November 22, 2024 • 36 mins
Explore the transformative world of mental health management with our guest Dale Cook, CEO and co-founder of Learn to Live. Dale shares his personal journey with cognitive behavioral therapy, which inspired him to create a platform that makes mental health support accessible to everyone, everywhere. Discover how Learn to Live is tackling the stigma associated with mental health and offering digital programs that bridge the gap for those who might not seek traditional therapy. From breaking geographical barriers to fostering a proactive approach to well-being, Dale's insights offer a fresh perspective on the future of mental health care.
Learn to Live’s growth story is one of innovation and impact. Dale reveals the strategic steps taken to develop this digital platform, initially targeting consumers directly to engage with millions who are underserved by conventional therapy. By creating engaging digital content and programs for depression, anxiety, and more, Learn to Live has reached millions of Americans, with an expansion on the horizon. Dale discusses the challenges and triumphs of building a mission-driven organization, highlighting how collaboration between clinicians and business experts has been key in transforming lives and expanding their reach.
The conversation doesn't stop there—Dale outlines how Learn to Live measures success and plans for future expansions. From simplifying access with memorable codes to launching new programs targeting trauma, OCD, and ADHD, the platform is committed to enhancing user experience and outcomes. By fostering innovation and a culture of well-being within organizations, Dale emphasizes the importance of mental health as part of a holistic approach to health. As we look toward 2025, Dale encourages listeners to prioritize their well-being and support platforms that democratize access to mental health resources.
Learn more about Learn to Live and how to join through the HealthSelect of Texas website.
Enroll today through the Learn to Live portal. If prompted for a code, use TEXAS
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dale Cook (00:01):
Mental health is health, and I think part of the
stigma is you hear the wordmental health and you think of a
problem versus just beinghealthy like we would with
watching our weight or gettingexercise.
And so I think one lessonlearned for us internally and in
our service and encouragementto all of your listeners, is
(00:22):
think proactively about yourmental health.
You don't have to be clinicallydepressed to get something
really meaningful out of thedepression program.
You don't have to be anxious toget something out of a
progressive muscle relaxationaudio.
Lacy Wolff (00:35):
Hi everyone and welcome back to the ERS Walk
Talk podcast.
I'm your host, lacey Wolfe.
In today's episode, which willbe the final episode for 2024, I
am joined by Dale Cook, the CEOand co-founder of Learn to Live
.
This innovative platform ishelping thousands of people
manage their mental healththrough evidence-based online
(00:56):
programs and tools.
As we wrap up the year, I amexcited to share this meaningful
conversation where we dive intowhat inspired the creation of
Learn to Live, how it works andthe impact it's having on lives
all over the country.
So lace up your walking shoesone more time with me and let's
explore how small, intentionalsteps can make a big difference
(01:18):
in our mental health.
All right, dale Cook, welcometo the podcast.
Thank you so much for being aguest on the ERS Walk Talk
podcast.
Dale Cook (01:27):
Well, thank you, Lacey.
It's a pleasure to be here.
Lacy Wolff (01:30):
I was wanting to just start with having you talk
a little bit about yourself.
Can you share with ourlisteners where you come from,
where you are today and what ledyou into the mental health care
space?
Dale Cook (01:47):
and what led you into the mental health care space.
I'm happy to do so.
I think I mean that's a bigquestion where I come from,
where I am, why I'm here, butI'm based in Minneapolis,
minnesota.
I spent most of my formativeyears actually in Latin America,
which was an amazing experienceand really, I think, set the
tone for kind of who I am andhow I think about the choices I
make in life, including where Ispend my time, which a lion's
(02:08):
share of that right now is learnto live.
And I think, in terms ofbackground and as we talk about
learn to live and mental healthtoday, you know there's probably
two dimensions I think about.
On the personal front, Iremember back in college I loved
college, it was an amazingexperience.
I was a little over-involvedand so I was pretty stressed and
(02:29):
I didn't realize I was gettingreally anxious and so I couldn't
sleep and I hadn't really heardabout mental health or insomnia
.
And I was one of the lucky fewwho was able to go see a
therapist on campus who waspracticing cognitive behavioral
therapy, which is a great CBTprotocol, and I learned that I
was actually just anxiousbecause I was overextended and I
(02:50):
took a couple sessions and thelight bulb came on for me and
started sleeping like a baby,and that was my kind of early
mental health experience.
I was really really fortunateto get that kind of help and so
fast forward to what I'm doingnow and sort of who I am and
what this brings us to is, youknow, founding, learn to Live,
(03:10):
co-founding, learn to Live forme was really an opportunity to
have impact, I think, for me inmy life that's what I look for
and, as I'm sure you know andI'm sure your listeners know,
you know, mental health in theUnited States has really been a
crisis for many years, for manydecades.
It's only gotten worse withCOVID and so, when we think
(03:30):
about all of those problems andnow even the research coming out
about increased depression,anxiety, reduced resilience in
our youth, all of the datacoming out about my generation,
gen X and nearby generations,the opportunity to address these
issues in a different way, asyou probably know, our
(03:52):
traditional model, which isreally counselors, therapists,
psychologists, is troubled inthat there's a limited supply,
right, there's a really highneed for a lot of those services
and a really limited supply ofthose services.
In fact, over half the countiesin the United States do not have
(04:12):
a single mental healthpractitioner in them, and so we
have a lot of people needing alot of services, but not a lot
of people able to providetraditional services either in
person or virtually, and so itreally demanded something
different.
And so it really demandedsomething different, and that
was where Learn to Live was bornabout 12 years ago to provide a
different kind of service,actually an array of services
that were still clinicallygrounded, very, very effective,
(04:33):
but could really be taken andengaged by anyone, anytime,
anywhere.
And that was really theexciting moment for me was to
engage and start a company likethat and have that kind of
impact.
Lacy Wolff (04:45):
It's incredible and I love hearing your story and
that you actually sought mentalhealth care in college, which I
think says a lot about you as aperson, and then we're really
interested in replicating orcreating a program that would be
scalable to reach so manypeople.
(05:07):
I'm really proud that we areable to offer Learn to Live to
our health plan participants.
I think it's an amazing tooland resource for folks, because
I think, especially in Texas,we're a huge state and we have
so many rural communities wherethere's not good access and also
, I think, with the stigma,there's a lot of people who
don't necessarily feelcomfortable talking to somebody.
So being able to access thiskind of care from anywhere is is
(05:31):
truly a gift I think that wecan give to our health plan
participants.
So thank you for that, I'mhoping.
Next, maybe you could just kindof describe the the program,
because a lot of people becauseit is very new for us we just
launched this in September a lotof people still don't know what
it is.
Can you explain the experiencefor like from the user
(05:51):
experience, what it is like togo in and participate in the
program?
Dale Cook (05:58):
I'd be happy to do that and, by the way, you know,
you mentioned the word stigmaand I think that's one of the
biggest barriers that we allface today and I was fortunate
in college, as you mentioned, tohave people around me who
helped really reduce that stigma, and that's one truly learn to
live, I think, does transformthe traditional care delivery
(06:26):
model of mental health careservices, in that we're able to
address these mental health careneeds really high acuity, low
acuity, really at scale andagain reach people where they
are.
You talk about, you know the,the, the, the kind of the crisis
of access in Texas, and we'llprobably talk about that a
little bit more.
(06:46):
But at our core, we providethese comprehensive,
self-directed digital cognitivebehavioral therapy programs that
have extensive services andtools that individuals can use.
