Nurse Psychotherapist, Tara Tourloukis

Meet Tara Tourloukis. Tara is a registered nurse psychotherapist with more than 20 years of experience in mental health care. It’s a truly unique and rewarding niche. As a nurse psychotherapist, she runs her own private therapy practice in Ontario, Canada—a role that blends clinical expertise with compassionate counseling.

During our conversation, I couldn’t help but tell her that if I had known about this nursing specialty 20 or 30 years ago, it would have been exactly the path for me.So what does Tara do in her role? She provides therapy for individuals facing everyday mental health challenges—things like low mood, stress, overwhelm, trouble coping, and finding balance between work and life. Let’s be honest, that’s something many of us can relate to.

What I especially admire is her holistic approach. As a nurse, Tara understands how physical health directly impacts mental well-being. She routinely checks in with her clients about things like hydration, nutrition, and sleep—those often-overlooked pieces that play a big role in how we feel.

Does the idea of becoming a nurse psychotherapist resonate with you? Tara shared some great advice for anyone considering this path: get hands-on experience in mental health, whether in inpatient or outpatient settings, take stock of your education, knowledge, and skills, get familiar with the standards of practice, connect with informal peer groups, and most importantly—find a mentor.

As someone currently working toward a PhD, I can confidently say that Tara’s advice is solid.

In the five-minute snippet: With a husband and five kids, this kind of day would be the best kind of day. For Tara's bio, visit my website (link below).

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Transcript

[00:01] Michelle: Meet Tara Tourloukis.

[00:03] Tara is a registered nurse psychotherapist with more than 20 years of experience in mental health care.

[00:09] It's a truly unique and rewarding niche. As a nurse psychotherapist, she runs her own private therapy practice in Ontario, Canada,

[00:19] a role that blends clinical expertise with compassionate counseling.

[00:24] During our conversation,

[00:26] I couldn't help but tell her that if I had known about this nursing specialty 20 or 30 years ago,

[00:33] it would have been exactly the path for me.

[00:37] So what does Tara do in her role?

[00:39] She provides therapy for individuals facing everyday mental health challenges.

[00:44] Things like low mood, stress,

[00:47] overwhelm, trouble coping, and finding balance between work and life.

[00:53] Let's be honest, that's something many of us can relate to.

[00:57] What I especially admire is her holistic approach. As a nurse, Tara understands how physical health directly impacts mental wellbeing.

[01:07] She routinely checks in with her clients about things like hydration,

[01:11] nutrition, and sleep,

[01:13] those often overlooked pieces that play a big role in how we feel.

[01:18] Does the idea of becoming a nurse psychotherapist resonate with you?

[01:23] Tara shared some great advice for anyone considering this path.

[01:28] Get hands on experience in mental health,

[01:30] whether in outpatient or inpatient settings,

[01:34] Take stock of your education,

[01:36] knowledge and skills, 

[01:38] Get familiar with the standards of practice,

[01:41] Connect with informal peer groups, and most importantly,

[01:46] find a mentor.

[01:48] As someone currently working toward a PhD,

[01:51] I can confidently say that Tara's advice is solid.

[01:55] In the five-minute snippet, with a husband and five kids,

[02:00] this kind of day would be the best kind of day.

[02:21] Well, good morning, Tara. Welcome to the podcast.

[02:24] Tara: Thank you.

[02:26] Michelle: I'm excited to talk to you today because you do something very unique.

[02:32] And when I think about,

[02:35] oh man, 20, 30 years ago, and if I had known that this was a possibility,

[02:41] I would have done it.

[02:43] I would have done it in a heartbeat. So thank you for joining us today to tell us all what you do as a nurse psychotherapist.

[02:55] Tara: Yeah, no, I'm really excited to be here.

[02:57] Michelle: Okay. Well, we're just going to jump into it and why don't you start by telling us, why did you go into nursing and how did you get to where you are today?

[03:08] Tara: Sure.

[03:09] So that I think always.

[03:12] I feel like it's a bit of a funny story.

[03:15] When I was a teenager,

[03:17] like in high school,

[03:19] initially I had this thought that maybe I wanted to be a teacher. And so I did a co-op and incredibly quickly realized that teaching with little kids was not in any way what I was interested in.

[03:31] And I watched two movies that sort of solidified for me where I wanted to be.

[03:40] And it's funny, when I tell people these movies, I often get, oh, really? Because that would have made me move really far away from mental health.

[03:49] But I saw One Flew over the Cuckoo's Nest and Sybil, and I was like, oh my gosh, this is what I want to do. Like, mental health is exactly where I want to be.

[04:00] And I can't even remember how old I was when I watched those movies.

[04:04] But from then on,

[04:05] that is exactly. I, I sort of just knew.

[04:09] We talk about or we hear about those people who are like, no, I just knew. And that is where I have directed my career in almost in its entirety.

[04:19] So, yeah, those two movies. And I went into nursing after high school.

[04:24] Michelle: wow, that's incredible.

[04:28] And, you know, I think anybody that's been around a little while can totally relate to those movies as having watched them. And,

[04:37] you know, maybe it resonated with you because those movies really struck a chord in me,

[04:44] especially about how people with mental challenges,

[04:49] mental health problems, are viewed by the community and by those in charge.

[04:56] Right. Those with power and, yeah, felt a great deal of compassion towards those individuals.

[05:05] But what a great story.

[05:06] And,

[05:07] you know, I've said this many times on here that,

[05:11] you know, nurses don't always go into nursing for the reasons that maybe people think we do.

[05:18] And, and, and yet we still love it. We're still very successful.

[05:23] Tara: You bet.

[05:24] Michelle: Okay, so let's talk about another thing on your horizon right now is that you are a PhD nursing student. So tell me about that. Why do you want to do that?

