April 28, 2025 • 32 mins
Crossing the finish line of a doctoral program leaves an unexpected void—a "phantom limb" where dissertation deadlines once lived. In this candid conversation with newly-minted Dr. Kate Melino, we explore the transformative journey of pursuing a PhD in psychiatric mental health nursing and the surprising discoveries that emerged from her research.
Dr. Melino's work uncovered a startling revelation: despite over 30 million Americans receiving care in community mental health centers across the country, almost no research examines these critical settings or the practitioners who serve there. Her research illuminates how psychiatric mental health nurse practitioners (PMHNPs) creatively navigate institutional barriers—sometimes literally leaving clinics to check on patients in encampments—to deliver holistic care that addresses not just symptoms, but the social and structural determinants affecting their patients' wellbeing.
The conversation shifts to the age-old question facing nursing students: DNP or PhD? Drawing from their collective experience, our panel offers refreshingly practical guidance. As Dr. Melino explains, "If you want to make change at the institutional level, DNP is for you. If you want to answer questions that don't have answers yet, consider PhD." Meanwhile, Dr. Sean Convoy shares his mentor's wisdom: "It comes down to your identity—do you see yourself as a clinician first and leader second, or a researcher first who builds knowledge over time?"
We also discuss groundbreaking survey findings revealing how psychotherapy skills—a cornerstone of psychiatric nursing practice—are being underutilized in today's healthcare settings, potentially contributing to overprescribing issues. As the hosts share their diverse experiences navigating doctoral education while balancing personal lives and responsibilities, they offer invaluable insights for anyone considering advanced nursing education.
Whether you're contemplating doctoral study, curious about the state of mental healthcare research, or interested in the evolving role of PMHNPs, this episode offers both inspiration and practical wisdom from those who've walked the path before you.
Let’s Connect
Dr Dan Wesemann
Email: daniel-wesemann@uiowa.edu
Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner
LinkedIn: www.linkedin.com/in/daniel-wesemann
Dr Kate Melino
Email: Katerina.Melino@ucsf.edu
Dr Sean Convoy
Email: sc585@duke.edu
Dr Kendra Delany
Email: Kendra@empowered-heart.com
Dr Melissa Chapman
Email: mchapman@pdastats.com
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Yeah, just my take on things.
My answer to number twodecrease until they cease.
Don't stop at a discovery.
(00:25):
Identify a challenge in yourbeliefs.
Speaker 2 (00:28):
Welcome everybody Back for another episode of Pep
Lau's Ghost.
All right, we're back.
If you're listening to this in2026, you may not know this, but
we did have a little break.
We're calling it kind of our2025 spring break, or at least
I'm calling it that.
But we're back and we're reallyexcited to kind of have an
(00:49):
exciting new kind of formatwhere we don't actually have an
external guest.
I'll say We'll have an internalguest, dr Kate Molina.
We've mentioned a little bit onthe podcast that she just
recently got her PhD and so wewanted to celebrate that a
little bit and kind of find outabout her journey and really
just kind of have her share alittle bit about you know how
this kind of came about andwhere this may be taking her and
(01:10):
such, and maybe we'll talkabout some other things too.
But I'm also here with Dr SeanConboy and Dr Melissa
Chapman-Hayes who are here aswell.
So let's just get into it, kate.
You know how's the world andmaybe let's start from the end,
kind of work our way backwards.
How's the world feel withouthaving assignments and you know,
(01:31):
dissertation drafts kind of doevery so often?
Speaker 3 (01:34):
So, yeah, thank you, dan, and thanks for the
opportunity to be interviewed onour esteemed podcast.
You know I think I mentioned toyou maybe when we started
together a couple weeks ago Ialmost feel like I have a
phantom limb.
Um, you know, after four yearsof of having this other thing to
do, all the always in the backof my mind, it feels really
strange actually, uh, to trulyhave my weekends to myself and,
(01:56):
you know, not be waking up inthe middle of the night with
ideas that I feel like I need towrite down.
So I think it.
I think it is a bit of anadjustment period, but it's
wonderful, really happy to bedone.
Speaker 2 (02:08):
I think.
You know, even though this isan audio podcast, I will share
with the listeners.
You know, your hair seems letdown a little more.
Speaker 3 (02:14):
I mean there's a little more bounce in it.
Speaker 2 (02:16):
I don't know.
I'm just kind of thinking ofKate before she got this done
and it just your hair was allkind of bound up.
So so, yeah, I think you knowstress comes out in many
different ways, right?
And so so you know this is aninteresting the question I would
like to ask you and thinkingabout, you know, being able to
talk to you and spend some timekind of diving into this.
You definitely had a choicehere and, and, and obviously
(02:38):
Sean and I have our DNPs.
You know the choice in nursingis always DNP and PhD.
So maybe just kind of sharethat.
Why did you pick the PhD route?
You had your master's andthings like that.
Maybe you know just kind oftalk about that a little bit.
Speaker 3 (02:54):
Yeah, that's such a great question, dan, and I'm
happy to talk about that.
So yeah, as you mentioned, Ihad been a master's prepared
nurse practitioner for severalyears.
I was a psych RN for severalyears before I went back to
school and got my NP degree.
And I guess there were a coupleof things.
One was I had always beenreally fortunate to have
(03:18):
exposure to working with nurseresearchers from even when I was
before I was a nurse.
Actually, my very firstfull-time job after my initial
undergraduate degree was at theProfessional Nursing Association
in Ontario, canada, which iswhere I'm originally from, and I
was.
I got hired as the researchassistant in their health and
nursing policy department.
(03:38):
I was like 22 years old and Imet so many incredible nurses
there, nurses who had had these,these amazing careers, worked
all over the world, been reallyinvolved in various change and
producing evidence-based bestpractice guidelines, and I
really admired them and theywere really the people who
(03:58):
inspired me to go back to schooland become a nurse.
And since I did that, I've beenworking in psych nursing the
entire time and I was reallyfortunate to be able to work in
various labs with nurseresearchers who were doing
really cool stuff.
So I feel like I had a windowinto that from pretty early on
(04:19):
and I also knew that I reallyliked writing.
I actually liked writing grantsand editing manuscripts and all
these sorts of things that, youknow, is not necessarily a
popular thing to do.
So it was always kind of in theback of my mind.
And then the other thing Ithink that really helped me make
the distinction was when I waslooking at sort of like the, not
(04:44):
the outcomes of a DNP versusPhD, but what it really prepares
you to do.
And I think, as is fairlycommon for nurse practitioners,
particularly maybe psych nursepractitioners, where there
aren't so many of us or thereweren't so many of us.
You know, a few years ago I gotthrust into a leadership role
very early in my NP career and Ihad to really kind of learn
(05:08):
while I was going about, how todo administration, how to set a
budget, how to hire staff, howto train people, how to do QI,
and so I kind of felt that I hadalready learned that a little
bit and if I was going to goback to school, I wanted to do
something that was totallydifferent and offer a new
chapter in my career, and sothat's ultimately why I chose
(05:32):
the.
Speaker 4 (05:34):
PhD you mentioned.
Before we got on, we turned onthe recording on that.
You know, upon completion ofyour PhD, you're going to be
rolling into, you know, doing alot more work within a DMP
program.