So think about a comprehensivedepression program or insomnia,
or substance use or anxiety orstress.
(07:09):
But it's not just theseself-directed programs.
There's other services.
We have clinician coaches onstaff 24-7.
And so our users, our members,can meet with coaches via text,
email and phone as much as theyneed to do that, which really
our coaches kind of encouragepeople to stay engaged in the
program, but they also then canhelp our members find other
(07:31):
services.
So if someone engages with uswho actually determines that in
fact they need to see atherapist or maybe a
psychiatrist, our team can helpthem find that.
So another service we provide isthis critical navigation
service, and we can even managecrises.
It doesn't happen a lot, but ifsomeone is in crisis, we're
tapped into all the localresources that are required to
(07:54):
address that appropriately froma clinical standpoint, from a
safety standpoint, and so ourgoal is to really scale that out
and enable someone to addresswhat we would call the probably
the seven biggest barriers, youknow.
So that's that stigma.
Another one is education.
A lot of us don't always knowwhat we're suffering from, or if
(08:16):
it's a mental health problem orsomething else.
A third is quality.
So are we finding quality carethat can actually move the
needle for us?
Another is stigma.
I mentioned that earlier.
Another is privacy and anotheris cost, and so we specifically
address each of those indifferent ways, which I'm happy
to talk about too, but maybeI'll pause there, so my answer
(08:40):
doesn't get too long for you.
Lacy Wolff (08:41):
That's great, yeah, and I was thinking it would be
also really good to have youdefine cognitive behavioral
therapy and just talk a littlebit about what that is for
people who don't know.
Dale Cook (08:53):
Happy to do so.
So cognitive behavioral therapyis really one of two primary
clinical ways of addressingmental health we're all probably
most familiar with or you mightthink, is that the counseling
format, which has been aroundfor over 100 years.
So that's kind of Freudianpsychology of talking about your
past, maybe experiences thatinform your present or your
(09:15):
future, and while that can behelpful to some, really over the
last 60 or 70 years cognitivebehavioral therapy has come to
the forefront as the mostevidence-based form of mental
health care and really whatthat's doing is saying it's
considering how we interpret thethings in our lives mentally,
so how we kind of filter thosein through our minds, and then
(09:40):
how that in turn drives ouremotions.
So if I'm a socially anxiousperson and I'm out to eat, I
might be incorrectly thinkingthat the individuals at the
table nearby are laughingthey're laughing and they seem
to be having a good time andthat they're making fun of me
and that's making me anxious,when in fact they don't even
(10:01):
notice me.
But I'm not realizing that andso my mental frame is changing
that into an anxious set ofemotions that drive my social
anxiety, and so what CBT does isreally unpack that process,
kind of puts an interruption inthat process.
And the exciting thing abouteven digital CBT programs is
(10:21):
that it's very structured.
Think of it as homework, thinkof it as practice, a lot of
practice on breaking momentsdown.
And so here you have now, youknow, with learn to live on your
phone you can take that momentand record something in your
homework and break up thatactivity and actually slow down
that process.
And over time then you becomejust very good at breaking up
(10:43):
that process so that you don'thave those anxious thoughts.
And so CBT again precedes learnto live by many years.
In fact, digital CBT precedeslearn to live.
It used to be on a CD-ROM about25 years ago.
It's research on digitallydelivered CBT that shows that
(11:08):
it's clinically as effective asface-to-face CBT.
Lacy Wolff (11:11):
That's amazing.
You just have to have thedesire and willingness to do it
right.
I mean, I guess that's thething is having that motivation.
And one of the things I thinkI've been going through the
resiliency course through Learnto live I love, like the
exercise that I did the otherday was so great because, like
you said, it's it teaches youkind of the concept, but then
(11:33):
you go in and you actually applyit to a moment in your own life
and that's powerful.
I think that's really powerfulas a participant because you you
start to recognize oh, that's apattern of thinking that I have
and then that can help you inall the other areas of life,
which is a game changer.
So hopefully that you cancontinue to use that in all
(11:54):
those different experiences.
The sessions are pretty short,right, they're not
overwhelmingly long.
That's another thing that Ithink is great for people to
kind of know about Learn to Live, that you don't have to, you
know, sit down for an hour a day.
How long do you try to keepyour sessions?
Dale Cook (12:08):
Well, you're exactly right, I think you know the goal
is to you know, technicallyspeaking, I think each program
has eight lessons and each ofthe lessons is about 45 minutes
of seat time if you sat down forthe whole thing.
But, lacey, you're exactlyright the goal is to enable each
of us to take somethingsignificant and meaningful and
(12:30):
actionable away from a lessonevery five or six minutes.
So if you think about theaverage time that any of us
spends on, let's say, an appexcept maybe for social media,
it's five to 10 minutes.
And so the goal here is to sayyou know, what is something that
Lacey or Dale can learn abouttheir depression or their
(12:50):
anxiety that they can then applyin their real life in such a
way that really moves the needlefor them and makes them say you
know what?
That was really helpful, I wantto go back and do something
again, you know.
And so part of that is reallythe magic of building, I think,
the right kind of digitalcontent to keep people coming
back.
But that's another reason whywe love what we do is that you
(13:14):
know, we believe we'redelivering something, a powerful
positive force, for reasons,you know, for good reasons for
people to be checking theirphone once in a while to be
checking in with these programs,and then the tools that they do
in between, the programs thatthey can do on devices.
They can print them out and dothem old school if they want to
do that.
(13:34):
But the idea there is again tohave these quick hit moments,
and whether that's in theprogram or also with other tools
, we have something called QuickBreaks that we recently
launched.
So these are, you know, two tofour minute video vignettes
about any number of things.
It could be grief, it could beanxiety, it could be public
speaking, it could be resilience.
(13:55):
So that's the other goal withthose tools is, you know, if
you're not three lessons deep inthe depression program, that's
okay.
If you'd rather take a quickvideo or listen to an audio on
progressive muscle relaxation ormeditation, we want to make
that really, really easy for you, because we know that it's not
a one-size-fits-all anywhere inhealthcare.
(14:16):
But for us, especially inmental healthcare, our mutual
experience of maybe the samequote-unquote mental health
problem could be very different,and what you need versus what I
need is also very different,and so part of our well learned
to live is to provide an arrayof services immediately
accessible, of course, at nocost, to employees and family
(14:38):
members, and retirees in thiscase, so that you can access at
any time in privacy, with noneof those barriers.
Lacy Wolff (14:46):
It's amazing.
Can you share a little bitabout the story of building?
Learn to Live.
I know this must not have beenan easy feat to get to where you
are today.
There's always roadblocks, Ithink, when you're trying to
build something, and it can bechallenging.
So how did you build thisscalable mental health product?
Dale Cook (15:07):
Well, that's almost asked as a fellow entrepreneur
and I don't know if you are one,lacey, but certainly it sounds
like you understand what can besometimes really tough about
building any kind oforganization, especially one
that's very mission-based andfocused.
Morfitt and I were reallyfortunate to connect on this
(15:29):
issue.
You know he's a clinician.
He's highly respected in hisfield, an experienced researcher
, so he's really the what I callthe lightning in a bottle when
it comes to the power of what wecan deliver.
What I brought was kind of thebusiness experience, the
background, to say, okay, how dowe take this really beautiful
(15:49):
content that's clinically based,that's research based, and make
it really consumable in a waythat I would want to use it or
that my teenage son would wantto use?