[05:36] Tara: Another question I get asked often and I don't really have a good answer other than I just want to do it. Like, I just, I want to do it. I started as a diploma nurse.

[05:48] I was one of the last graduating classes in 2003 to get a diploma here in Ontario, Canada,

[05:56] and just sort of moved up from there. So I got my Bachelor of Science in Nursing. I went back, got my Master of Psychiatric Nursing.

[06:03] And it was interesting because a couple years went by and I had it in my mind. I thought, oh, I'd really like to do a PhD. But I never published my master's thesis.

[06:12] So for me, that sort of felt like something that would hold me back or wasn't maybe looked upon as something that would get me into a program and I was talking to a colleague who was a first year PhD student in nursing at that time,

[06:27] and he said,

[06:28] basically, who cares? He's like, yeah, there's lots of people that ever published their master's thesis. Doesn't matter, apply anyway.

[06:35] And in that moment, I was like,

[06:37] right, why didn't I think of that? Like, just do it. Just apply. So I applied and I got in and I am really, really excited to do the research that I'm looking forward to.

[06:50] I'm very close to submitting my research proposal and doing that defense and then that can move forward after that's done. So, yeah, I. I guess. Why do I want to do it?

[07:01] Because I just want to do it. And I'm also excited to bring a voice to the nurses that I will be doing some research with.

[07:11] If that sounds like a good enough answer.

[07:13] Michelle: that's very cool.

[07:16] Okay, so what is it like in a PhD program as far as difficulty? You've been, in a master's program.

[07:24] I'm sure you had to do a capstone project,

[07:27] all of that stuff.

[07:29] So what is the degree of difficulty as a PhD student?

[07:34] Tara: I don't know. I think that's a bit of a tricky question to answer.

[07:38] It's so different, though. Like, each level is so different. Right. If I ever had to do undergrad again, I would never, Like, I would never.

[07:47] It's busy, It's hard. You have to study all these tests. There's so much new learning in a different way that there's new learning at the graduate level.

[07:56] In the master's program, it was thesis-based. So I did sort of step my foot into the world of research a little bit,

[08:05] I think, at the PhD level. And anybody who's listening who has gone through this, I hope I'm doing it service by describing it in this way, I think it broadens our ability to think critically about bigger ish

[08:19] Not bigger issues, different things in nursing or different issues in nursing.

[08:25] And a PhD is very much about generating new research where I think there are other doctorate programs that are focused a little bit different in terms of the research piece.

[08:37] Yeah. So in terms of the level of difficulty,

[08:40] I'm not sure there were two years of coursework and certainly some of that felt difficult.

[08:46] However, it's just a different pace and it is.

[08:50] There are lots of conversations with other colleagues and I really, really enjoy that. We had a very small cohort. There's only four of us in our cohort.

[09:01] Michelle: Wow.

[09:02] Tara: Yeah. My understanding is in Canada, there's less than 1% of nurses that have a PhD in nursing.

[09:08] So, yeah, it's just different,

[09:11] basically, is how I always sort of end up describing it. Fun, lots of fun. Lots of stretching your brain. But different for sure.

[09:19] Michelle: I like that. Different. I mean,

[09:21] we can all understand that and wrap our heads around that.

[09:26] So you said that you're excited about some of your research that you're going to be doing with nurses. Can you share any of that at all?

[09:33] Tara: Yes. If any of you Canadian registered psychiatric nurses are listening,

[09:39] I'm going to be coming after you to answer some survey questions in the fall.

[09:44] So Canada is a little bit unique and I'm not sure if people are aware we sort of have this,

[09:49] this two education model. So to the west,

[09:53] British Columbia, Alberta, Saskatchewan and Manitoba, they all have a designation that is a registered psychiatric nurse.

[10:00] We in Ontario and East don't have that undergraduate program.

[10:06] My understanding is I think they're bringing RPNs to Newfoundland. I could be wrong,

[10:11] but I feel like there's been some talk about that.

[10:13] So it's sort of interesting that here in Ontario,

[10:16] when we want to be mental health nurses,

[10:19] it's sort of upon ourselves to figure out that specialty and figure out what sort of courses and certifications we want.

[10:25] And I think if I was born in the West, I most certainly would have been an RPN,

[10:30] but a psychiatric nurse.

[10:32] And so that's sort of where my research focuses. I'm also at the University of Manitoba, so I thought it would be sort of fitting to stay.

[10:39] Not that I had to, but that felt like a really good idea. So looking at the facilitators and barriers to continuing education among registered psychiatric nurses in the western provinces of Canada sort of mirrors in some way my own life.

[10:56] The framework will be a feminist framework, which I'm really excited about.

[11:01] And there's a sub theory of feminism called feminist standpoint theory. And so it really,

[11:07] the focus is on elevating the voices of individuals, not necessarily women in particular, however, the voices of men nurses within the healthcare system. So I'm really looking forward to that.

[11:20] RPNs are a small group if we look across Canada, because they're only regulated in those provinces.

[11:26] And there is a,

[11:29] I think there's a deficit certainly in research around RPN specifically. So,

[11:34] yeah, so that will be its mixed methods, which means there's quantitative and qualitative. So there's a survey first and then interviews.

[11:42] So again, if any RPNs are listening,

[11:45] it'd be great if you wanna sort of contribute to some of that research.

[11:50] So yeah, so that's it in a nutshell.

[11:53] Michelle: Wow, that is fantastic. It sounds really exciting and I love the underlying theme of feminism.

[12:02] You know, I proudly call myself a feminist and my late husband did too.

[12:09] Tara: Love it.

[12:11] Michelle: Yeah. So let's say a nurse is listening to this. Like, do you have a link to,

[12:17] you know, to participate in your research study that we could put in the show notes?

[12:21] Tara: Oh, Michelle, I wish I did. I'm not quite there yet.