I'll share with you myexperiences is that there's this
perpetual kind of push-pull andthe push and pull is valuable
but nonetheless it still feelslike a push-pull between our
(05:57):
PhD-prepared faculty and ourDMP-prepared faculty as it
relates to that awkward spacebetween you, space between
traditional research, science,versus translational work.
For a DMP, what's your calculusin terms of being PhD prepared
but kind of jumping into a DMPprogram, kind of straddling that
(06:19):
space between research andtranslational work?
Speaker 3 (06:22):
Yes, I love this question and you know, I
actually think that this iswhere the PhD prepared PMHNP is
the ticket, because we have, youknow, real clinical on the
ground experience that you knowwe're still practicing, we're
very much immersed in the sortof material realities of what's
going on there and what needs tobe done, and we also have this
(06:44):
sort of theoretical researchtraining, and so I actually
think that faculty members likeus can be a real bridge, not
only for student projects youwere also mentioning, sean,
before we turn on the recordingthat you know some of your
students are working together.
I think bringing students indyads, even bringing PhD
learners together with DMPlearners, is a fabulous idea but
(07:05):
also bridging the gap between,you know, phd prepared faculty
who this is not always true, butoften, you know, may not be
working clinically or haven'tfor some time and then DMP
faculty who are very muchimmersed in the clinical
environment.
Speaker 2 (07:22):
Thanks, yeah, yeah, very cool yeah, and it's a great
question because I know a lotof um.
You know just, I guess,personally from my experience
that sometimes people dostruggle with that transition,
because I know I've had kind ofphd prepared faculty.
You know, especially early intheir career when they get into
a dmp program they kind of havethe same level of like a
(07:45):
dissertation as a DMP projectand they struggle with kind of
where that kind of fits in andeverything.
So you know, do you mind kindof sharing a little bit about
what's your dissertation andwhat you did in your PhD?
Speaker 3 (08:00):
Yeah, absolutely, and I think it is a perfect segue,
actually, because mydissertation work is actually
very much concerned with thematerial realities on the ground
of what PMHMPs are doing intheir practice and how they are,
you know, working with patientsto address a lot of what
they're facing.
(08:20):
And so, you know, sort of thegenesis of this was I've spent
the vast majority of my NPcareer working in community
mental health, and so, you know,in public quote, unquote safety
net settings in community-basedpsychiatric urgent care,
outpatient, you know, and so on,and just being so attuned to
the fact that so much of whatreally needed addressing were
(08:45):
the social and structuraldeterminants of health, and
contrasting that with sort ofwhat the expectation of my
practice was, which was mostlyto prescribe medication.
And so, you know, in doing a bitof a literature search on this
topic, I was actually reallysurprised that at least this was
true in 2021 when I started.
(09:06):
I know there has been moreliterature since, but there was
almost nothing available onPMHMP practice, and not only
that, but almost nothingavailable on the type of care
that's available in, you know,community mental health
outpatient clinics across the US.
In fact, I think one of theonly pieces of writing I found
(09:27):
was actually back from the 1960s, when they were trying to
establish this under JFK, so Iwas like, wow, that really
shocked me.
Actually, for the listeners outthere, there are more than 30
million Americans who receivecare in community mental health
centers across the US and no oneis doing research on this topic
and these clinics have beenestablished to set up or have
(09:50):
been established to care forpeople who are suffering a
really great burden of diseasein terms of mental illness.
Speaker 2 (09:56):
How does that happen, Kate?
How does that happen?
Speaker 3 (09:58):
Gee, I don't know.
Speaker 2 (10:00):
I mean there's a lot of funding, right, you know,
because there's federal funding,there's even state, even local
funding.
I always think when and again Iam not the proficient grant
writer that you are, you know Ithink some people have to have
data to get money right.
I mean that's usually the case.
So where I don't know, I meanagain in your travels and kind
(10:27):
of you know, uncovering this,you know, I'm just kind of I
don't know the question, I mean,why, how can this kind of
continue to happen?
Like you said, I unfortunatelyjust get to the very cynical
part that this is kind of apopulation that just is
underserved and undervalued inour communities, so they don't
have a voice and so, but isthere other explanations for it?
Speaker 3 (10:43):
I think that's part of it.
I also wonder about, you know,sort of evaluation at the very
local level and whether thosethat evaluation ever makes it
out of the county healthdepartment, for example, right.
So maybe there is a lot of datathat just isn't being collected
anywhere and isn't beingsynthesized.
I think that's totally possible.
You know, it was a little biteye-opening I won't say the
(11:07):
Department of Public Health thatI was working with, but just,
you know, for their sake.
But it was pretty clear when Isought ethics approval with them
that I was the only researcherwho had been looking to do this
in a very, very long time.
So you know, there's lots ofroom for anybody who wants to
get involved in this researchspace.
So essentially my work reallyfocused on, yeah, interviewing
(11:29):
and observing psych NPs inpractice and you know how they
sort of negotiate, I guess youcould say, the expectations and
requirements of the institution,which is also very much
governed by billing andreimbursement, and also getting
patients what they really needand all the creativity that goes
(11:51):
into doing that and how.
I think the way in which we aretrained in this sort of like
biopsychosocial, holisticnursing model is so much more
responsive to what patients needthan the very sort of
biomedical lens that some otherproviders bring to this patient
population.
Speaker 2 (12:13):
Very cool.
I'm dying to know whatMelissa's thinking right now.
I mean because, again, I know,Melissa, you have your PhD,
right, and it's in a differentfield, but it's very there's a
lot of crossover, right.
I mean, what are you thinkingabout now and is this kind of
sending you back to when you gotyour PhD and all the anxiety
associated with that?
Speaker 5 (12:33):
Or you know, I just shared a horror story.
You know know, a low moment andtaking comps, and I didn't even
do bad, but I like went tosubway or something and they
couldn't I can't remember thedetails but like didn't have
something I wanted and it wasjust kind of like, ah, you know,
like, and nothing bad happened.
I did great at my comps.
It was just, you know, um,that's I.
(12:56):
I kind of have like wonderingwhat sustained you through those
moments, kate, and maybe it'syour why or purpose so you go
that route.
But also, um, what resonated?
Is you talking about, um, wherethe data is or what's known at
that more local level?
And that kind of questioninterests me a lot because we do
(13:17):
a lot of work with behavioralhealth or mental health clinics
and then local public healthunits, and sometimes we need a
different framework too.
It's not necessarily theframeworks that you would use
for other settings and research.
So those are two differentroutes you can pick, yeah.
Speaker 3 (13:36):
Well, maybe I'll start with the data part,
because so one of the findingsthat came out was and I don't
think this will be a surprise toanyone here, but now we have
the data to show that, you know,nps are really sort of going
above, beyond, sideways, aroundthese type of institutional
strictures to get patients whatthey need.
(13:59):
So, for example, nps that I, youknow, observed and worked with,
were doing things like leavingthe clinic and going out to the
encampment where their patientwas living.
Make sure they're getting theirmeds, make sure they're okay.
You know that's not in theirrole, that's nowhere in the
thing, but they're doing whatthey need to do.
And then, on the flip side, youknow, the Department of Public
(14:22):
Health asks patients to fill outa patient satisfaction survey
every year, and you know, thisDepartment of Public Health
routinely has pretty highsatisfaction rates actually
among patients, which is great.