And then how do we create abusiness around that so that,
you know, we can keep the lightson and we can pay for really
good employees who do reallygood work.
And how can we scale that out?
You know, and so fast forward,12 years in, we're scaled out to
(16:12):
36 million Americans.
You know, we work with healthplans and universities and
employers and pharmacy benefitmanagers, and so we're blessed
and fortunate to have scaled out.
But to your point many, manytimes along the way, very
difficult.
Especially 10 years ago, thiswasn't even really a category.
(16:33):
No one really knew aboutdigital CBT, where now it's a
little bit more ubiquitous andcertainly with COVID there's a
lot of noise in the space, andso we were way ahead of that
curve and so I think, probablyfiguring out how to build this,
and in fact we went direct toconsumer at the beginning
intentionally.
We always knew that at the endof the day, we wanted health
(16:55):
plans or employers to pay forthe service so that we could
remove that cost access forusers.
But we believe that unless wecould offer our services out on
the internet and find people outthere who are suffering so
three out of four people in theUS will never seek in-person or
virtual therapy.
So we have this large group andalmost half the people in the
(17:16):
United States will have a mentalhealth problem at some point in
their lives.
So three out of four of half ofthe people in the United States
will not seek traditionaltherapy.
And so our goal was at thebeginning how do we find those
people online?
How do we get them to kind ofwalk through our digital doors,
if you will and trust us andstay with us long enough to have
(17:38):
a real change in their life andfor us to measure that
clinically.
If we can't do that, then wereally don't have any business
going to an ERS or going to ahealth plan and saying, hey, if
you're willing to pay for thisservice, we can really help
people and really get them toengage.
And so the first year and ahalf or so was direct to
consumer only, which, as youprobably know, is very difficult
(17:59):
and it's expensive, but it isextremely valuable and really
formed the DNA of our ability togo in and get 20, 30, 40%
engagement of a population everyyear, which is very, very high
when you think about traditionalmental health services.
So I'm not sure if thatanswered your question and just
(18:22):
want to be clear.
Lacy Wolff (18:23):
You said 36 million people have access to Learn to
Live right now.
Dale Cook (18:27):
That's right, and soon to be by November, it will
be 47.
So we're on the doorstep ofanother big collaboration that
will be announced a little bitlater this year.
Lacy Wolff (18:38):
That has to feel so good to know that you can help
that many people.
I cannot imagine.
Do you have any advice forsomebody like me who is in a
role where I'm trying to supportmental health of my workforce
with your product?
Do you have any kind of successstories for how to engage
people?
Dale Cook (18:57):
We are happy to share .
You know, I think, what ourteam would consider hard fought
experiences and life lessons on.
You know how to engage a groupof individuals you know myself
included from college who arereally struggling and they
really want to do somethingabout it.
But part of the struggle is asocial struggle, and you know
(19:19):
whether that's stigma or accessor cost or concerns about
privacy is is how do you engagesomeone who wants to be, you
know, be different, wants tochange, but is a little bit wary
and rightfully so of theservices that are out there?
And so I think number one ismeet people where they are.
(19:40):
So with your messaging when youreach out, you know, understand
that someone who's strugglingwith something isn't going to
respond to messaging that says,hey, lacey, go get them.
You know you can do it.
You know exclamation them, youcan do it, Exclamation point.
It's a different kind ofmessage to somehow communicate
to you that we understand whatyou're struggling with and we've
been there.
(20:00):
We have other members here inour community that have been
there, that are there, and it'sokay, it's a safe place to be.
I think the second thing ismaking it really, really easy to
access, and so when people cometo our website, they have a
code, so an ERS employee willhave a code.
It's really easy code toremember.
They can log in.
What's that?
Lacy Wolff (20:21):
It's Texas.
Dale Cook (20:22):
Exactly.
I'm so glad you share the code.
It's very, very easy toremember.
They can immediately access allkinds of services.
And the third thing I would sayis making the education very
easy.
So in the case of mental health,you know, the first thing
someone sees is what we call acomprehensive assessment.
What it really is is ashortened version of gold
(20:45):
standard, what we callpsychometric assessment.
So you may have heard of aPHQ-9 for depression or a GAD-7
for anxiety, but it's about afive-minute assessment that you
can take very quickly, but it'sclinically very sound, where
there are a lot of algorithmsthat sit underneath that that
will then say to you Lacey,based on what you've entered,
here's the program we think youshould start with.
(21:06):
You don't have to, you canchoose a different program, but
here's what we think you shoulddo.
The last thing I would say iswe're really selective about how
often we communicate with you.
So, even once you become amember, we're not sending you
emails every day.
We never sell our data.
We never share our dataexternally.
(21:27):
We never do ads.
We never do any of that, becausewe know that the trust we have
to build with you is very, veryimportant and we need you to
want to keep coming back, and soone of the ways we can do that
is strike a balance of when dowe reach out to give you a
little nudge and encourage youand when do we just leave you
alone.
Because also, people are on adifferent, everyone is at a
(21:48):
different place of what we callchange readiness.
And so we measure that youmight enroll in a program right
away.
On the first day you get thelink you put in Texas, you
enroll in the anxiety program,but then you may not really be
ready to start and it may justsit dormant for a month and then
you might just take off.
And so we want to be carefulabout how much we're pushing
(22:10):
versus encouraging, if thatmakes sense.
Lacy Wolff (22:13):
And I'm guessing you probably do research around
that and at what cadence ofcommunication works best for
people.
Dale Cook (22:23):
We do so.
We do our own research aroundthat and then we also survey
twice a year.
That's voluntary, our membersdon't have to complete the
survey, it's anonymous.
But we get a lot of, as youmight imagine, product
experience, product feedback.
We get mental health feedback,user experience feedback.
(22:44):
So that informs a lot of whatwe do, and then a lot of it is
informed by other clinicalpractice.
So Dr Russ is also ina clinicalpractice and our coaches are
all clinicians, so they all haveclinical experience and so
they've had a lot of experiencein understanding optimal ways to
communicate with people whomight be suffering with
(23:04):
something.
Lacy Wolff (23:05):
Okay, that's great.
You talked a little bit earlierabout when you were starting
your program.
You had to be able to show thatit is impactful.
How do you measure successtoday, and what kinds of impact
are you looking for?
Dale Cook (23:22):
Well, we measure success in a number of ways, I
think you know.
First and foremost we thinkabout sort of what are the
clinical markers of success?
So sort of those unassailabledata points that any
psychiatrist or therapist orclinician or researcher would
say, clearly, based on this,someone's depression is
decreasing, they are improvingtheir mental health, and so that
(23:44):
primary marker is what we callthese clinical psychometric
assessments.
So, for example, in thedepression program, if I
enrolled I would take the PHQ-9,which is the gold standard nine
questionnaire, nine questionquestionnaire for depression.
We get a baseline measure andthen I take it at the beginning
of each of the subsequent sevenlessons.
That helps me see my ownprogress, but that also helps
(24:06):
learn to live, understand.
Is my score decreasing?
So in this case a decrease isvery good and on average across
our entire population, our usersfor depression, for example,
decreased by 29%, which is avery, very good clinical outcome
.
So even in psychiatric carethat's good.
So that's what you know.
(24:26):
We have a number of clinicalmeasures that really are at the
tip of the spear.
We have a number of clinicalmeasures that really are at the
tip of the spear.
The other measures areself-reported.
So is Lacey hitting the goalsthat she set for herself?