[12:25] I still have to wait for ethics approval and then there will be so leveraging the nursing associations and the nursing regulatory bodies to send out, however they send out to their members via email or newsletter,

[12:39] all the study information with a link for sure.

[12:43] Michelle: Okay, sweet.

[12:45] Well, I'll tell you what, I would love to follow up with you after you get this Ph.D. and yeah, and to hear about this study. It sounds really fascinating. I'm kind of a geek on that kind of stuff.

[12:59] I will say I love the studies that are qualitative. I always loved reading those just basically because a lot of the other ones I didn't understand all the jargon, so.

[13:15] Tara: Absolutely, I still don't understand all the jargon.

[13:20] Michelle: So there's a lot of jargon, Tara.

[13:24] Yeah. And I'm going to be sitting down with my brother Chris Patty, he's a DNP and the head of research at our local institution and we're going to go through some of those things because I think reading research studies can be kind of intimidating to I guess the,

[13:45] I don't want to say the regular nurse because no nurses are regular. They're all special.

[13:50] But many nurses find reading those studies and deciphering the studies really tedious and kind of overwhelming. And so we're going to sit down and have a three part series on just kind of how to like Research Study 101.

[14:08] So.

[14:10] Tara: Ah, that's amazing. Oh, I love that so much.

[14:13] Michelle: Does that sound fun? Yeah. And with Chris, it'll be a lot of fun.

[14:18] Okay, let's get into your,

[14:20] What you do on the daily.

[14:23] So who are your clients, Tara?

[14:27] Tara: You know, historically I have in my mental health clinical practice,

[14:33] I have really loved working with folks who have psychosis and I have worked with young people with psychosis first episode and older folks, adults.

[14:44] However, when I transitioned out of the hospital system into private practice where I work now as a nurse psychotherapist,

[14:51] it was really clear that folks with some diagnoses are not as well served in the private system as they are in a system that can offer some better wraparound services.

[15:04] So just as a background in terms of. I know you didn't ask Michelle what is to say? That is sort of who I really love to work with. And I also really enjoy the population that I tend to see now.

[15:16] I think my heart will always be with individuals who have psychosis.

[15:21] So to your actual question,

[15:23] the people that I tend to see now are folks who present often with symptoms of low mood, overwhelm, difficulty coping, difficulty coping at work,

[15:36] difficulty balancing work and life and play and all the things that can be a struggle sometimes,

[15:44] and folks who most often, I will say within that are difficulties with sleep and diet and getting decent food and movement.

[15:56] And I think that's sort of the,

[15:58] the.

[15:59] I don't know. Sometimes I think it's funny because I ask people this. Oh, like, do you sleep at all? Like, do you move at all? Do you drink water? Like,

[16:08] you know, I'll often say to people, it's two o' clock. Have you eaten yet?

[16:13] And they say, oh, you're sort of the first person that's ever asked me those questions.

[16:19] And I always say, oh, it's probably a nursing thing. Right. Like, I'm like, what's your blood sugar like? Shaky even, you need a granola bar for my backpack.

[16:29] I don't know.

[16:30] So,

[16:32] yeah, so those are the folks that I tend to see in my,

[16:35] in my practice now.

[16:37] Michelle: Wow. I could recognize myself in so many of those scenarios that you put forth.

[16:45] That's really fascinating.

[16:48] I've seen therapists, you know,

[16:51] all my life. I'm not ashamed to say that.

[16:53] Tara: Yeah.

[16:54] Michelle: And, you know, they haven't been nurses, Tara.

[16:57] And so no one has ever asked me that as well.

[17:01] So maybe that is a nursing thing that we are more holistically approaching the person that, you know, it's not just your mental health challenge that you're having right now, but all these other things play a part in,

[17:17] in your health, you know, mental and physical health.

[17:20] So I love that you are asking that.

[17:25] Tara: Right.

[17:25] And I sort of say to people, you know, 

[17:28] I'm here to support you in building some skills.

[17:31] It is probably going to be easier if you are not completely exhausted,

[17:36] if you're not slightly dehydrated,

[17:38] and if you've had something to eat. Right. Like, so I,

[17:42] Yeah, so we have that discussion and it's really funny because you're right. Like this light bulb goes off and people are like, oh, right, that makes a lot of sense.

[17:52] Yeah, it does, absolutely.

[17:56] Michelle: I think back to my nursing days, but also to just, you know, my days as a younger person and there wasn't the focus at all on things like nutrition,

[18:08] hydration.

[18:10] I mean, I remember working 12 hour shifts where maybe I drank, you know,

[18:15] 8 or 10 ounces of water and it just wasn't a thing. Right. It's like nobody carried a 40 ounce Stanley around with them.

[18:24] Right.

[18:25] It's like, that's funny.

[18:28] And you know, the whole thing, the whole nutrition thing and how, how it affects people, you know, I remember starting my shift, my 12 hour shift as a pediatric nurse at 5 o' clock in the morning, waking up and having a big glass of orange juice.

[18:48] Oh,

[18:50] right. Like the worst thing, going to work, sitting in report and now boom, my blood sugar is dropping, I'm shaky,

[19:01] right. And then what do I do? I go on my break and I eat a bagel.

[19:05] So like more simple sugars, you know, and I'm,

[19:09] yeah, I'm just chasing it all day and I'm wondering why I'm feeling like total shit.

[19:14] So. Yeah,

[19:15] I love that you're addressing those things.

[19:18] So, so important.

[19:21] So can you share with us confidentially,

[19:25] of course, some of the issues that your clients are having?

[19:29] Tara: Yeah. So I tend to see probably three big areas. So one are folks who are in a life transition.

[19:41] So for example, children leaving the house, maybe to go to school,

[19:47] recently retired folks who are sort of trying to figure out what to do or how. Yeah. To structure life now that they don't have work or individuals who maybe are preparing for one of those sorts of things.