And so then that is then usedas additional justification for
the department to keep doingthings the way that they're
doing, because it's not reallycapturing what makes that
(14:43):
satisfaction happen, which isthat the NPs are doing things
outside of those structures.
So it becomes this sort of wildself-fulfilling cycle.
Speaker 4 (14:55):
It's interesting.
It's almost like this is a newgeneration of like the frontier
nursing service, but focused onpsychiatry.
Speaker 3 (15:02):
Absolutely yes, exactly, very cool.
Speaker 4 (15:04):
Yeah, oh, sorry.
Speaker 5 (15:08):
Please go Like that works, but it puts a lot on the
individual practitioners, youknow, to go above and beyond,
which of course they're doinganyway.
Sorry, sean, that's can that'sright.
Speaker 3 (15:18):
Well, and then and then I think that's part of it,
melissa is when we look at whatare the implications for us,
what are the implications forworkforce, you know, burnout,
retention, um, all of thosethings.
Speaker 2 (15:27):
It's pretty dire actually that's the first word
that came to my burnout.
Speaker 4 (15:31):
Yeah, yeah yeah, kate , I was.
I was thinking.
You know, one of the coolthings you know, I'm presuming
that there are some subset ofour audience are individuals who
are either registered nurses orsoon to be advanced practice
nurses, who are consideringdoctoral preparation.
What would your elevator speechbe for a graduate student who
(15:55):
says I'm not really sure if Iwant to do DNP or PhD.
What can you guide me through?
What would you say to them?
Speaker 3 (16:02):
It's a million-dollar speech and this is from my
viewpoint, so others may feeldifferently.
I really see the DNP as adegree that prepares you to be a
leader in the clinicalenvironment.
If you are a person who wantsto make change at the
institutional level, who wantsto bring you know, do that
(16:25):
knowledge, translation I thinkDNPs have a huge role in that
Improve policies and processesand care within an organization
or a system, or even a, you know, state government level.
Potentially, I think that is areally really good track for you
.
If you are a person who youknow wants to answer questions
that there might not be answersto right now and, you know,
(16:49):
investigate phenomena that wedon't really, you know, have
good data on, I think a PhD issomething I would encourage you
to think more clearly about.
Speaker 4 (16:59):
Awesome, Danny.
How would you answer thatquestion?
Speaker 2 (17:03):
Yeah, I would answer that question.
Yeah, probably not as in-depthas you did, kate, but it really
becomes in my mind.
If you want a PhD I mean if youlike your head in the clouds,
if you like to be thinking likethe next 10 years, where is
healthcare going and what can Icontribute today to add to that
(17:24):
future, I think PhD is where yougot to go.
I mean, I think you need thoseskills to know how to set up a
research design that's going tohave good rigor and validation
and all that good stuff, and soI think the PhD is there.
If you want to kind of havemore you know and again, I know
we talk about population healthwith the DNP, but I still think
(17:45):
a little bit of you know inserving populations and serving
more micro care, helping peopleout, still want to kind of be in
the, you know, in the clinic,seeing patients, even though I
know PhDs are seeing patients aswell.
But yeah, I mean that's kind ofwhere I see the differentiation
and that translational care.
I still, you know, I still don'tthink we utilize that model
(18:07):
enough, of that PhD DNP model.
It's just not well supported atthis time.
I don't think the systems, evenin academia, we don't, you know
, kind of do that becausethere's so much pressure for our
tenure track to get.
You know it's the you know.
Publish or perish, it's the youknow, you know it's.
You gotta get all these grantswritten, you gotta get this huge
, you know funding and all theblah blah blah.
(18:29):
So yeah, that's it.
Do you have a?
Do you have a better answer,sean?
Speaker 4 (18:33):
I don't have a better answer.
I have an appropriated answerfrom a mentor of mine who's no
longer with us, dr Ann Hamrick,and she said you know, when I
asked her this question back in2003, I think she said it really
comes down to your identity,sean.
She said do you see yourself asa clinician first and then a
(18:57):
leader second, then you need tobe doing the DNP work.
If you see yourself as aresearcher first who's going to
be building the body ofknowledge over time, then you
need to be a researcher.
And she says and if you have nosocial life whatsoever, maybe
you do both.
Speaker 2 (19:17):
Very well said.
Yeah, I'm still fascinated withMelissa's question to you.
You know how you sustainedyourself through this.
It got me thinking about youknow.
You may know I was kind of a,you know, coming out of high
school I was a GI Bill baby andyou know, went and got that and
then when I came back out I wasvery kind of singularly focused
that I wanted to go to gradschool.
(19:38):
And you know we've all, on thiscall you know, been through grad
school.
We all got our doctorateeducation.
So when I was undergrad I wasjust very focused.
But I remember very succinctlyone of my professors kind of
talking about that when she wentand got her PhD.
She almost got divorced becauseof the PhD and it just stuck
with me.
But I just kind of blew it off.
You know, kind of just thatdenial like nah, it's not gonna
happen to me.
Um, but that happens, right.
(20:00):
I mean, the work is isextensive, so, um, so yeah, I
would love to kind of hear howyou kind of kept your men own
mental health buoyed and kind of, you know, steered the ship as
you did yeah, well, thankfullymy marriage is still intact, um,
so that's great.
Speaker 3 (20:18):
And you know, I'm not sure that I have any real
insight.
You know, I think one thing,and this is perhaps a wild
generalization, but you know, atleast anecdotally, nurses to me
tend to go back to school a bitlater, you know, after they've
had some experience under theirbelt and some life years under
their belt, and and that bringsits own challenges, right, I
(20:39):
mean, I started the program whenI was 39.
And you know, doing anintensive program when you are
in your early 40s and have allthe things that comes with that
is really different than doingschool in your 20s.
And so you know, I think, andso you know, I think I just
really tried to keep my sightson this is a.
(21:00):
I have a goal in mind.
This is not going to lastforever, so I can push, you know
, for a certain period of time,and beyond that I'm not sure
that I can keep pushing.
So that timeline worked out forme.
No-transcript.
Speaker 2 (21:33):
I'll do the same with Shonda Demean.
Melissa, how did you, how doyou get yourself through?
How did you kind of surviveyour PhD?
Speaker 5 (21:39):
Well, first, I appreciate what you said, kate,
because I went straight fromundergrad to a doctoral program
and I can't imagine, but knowlots of people who have done it
with other life responsibilities, so my experience was different
.
And friends cohort people likeyou, create your network and you
lean on each other and we allneed it, I would say that.
(22:00):
And good mentors, which I didhave, and if you don't have good
mentors, finding someone elseit's just a better match for
what you need, whether they'reofficially your advisor or not.
Speaker 3 (22:10):
I couldn't agree more and I will.
I will put an extra plug in forthe mentors.
I just want to say I thinkfinding supervisors and mentors
who are kind and supportive itcannot be overrated enough.
Speaker 2 (22:27):
Yeah, I will answer that question too, for myself
and Sean.
You can kind of jump in afterthis too to kind of round it out
but I've kind of done somethinking of how I did it it out.
But I've kind of done somethinking of how I did it and
again, had you know, yes,fortunately didn't lose the
marriage and had a couple ofkids.
I remember kind of cradling myson, you know, at midnight
(22:47):
trying to get him to sleep, andkind of finishing out a paper
and things.