Is she expressing andarticulating that she's feeling
better?
Is she doing things?
Is she maybe back at work or isshe getting up sooner in the
morning?
Is she activating?
(24:47):
Is she going for walks when shewasn't going for walks before?
So there's a lot ofself-reported measures that are
just as legitimate.
A little less black and whiteon the data, pure data side.
But that's the second thing, andthen we have a few others.
I think one is are users happywith their experience with our
services?
So, just like in any kind ofconsumer situation, do they like
(25:12):
the app?
Are they happy with thecoaching?
Do they like the other toolsthat we provide?
But we don't stop there, Ithink.
The other pieces are things likeare we moving people?
For example, 46% of our usersmove from a clinical to a
subclinical level in theirlevels of suffering, and so
that's really meaningful whenyou start to think about not
(25:33):
just their life being changedbut driving costs out of the
system.
So, whether that's for ERS orfor the health plans, or for
employers, that's fewer visitsto the ER, or maybe it's getting
off a short or long-termdisability or it's, you know,
going to work more or being morepresent right when you're at
work, and so those are alsomeasurable outcomes that are
(25:56):
really more on the business tobusiness side but are also very
important because everybody winswith that.
When someone feels better,that's the most important thing,
but then when an employer canreduce costs, they can use those
saved funds for other thingsthat can also benefit their
community.
Lacy Wolff (26:14):
Yeah, that makes so much sense.
Yeah, and helping someone'smental health helps everyone,
essentially the employee, thefamily, all the way through.
I love that you can measure theimpact in that way, actually
showing I mean 29,.
Do you say 29% decrease indepression.
Dale Cook (26:33):
That's right.
Yeah, just in depression, yep.
Lacy Wolff (26:37):
And can you run down for me just the list of the
programs that are available,like the mental health
conditions that people can seekhelp through your platform for?
Dale Cook (26:49):
We currently offer seven different programs and
then we have another 11 in ourroadmap, and I think that's
important to know that was mynext question.
Yeah, well, there we go.
I just segued you.
Yeah, that's perfect.
But the current programs wehave are and I'm saying these by
memory, I don't have the listin front of me, so this is a
(27:10):
good test for me with so muchbut we have programs for social
anxiety, for what we call stress, anxiety and worry, or,
clinically speaking, it'sgeneralized anxiety, insomnia,
substance use.
Let's see what am I missing?
Resilience, panic anddepression.
(27:32):
Oh my goodness, we've beentalking about that the most
today.
So that's the seven, and thenearly this next year we're going
to launch our eighth, which iscalled trauma.
So it's often, I think, peoplethink of post-traumatic stress
disorder, ptsd, which is part ofthe trauma set, if you will.
But PTSD is really one part ofa broader mental health problem,
(27:55):
of trauma, and so I think ourtrauma program is going to be
very impactful.
And then we've got, you know,another 10 after that that are
slated to come out, about two ayear.
So we're really excited aboutgetting those out, and that
doesn't include all of the othertools that sit around that.
So we have, you know, thesequick breaks that are on grief
or on, you know, other problemsets that maybe we don't have an
(28:17):
eight lesson program for yet,but are very specifically
targeted for different issuesthat people might be struggling
with in the moment.
Lacy Wolff (28:26):
Wow, I can't wait to see the evolution of this
program.
It sounds like you've got somegreat stuff coming.
Just today we had a, oryesterday we had a webinar with
your team, with our planparticipants, and people are
asking do you have a program forOCD, Do you have a program for
various things?
And so it's good to kind ofknow for us what is in that
(28:47):
roadmap so we can say no, notyet, but it will be coming.
So I love that you'recontinuing to innovate and think
about how to make things moreaccessible for folks.
Dale Cook (29:00):
And I would add, Lacey, if I may, on that front,
that you're exactly right WhileOCD, ADHD, conflict resolution
which people often don't reallythink about anger management,
while these are on the roadmap,the other thing that's important
to note is, again, we havetools that are really focused
around almost all of thesealready that people can access,
(29:25):
really focused around almost allof these already that people
can access.
So, if it's a, we do a lot ofwhat we call clinical webinars
so that's hosted by ourclinicians that are all CBT
based, that the community canaccess at any time they can.
They're the first time we dothem.
They're live and then they'rerecorded and then they can
access them either synchronouslyor asynchronously, but they can
address, they can get intothese other issues that may not
(29:47):
yet have a full-blown program.
So for OCD or ADHD, they canjust look through our site and
they can see where those toolsare, which is important to them.
Lacy Wolff (29:56):
That's great.
So I wanted to ask you as a CEOand leader, I'm sure and being
so aware of what's going on inthe mental health space how do
you foster a culture of healthand wellbeing for your employees
, and do you have any advice forleaders that are trying to do
that?
Dale Cook (30:17):
I'm actually really glad you asked this question
because I think we as a team atLearn to Live, we try to
intentionally discuss thisweekly if we can, because I
think when you're a part of sucha mission-based organization,
you know we can only speak toour organization.
I think that term that you know, superman or Superwoman also
(30:39):
needs to be able to take offtheir cape, sometimes right, to
be able to take off their capesometimes right.
Or the idea that parents put onthe air mask right On an
airplane if something goes wrongbefore they help their kids,
because they need to make surethey're okay first in order to
help others, that's reallyimportant for us.
And so I think reminding eachother to take days off, to take
(31:01):
wellbeing days, to take timeaway, even time during the day
if they have a particularlystressful call or they need that
time it's really important.
You know, if we can't do it andwe're a mental health care
company, then something isreally wrong.
But I think also, aside from thewell-being, I think you had
asked about innovation maybe wehad talked earlier about that
(31:24):
and I think for us you know, forany organization like ours,
where we're really pushing,we're pushing hard to innovate,
we're pushing hard to considerthings like AI or consider
what's coming, and is that abenefit or a detriment and how
does that impact our members?
We need spaces in our companyfor people to innovate and fail,
and that it's okay to fail andit's safe to fail, and we don't
(31:47):
do that on the front side withour members, because that's a
sacred place where we need touse tested, tried and true
methods, of course, but behindthe scenes, within our teams,
when we're looking for that nextthing and we're looking to push
the envelope, our teams need toexperience failure and
experience that management thattheir colleagues still support
(32:08):
them, still believe in them,still see all the amazing
superpowers that they have andthat they still have those
superpowers.
It's just that sometimes thingsaren't going to work and that
should be happening.
If we're not failing, thenwe're not innovating, and I
think that's a really, reallyimportant thing that it's easy
to say.
I think it's an entirelydifferent thing for people to
(32:30):
really experience that and feelsafe in that, and that really is
in the behavior, that's in theculture.
I think it's there or it's not.
Lacy Wolff (32:37):
If that makes sense Wow, yeah, I can, that is so.
It's so interesting because Ithink even just in the culture
as Americans, that's hard for us.
So, yeah, I can imagine it'sdifficult and I think a lot of
leaders are really trying tofigure this stuff out.
You know support employees,mental health.
We know it's a problem, we knowwe have challenges and I do
(33:00):
really appreciate your solution.
Do you have any closingthoughts for our listeners?
Anything that I should haveasked you that I didn't?
Dale Cook (33:10):
Well, I think I would .
You know, one thing I would sayand this is maybe a lesson
learned for me and for ourcompany, but also an
encouragement to the listenersis that you know, as we've
talked a little bit about Lacey,you know, as we've talked a
little bit about Lacey, you knowmental health is health and you
know, I think this part of thestigma is you hear the word
(33:32):
mental health and you think of aproblem versus just being
healthy like we would withwatching our weight or getting
exercise.