[20:04] I think the other scenario I tend to see a lot are individuals who are struggling at work,

[20:13] so some high stress work environments and just really trying to figure out, you know, that balance. And you know, so we talk a lot about emotion regulation and how do I survive through this.

[20:28] And also, you know, a lot of stuff around assertiveness and communication,

[20:34] which can be really helpful.

[20:35] And then I think the third individual that I tend to see is folks who are already off work. And I, I hear this a lot. I didn't know what to do.

[20:45] I didn't realize that there was somebody I could talk to before I went off work. And so I tend to see people at that point in time they have said, well, I'm off work and now I don't know what to do.

[20:58] And I don't know what to do before I go back.

[21:01] So I'm coming to look for some support around that.

[21:04] Michelle: Those are all challenging things. And I, you know, personally, I will say I was one of those people that I knew about a year before I retired that I was going to retire maybe nine months before,

[21:17] and I just had anticipatory anxiety about it. And I knew that I might have a difficult time sort of disconnecting from the nurse life, the nurse identity and all of that.

[21:32] And I sought a therapist,

[21:34] and she really helped me through the transition,

[21:40] and, you know, stayed with me about six months into retirement when I knew, like, oh, I might actually make it. 

[21:51] I might not run out of money or, you know, run out of things to do, or I might be able to find an identity outside of nursing and cultivate some of these other hobbies and interests that I have, you know, besides nursing.

[22:08] So I think that's a great strategy for people who are preparing for huge life changes like that, to seek out a therapist.

[22:20] And do nurses seek you out knowing that you're a nurse?

[22:25] Is there a connection there?

[22:28] Tara: Yeah, I'd like to think there is a connection.

[22:32] And what I often hear when I do connect with nurses,

[22:36] like, 10 times out of 10,

[22:38] is it is so nice to talk to a nurse, another nurse, because I don't have to describe everything to you. Right. You just get it.

[22:47] And I will say I have not worked in the hospital system for a while, and I haven't worked shift work in a while.

[22:53] However,

[22:54] as you articulate, you know, that identity, our nurse identity,

[22:59] it is embedded in us, all of these experiences that we've had over our career.

[23:04] And that doesn't seem at all ever to be a barrier for other nurses who will think, oh, gosh, but maybe she hasn't been in the hospital for a while.

[23:14] It's just the.

[23:16] common ground, right, that we are both nurses and we have both worked good in healthcare.

[23:21] And on some level, and I guess I would say many levels,

[23:26] I do understand. I get it. I don't have the same experiences, certainly. However, there's an element of understanding, for sure.

[23:34] Michelle: Yeah. And I think so. I'm gonna talk about a podcaster that I've come to really admire, James Geering.

[23:43] He's the host of Behind the Shield podcast,

[23:47] and he's a retired firefighter. And so he's bringing to light many of the issues in the firefighting community which spill over in other communities, share that as, like, law enforcement,

[24:01] medical stuff like that. And one of the things that he's very passionate about is if you are a first responder, if you are a firefighter,

[24:14] if you are a nurse, a physician, that it's really important to,

[24:21] first of all, engage in help for yourself, mental help for yourself through a therapist,

[24:27] but that therapist

[24:30] Has some knowledge about the issues that you face in your career.

[24:37] So, you know, sleep deprivation,

[24:40] suicide prevention,

[24:42] substance use, you know, all of those things,

[24:46] relationship issues that people in those communities suffer from.

[24:52] And so I think to be a nurse and to also be able to counsel nurses, like you said in, in the beginning, it's like,

[25:01] you don't have to go through all that stuff because.

[25:05] Tara: Right.

[25:06] Michelle: They just get it.

[25:07] I would think that that has to lead to kind of the effectiveness of your

[25:14] Of your sessions.

[25:17] So thank you for talking about that. Yeah.

[25:20] One of the things, Tara, that, you know, over the years, as I've said, I've seen therapists and therapists are all different in their approach with that.

[25:31] Yeah. And the therapists that I really gravitated towards were the ones that helped me help myself.

[25:42] So they weren't just telling me, like,

[25:45] do this,

[25:47] you know, try this. It was like,

[25:50] well, how do you think you could approach this differently?

[25:55] So looking to me, you know, fostering that communication,

[26:00] those questions,

[26:02] those scenarios of how can you help yourself? What do you recognize in yourself when you're in this moment, and how could you change that?

[26:14] So how do you help your clients help themselves?

[26:17] Tara: Tara,

[26:18] I'm really glad to hear that you've had some really great collaborative experiences,

[26:24] because that is a big piece of, I mean, I think we can all agree that nobody wants to, you know, go and not feel heard or for somebody to tell them, you know, this is what you should,

[26:36] quote, be doing.

[26:38] And I think there was another podcast, and I wish I could remember the name of it. Since you brought up podcasts, they were talking about therapists and saying that the interesting thing is if you're a surgeon,

[26:53] you get better over time by doing the same surgery.

[26:57] However, for therapists,

[26:58] if you are not necessarily effective or for whatever reason people are not connecting with you, you are not actually going to get better over time because you're just going to be doing the same thing and not creating those really strong therapeutic relationships or clients won't stay or they, you know,

[27:17] won't have a connection.

[27:19] So I think there's a couple things that I've learned to do over the years.

[27:26] One is, you're right, top of mind is that it is a collaborative experience.

[27:32] It is not.

[27:34] We are not highlighting that power imbalance which exists. I mean, we can't. We certainly can't ignore the fact that it exists. However,

[27:42] by being as collaborative as possible, I think we can certainly diminish the impact that we, that that has.

[27:49] There has been,

[27:50] I know, sort of we have, and I, I think in lots of areas of healthcare and certainly counseling, they have talked about a trauma-informed approach.

[28:01] And I heard a couple years ago a slight variation on that and it is called a trauma-responsive approach.

