when I become overwhelmed, when I become bored, what I do in response to these stimuli, et cetera. But then you've got the other tools. It's like how to be organized, how to use a calendar, how to let you know all that stuff. What are the kind of tools that you're using? If I didn't know any better, I'd say you probably crafted some of your own that fit into the ot process but, are linked to emotional awareness as well as executive functioning pieces, and they come together.
Speaker 1:What? What are the tools that you're using to work with these? What are you giving them as they, as they progress and develop?
Speaker 2:the first thing we always look at before implementing like a tool is motivation. How are they inherently motivated? So neurotypical people, typically it's like they can be and neurotypical is a term used for someone who's not neurodivergent, right and so they're inherently more easily motivated and so they can withhold gratification, whereas neurodivergent people struggle a little bit more with motivation or seek out immediately gratifying activities. Right, they need that dopamine right away. And so first we look at you know, are you motivated by challenge, passion, interest, novelty or urgency? And then, once we can identify what are the primary motivators for a person, then we can figure out how do we incorporate tools that can then match those motivators. And sometimes the tools aren't always matching motivators, but we try to incorporate ways to be motivated to use the tools. So, planners, we do use some digital stuff. I love this app called Habit Share. It's completely free.
Speaker 1:It allows for Habit Share it's completely free.
Speaker 2:It allows for HabitShare, it allows for accountability. So I have some clients that will send me their habits and they check in and what's really nice. Of course, I make them sign a consent form because HabitShare is not HIPAA compliant. But I can directly message them and just say hey, like I noticed that you didn't do, you didn't brush your teeth for two days in a row. Let's track that the next time that we meet, like. And then they're like oh gosh, she is watching.
Speaker 2:And then sometimes for some of them that accountability is really helpful until it becomes a habit. I really love incorporating sensory-based tools. So before we implement an executive function tool, we look at a person's sensory processing. So we use an evidence-based assessment called the adolescent adult sensory profile, and it helps us understand. Does this person have sensory processing differences? Are they more sensitive? Are they a sensation seeker? Do they avoid when things are too much, or do they have something called low registration, which essentially means they need a lot of the stimuli to register that it's there, and typically with people with ADHD we see a lot of that, and also for people who experienced trauma and are dissociating, we also see that as well, and so that helps us understand if we need certain types of cues. So let's say, someone shows that they have low registration patterns for visual stimuli. It doesn't matter.
Speaker 1:Now define for our audience what that means.
Speaker 2:Yep. So the low registration means right. So for sensory processing, with this model that we use, with this assessment, we look at threshold. Does a person have a high threshold where they need a lot of the stimuli, whether it's visual or movement or touch, to know that it's there? Or do they have a low threshold where a little bit goes a long way? So someone who would wear noise canceling headphones would likely have a low threshold for auditory stimuli.
Speaker 1:Your high threshold of folks are the ones that are out there doing very stimulant-based drugs. They can be. They're like I need something to crank me up because I'm going for the stimuli right.
Speaker 2:So my colleague that I had mentioned before, dr Brown, she actually did a study on this two years ago, thinking that drug of choice would match the sensory processing pattern, and it actually didn't.
Speaker 1:All in all.
Speaker 2:all in all, it's just being and, yes, is there very are? Is there some truth? Potentially there, Absolutely, but it wasn't statistically significant enough to say, yes, someone who is a high threshold is going to seek out a stimulant, versus someone who has a high threshold is going to seek out a stimulant versus someone who has a low threshold is going to seek out more of like a depressant, like alcohol. However, I will say I do track that with the clients I work with and I do see some patterns. It just wasn't significant enough in the research.
Speaker 1:Well, you're also talking about a person's chemistry, like their drug of choice is their drug of choice. You know what I mean and that's and that's what they're using. So it may not line up. That's an interesting finding. That's really cool.
Speaker 2:It is yeah and so right. So someone who is showing low registration patterns with visual stimuli right, they're not actively seeking out, they're just hanging out and they're just missing stuff. So these are like the people that are being labeled like lazy, or they're just choosing not to engage, they don't want to engage or like like a child in the classroom and they're missing cues. They're missing things on the board. They might need things bolded and highlighted and maybe they need an auditory cue with the visual cue.