That's, you know, I cherishthose moments.
But I think what I did is Ijust kind of narrowed my focus
and so, socially, I, you know,it was really kind of a bit more
withdrawn.
I, I just kind of tuned in.
I think, like you said, melissa, it really kind of, you know,
leaned into my cohort.
But but if it was, you know, itwas a personal relationships.
I, they, they kind of took atoll.
(23:09):
And you know, now that I'vebeen out of school now for, you
know, got my doctorate in 2015.
So it's, you know, it's been acouple of years I've found that
I'm really craving that now.
So, my personal relationships,I'm reaching out.
I'm really kind of, you know,connecting with traveling.
I didn't do any travel.
When I I mean all that kind ofyou know stuff, I really didn't
know.
I liked travel and now I'mtraveling a bunch.
(23:30):
So it's an interesting kind ofevolution too.
So how about you, Sean?
Speaker 4 (23:38):
Yeah.
So how about you, sean?
Yeah, so everybody on the callknows me well enough to know
that I'm part of a dual activeduty family.
So I think it was veryintentional in when I went back
to get my doctorate and it wasright at the beginning when my
wife was ready to schedule an18-month deployment to
Afghanistan.
So I did that intentionallyjust to distract myself from the
concerns associated with mywife being over there.
So I literally doubled up oncoursework and pushed through
(24:00):
the program a little moreefficiently just to keep myself
really busy, so I could controlfor my risk of worry.
Speaker 2 (24:09):
Awesome, awesome, yeah, yeah.
Millions of paths through this,right, but, but definitely so
anything else to say or reflecton.
Kate, you kind of knew this wascoming.
We were going to shine thespotlight on you and and again,
just really admire to kind ofthe work that you've done and,
and we'll continue to do, carefor those people who don't have
(24:31):
a voice, especially within thepsych, mental health community.
So any other thoughts, lastingthoughts, and we'll maybe
transition to another topic here.
Speaker 3 (24:40):
Yeah, I just want to say thanks for the opportunity.
I think this is such a greatdiscussion and as we do move to
more and more nurses becomingdoctorally prepared and also
just think about all of theissues that are facing us, that
are facing our patients thesedays, I think you know, the more
the merrier.
So if there are any listenersout there who are on the fence,
(25:02):
you know our emails are in theshow notes.
Feel free to contact me.
Happy to chat.
Speaker 2 (25:07):
Thanks, kate, that's great.
All right, let's fill up Kate'sinbox no-transcript passion
(25:34):
that we have for continuing tohave psychotherapy within the
role and hearing from our guests, which have been amazing and,
like I said, we've got somereally awesome, you know, world
leaders, actuallyinternationally.
We got somebody from Canadathat's recognized
internationally for this kind ofwork.
We're really excited to kind ofhave her on that upcoming
(25:56):
episode.
But you know this survey thatwe sent out not too long ago
where we actually surveyedpeople who are in school right
now in the PMHMP programs,recent alumni and then employers
and so those three groups thatwe kind of interviewed to kind
of triangulate these opinions onpeople PMHMPs doing
psychotherapy.
(26:16):
So what do you guys think?
You know we were all kind of apart of that what is what's kind
of your, some of your takeaways?
Maybe we'll just kind of startthere with.
You know we're hoping to getthis manuscript out, which, for
those of you listening and areexcited, you're just, you know
you're one of us, but otherwiseI know some people probably
(26:38):
aren't going to dive into thenursing journals to get this.
But yeah, I'd love to kind ofhear what from the work we've
been doing for the last you knowcouple of years now.
What's your takeaway as far asthat survey and what it said?
Oh, this is an audio podcast,so I'm going'm gonna do some
filler, so, uh.
So springtime is nice, you know, it's uh, it's actually
starting to warm up out here,and so I'm like I was gonna jump
(27:01):
in because, like of course, Iwent to the measurements, right
I love it.
Speaker 5 (27:05):
Yes, from the start that, yeah, you wanted to survey
those three groups and getthose three perspectives, and it
was a nice collaborativeprocess of developing the
surveys too.
So I think it was really solidin terms of having some multiple
eyes on it.
Speaker 2 (27:24):
Yeah, so I'll start with the measurement and then we
can go to the data know, and Iagree I think it's like Kate
mentioned that it's one of thoseareas you know when you get in
practice.
I just kind of have thisassumption that someone's
already kind of done this.
You know, somebody's alreadykind of surveyed the mentors,
the employers, of how they view,you know, utilizing PMH MPs and
how they value psychotherapy.
So I guess I thought it outthat, no, it hadn't been done.
(27:46):
So so, yeah, I like I, you know, thinking about for myself, I
think I'm thinking about formyself, I think I'm most proud
of that aspect and I'm excitedto kind of get that out in the
community, and so so, yeah,thanks, melissa.
Speaker 4 (28:00):
My thoughts were.
I really found that the resultskind of reinforced.
Some provided some context asto why we struggle with
polypharmacy in this country,pharmacy in this country, right,
I mean, in many regards we havea well-researched skill set
(28:21):
that is withering on the vine inour community, probably because
of some larger systems changesin terms of how reimbursement is
driven.
But you know, as we wereworking on the manuscript, I was
thinking, you know, this is whystudents are attracted to
prescribing, this is why schoolsare downregulating teaching the
programs, and this is also whyone of the two credentialing
bodies is not requiringpsychotherapy as a required
(28:44):
training element for boardcertification.
So I do believe that PEPLAwould be really, really
disappointed today.
Speaker 2 (28:51):
Well, there goes one of our sponsor potentials there
you go.
Speaker 4 (28:54):
Just kidding, John, I agree.
Maybe they'll change their mindright?
Maybe?
Speaker 2 (28:58):
Maybe.
I hope that I really do.
I couldn't.
Yes, I agree with you 100% andthat is a missing gap in our
certification process.
So, but yeah.
Speaker 3 (29:08):
Yeah, I've been thinking a lot about our survey
and our manuscript resultsbecause I taught earlier this
week and my students areapproaching graduation next
month, so they're reflecting on,you know, what are they going
to do after graduation, andseveral of them mentioned that
you know.
(29:29):
Oh, I really hope that I canfind a job where I can do
psychotherapy as part of mypractice, and I was like well,
hold the phone, you can do thatin any job, right, like it's not
a binary here.
Let's talk about some ways thatyou can integrate that in any
(29:50):
visit that you're doing, thatyou can integrate that in any
visit that you're doing, and sothat was also.
Sort of.
Another dimension for me is, Ithink that people are thinking
about this in a very black andwhite way.
Speaker 2 (30:04):
And we know that in practice that's not often how it
works.
Yeah, and I think it's.
It's, and just to share to Kate, and I kind of presented this
at the National Organization ofNurse Practitioner Faculty
Conference a week or so ago inDenver and that was a great
experience and had a room fullof people that were interested
in this and that was, I think,one of those things that was
echoed in our discussions, whichwas great because we did have
such a lively discussion aboutthat.
(30:25):
So it's, yeah, in our surveyresults we kind of I think we
went after that we looked at,you know, where are you going to
be practicing psychotherapy?
It's, you know, again, someemployers are a little more
maybe accepting of this thanothers, but it's still a
perception that students can'tdo this, they want to, they
actually have to kind of do thata little more.