[28:09] So instead of. Yeah. Which I like, really loved because I felt again, it made it a much more collaborative space to say I could be trauma-informed and I could tell you as the, the client that I'm trauma-informed.

[28:26] But again, I am.

[28:28] That is sort of, you know, reinforcing the idea that I hold the power because I'm the informed one.

[28:35] And so with a trauma-responsive approach, I really like the idea of saying, yeah, you get to decide if this is a safe space. Right. You get to decide,

[28:44] you know, how we're gonna go about this or what we're gonna do. And it's our approach together and we're gonna talk about these different,

[28:52] you know, ways of doing therapy and,

[28:55] you know, you sort of run the show.  I'm here to support you in that.

[29:01] So I really gravitated to that when I heard it a while ago.

[29:05] I think the other two big pieces are. One is a strength-based approach.

[29:12] And I,

[29:14] it is, and I sort of said this before, you know, this light bulb goes off. But I try as much as possible to inject validation, right. To say, hi, you did a great job, or holy cow, you put so much effort into that over this week.

[29:29] And people are, I'm shocked at how many people are shocked.

[29:34] Honestly. People will say, oh really?

[29:38] They'll say, oh really? Like, that was a good job. I'm like, well, I don't know. You focused on doing this like three times this week. That's huge.

[29:45] And they'll say, oh, yeah, I guess. Right.

[29:48] And so,

[29:50] and that's the human condition. I think all of us like to be told that, you know, the effort that we've put in is noticed or that somebody else is picking up on our gains.

[29:59] And,

[30:00] and so 

[30:03] I really try as much as possible to use that strength based approach and really highlight people in terms of what they're doing and working towards,

[30:12] you know, like recovery oriented framework is that this is long term, right? We're just, we're doing what we can and everybody's doing our best and you're doing a great job.

[30:21] The other big piece, I think that I have found over the last couple years that has been really impactful.

[30:28] Is intentionally asking for feedback from clients.

[30:33] And I've had this discussion a lot in different spaces, and I know a lot of therapists are a little bit apprehensive about that. However, the research is clear in terms of when clients get an opportunity to offer their feedback about how things are going.

[30:51] That is really empowering, and it gives them that autonomy to in that space,

[30:57] and it can be really supportive for the therapeutic relationship.

[31:02] So I do it in a couple ways. At the end of every session, I try to make a point to say, okay, what, you know, how are you feeling? And I sort of make a joke and say, I hope you're feeling better than when you walked in.

[31:14] That's always going to be the goal.

[31:16] And say, what resonated with you? What stood out?

[31:21] But I also use a tool, a session rating scale that I will send out every couple sessions, and that becomes part of the client record, and so they have an opportunity to answer.

[31:31] I think there's five questions on it,

[31:33] and basically it's very basic. And it asks, did I, do I feel heard by my therapist? Does my therapist seem to understand where I'm at? Did I get the chance to speak as much as I want?

[31:45] I can't remember exactly. Maybe I'm not doing it, so don't quote me.

[31:50] But they tell,

[31:52] when I meet a new client, I say, listen, I really want to give you the opportunity. This is about you. It's not about me. It's never about me.

[31:58] So, yeah, and I think it has gone really well.

[32:01] And I think it also,

[32:03] from the very beginning, helps to break down that apprehension that they might have about giving that feedback. And I usually, you know,

[32:11] make a joke again about it and say, oh, I never take anything personal. Right. This is your time, and let's make it work the best way that we can for you.

[32:19] And if something is sort of veering off track or it's not like what you thought it might be, then we're here to, we're here to maneuver that in whatever way feels good to you.

[32:29] So I think, Michelle, it was probably a really long-winded answer to your question, but those are sort of the, the big three things that I really try to focus on in terms of that empowerment piece for clients.

[32:42] Michelle: Well, it was a very comprehensive answer, Tara, and I really appreciate your approach. It's so different than traditional therapy. Again, I will say,

[32:56] and I don't know, I'm going to venture to say that it is be because you are a nurse. Because feedback is everything.

[33:06] Right?

[33:07] Tara: Right.

[33:07] Michelle: Like it drives our care.

[33:10] So it's like part of the nursing process. It's, you know, as you were describing the process, it reminded me of the, you know, the PDSA cycle. And,

[33:22] you know,

[33:23] it's

[33:24] like you need that loop of feedback for your patient to get better,

[33:30] you know, for your client to get better, for you to get better at what you do,

[33:34] because you don't want to sit there wasting your time or wasting your clients time,

[33:40] you know, and, and not, not being effective and not being able to help them help themselves.

[33:45] So I just love that. And I'm gonna say it's because you have that emotional intelligence, you have that nursing,

[33:54] you know, gut instinct or whatever it is, but I love it. That's absolutely very cool.

[34:01] Tara: Thanks. Yeah, I think the kinds I see think so too.

[34:08] Michelle: So can you practice independently, Tara? Do you need any governing body? Do you need to be under, you know, a physician's wing? Tell me about that.

[34:23] Tara: Yeah, and that's a really good question.

[34:26] And a lot of nurses get a little bit confused about that.

[34:29] But as we know, nurses sort of practice autonomously as we are. We are responsible to our own College of Nurses of Ontario. Here in Ontario,

[34:39] but also under the provincial Regulated Health Professions act, there are five regulatory colleges whose members can engage in the active psychotherapy and the nurses are one of them.

[34:52] So I mean, that being said,

[34:54] as with any single in nursing, we have to,

[34:59] well, we have to have the knowledge, skill and judgment. Right. We have to feel comfortable. And I think my big thing is, whenever I am talking to a nurse who is interested in this is to sort of say,

[35:13] you know,

[35:14] evidence-based practice, root your clinical practice in the evidence and the research,

[35:21] use evidence based modalities.

[35:25] And the rest will probably come pretty naturally, hopefully.