And so I think one lessonlearned for us internally and in
our service, and encouragementto all of your listeners, is
think proactively about yourmental health.
You know you don't have to beclinically depressed to get
something really meaningful outof the depression program.
(33:54):
You don't have to be anxious toget something out of a
progressive muscle relaxationaudio.
So that's one thing I would sayno-transcript, to not forget
(34:27):
that your mental health is tiedto so many other things.
I heard a snippet of a reallygreat podcast you did with Hinge
Health, and I think one of theopening statements in Hinge
Health, which is really aboutmusculoskeletal issues and right
and joint health, is mentalhealth and how closely they're
tied together, and so I thinkthe last thing I would say is
(34:49):
please remember that your mentalhealth and your physical health
and your relational healththey're all inextricably tied
together, and so the more, evenfor myself, that I can remember
that every day, a meditation orevery day logging in whether
it's our app or a different appproactively can have an outsized
impact on your life.
(35:10):
I think is a really criticalmessage to provide for all of us
as we go.
Lacy Wolff (35:18):
That is great closing thoughts and I am so
appreciative of your time, dale,and I look forward to getting
this out to our listeners.
Dale Cook (35:26):
Thank you so much, lacey, great to talk to you.
Lacy Wolff (35:29):
Thank you so much for joining me on this special
episode of the ERS Walk Talkpodcast.
As my last episode for 2024, Iwant to thank you for walking
with me this year and being apart of these important
conversations.
I hope you enjoyed learningmore about Learn to Live and how
it's helping to make mentalhealth resources more accessible
and effective.
(35:49):
If you'd like to explore thisplatform or share with someone
else who might benefit, pleasecheck out our show notes for all
the details for eligibilityrequirements and how to enroll.
As we look ahead to 2025, Iencourage you to keep
prioritizing your well-being,one step at a time.
Don't forget to subscribe tothe podcast and share it with
(36:10):
others.
It's a great way to shareinformation and inspiration.
Take care and keep movingforward.
I will see you in the new year.
Take care everybody.
Mental health is health, and I think part of the
stigma is you hear the wordmental health and you think of a
problem versus just beinghealthy like we would with
watching our weight or gettingexercise.
And so I think one lessonlearned for us internally and in
our service and encouragementto all of your listeners, is
(00:22):
think proactively about yourmental health.
You don't have to be clinicallydepressed to get something
really meaningful out of thedepression program.
You don't have to be anxious toget something out of a
progressive muscle relaxationaudio.
Lacy Wolff (00:35):
Hi everyone and welcome back to the ERS Walk
Talk podcast.
I'm your host, lacey Wolfe.
In today's episode, which willbe the final episode for 2024, I
am joined by Dale Cook, the CEOand co-founder of Learn to Live
.
This innovative platform ishelping thousands of people
manage their mental healththrough evidence-based online
(00:56):
programs and tools.
As we wrap up the year, I amexcited to share this meaningful
conversation where we dive intowhat inspired the creation of
Learn to Live, how it works andthe impact it's having on lives
all over the country.
So lace up your walking shoesone more time with me and let's
explore how small, intentionalsteps can make a big difference
(01:18):
in our mental health.
All right, dale Cook, welcometo the podcast.
Thank you so much for being aguest on the ERS Walk Talk
podcast.
Dale Cook (01:27):
Well, thank you, Lacey.
It's a pleasure to be here.
Lacy Wolff (01:30):
I was wanting to just start with having you talk
a little bit about yourself.
Can you share with ourlisteners where you come from,
where you are today and what ledyou into the mental health care
space?
Dale Cook (01:47):
and what led you into the mental health care space.
I'm happy to do so.
I think I mean that's a bigquestion where I come from,
where I am, why I'm here, butI'm based in Minneapolis,
minnesota.
I spent most of my formativeyears actually in Latin America,
which was an amazing experienceand really, I think, set the
tone for kind of who I am andhow I think about the choices I
make in life, including where Ispend my time, which a lion's
(02:08):
share of that right now is learnto live.
And I think, in terms ofbackground and as we talk about
learn to live and mental healthtoday, you know there's probably
two dimensions I think about.
On the personal front, Iremember back in college I loved
college, it was an amazingexperience.
I was a little over-involvedand so I was pretty stressed and
(02:29):
I didn't realize I was gettingreally anxious and so I couldn't
sleep and I hadn't really heardabout mental health or insomnia
.
And I was one of the lucky fewwho was able to go see a
therapist on campus who waspracticing cognitive behavioral
therapy, which is a great CBTprotocol, and I learned that I
was actually just anxiousbecause I was overextended and I
(02:50):
took a couple sessions and thelight bulb came on for me and
started sleeping like a baby,and that was my kind of early
mental health experience.
I was really really fortunateto get that kind of help and so
fast forward to what I'm doingnow and sort of who I am and
what this brings us to is, youknow, founding, learn to Live,
(03:10):
co-founding, learn to Live forme was really an opportunity to
have impact, I think, for me inmy life that's what I look for
and, as I'm sure you know andI'm sure your listeners know,
you know, mental health in theUnited States has really been a
crisis for many years, for manydecades.
It's only gotten worse withCOVID and so, when we think
(03:30):
about all of those problems andnow even the research coming out
about increased depression,anxiety, reduced resilience in
our youth, all of the datacoming out about my generation,
gen X and nearby generations,the opportunity to address these
issues in a different way, asyou probably know, our
(03:52):
traditional model, which isreally counselors, therapists,
psychologists, is troubled inthat there's a limited supply,
right, there's a really highneed for a lot of those services
and a really limited supply ofthose services.
In fact, over half the countiesin the United States do not have
(04:12):
a single mental healthpractitioner in them, and so we
have a lot of people needing alot of services, but not a lot
of people able to providetraditional services either in
person or virtually, and so itreally demanded something
different.
And so it really demandedsomething different, and that
was where Learn to Live was bornabout 12 years ago to provide a
different kind of service,actually an array of services
that were still clinicallygrounded, very, very effective,
(04:33):
but could really be taken andengaged by anyone, anytime,
anywhere.
And that was really theexciting moment for me was to
engage and start a company likethat and have that kind of
impact.
Lacy Wolff (04:45):
It's incredible and I love hearing your story and
that you actually sought mentalhealth care in college, which I
think says a lot about you as aperson, and then we're really
interested in replicating orcreating a program that would be
scalable to reach so manypeople.
(05:07):
I'm really proud that we areable to offer Learn to Live to
our health plan participants.
I think it's an amazing tooland resource for folks, because
I think, especially in Texas,we're a huge state and we have
so many rural communities wherethere's not good access and also
, I think, with the stigma,there's a lot of people who
don't necessarily feelcomfortable talking to somebody.
So being able to access thiskind of care from anywhere is is
(05:31):
truly a gift I think that wecan give to our health plan
participants.
So thank you for that, I'mhoping.
Next, maybe you could just kindof describe the the program,
because a lot of people becauseit is very new for us we just
launched this in September a lotof people still don't know what
it is.
Can you explain the experiencefor like from the user
(05:51):
experience, what it is like togo in and participate in the
program?