(30:46):
So, all right, well, we'regetting close to the end, so
we'll kind of wrap up hereBefore we kind of log off, do
you want to congratulate againDr Kate Molino and also
congratulate her nationalrankings Big time.
You know, appreciate you sharingus.
You know your time with us.
It must be hard with all thatbig time.
National rankings, what is itNumber one, number two?
Speaker 3 (31:07):
We're number two.
Thank you, Dan.
Speaker 2 (31:12):
That's awesome.
University of California, sanFrancisco Congratulations.
That's amazing.
So, all right, well, again,thank you so much for listening,
appreciate everybody and, yes,we're looking forward to having
another episode out soon andcontinue it Again.
If you're listening to this andyou made it all the way to the
end, congratulations.
But if you're really interestedin being a guest on this
podcast, please reach out Again.
(31:34):
I really want to try to pushour filling up Kate's inbox, but
you can also email any one ofus about being a guest.
We have definitely lots ofslots available, so love to hear
from you.
So make sure you like,subscribe and comment for the
podcast and we'll see you in aweek or so.
Outro Music.
Yeah, just my take on things.
My answer to number twodecrease until they cease.
Don't stop at a discovery.
(00:25):
Identify a challenge in yourbeliefs.
Speaker 2 (00:28):
Welcome everybody Back for another episode of Pep
Lau's Ghost.
All right, we're back.
If you're listening to this in2026, you may not know this, but
we did have a little break.
We're calling it kind of our2025 spring break, or at least
I'm calling it that.
But we're back and we're reallyexcited to kind of have an
(00:49):
exciting new kind of formatwhere we don't actually have an
external guest.
I'll say We'll have an internalguest, dr Kate Molina.
We've mentioned a little bit onthe podcast that she just
recently got her PhD and so wewanted to celebrate that a
little bit and kind of find outabout her journey and really
just kind of have her share alittle bit about you know how
this kind of came about andwhere this may be taking her and
(01:10):
such, and maybe we'll talkabout some other things too.
But I'm also here with Dr SeanConboy and Dr Melissa
Chapman-Hayes who are here aswell.
So let's just get into it, kate.
You know how's the world andmaybe let's start from the end,
kind of work our way backwards.
How's the world feel withouthaving assignments and you know,
(01:31):
dissertation drafts kind of doevery so often?
Speaker 3 (01:34):
So, yeah, thank you, dan, and thanks for the
opportunity to be interviewed onour esteemed podcast.
You know I think I mentioned toyou maybe when we started
together a couple weeks ago Ialmost feel like I have a
phantom limb.
Um, you know, after four yearsof of having this other thing to
do, all the always in the backof my mind, it feels really
strange actually, uh, to trulyhave my weekends to myself and,
(01:56):
you know, not be waking up inthe middle of the night with
ideas that I feel like I need towrite down.
So I think it.
I think it is a bit of anadjustment period, but it's
wonderful, really happy to bedone.
Speaker 2 (02:08):
I think.
You know, even though this isan audio podcast, I will share
with the listeners.
You know, your hair seems letdown a little more.
Speaker 3 (02:14):
I mean there's a little more bounce in it.
Speaker 2 (02:16):
I don't know.
I'm just kind of thinking ofKate before she got this done
and it just your hair was allkind of bound up.
So so, yeah, I think you knowstress comes out in many
different ways, right?
And so so you know this is aninteresting the question I would
like to ask you and thinkingabout, you know, being able to
talk to you and spend some timekind of diving into this.
You definitely had a choicehere and, and, and obviously
(02:38):
Sean and I have our DNPs.
You know the choice in nursingis always DNP and PhD.
So maybe just kind of sharethat.
Why did you pick the PhD route?
You had your master's andthings like that.
Maybe you know just kind oftalk about that a little bit.
Speaker 3 (02:54):
Yeah, that's such a great question, dan, and I'm
happy to talk about that.
So yeah, as you mentioned, Ihad been a master's prepared
nurse practitioner for severalyears.
I was a psych RN for severalyears before I went back to
school and got my NP degree.
And I guess there were a coupleof things.
One was I had always beenreally fortunate to have
(03:18):
exposure to working with nurseresearchers from even when I was
before I was a nurse.
Actually, my very firstfull-time job after my initial
undergraduate degree was at theProfessional Nursing Association
in Ontario, canada, which iswhere I'm originally from, and I
was.
I got hired as the researchassistant in their health and
nursing policy department.
(03:38):
I was like 22 years old and Imet so many incredible nurses
there, nurses who had had these,these amazing careers, worked
all over the world, been reallyinvolved in various change and
producing evidence-based bestpractice guidelines, and I
really admired them and theywere really the people who
(03:58):
inspired me to go back to schooland become a nurse.
And since I did that, I've beenworking in psych nursing the
entire time and I was reallyfortunate to be able to work in
various labs with nurseresearchers who were doing
really cool stuff.
So I feel like I had a windowinto that from pretty early on
(04:19):
and I also knew that I reallyliked writing.
I actually liked writing grantsand editing manuscripts and all
these sorts of things that, youknow, is not necessarily a
popular thing to do.
So it was always kind of in theback of my mind.
And then the other thing Ithink that really helped me make
the distinction was when I waslooking at sort of like the, not
(04:44):
the outcomes of a DNP versusPhD, but what it really prepares
you to do.
And I think, as is fairlycommon for nurse practitioners,
particularly maybe psych nursepractitioners, where there
aren't so many of us or thereweren't so many of us.
You know, a few years ago I gotthrust into a leadership role
very early in my NP career and Ihad to really kind of learn
(05:08):
while I was going about, how todo administration, how to set a
budget, how to hire staff, howto train people, how to do QI,
and so I kind of felt that I hadalready learned that a little
bit and if I was going to goback to school, I wanted to do
something that was totallydifferent and offer a new
chapter in my career, and sothat's ultimately why I chose
(05:32):
the.
Speaker 4 (05:34):
PhD you mentioned.
Before we got on, we turned onthe recording on that.
You know, upon completion ofyour PhD, you're going to be
rolling into, you know, doing alot more work within a DMP
program.
I'll share with you myexperiences is that there's this
perpetual kind of push-pull andthe push and pull is valuable
but nonetheless it still feelslike a push-pull between our
(05:57):
PhD-prepared faculty and ourDMP-prepared faculty as it
relates to that awkward spacebetween you, space between
traditional research, science,versus translational work.
For a DMP, what's your calculusin terms of being PhD prepared
but kind of jumping into a DMPprogram, kind of straddling that
(06:19):
space between research andtranslational work?
Speaker 3 (06:22):
Yes, I love this question and you know, I
actually think that this iswhere the PhD prepared PMHNP is
the ticket, because we have, youknow, real clinical on the
ground experience that you knowwe're still practicing, we're
very much immersed in the sortof material realities of what's
going on there and what needs tobe done, and we also have this
(06:44):
sort of theoretical researchtraining, and so I actually
think that faculty members likeus can be a real bridge, not
only for student projects youwere also mentioning, sean,
before we turn on the recordingthat you know some of your
students are working together.