[35:30] So, yeah, we certainly can. We are autonomous practitioners. We are not, we don't have to work under a physician.

[35:37] However,

[35:39] I, again, I'm a big proponent of saying to nurses,

[35:43] make sure that, you know, you read the standards of practice for nurse psychotherapists in Ontario, make sure that you follow the College of Nurses of Ontario guidelines around documentation, for example, and all the other ethical guidelines,

[35:58] and ensure that your clinical practice is rooted in evidence-based research.

[36:04] Michelle: Those are all great things to do. Thank you for speaking to that,

[36:08] because it was just one of my burning questions, you know,

[36:12] and you answered it expertly. So thank you.

[36:16] I want to talk about an article that I saw from,

[36:21] It was talking about patients being denied coverage and it was from April 2022, "Nurse psychotherapist patients denied coverage." So let's talk about insurance, because that's a big, huge part of this puzzle.

[36:40] Has that been resolved? And I guess how can clients find out if they're going to be covered for, for your, your care?

[36:52] Tara: Well, it is not resolved, but we are working on it.

[36:56] Michelle: Wow, three years.

[36:58] Tara: Yeah, right.

[37:00] I don't know much about the insurance industry.

[37:03] I do know it's rather tricky ever to navigate.

[37:07] The Nurse Psychotherapy association of Ontario, of which I sit on the board, is, is a real advocate for ensuring that private benefits cover nurse psychotherapy and their mental health coverage.

[37:21] And, and I understand that the companies can put whoever they want. So I don't know if it's the same in the states as is in Canada,

[37:30] but, you know, you might have this insurance benefit company, and then each employer purchases whatever package fits the that employer. And within that package in mental health, for example,

[37:43] the benefit provider will say, okay, well, you have mental health coverage for each employee and it's X number of dollars.

[37:50] And that can be used to see, you know, this type of clinician or this type of clinician. It is very specific down to the designation of that clinician.

[37:59] Traditionally, nurses have not really been included in that.

[38:04] And so that is, our advocacy is not only nurses,

[38:08] but for insurance benefit packages really to be inclusive and include all of those designations that fall under the provincial piece of legislation.

[38:20] So, yes, of course we want nurses, but really we want everybody because the patient or the client is always at the center of that. And if we can,

[38:27] if, you know, they can be offered the choice to see whomever fits best, then that would be a really great thing for folks.

[38:38] So that is not entirely resolved, however,

[38:42] we're just working on it, so.

[38:44] Michelle: yeah, I saw that article from three years ago and I was like thinking,

[38:50] well, for sure that's been resolved by now. I mean, that was three years ago. But it shows you how much red tape is involved, right?

[38:59] Tara: Yeah,

[39:00] it was really interesting.

[39:02] I was talking to someone else on the board and they were at the table, the actual table, not the proverbial table with an insurance company.

[39:10] And they said, you know, just, I'll ask you something.

[39:14] So who do you think they posed this to? Somebody from the insurance company and they said, who do you think takes care of folks when they are acutely ill, like in the hospital?

[39:24] Who do you think?

[39:25] And the insurance company said, I don't know. Social workers.

[39:28] She said, okay, try again.

[39:31] Psychiatrists,

[39:33] try again.

[39:34] Sort of went down the line, oh, I'm not really sure. And she said, nurses.

[39:38] Nurses are at the bedside taking care of the sickest individuals in the mental health units. Nurses are running groups. Nurses are doing outpatient planning. Nurses work in outpatient mental health.

[39:50] Nurses work on intensive treatment teams outside of the hospital.

[39:55] And they were just like, what?

[39:57] And she said, yeah, nurses work in almost every role in mental health from the sickest patients to when they are doing better, presumably in an outpatient basis.

[40:09] And I'm curious as to how come you think nurses ought not to be included in your benefit package to see people who are probably,

[40:19] I mean, certainly more stable than the sickest people in the.

[40:23] In the mental health units. Right. So she was like,

[40:27] I know they didn't know what to say. And I was, like, blown away by that conversation.

[40:32] So hopefully that kept somebody's wheels turning at night.

[40:37] Michelle: Yeah. It goes to show how ignorant some of these companies are that give the approval stamp. Right. A lot of them need to be educated.

[40:50] And also it talks about the importance of advocacy for our profession for always,

[40:57] you know,

[40:58] educating and advocating for what we do and why we do it and why it's important that we do it.

[41:05] And so I imagine your advocacy is very important on the board and elsewhere.

[41:14] So, Tara, one of the things I really love about you is your tagline, The Wellness Nurse.

[41:23] Tara: Right.

[41:25] Michelle: And I think that's great.

[41:28] It says exactly what you are. It's succinct. And I know if I go to your website, I'm going to find something about mental health.

[41:36] So I just wanted to mention that.

[41:39] Tara, if there's a nurse out there listening that says this really resonates with me, what Tara does really resonates with me. I didn't know that it was even a specialty that nurses could go into.

[41:56] What would your advice be to them for getting into your kind of niche profession?

[42:05] Tara: I get asked this question incredibly often.

[42:09] I sort of have the same feedback for almost everybody.

[42:14] First of all, if you don't have any experience in mental health, my encouragement to folks is often, if you have an opportunity,

[42:23] get some experience within mental health, find an outpatient role or an inpatient role, even casually.

[42:29] Certainly you don't have to have a foundation in mental health. Nurses have,

[42:33] as we had talked about, the nursing process, and there are loads of transferable skills.

[42:38] But I still encourage folks to somehow get some experience in mental health if they're able to. Sometimes that's not necessarily an option.

[42:48] Outside of that, again, I encourage folks to,

[42:52] first of all, assess their own education,

[42:55] their knowledge and their skill. Because as we do know, nurses will say I don't have any, I really don't have any experience.