Dale Cook (05:58):
I'd be happy to do that and, by the way, you know,
you mentioned the word stigmaand I think that's one of the
biggest barriers that we allface today and I was fortunate
in college, as you mentioned, tohave people around me who
helped really reduce that stigma, and that's one truly learn to
live, I think, does transformthe traditional care delivery
(06:26):
model of mental health careservices, in that we're able to
address these mental health careneeds really high acuity, low
acuity, really at scale andagain reach people where they
are.
You talk about, you know the,the, the, the kind of the crisis
of access in Texas, and we'llprobably talk about that a
little bit more.
(06:46):
But at our core, we providethese comprehensive,
self-directed digital cognitivebehavioral therapy programs that
have extensive services andtools that individuals can use.
So think about a comprehensivedepression program or insomnia,
or substance use or anxiety orstress.
(07:09):
But it's not just theseself-directed programs.
There's other services.
We have clinician coaches onstaff 24-7.
And so our users, our members,can meet with coaches via text,
email and phone as much as theyneed to do that, which really
our coaches kind of encouragepeople to stay engaged in the
program, but they also then canhelp our members find other
(07:31):
services.
So if someone engages with uswho actually determines that in
fact they need to see atherapist or maybe a
psychiatrist, our team can helpthem find that.
So another service we provide isthis critical navigation
service, and we can even managecrises.
It doesn't happen a lot, but ifsomeone is in crisis, we're
tapped into all the localresources that are required to
(07:54):
address that appropriately froma clinical standpoint, from a
safety standpoint, and so ourgoal is to really scale that out
and enable someone to addresswhat we would call the probably
the seven biggest barriers, youknow.
So that's that stigma.
Another one is education.
A lot of us don't always knowwhat we're suffering from, or if
(08:16):
it's a mental health problem orsomething else.
A third is quality.
So are we finding quality carethat can actually move the
needle for us?
Another is stigma.
I mentioned that earlier.
Another is privacy and anotheris cost, and so we specifically
address each of those indifferent ways, which I'm happy
to talk about too, but maybeI'll pause there, so my answer
(08:40):
doesn't get too long for you.
Lacy Wolff (08:41):
That's great, yeah, and I was thinking it would be
also really good to have youdefine cognitive behavioral
therapy and just talk a littlebit about what that is for
people who don't know.
Dale Cook (08:53):
Happy to do so.
So cognitive behavioral therapyis really one of two primary
clinical ways of addressingmental health we're all probably
most familiar with or you mightthink, is that the counseling
format, which has been aroundfor over 100 years.
So that's kind of Freudianpsychology of talking about your
past, maybe experiences thatinform your present or your
(09:15):
future, and while that can behelpful to some, really over the
last 60 or 70 years cognitivebehavioral therapy has come to
the forefront as the mostevidence-based form of mental
health care and really whatthat's doing is saying it's
considering how we interpret thethings in our lives mentally,
so how we kind of filter thosein through our minds, and then
(09:40):
how that in turn drives ouremotions.
So if I'm a socially anxiousperson and I'm out to eat, I
might be incorrectly thinkingthat the individuals at the
table nearby are laughingthey're laughing and they seem
to be having a good time andthat they're making fun of me
and that's making me anxious,when in fact they don't even
(10:01):
notice me.
But I'm not realizing that andso my mental frame is changing
that into an anxious set ofemotions that drive my social
anxiety, and so what CBT does isreally unpack that process,
kind of puts an interruption inthat process.
And the exciting thing abouteven digital CBT programs is
(10:21):
that it's very structured.
Think of it as homework, thinkof it as practice, a lot of
practice on breaking momentsdown.
And so here you have now, youknow, with learn to live on your
phone you can take that momentand record something in your
homework and break up thatactivity and actually slow down
that process.
And over time then you becomejust very good at breaking up
(10:43):
that process so that you don'thave those anxious thoughts.
And so CBT again precedes learnto live by many years.
In fact, digital CBT precedeslearn to live.
It used to be on a CD-ROM about25 years ago.
It's research on digitallydelivered CBT that shows that
(11:08):
it's clinically as effective asface-to-face CBT.
Lacy Wolff (11:11):
That's amazing.
You just have to have thedesire and willingness to do it
right.
I mean, I guess that's thething is having that motivation.
And one of the things I thinkI've been going through the
resiliency course through Learnto live I love, like the
exercise that I did the otherday was so great because, like
you said, it's it teaches youkind of the concept, but then
(11:33):
you go in and you actually applyit to a moment in your own life
and that's powerful.
I think that's really powerfulas a participant because you you
start to recognize oh, that's apattern of thinking that I have
and then that can help you inall the other areas of life,
which is a game changer.
So hopefully that you cancontinue to use that in all
(11:54):
those different experiences.
The sessions are pretty short,right, they're not
overwhelmingly long.
That's another thing that Ithink is great for people to
kind of know about Learn to Live, that you don't have to, you
know, sit down for an hour a day.
How long do you try to keepyour sessions?
Dale Cook (12:08):
Well, you're exactly right, I think you know the goal
is to you know, technicallyspeaking, I think each program
has eight lessons and each ofthe lessons is about 45 minutes
of seat time if you sat down forthe whole thing.
But, lacey, you're exactlyright the goal is to enable each
of us to take somethingsignificant and meaningful and
(12:30):
actionable away from a lessonevery five or six minutes.
So if you think about theaverage time that any of us
spends on, let's say, an appexcept maybe for social media,
it's five to 10 minutes.
And so the goal here is to sayyou know, what is something that
Lacey or Dale can learn abouttheir depression or their
(12:50):
anxiety that they can then applyin their real life in such a
way that really moves the needlefor them and makes them say you
know what?
That was really helpful, I wantto go back and do something
again, you know.
And so part of that is reallythe magic of building, I think,
the right kind of digitalcontent to keep people coming
back.
But that's another reason whywe love what we do is that you
(13:14):
know, we believe we'redelivering something, a powerful
positive force, for reasons,you know, for good reasons for
people to be checking theirphone once in a while to be
checking in with these programs,and then the tools that they do
in between, the programs thatthey can do on devices.
They can print them out and dothem old school if they want to
do that.
(13:34):
But the idea there is again tohave these quick hit moments,
and whether that's in theprogram or also with other tools
, we have something called QuickBreaks that we recently
launched.
So these are, you know, two tofour minute video vignettes
about any number of things.
It could be grief, it could beanxiety, it could be public
speaking, it could be resilience.
(13:55):
So that's the other goal withthose tools is, you know, if
you're not three lessons deep inthe depression program, that's
okay.
If you'd rather take a quickvideo or listen to an audio on
progressive muscle relaxation ormeditation, we want to make
that really, really easy for you, because we know that it's not
a one-size-fits-all anywhere inhealthcare.
(14:16):
But for us, especially inmental healthcare, our mutual
experience of maybe the samequote-unquote mental health
problem could be very different,and what you need versus what I
need is also very different,and so part of our well learned
to live is to provide an arrayof services immediately
accessible, of course, at nocost, to employees and family
(14:38):
members, and retirees in thiscase, so that you can access at
any time in privacy, with noneof those barriers.
Lacy Wolff (14:46):
It's amazing.
Can you share a little bitabout the story of building?
Learn to Live.
I know this must not have beenan easy feat to get to where you
are today.
There's always roadblocks, Ithink, when you're trying to
build something, and it can bechallenging.
So how did you build thisscalable mental health product?
Dale Cook (15:07):
Well, that's almost asked as a fellow entrepreneur
and I don't know if you are one,lacey, but certainly it sounds
like you understand what can besometimes really tough about
building any kind oforganization, especially one
that's very mission-based andfocused.