I think bringing students indyads, even bringing PhD
learners together with DMPlearners, is a fabulous idea but
(07:05):
also bridging the gap between,you know, phd prepared faculty
who this is not always true, butoften, you know, may not be
working clinically or haven'tfor some time and then DMP
faculty who are very muchimmersed in the clinical
environment.
Speaker 2 (07:22):
Thanks, yeah, yeah, very cool yeah, and it's a great
question because I know a lotof um.
You know just, I guess,personally from my experience
that sometimes people dostruggle with that transition,
because I know I've had kind ofphd prepared faculty.
You know, especially early intheir career when they get into
a dmp program they kind of havethe same level of like a
(07:45):
dissertation as a DMP projectand they struggle with kind of
where that kind of fits in andeverything.
So you know, do you mind kindof sharing a little bit about
what's your dissertation andwhat you did in your PhD?
Speaker 3 (08:00):
Yeah, absolutely, and I think it is a perfect segue,
actually, because mydissertation work is actually
very much concerned with thematerial realities on the ground
of what PMHMPs are doing intheir practice and how they are,
you know, working with patientsto address a lot of what
they're facing.
(08:20):
And so, you know, sort of thegenesis of this was I've spent
the vast majority of my NPcareer working in community
mental health, and so, you know,in public quote, unquote safety
net settings in community-basedpsychiatric urgent care,
outpatient, you know, and so on,and just being so attuned to
the fact that so much of whatreally needed addressing were
(08:45):
the social and structuraldeterminants of health, and
contrasting that with sort ofwhat the expectation of my
practice was, which was mostlyto prescribe medication.
And so, you know, in doing a bitof a literature search on this
topic, I was actually reallysurprised that at least this was
true in 2021 when I started.
(09:06):
I know there has been moreliterature since, but there was
almost nothing available onPMHMP practice, and not only
that, but almost nothingavailable on the type of care
that's available in, you know,community mental health
outpatient clinics across the US.
In fact, I think one of theonly pieces of writing I found
(09:27):
was actually back from the 1960s, when they were trying to
establish this under JFK, so Iwas like, wow, that really
shocked me.
Actually, for the listeners outthere, there are more than 30
million Americans who receivecare in community mental health
centers across the US and no oneis doing research on this topic
and these clinics have beenestablished to set up or have
(09:50):
been established to care forpeople who are suffering a
really great burden of diseasein terms of mental illness.
Speaker 2 (09:56):
How does that happen, Kate?
How does that happen?
Speaker 3 (09:58):
Gee, I don't know.
Speaker 2 (10:00):
I mean there's a lot of funding, right, you know,
because there's federal funding,there's even state, even local
funding.
I always think when and again Iam not the proficient grant
writer that you are, you know Ithink some people have to have
data to get money right.
I mean that's usually the case.
So where I don't know, I meanagain in your travels and kind
(10:27):
of you know, uncovering this,you know, I'm just kind of I
don't know the question, I mean,why, how can this kind of
continue to happen?
Like you said, I unfortunatelyjust get to the very cynical
part that this is kind of apopulation that just is
underserved and undervalued inour communities, so they don't
have a voice and so, but isthere other explanations for it?
Speaker 3 (10:43):
I think that's part of it.
I also wonder about, you know,sort of evaluation at the very
local level and whether thosethat evaluation ever makes it
out of the county healthdepartment, for example, right.
So maybe there is a lot of datathat just isn't being collected
anywhere and isn't beingsynthesized.
I think that's totally possible.
You know, it was a little biteye-opening I won't say the
(11:07):
Department of Public Health thatI was working with, but just,
you know, for their sake.
But it was pretty clear when Isought ethics approval with them
that I was the only researcherwho had been looking to do this
in a very, very long time.
So you know, there's lots ofroom for anybody who wants to
get involved in this researchspace.
So essentially my work reallyfocused on, yeah, interviewing
(11:29):
and observing psych NPs inpractice and you know how they
sort of negotiate, I guess youcould say, the expectations and
requirements of the institution,which is also very much
governed by billing andreimbursement, and also getting
patients what they really needand all the creativity that goes
(11:51):
into doing that and how.
I think the way in which we aretrained in this sort of like
biopsychosocial, holisticnursing model is so much more
responsive to what patients needthan the very sort of
biomedical lens that some otherproviders bring to this patient
population.
Speaker 2 (12:13):
Very cool.
I'm dying to know whatMelissa's thinking right now.
I mean because, again, I know,Melissa, you have your PhD,
right, and it's in a differentfield, but it's very there's a
lot of crossover, right.
I mean, what are you thinkingabout now and is this kind of
sending you back to when you gotyour PhD and all the anxiety
associated with that?
Speaker 5 (12:33):
Or you know, I just shared a horror story.
You know know, a low moment andtaking comps, and I didn't even
do bad, but I like went tosubway or something and they
couldn't I can't remember thedetails but like didn't have
something I wanted and it wasjust kind of like, ah, you know,
like, and nothing bad happened.
I did great at my comps.
It was just, you know, um,that's I.
(12:56):
I kind of have like wonderingwhat sustained you through those
moments, kate, and maybe it'syour why or purpose so you go
that route.
But also, um, what resonated?
Is you talking about, um, wherethe data is or what's known at
that more local level?
And that kind of questioninterests me a lot because we do
(13:17):
a lot of work with behavioralhealth or mental health clinics
and then local public healthunits, and sometimes we need a
different framework too.
It's not necessarily theframeworks that you would use
for other settings and research.
So those are two differentroutes you can pick, yeah.
Speaker 3 (13:36):
Well, maybe I'll start with the data part,
because so one of the findingsthat came out was and I don't
think this will be a surprise toanyone here, but now we have
the data to show that, you know,nps are really sort of going
above, beyond, sideways, aroundthese type of institutional
strictures to get patients whatthey need.
(13:59):
So, for example, nps that I, youknow, observed and worked with,
were doing things like leavingthe clinic and going out to the
encampment where their patientwas living.
Make sure they're getting theirmeds, make sure they're okay.
You know that's not in theirrole, that's nowhere in the
thing, but they're doing whatthey need to do.
And then, on the flip side, youknow, the Department of Public
(14:22):
Health asks patients to fill outa patient satisfaction survey
every year, and you know, thisDepartment of Public Health
routinely has pretty highsatisfaction rates actually
among patients, which is great.
And so then that is then usedas additional justification for
the department to keep doingthings the way that they're
doing, because it's not reallycapturing what makes that
(14:43):
satisfaction happen, which isthat the NPs are doing things
outside of those structures.
So it becomes this sort of wildself-fulfilling cycle.
Speaker 4 (14:55):
It's interesting.
It's almost like this is a newgeneration of like the frontier
nursing service, but focused onpsychiatry.
Speaker 3 (15:02):
Absolutely yes, exactly, very cool.
Speaker 4 (15:04):
Yeah, oh, sorry.
Speaker 5 (15:08):
Please go Like that works, but it puts a lot on the
individual practitioners, youknow, to go above and beyond,
which of course they're doinganyway.
Sorry, sean, that's can that'sright.
Speaker 3 (15:18):
Well, and then and then I think that's part of it,
melissa is when we look at whatare the implications for us,
what are the implications forworkforce, you know, burnout,
retention, um, all of thosethings.
Speaker 2 (15:27):
It's pretty dire actually that's the first word
that came to my burnout.
Speaker 4 (15:31):
Yeah, yeah yeah, kate , I was.