[43:01] And yet, you know, maybe they've worked in public health for a decade and they've done loads of counseling and they've done loads of family work and they know how to work with individuals and groups and families.

[43:13] And so really highlighting or encouraging people to take a critical look at their experience and their education and their knowledge because sometimes we will highlight some things that we hadn't really thought of before.

[43:27] I will also again go back to read the standards of practice. There are nurse psychotherapist standards practice for folks who live in Ontario. So read those standards and gauge, 

[43:43] how your own education and your knowledge and your skills stand up against that and find the spaces where you can get around other nurse psychotherapists.

[43:53] So we have a couple informal groups, we have our Nurse Psychotherapy association of Ontario and get involved in those activities that are going to support you in embedding that evidence base into your practice.

[44:09] I guess sort of anybody can do almost anything.

[44:13] But as nurses we really want to uphold those standards of clinical practice. And so I offer you know, again the information to individuals.

[44:23] You know, find a course that has some sort of mentorship involved in it or find a course that has some ability to have like supervision or the opportunity to practice.

[44:36] If you're going to do a course, a CBT course, cognitive behavioral therapy course,

[44:40] find one that offers roleplay or that is really interactive.

[44:45] If you are going to do some supervision or mentorship. There are a number of nurses that can offer that to you.

[44:53] They're in the Nurse Psychotherapy Association. We do a journal club once a month.

[44:59] Which is why I love that you're going to sit down with your brother and talk about reading journals. I try to make it as fun as possible.

[45:07] It's called Nurse Tales and Tea.

[45:09] So we meet.

[45:10] Michelle: Oh cool.

[45:12] Tara: Yeah, once a month, Monday mornings. Because again I'm so,

[45:17] I'm just really wanting nurses to see that you can do it in so many different ways. It doesn't have to be right reading that quantitative stuff that nobody really understands except those statisticians out there.

[45:32] Right.

[45:33] Yeah. We have a mentorship program the Nurse Psychotherapy association of Ontario has. We did a pilot last year. It was a year long program where we met with folks members who are interested and we met once a month.

[45:46] This year I think we're going to cut it down to about nine months. But it's a really great experience to meet with other nurses and to talk about that.

[45:55] There are other informal groups as well. There's an informal Facebook group that meets once a month. There's loads of peer networks, and it doesn't have to be with nurses.

[46:05] Right. You can join a, there's different groups, like therapists in Ontario that will have peer meetings once a month so that they can connect.

[46:14] So there's lots of resources. And I really encourage people to just get out there, put your feelers out there, talk to people and see what it's like. And again, just, you know, get in those spaces that.

[46:28] That you can.

[46:29] And I think the rest sort of happens. Right. You'll figure it out. Because I hear people say, oh, what course should I take? Which I can't give people advice in terms of what.

[46:38] What specific course to take.

[46:40] But I sort of go back to the idea about assessing where you're at and then, you know, look at those gaps. Right.

[46:47] Every year,

[46:48] legally, as part of our registration for the College of Nurses, we have to do a learning plan. So, yeah, go back to your learning plan, revisit that and do another learning plan about nurse psychotherapy.

[46:58] Maybe that will help shed some light on where the gaps are. And once you find those gaps,

[47:03] make a plan to address them all.

[47:06] Michelle: Great advice for aspiring nurse psychotherapists. Tara, thank you so much. Yeah. And mentorship is so, so important. So I love that you added that in there, too.

[47:19] Tara: A hundred percent.

[47:20] Michelle: Well, Tara,

[47:21] how do you care for your own mental health? Because I imagine that in the course of your work,

[47:27] you deal with a lot of heavy things.

[47:31] So how do you care for your own mental health?

[47:34] Tara: How do I care for my own mental health? You know, I think working in mental health for so long, I have learned a long time ago to create a bit of separation.

[47:43] And so for me, I think when I am with a client,

[47:48] I will give that client a hundred percent of who I am in those moments, in that hour, 50 minutes.

[47:57] And when I go home,

[47:59] I have,

[48:00] you know, I have five kids, I have two dogs. We're always doing something. I'm a student. And I also want to give justice to that piece of my life, because that is really important to me.

[48:10] And so I want to give that a hundred percent as well.

[48:14] So for me,

[48:16] again, I learned a long time ago that I.

[48:19] I can give what I can when I'm there,

[48:22] and I also want to do the same justice to the other piece of my life.

[48:27] So I value the transition in between work and home, and I make sure I take a couple moments. I do, you know, mindful or spend some time in my car before I come home.

[48:38] Because certainly coming home isn't quiet to all the kids and all the things that we all have to do.

[48:45] So really focusing on that transition and just sort of centering myself again to step into that other piece of my life because 

[48:54] I want to give that everything that I can as well.

[48:57] Michelle: Wow. Again, yeah. Great strategies to maintain your own mental health. The carers have to care for themselves. Right? Yeah. Very cool.

[49:13] Tara: Yeah.

[49:13] Michelle: Well, man, this has been fun today, Tara. I've learned so much. It's just so fascinating.

[49:22] And again, if I could go back 20, 30 years and I knew this was a specialty, I would be there. I think it's fantastic.

[49:33] And yeah. So in awe of what you do. And thank you. Thank you for what you do. It's so necessary.

[49:42] Tara: I mean, I guess we could argue that wherever nurses are, they're necessary.

[49:48] Michelle: Absolutely agree with that. Tara, is there someone that you recommend as a guest on this podcast?

[49:54] Tara: Oh, I don't know.

[49:57] Michelle: And you don't have to answer right now. You can think about it, right?

[50:02] Tara: Oh, that was sort of a surprising question. I wouldn't even thought about that.

[50:05] Michelle: Oh,

[50:07] I've gotten so many great guests as just other people recommending them. Like, oh, yeah, you need to have this person or that person. And so think about it. And we can, we can chat by email or off air about it.