Morfitt and I were reallyfortunate to connect on this
(15:29):
issue.
You know he's a clinician.
He's highly respected in hisfield, an experienced researcher
, so he's really the what I callthe lightning in a bottle when
it comes to the power of what wecan deliver.
What I brought was kind of thebusiness experience, the
background, to say, okay, how dowe take this really beautiful
(15:49):
content that's clinically based,that's research based, and make
it really consumable in a waythat I would want to use it or
that my teenage son would wantto use?
And then how do we create abusiness around that so that,
you know, we can keep the lightson and we can pay for really
good employees who do reallygood work.
And how can we scale that out?
You know, and so fast forward,12 years in, we're scaled out to
(16:12):
36 million Americans.
You know, we work with healthplans and universities and
employers and pharmacy benefitmanagers, and so we're blessed
and fortunate to have scaled out.
But to your point many, manytimes along the way, very
difficult.
Especially 10 years ago, thiswasn't even really a category.
(16:33):
No one really knew aboutdigital CBT, where now it's a
little bit more ubiquitous andcertainly with COVID there's a
lot of noise in the space, andso we were way ahead of that
curve and so I think, probablyfiguring out how to build this,
and in fact we went direct toconsumer at the beginning
intentionally.
We always knew that at the endof the day, we wanted health
(16:55):
plans or employers to pay forthe service so that we could
remove that cost access forusers.
But we believe that unless wecould offer our services out on
the internet and find people outthere who are suffering so
three out of four people in theUS will never seek in-person or
virtual therapy.
So we have this large group andalmost half the people in the
(17:16):
United States will have a mentalhealth problem at some point in
their lives.
So three out of four of half ofthe people in the United States
will not seek traditionaltherapy.
And so our goal was at thebeginning how do we find those
people online?
How do we get them to kind ofwalk through our digital doors,
if you will and trust us andstay with us long enough to have
(17:38):
a real change in their life andfor us to measure that
clinically.
If we can't do that, then wereally don't have any business
going to an ERS or going to ahealth plan and saying, hey, if
you're willing to pay for thisservice, we can really help
people and really get them toengage.
And so the first year and ahalf or so was direct to
consumer only, which, as youprobably know, is very difficult
(17:59):
and it's expensive, but it isextremely valuable and really
formed the DNA of our ability togo in and get 20, 30, 40%
engagement of a population everyyear, which is very, very high
when you think about traditionalmental health services.
So I'm not sure if thatanswered your question and just
(18:22):
want to be clear.
Lacy Wolff (18:23):
You said 36 million people have access to Learn to
Live right now.
Dale Cook (18:27):
That's right, and soon to be by November, it will
be 47.
So we're on the doorstep ofanother big collaboration that
will be announced a little bitlater this year.
Lacy Wolff (18:38):
That has to feel so good to know that you can help
that many people.
I cannot imagine.
Do you have any advice forsomebody like me who is in a
role where I'm trying to supportmental health of my workforce
with your product?
Do you have any kind of successstories for how to engage
people?
Dale Cook (18:57):
We are happy to share .
You know, I think, what ourteam would consider hard fought
experiences and life lessons on.
You know how to engage a groupof individuals you know myself
included from college who arereally struggling and they
really want to do somethingabout it.
But part of the struggle is asocial struggle, and you know
(19:19):
whether that's stigma or accessor cost or concerns about
privacy is is how do you engagesomeone who wants to be, you
know, be different, wants tochange, but is a little bit wary
and rightfully so of theservices that are out there?
And so I think number one ismeet people where they are.
(19:40):
So with your messaging when youreach out, you know, understand
that someone who's strugglingwith something isn't going to
respond to messaging that says,hey, lacey, go get them.
You know you can do it.
You know exclamation them, youcan do it, Exclamation point.
It's a different kind ofmessage to somehow communicate
to you that we understand whatyou're struggling with and we've
been there.
(20:00):
We have other members here inour community that have been
there, that are there, and it'sokay, it's a safe place to be.
I think the second thing ismaking it really, really easy to
access, and so when people cometo our website, they have a
code, so an ERS employee willhave a code.
It's really easy code toremember.
They can log in.
What's that?
Lacy Wolff (20:21):
It's Texas.
Dale Cook (20:22):
Exactly.
I'm so glad you share the code.
It's very, very easy toremember.
They can immediately access allkinds of services.
And the third thing I would sayis making the education very
easy.
So in the case of mental health,you know, the first thing
someone sees is what we call acomprehensive assessment.
What it really is is ashortened version of gold
(20:45):
standard, what we callpsychometric assessment.
So you may have heard of aPHQ-9 for depression or a GAD-7
for anxiety, but it's about afive-minute assessment that you
can take very quickly, but it'sclinically very sound, where
there are a lot of algorithmsthat sit underneath that that
will then say to you Lacey,based on what you've entered,
here's the program we think youshould start with.
(21:06):
You don't have to, you canchoose a different program, but
here's what we think you shoulddo.
The last thing I would say iswe're really selective about how
often we communicate with you.
So, even once you become amember, we're not sending you
emails every day.
We never sell our data.
We never share our dataexternally.
(21:27):
We never do ads.
We never do any of that, becausewe know that the trust we have
to build with you is very, veryimportant and we need you to
want to keep coming back, and soone of the ways we can do that
is strike a balance of when dowe reach out to give you a
little nudge and encourage youand when do we just leave you
alone.
Because also, people are on adifferent, everyone is at a
(21:48):
different place of what we callchange readiness.
And so we measure that youmight enroll in a program right
away.
On the first day you get thelink you put in Texas, you
enroll in the anxiety program,but then you may not really be
ready to start and it may justsit dormant for a month and then
you might just take off.
And so we want to be carefulabout how much we're pushing
(22:10):
versus encouraging, if thatmakes sense.
Lacy Wolff (22:13):
And I'm guessing you probably do research around
that and at what cadence ofcommunication works best for
people.
Dale Cook (22:23):
We do so.
We do our own research aroundthat and then we also survey
twice a year.
That's voluntary, our membersdon't have to complete the
survey, it's anonymous.
But we get a lot of, as youmight imagine, product
experience, product feedback.
We get mental health feedback,user experience feedback.
(22:44):
So that informs a lot of whatwe do, and then a lot of it is
informed by other clinicalpractice.
So Dr Russ is also ina clinicalpractice and our coaches are
all clinicians, so they all haveclinical experience and so
they've had a lot of experiencein understanding optimal ways to
communicate with people whomight be suffering with
(23:04):
something.
Lacy Wolff (23:05):
Okay, that's great.
You talked a little bit earlierabout when you were starting
your program.
You had to be able to show thatit is impactful.
How do you measure successtoday, and what kinds of impact
are you looking for?
Dale Cook (23:22):
Well, we measure success in a number of ways, I
think you know.
First and foremost we thinkabout sort of what are the
clinical markers of success?
So sort of those unassailabledata points that any
psychiatrist or therapist orclinician or researcher would
say, clearly, based on this,someone's depression is
decreasing, they are improvingtheir mental health, and so that
(23:44):
primary marker is what we callthese clinical psychometric
assessments.
So, for example, in thedepression program, if I
enrolled I would take the PHQ-9,which is the gold standard nine
questionnaire, nine questionquestionnaire for depression.
We get a baseline measure andthen I take it at the beginning
of each of the subsequent sevenlessons.