I was thinking.
You know, one of the coolthings you know, I'm presuming
that there are some subset ofour audience are individuals who
are either registered nurses orsoon to be advanced practice
nurses, who are consideringdoctoral preparation.
What would your elevator speechbe for a graduate student who
(15:55):
says I'm not really sure if Iwant to do DNP or PhD.
What can you guide me through?
What would you say to them?
Speaker 3 (16:02):
It's a million-dollar speech and this is from my
viewpoint, so others may feeldifferently.
I really see the DNP as adegree that prepares you to be a
leader in the clinicalenvironment.
If you are a person who wantsto make change at the
institutional level, who wantsto bring you know, do that
(16:25):
knowledge, translation I thinkDNPs have a huge role in that
Improve policies and processesand care within an organization
or a system, or even a, you know, state government level.
Potentially, I think that is areally really good track for you
.
If you are a person who youknow wants to answer questions
that there might not be answersto right now and, you know,
(16:49):
investigate phenomena that wedon't really, you know, have
good data on, I think a PhD issomething I would encourage you
to think more clearly about.
Speaker 4 (16:59):
Awesome, Danny.
How would you answer thatquestion?
Speaker 2 (17:03):
Yeah, I would answer that question.
Yeah, probably not as in-depthas you did, kate, but it really
becomes in my mind.
If you want a PhD I mean if youlike your head in the clouds,
if you like to be thinking likethe next 10 years, where is
healthcare going and what can Icontribute today to add to that
(17:24):
future, I think PhD is where yougot to go.
I mean, I think you need thoseskills to know how to set up a
research design that's going tohave good rigor and validation
and all that good stuff, and soI think the PhD is there.
If you want to kind of havemore you know and again, I know
we talk about population healthwith the DNP, but I still think
(17:45):
a little bit of you know inserving populations and serving
more micro care, helping peopleout, still want to kind of be in
the, you know, in the clinic,seeing patients, even though I
know PhDs are seeing patients aswell.
But yeah, I mean that's kind ofwhere I see the differentiation
and that translational care.
I still, you know, I still don'tthink we utilize that model
(18:07):
enough, of that PhD DNP model.
It's just not well supported atthis time.
I don't think the systems, evenin academia, we don't, you know
, kind of do that becausethere's so much pressure for our
tenure track to get.
You know it's the you know.
Publish or perish, it's the youknow, you know it's.
You gotta get all these grantswritten, you gotta get this huge
, you know funding and all theblah blah blah.
(18:29):
So yeah, that's it.
Do you have a?
Do you have a better answer,sean?
Speaker 4 (18:33):
I don't have a better answer.
I have an appropriated answerfrom a mentor of mine who's no
longer with us, dr Ann Hamrick,and she said you know, when I
asked her this question back in2003, I think she said it really
comes down to your identity,sean.
She said do you see yourself asa clinician first and then a
(18:57):
leader second, then you need tobe doing the DNP work.
If you see yourself as aresearcher first who's going to
be building the body ofknowledge over time, then you
need to be a researcher.
And she says and if you have nosocial life whatsoever, maybe
you do both.
Speaker 2 (19:17):
Very well said.
Yeah, I'm still fascinated withMelissa's question to you.
You know how you sustainedyourself through this.
It got me thinking about youknow.
You may know I was kind of a,you know, coming out of high
school I was a GI Bill baby andyou know, went and got that and
then when I came back out I wasvery kind of singularly focused
that I wanted to go to gradschool.
(19:38):
And you know we've all, on thiscall you know, been through grad
school.
We all got our doctorateeducation.
So when I was undergrad I wasjust very focused.
But I remember very succinctlyone of my professors kind of
talking about that when she wentand got her PhD.
She almost got divorced becauseof the PhD and it just stuck
with me.
But I just kind of blew it off.
You know, kind of just thatdenial like nah, it's not gonna
happen to me.
Um, but that happens, right.
(20:00):
I mean, the work is isextensive, so, um, so yeah, I
would love to kind of hear howyou kind of kept your men own
mental health buoyed and kind of, you know, steered the ship as
you did yeah, well, thankfullymy marriage is still intact, um,
so that's great.
Speaker 3 (20:18):
And you know, I'm not sure that I have any real
insight.
You know, I think one thing,and this is perhaps a wild
generalization, but you know, atleast anecdotally, nurses to me
tend to go back to school a bitlater, you know, after they've
had some experience under theirbelt and some life years under
their belt, and and that bringsits own challenges, right, I
(20:39):
mean, I started the program whenI was 39.
And you know, doing anintensive program when you are
in your early 40s and have allthe things that comes with that
is really different than doingschool in your 20s.
And so you know, I think, andso you know, I think I just
really tried to keep my sightson this is a.
(21:00):
I have a goal in mind.
This is not going to lastforever, so I can push, you know
, for a certain period of time,and beyond that I'm not sure
that I can keep pushing.
So that timeline worked out forme.
No-transcript.
Speaker 2 (21:33):
I'll do the same with Shonda Demean.
Melissa, how did you, how doyou get yourself through?
How did you kind of surviveyour PhD?
Speaker 5 (21:39):
Well, first, I appreciate what you said, kate,
because I went straight fromundergrad to a doctoral program
and I can't imagine, but knowlots of people who have done it
with other life responsibilities, so my experience was different
.
And friends cohort people likeyou, create your network and you
lean on each other and we allneed it, I would say that.
(22:00):
And good mentors, which I didhave, and if you don't have good
mentors, finding someone elseit's just a better match for
what you need, whether they'reofficially your advisor or not.
Speaker 3 (22:10):
I couldn't agree more and I will.
I will put an extra plug in forthe mentors.
I just want to say I thinkfinding supervisors and mentors
who are kind and supportive itcannot be overrated enough.
Speaker 2 (22:27):
Yeah, I will answer that question too, for myself
and Sean.
You can kind of jump in afterthis too to kind of round it out
but I've kind of done somethinking of how I did it it out.
But I've kind of done somethinking of how I did it and
again, had you know, yes,fortunately didn't lose the
marriage and had a couple ofkids.
I remember kind of cradling myson, you know, at midnight
(22:47):
trying to get him to sleep, andkind of finishing out a paper
and things.
That's, you know, I cherishthose moments.
But I think what I did is Ijust kind of narrowed my focus
and so, socially, I, you know,it was really kind of a bit more
withdrawn.
I, I just kind of tuned in.
I think, like you said, melissa, it really kind of, you know,
leaned into my cohort.
But but if it was, you know, itwas a personal relationships.
I, they, they kind of took atoll.
(23:09):
And you know, now that I'vebeen out of school now for, you
know, got my doctorate in 2015.
So it's, you know, it's been acouple of years I've found that
I'm really craving that now.
So, my personal relationships,I'm reaching out.
I'm really kind of, you know,connecting with traveling.
I didn't do any travel.
When I I mean all that kind ofyou know stuff, I really didn't
know.
I liked travel and now I'mtraveling a bunch.
(23:30):
So it's an interesting kind ofevolution too.
So how about you, Sean?
Speaker 4 (23:38):
Yeah.
So how about you, sean?
Yeah, so everybody on the callknows me well enough to know
that I'm part of a dual activeduty family.