[50:20] You don't have to think about it right now. It's a big question.

[50:23] Tara: Right.

[50:24] Michelle: So, yeah, definitely. Well, where can we find you if, if people want to get in contact with you?

[50:31] Tara: You had already mentioned my website. You can find that at thewellnessnurse.ca.

[50:38] Or you can email me, Tara@thewellnessnurse.ca.

[50:42] Or you know, the socials. I'm on LinkedIn and Instagram and Facebook,

[50:48] all over.

[50:49] Michelle: Yeah,

[50:50] all the things. Yeah, I have all those,

[50:53] I have all those links and I'll put those in the show notes so that people can reach out.

[50:58] Very cool.

[51:00] Thank you so much for being with me today, Tara, and sharing what you do as a nurse psychotherapist and just a good human.

[51:09] It's been fun talking to you.

[51:11] Tara: Same. Absolutely. I really appreciate it, Michelle. Thanks a lot.

[51:15] Michelle: Well, you know, at the end, Tara, we do the five-minute snippet, and this is just five minutes of fun to get to know Tara just as a person.

[51:29] Yeah. Not as an RN psychotherapist, a PhD student.

[51:35] So it's just our time to have some fun. So you're ready to do the five- minute snippet?

[51:39] Tara: Sure thing.

[52:20] Tara: Okay.

[52:23] Michelle: And I hope I pronounced this right. Okay, convince me to live in in Kincardine, Ontario.

[52:30] Tara: Oh,

[52:32] did I say it right?

[52:33] Yeah, Kincardine. Yep. Okay,

[52:37] I can convince you to live in Kincardine in the summer.

[52:41] It is a hard sell in the winter.

[52:44] In the summer it's a little tourist town on the water.

[52:48] Our sign says 12,000 people, but I think that's grown certainly over the years.

[52:54] We are right on the beach. We are right on Lake Huron in southwestern Ontario and there are tons of cute little shops, as we would think the little beach town would be.

[53:04] There's some great hotels, there's great entertainment, there's great restaurants.

[53:09] Michelle: Wow.

[53:11] Yeah, it sounds lovely actually.

[53:15] And you know, conversely, where I live it's like you don't want to be here in the summer. You know, it's 110 degrees,

[53:24] but the falls and winters and springs are really nice.

[53:30] So.

[53:31] Okay, what has been your best purchase under a hundred dollars?

[53:39] Tara: Oh,

[53:40] hands down.

[53:41] A chicken shredder.

[53:43] That circle thing from Amazon where you put your chicken in and you go back and forth. Yeah. And it shreds your chicken. I love it.

[53:51] Michelle: Oh, wow. Okay. It sounds better than just using two forks, right?

[53:57] Tara: Yes, absolutely.

[53:59] Michelle: We're all about simplicity.

[54:02] Okay, this next one we're going to do, it's called five words,

[54:06] five seconds each and guess what? No one's counting.

[54:10] So this is where I'm going to give you five words, one at a time. You get five seconds.

[54:16] Your kids would love this one, to just describe it or define it. So like for example,

[54:22] cat.

[54:23] So you could say an obnoxious feline or you could say furry,

[54:30] Whiskers, Tail.

[54:32] Okay,

[54:34] got it?

[54:36] All right, first word.

[54:39] Roman.

[54:41] Tara: Numerals, start of a paper. The first couple pages of a paper.

[54:48] Michelle: Okay. Treat.

[54:51] Tara: Treat. Ice cream. Oreos. Bedtime. Nighttime.

[55:02] Michelle: I love it. I love bedtime. Okay. Detour.

[55:06] Tara: Construction. Nuisance. Anxious. Being late.

[55:15] Michelle: All the things. Okay, you're almost done. Poem

[55:18] Tara: I'm not very good at. Reminds me of elementary school. Okay to read sometimes.

[55:31] Michelle: Oh, you're good. Okay, last one. Soup.

[55:34] Tara: Chicken noodle, creamy, not my kid's favorite ever.

[55:44] Michelle: I love it. You did great, Tara. Isn't that fun?

[55:49] Tara: Yeah, it was fun. You're right. It was definitely.

[55:52] Michelle: Okay, a couple more. If you have an entire day to yourself, Tara, with zero responsibilities, how would you spend it?

[56:02] Tara: Oh, my gosh. That is like, literally dream come true.

[56:08] Michelle: Does that ever happen?

[56:10] Tara: No, never.

[56:11] I would totally spend it.

[56:15] I don't have a TV in my room, but if I did,

[56:18] I would watch TV in bed for hours.

[56:22] I have always loved.

[56:23] Michelle: Oh, wow.

[56:25] Tara: No, I love shows and programs and scary movies.

[56:29] And so that is how I would spend my day is in a bed. Like, I like stretching my legs out in a bed, propped up, watching tv. And that is what I would do for hours and hours.

[56:41] Michelle: Sounds divine. I love it. Okay, last question. And I'm asking this to my Canadian friends. Will Canada become the 51st US state?

[56:58] Tara: I guess if you ask some of our biggest Canadian celebrities, they would say no.

[57:05] So who's to tell? I don't know. I think the majority of us would probably say no.

[57:10] Michelle: Who's to tell?

[57:12] That's kind of the gist I'm getting. And personally, I hope that never happens. I hope Canada stays a sovereign state.

[57:21] So thank you so much, Tara, for everything that you've brought today. I just absolutely love what you do and your professionalism and your advocacy and your compassion and your humor.

[57:38] I love your humor.

[57:40] So thank you so much.

[57:42] Tara: Awesome. Well, I've had a great time, and I hope somebody somewhere gets something out of this. I hope a lot of people somewhere get something out of this.

[57:49] Michelle: I should say. I think that is going to be a certainty. Thank you so much, Tara. Have a great rest of your day.

[57:56] Tara: Yeah, you bet.