Speaker 2:And so, as an OT, if someone is showing that type of pattern visually, I'm not going to just say put it in your calendar and then make sure you look at it. We're going to have alarms, we're going to have a calendar on their wall. We're going to have the calendar in the phone with the alarm paired with it. We are pairing a lot of sensory cues that you need to pay attention to this. But when you're doing executive function work and you don't understand the sensory processing component, we can miss a lot of things, and so those paired together can really help support success for individuals.
Speaker 1:So the thing that occurs to me is let's circle back to trauma for a second. When you're engaged in this kind of evaluative and observative process with a person and one of their key triggers is traumatic events and you know, some of the things that you see in people who suffer from significant trauma is there, are, you know, people, places or things that can be a trigger. Sometimes they're aware of them and sometimes they're not and even processing with them about potential triggers and these places and being able to identify okay, let's track this, let's figure out where you're going, let's make sure that we're aware of what's in our environment. Do you see trauma response, response, re-engage, sometimes when you're working with them in ot session, does that happen?
Speaker 2:oh, it can happen, and usually, like when I do my evaluation, and I try to grab as much information as I can, whether from a previous therapist, or intake paperwork about the trauma and then tracking that as it matches then like different sensory stimuli, or we try to work around it, and so that is something that I'm really conscientious of, and that's also why it's really important to pair with a primary therapist or a trauma therapist who's working with a client to understand, like, what those triggers are and how to avoid them until they are at a point where they're not getting out of their window of tolerance, because if someone is getting triggered by a past trauma, the work that I do is probably not going to stick because they're so activated yeah.
Speaker 2:Yeah, they're either in sympathetic right when where the fight or flight, or they are past that and they are dissociating and they're not connected with the present moment.
Speaker 1:Right. Well, and I guess that's when you know you've got an entire clinical team that's surrounding you. You know, as you work with these individuals, it's like, hey, they may not be ready for OT. It sounds like they really need to ground out and do some more trauma work so that they can feel like they're able to regulate as they go out into the world and they do some of this OT executive functioning work with me, and so you know, that's this is so. This is where I mean all this stuff is cool to me, but I think that some of the you peel back to the veil on how programming works, and that's something that I like to.
Speaker 1:Some of the you peel back the veil on how programming works, and that's something that I like to do in the show. How does that like, how do you interface with the clinical team? You got a psychiatrist, you got clinicians, you got coaches that are on the ground every day with folks. Like, how does that mechanism work? As you're working with a person individually, I know that you're also passing information off to the other care providers. What does that look like in your day?
Speaker 2:I am constantly in communication, right, so I think about, like, let's even just say residential. If someone is in residential care, usually, right, the capacity of what we expect for like active cognitive engagement is a little bit less than when someone moves to PHP or IOP. And so I might get called in to do a sensory eval and then give some sensory tools for grounding while they're working on maybe some of the processing and stuff like that before they come to more intensive programming. And so I'm communicating with the residential staff in terms of, like, let's do a sensory assessment. What are the sensory tools? Whether they're focused tools like fidgets or weighted products, or using smell in a like a very intentional way to help facilitate grounding and regulation.
Speaker 2:At the same time, whenever our psychiatric practitioner at SPRC is doing an evaluation, if she is noticing potential neurodivergence or she sees a client who has ADHD, she immediately will, like, put in the chat. Hey, I want you to have eyes on this person, let me know your thoughts. Often also, what she is potentially catching is autism. That is the biggest thing you're noticing specifically more with, like, the millennial and Gen X population is missed like level one autism. So very low support needs, high masking individuals and probably in the time that I've worked at SPRC, I mean and like probably. I mean like I'm thinking like 10 to 15 people we have caught like missed autism as it's related to significant mental health struggles and or addiction, and that is a very important thing not to miss, and so I'm constantly communicating.