So I think it was veryintentional in when I went back
to get my doctorate and it wasright at the beginning when my
wife was ready to schedule an18-month deployment to
Afghanistan.
So I did that intentionallyjust to distract myself from the
concerns associated with mywife being over there.
So I literally doubled up oncoursework and pushed through
(24:00):
the program a little moreefficiently just to keep myself
really busy, so I could controlfor my risk of worry.
Speaker 2 (24:09):
Awesome, awesome, yeah, yeah.
Millions of paths through this,right, but, but definitely so
anything else to say or reflecton.
Kate, you kind of knew this wascoming.
We were going to shine thespotlight on you and and again,
just really admire to kind ofthe work that you've done and,
and we'll continue to do, carefor those people who don't have
(24:31):
a voice, especially within thepsych, mental health community.
So any other thoughts, lastingthoughts, and we'll maybe
transition to another topic here.
Speaker 3 (24:40):
Yeah, I just want to say thanks for the opportunity.
I think this is such a greatdiscussion and as we do move to
more and more nurses becomingdoctorally prepared and also
just think about all of theissues that are facing us, that
are facing our patients thesedays, I think you know, the more
the merrier.
So if there are any listenersout there who are on the fence,
(25:02):
you know our emails are in theshow notes.
Feel free to contact me.
Happy to chat.
Speaker 2 (25:07):
Thanks, kate, that's great.
All right, let's fill up Kate'sinbox no-transcript passion
(25:34):
that we have for continuing tohave psychotherapy within the
role and hearing from our guests, which have been amazing and,
like I said, we've got somereally awesome, you know, world
leaders, actuallyinternationally.
We got somebody from Canadathat's recognized
internationally for this kind ofwork.
We're really excited to kind ofhave her on that upcoming
(25:56):
episode.
But you know this survey thatwe sent out not too long ago
where we actually surveyedpeople who are in school right
now in the PMHMP programs,recent alumni and then employers
and so those three groups thatwe kind of interviewed to kind
of triangulate these opinions onpeople PMHMPs doing
psychotherapy.
(26:16):
So what do you guys think?
You know we were all kind of apart of that what is what's kind
of your, some of your takeaways?
Maybe we'll just kind of startthere with.
You know we're hoping to getthis manuscript out, which, for
those of you listening and areexcited, you're just, you know
you're one of us, but otherwiseI know some people probably
(26:38):
aren't going to dive into thenursing journals to get this.
But yeah, I'd love to kind ofhear what from the work we've
been doing for the last you knowcouple of years now.
What's your takeaway as far asthat survey and what it said?
Oh, this is an audio podcast,so I'm going'm gonna do some
filler, so, uh.
So springtime is nice, you know, it's uh, it's actually
starting to warm up out here,and so I'm like I was gonna jump
(27:01):
in because, like of course, Iwent to the measurements, right
I love it.
Speaker 5 (27:05):
Yes, from the start that, yeah, you wanted to survey
those three groups and getthose three perspectives, and it
was a nice collaborativeprocess of developing the
surveys too.
So I think it was really solidin terms of having some multiple
eyes on it.
Speaker 2 (27:24):
Yeah, so I'll start with the measurement and then we
can go to the data know, and Iagree I think it's like Kate
mentioned that it's one of thoseareas you know when you get in
practice.
I just kind of have thisassumption that someone's
already kind of done this.
You know, somebody's alreadykind of surveyed the mentors,
the employers, of how they view,you know, utilizing PMH MPs and
how they value psychotherapy.
So I guess I thought it outthat, no, it hadn't been done.
(27:46):
So so, yeah, I like I, you know, thinking about for myself, I
think I'm thinking about formyself, I think I'm most proud
of that aspect and I'm excitedto kind of get that out in the
community, and so so, yeah,thanks, melissa.
Speaker 4 (28:00):
My thoughts were.
I really found that the resultskind of reinforced.
Some provided some context asto why we struggle with
polypharmacy in this country,pharmacy in this country, right,
I mean, in many regards we havea well-researched skill set
(28:21):
that is withering on the vine inour community, probably because
of some larger systems changesin terms of how reimbursement is
driven.
But you know, as we wereworking on the manuscript, I was
thinking, you know, this is whystudents are attracted to
prescribing, this is why schoolsare downregulating teaching the
programs, and this is also whyone of the two credentialing
bodies is not requiringpsychotherapy as a required
(28:44):
training element for boardcertification.
So I do believe that PEPLAwould be really, really
disappointed today.
Speaker 2 (28:51):
Well, there goes one of our sponsor potentials there
you go.
Speaker 4 (28:54):
Just kidding, John, I agree.
Maybe they'll change their mindright?
Maybe?
Speaker 2 (28:58):
Maybe.
I hope that I really do.
I couldn't.
Yes, I agree with you 100% andthat is a missing gap in our
certification process.
So, but yeah.
Speaker 3 (29:08):
Yeah, I've been thinking a lot about our survey
and our manuscript resultsbecause I taught earlier this
week and my students areapproaching graduation next
month, so they're reflecting on,you know, what are they going
to do after graduation, andseveral of them mentioned that
you know.
(29:29):
Oh, I really hope that I canfind a job where I can do
psychotherapy as part of mypractice, and I was like well,
hold the phone, you can do thatin any job, right, like it's not
a binary here.
Let's talk about some ways thatyou can integrate that in any
(29:50):
visit that you're doing, thatyou can integrate that in any
visit that you're doing, and sothat was also.
Sort of.
Another dimension for me is, Ithink that people are thinking
about this in a very black andwhite way.
Speaker 2 (30:04):
And we know that in practice that's not often how it
works.
Yeah, and I think it's.
It's, and just to share to Kate, and I kind of presented this
at the National Organization ofNurse Practitioner Faculty
Conference a week or so ago inDenver and that was a great
experience and had a room fullof people that were interested
in this and that was, I think,one of those things that was
echoed in our discussions, whichwas great because we did have
such a lively discussion aboutthat.
(30:25):
So it's, yeah, in our surveyresults we kind of I think we
went after that we looked at,you know, where are you going to
be practicing psychotherapy?
It's, you know, again, someemployers are a little more
maybe accepting of this thanothers, but it's still a
perception that students can'tdo this, they want to, they
actually have to kind of do thata little more.
(30:46):
So, all right, well, we'regetting close to the end, so
we'll kind of wrap up hereBefore we kind of log off, do
you want to congratulate againDr Kate Molino and also
congratulate her nationalrankings Big time.
You know, appreciate you sharingus.
You know your time with us.
It must be hard with all thatbig time.
National rankings, what is itNumber one, number two?
Speaker 3 (31:07):
We're number two.
Thank you, Dan.
Speaker 2 (31:12):
That's awesome.
University of California, sanFrancisco Congratulations.
That's amazing.
So, all right, well, again,thank you so much for listening,
appreciate everybody and, yes,we're looking forward to having
another episode out soon andcontinue it Again.
If you're listening to this andyou made it all the way to the
end, congratulations.
But if you're really interestedin being a guest on this
podcast, please reach out Again.
(31:34):
I really want to try to pushour filling up Kate's inbox, but
you can also email any one ofus about being a guest.
We have definitely lots ofslots available, so love to hear
from you.
So make sure you like,subscribe and comment for the
podcast and we'll see you in aweek or so.
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