Speaker 2:It is, and you know, like the AQ isn't going to catch it which is the autism quotient. That is one that was kind of developed, and it does focus more on more male traits. However, the CATQ, which is Camouflage Autistic Test Questionnaire, something like that that is a really good one very low support needs, high maskers, and so that's like one piece of the puzzle. And then the primary therapist. We are interfacing on a very regular basis of like, what are they doing? What am I seeing? I am typically advocating for clients to like be able to not engage as much. Right, when we think about treatment facilities, you know most of them have a lot of structure, and they have to, otherwise it could be complete chaos. But neurodivergent individuals need a lot of flexibility and autonomy for regulation. Structure is important, but there's got to be flexibility in it, and so when someone is on my caseload, everyone at SPRC is interested in hearing like how do we integrate more autonomy and flexibility for their care, but also making sure it's structured enough that expectations are known, and so that is probably a huge part of my job, um, whether it's being able to stay back from events or having alternative events to go to, like we even think about, they are very stimulating. Um, and I've had a lot of people even ask like hi, are there any? Like neuro affirming AA meetings and I don't know of any yet Doesn't mean they're not out there and it doesn't mean that they won't be developed.
Speaker 2:But these individuals have high sensitivity to sound and smell and movement and when they are in fight or flight, that can also be really triggering and they get out of the window of tolerance and then the meeting is no longer beneficial. So we're always trying to collaborate like what is the best path for each individual so that they can have a sustainable recovery. I even collaborate with, like our CEO, alex, all of the time. We just got a new PHP house for the women and I'm designing one of the rooms to be like a sensory space slash lounge area and also. So it's like how do you make this space beautiful and adult focused but also have all of the necessary sensory components that people can go in and learn how to self-regulate when they are overwhelmed? So we'll have things like noise canceling headphones that also are like similar to Bose there's really a really great brand that's not quite as expensive, but they can access music or podcasts but also have the noise canceling feature, having chairs that swivel.
Speaker 1:Yeah, right.
Speaker 2:I. We also talked about like having a swing from the ceiling because that linear vestibular input right, which is not spinning, it's just going back and forth, can be really regulated for some weighted lap pads and pillows and blankets and different textures in the room, helping people understand, like, how much of a difference that can make. So it's like creating this space allows them to practice these skills outside of the OT session.
Speaker 1:Well and know what tools they need when they leave you know it's like I need my own chair and I need my own weighted blanket or I need these things, you know. And the other thing that that you know, as you talk about working with these individuals and working with them in the context of a treatment program, and they've got all these tools that are available to them. We'll shift over to the outpatient side of things. What does it look like when you don't have a team but you're addressing an individual who's you know, maybe they're trying to go back to school or they got back to work, whatever it is? How does the outpatient practice differ? A little bit Like what?
Speaker 2:does that look like. So my team isn't there with me, but if they have a team. I am coordinating with them all the time. For the most part. There are some clients where they actually don't want as much coordination and sometimes even in the ROI they'll say I need some tools, and then I'm good, yeah.
Speaker 2:And so my office space is very sensory friendly, like everything about it. We have lamps everywhere so we don't have to turn the big light on, but for people that want it, we can do it. If they're, if they have visual sensitivity, we've got tons of sensory based tools that mirror like what a home looks like, so that they can. We're modeling essentially how they could design and set up their own space. We are working on grounding exercises. We do. We do help with like mindfulness and breathing, but we're always other sensory components. We have planners up the wazoo, every type of planner you could imagine in our cabinets to try to see if it could help support a client. We use old school timers for time management If people have time blindness, because once you get into your phone most people forget why they were there in the first place, and so we're very focused on what are the goals for that person. And so let's say they want to go back to work or they're trying to go back to work. The first thing I do ask is would you like formal accommodations or a letter of accommodations written? And so the big thing to know with this one is they have to be feasible and doable for the employer. So things like you know, breaks or noise canceling, headphones or like a dedicated space if you have to have a one-to-one meeting, if someone struggles with attention regulation, right. So the focus is really hard. Most of the time those are easily met.
Speaker 2:I have had clients that have said you know, I work a 40-hour work week but I only want to work 25 hours and like that's just not doable, right, they're paying you for a job. So I always keep that in mind when I am writing my letters of accommodation, that I've done so many of them. I know what will get rejected, um, and I know what likely won't, um. Oftentimes I'll go into um accommodation focused meetings with HR and the client to be able to help further explain or to clarify what the accommodation means. I always tell my clients, though, like as an advocate with them, I don't speak for them and so we practice like what are the cues when you want me to jump in? Or they'll just say you know, I'm going to have you know, dr Sarah, explain this part. They'll just say you know, I'm going to have you know, dr Zara, explain this part, because it's really important that in that process I'm also helping to foster and develop skills around empowerment and self-advocacy.
Speaker 2:Same thing goes for schools. So, having worked as a professor, I know the back end of that. I know what universities do need to honor and I know what is feasible to honor. And I know what is feasible and so I do a lot of letters of accommodation for whether it's undergrad or graduate programs to help support that. And then the other part is skill development around time management, skill development around organization and planning. And so I have to know a lot about like what is the job they're wanting to do or what is the program that they are in and what do they have to do on an everyday basis. Study skills is the big one that comes up. No one ever gets motivated to study, and so it's like, how can we make that as engaging and pleasurable as possible? And so every client I work with it looks different, but we use a lot of the same types of techniques and strategies. We just adapt them.
Speaker 1:Wow, uh, you know the um. The one of the things that I'm trying to bridge when we go out and we do the podcast, we're we're passing information to the, the greater public is that there are all kinds, you know these, as you say, the neurodiverse umbrella. A lot of us could fall in there. Some of us fall in there a little easier than others, but everybody's got this little quirk or there's something else, and one of the things is that a lot of the stuff, that this kind of ingenious stuff that we're, that we're life and these things are habit tracking and where are you? You know where are you feeling like depression onsets? You know what part of the day, do you?
Speaker 1:feel best in and just having those kinds of awareness, like sharing some of this stuff to the world is part of the goal of what we're doing here. If you were to share one, maybe two things with just the average Joe slash Jill in the world, slash they in the world what would you say is great common practice for the person who didn't necessarily need treatment, who didn't necessarily need therapeutic approaches, but could really benefit from some of this stuff, like what's the, what are a couple of things that you would give to the world?
Speaker 2:Number one know what your values are, because if your goals don't match your values, you will never have the motivation to meet them. And so, like an example is, I had a client come to me and say I want to work on organizing my car and keeping it really clean, and I said, okay, tell me the value behind that. And they're like my mom and dad always instill that into me. And I said, no, what is the value for you? And they're like I don't really have one, it doesn't really matter to me. And like, well, this is why this isn't working. You've been trying this for three months. It's not working because you're not motivated, it's not a value. And so I think important for every single person Like what are your values and how does it align to a goal? Because then there will be a direct connection and more of an internal motivation to to fulfill and meet that goal. Like that's number one. And for some people it gives them pause and they think about like what are my values? And I don't just mean like honesty and respect, I mean like your values as a person.
Speaker 2:So for me, I have ADHD. I found out when I was an adult and I love stimulation, I love learning. My job is not a job. It is like every part of my being. I'm also a mom to a child who has ADHD. She is level one autism, super high maskers, so if someone met her on the street they would have no idea, right? But it's very clear to us as parents and so there is this greater drive for me to do this type of work. It's my special interest and so that is a value for me. Like neuroaffirming care and neuroaffirming support and building a community is a huge value for me. So when I am working with clients, I really want them to think about like, what are your values? I had one client the other day list alone time is a huge value for me. Like that is really important, and so sometimes our values aren't what we actually expected our values to be.
Speaker 2:So that would be my first one. The other one is slowing down and being willing to have less. And right, when you have to maintain a lot, it's a lot harder, and when we're in our day-to-day life, it's really easy to accumulate a lot, and usually having less to take care of makes it so much easier to care for the things that you have to be able to find things in your space. So many of the people I work with, and even if you're out there and you struggle with organization and planning, having a decluttered space is going to make a huge difference, and so that goes into the environment aspect. Your environment plays a huge role in how you feel and how you perceive the world.
Speaker 2:Um, and then the last one would be I like understand your own sensory processing. So many people don't realize how much sensory processing plays a role in mental health. Um, there are a lot of tools out there that can support sensory processing, whether it's noise-canceling headphones or loop earbuds or just having sunglasses with you every time you step outside, if you're really visually sensitive, or keeping the drapes drawn during the day. Understanding your own sensory processing is a really easy way to feel empowered in terms of being able to control for things that might make you feel anxious, and so that's a really easy one. Usually, when people I'll do workshops in sensory processing, people will be like I learned so much, but now I can like just take this information and adapt it to my own life.
Speaker 2:You know that's not a I need to see your type of thing Usually it's just I need to learn about this and learn about mine, and then I can move forward and implement this stuff in my everyday life.
Speaker 1:Well, and it goes to this, you know, what you're talking about is just this increased awareness of self. Um. One thing I would probably add to this having, you know, being a person with ADHD who's had to come up with these strategies and doing all these things, and then I also noticed that it's, you know, every decade goes by and changes a little bit. You know your values change, which you, your sensory stuff changes. In your fifties, your memory starts to go, especially after two kids. You know what I mean, right, and so you know the, the.
Speaker 1:The interesting thing about a lot of this conversation and you and I are probably just going to have to come back and do some more but the, the thing about masking, um, and you and I have a. We have an understanding of that from a clinical standpoint and what it looks like in a, in a clinical environment. But I think the world does it. You know everybody's masking on some level, like your guy with the car. It's like why are you doing this? This was, and I you know, part of the process. Developmental process, for me as an adult, has been like you know, there are things that your parents gave you, and some of those things were values and then you get to a certain point and you're like wait a minute, those actually aren't my values. I, I have different values than that and you do this, you do this. You know this individuation, you know and.
Speaker 1:I think, individuation is something that you're doing all along and, um, people who, if you feel like you're wearing a mask to the world, to your job, to your kids, to your spouse, to these people like you're talking about a process, and I think the most salient thing and something that's really valuable is a lot of the changes that you're looking for, because we think of change as, like grand life change, this big thing. The changes you're looking for are often really subtle. I need a chair that swings back and forth. I need a little more private time. I just need these tiny little things to implement in my life that are going to make this massive difference in everything and my satisfaction with everything you know. On the other side, do you see people kind of coming away with this like great gratitude to you because you pointed out something? What does that look like?
Speaker 2:Yeah, yes, often, and that takes time, like I just met with a client yesterday where they've hit that point. They are an adult, very successful, struggled with addiction, found out that they had autism, had no idea. Their whole life their parents have been reading books and learning and, like now they've got all these systems in place. But it's a very up and down process. Sometimes there will be sessions where they're very angry not with me, but they're upset that they didn't know about this earlier.
Speaker 2:Or the you know the question of like who am I outside of these instilled values? Like what are my values? And that's a hard thing. But what a gift at any point in your life to start reconnecting with who you are naturally. And I think the more that we can do this, and especially for those of you who are listeners and have children. You know, the number one thing is to support who they are naturally and to naturally help them develop coping skills and regulation skills that naturally meet their own, like body and brain needs versus you know, here's a sticker for sitting still in a chair, right, If they're a mover and groover, let's help them learn how to move and groove in an appropriate way in the very context right, and so so many millennials and Gen Xers didn't have that, and so once they start to learn like these are my natural needs and now I know how to meet them they see themselves very different, and especially when we can connect that to substance use, that can also help support sustainable recovery.
Speaker 1:Absolutely. Well, I mean, you threw Gen Xers in. I'll agree that we have some deficits we had to work through.
Speaker 2:But now we know more, we have some deficits.
Speaker 1:we had to work through, but now we know more. Sarah, it has been. You know I've just had so much fun, you know, being here with you and the show today. Thanks for taking the time. I appreciate it very much. This has been Head Inside Mental Health. Todd Weatherly, your host, Dr Sarah Anderson has been our guest and we really appreciate the work that you're doing out there. We'll look forward to seeing you all next time. Thanks, Sarah.
Speaker 2:Thank you. I'm a little little, little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little little. Thank you, bye. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here, bye.