That helps me see my ownprogress, but that also helps
(24:06):
learn to live, understand.
Is my score decreasing?
So in this case a decrease isvery good and on average across
our entire population, our usersfor depression, for example,
decreased by 29%, which is avery, very good clinical outcome
.
So even in psychiatric carethat's good.
So that's what you know.
(24:26):
We have a number of clinicalmeasures that really are at the
tip of the spear.
We have a number of clinicalmeasures that really are at the
tip of the spear.
The other measures areself-reported.
So is Lacey hitting the goalsthat she set for herself?
Is she expressing andarticulating that she's feeling
better?
Is she doing things?
Is she maybe back at work or isshe getting up sooner in the
morning?
Is she activating?
(24:47):
Is she going for walks when shewasn't going for walks before?
So there's a lot ofself-reported measures that are
just as legitimate.
A little less black and whiteon the data, pure data side.
But that's the second thing, andthen we have a few others.
I think one is are users happywith their experience with our
services?
So, just like in any kind ofconsumer situation, do they like
(25:12):
the app?
Are they happy with thecoaching?
Do they like the other toolsthat we provide?
But we don't stop there, Ithink.
The other pieces are things likeare we moving people?
For example, 46% of our usersmove from a clinical to a
subclinical level in theirlevels of suffering, and so
that's really meaningful whenyou start to think about not
(25:33):
just their life being changedbut driving costs out of the
system.
So, whether that's for ERS orfor the health plans, or for
employers, that's fewer visitsto the ER, or maybe it's getting
off a short or long-termdisability or it's, you know,
going to work more or being morepresent right when you're at
work, and so those are alsomeasurable outcomes that are
(25:56):
really more on the business tobusiness side but are also very
important because everybody winswith that.
When someone feels better,that's the most important thing,
but then when an employer canreduce costs, they can use those
saved funds for other thingsthat can also benefit their
community.
Lacy Wolff (26:14):
Yeah, that makes so much sense.
Yeah, and helping someone'smental health helps everyone,
essentially the employee, thefamily, all the way through.
I love that you can measure theimpact in that way, actually
showing I mean 29,.
Do you say 29% decrease indepression.
Dale Cook (26:33):
That's right.
Yeah, just in depression, yep.
Lacy Wolff (26:37):
And can you run down for me just the list of the
programs that are available,like the mental health
conditions that people can seekhelp through your platform for?
Dale Cook (26:49):
We currently offer seven different programs and
then we have another 11 in ourroadmap, and I think that's
important to know that was mynext question.
Yeah, well, there we go.
I just segued you.
Yeah, that's perfect.
But the current programs wehave are and I'm saying these by
memory, I don't have the listin front of me, so this is a
(27:10):
good test for me with so muchbut we have programs for social
anxiety, for what we call stress, anxiety and worry, or,
clinically speaking, it'sgeneralized anxiety, insomnia,
substance use.
Let's see what am I missing?
Resilience, panic anddepression.
(27:32):
Oh my goodness, we've beentalking about that the most
today.
So that's the seven, and thenearly this next year we're going
to launch our eighth, which iscalled trauma.
So it's often, I think, peoplethink of post-traumatic stress
disorder, ptsd, which is part ofthe trauma set, if you will.
But PTSD is really one part ofa broader mental health problem,
(27:55):
of trauma, and so I think ourtrauma program is going to be
very impactful.
And then we've got, you know,another 10 after that that are
slated to come out, about two ayear.
So we're really excited aboutgetting those out, and that
doesn't include all of the othertools that sit around that.
So we have, you know, thesequick breaks that are on grief
or on, you know, other problemsets that maybe we don't have an
(28:17):
eight lesson program for yet,but are very specifically
targeted for different issuesthat people might be struggling
with in the moment.
Lacy Wolff (28:26):
Wow, I can't wait to see the evolution of this
program.
It sounds like you've got somegreat stuff coming.
Just today we had a, oryesterday we had a webinar with
your team, with our planparticipants, and people are
asking do you have a program forOCD, Do you have a program for
various things?
And so it's good to kind ofknow for us what is in that
(28:47):
roadmap so we can say no, notyet, but it will be coming.
So I love that you'recontinuing to innovate and think
about how to make things moreaccessible for folks.
Dale Cook (29:00):
And I would add, Lacey, if I may, on that front,
that you're exactly right WhileOCD, ADHD, conflict resolution
which people often don't reallythink about anger management,
while these are on the roadmap,the other thing that's important
to note is, again, we havetools that are really focused
around almost all of thesealready that people can access,
(29:25):
really focused around almost allof these already that people
can access.
So, if it's a, we do a lot ofwhat we call clinical webinars
so that's hosted by ourclinicians that are all CBT
based, that the community canaccess at any time they can.
They're the first time we dothem.
They're live and then they'rerecorded and then they can
access them either synchronouslyor asynchronously, but they can
address, they can get intothese other issues that may not
(29:47):
yet have a full-blown program.
So for OCD or ADHD, they canjust look through our site and
they can see where those toolsare, which is important to them.
Lacy Wolff (29:56):
That's great.
So I wanted to ask you as a CEOand leader, I'm sure and being
so aware of what's going on inthe mental health space how do
you foster a culture of healthand wellbeing for your employees
, and do you have any advice forleaders that are trying to do
that?
Dale Cook (30:17):
I'm actually really glad you asked this question
because I think we as a team atLearn to Live, we try to
intentionally discuss thisweekly if we can, because I
think when you're a part of sucha mission-based organization,
you know we can only speak toour organization.
I think that term that you know, superman or Superwoman also
(30:39):
needs to be able to take offtheir cape, sometimes right, to
be able to take off their capesometimes right.
Or the idea that parents put onthe air mask right On an
airplane if something goes wrongbefore they help their kids,
because they need to make surethey're okay first in order to
help others, that's reallyimportant for us.
And so I think reminding eachother to take days off, to take
(31:01):
wellbeing days, to take timeaway, even time during the day
if they have a particularlystressful call or they need that
time it's really important.
You know, if we can't do it andwe're a mental health care
company, then something isreally wrong.
But I think also, aside from thewell-being, I think you had
asked about innovation maybe wehad talked earlier about that
(31:24):
and I think for us you know, forany organization like ours,
where we're really pushing,we're pushing hard to innovate,
we're pushing hard to considerthings like AI or consider
what's coming, and is that abenefit or a detriment and how
does that impact our members?
We need spaces in our companyfor people to innovate and fail,
and that it's okay to fail andit's safe to fail, and we don't
(31:47):
do that on the front side withour members, because that's a
sacred place where we need touse tested, tried and true
methods, of course, but behindthe scenes, within our teams,
when we're looking for that nextthing and we're looking to push
the envelope, our teams need toexperience failure and
experience that management thattheir colleagues still support
(32:08):
them, still believe in them,still see all the amazing
superpowers that they have andthat they still have those
superpowers.
It's just that sometimes thingsaren't going to work and that
should be happening.
If we're not failing, thenwe're not innovating, and I
think that's a really, reallyimportant thing that it's easy
to say.
I think it's an entirelydifferent thing for people to
(32:30):
really experience that and feelsafe in that, and that really is
in the behavior, that's in theculture.
I think it's there or it's not.
Lacy Wolff (32:37):
If that makes sense Wow, yeah, I can, that is so.
It's so interesting because Ithink even just in the culture
as Americans, that's hard for us.
So, yeah, I can imagine it'sdifficult and I think a lot of
leaders are really trying tofigure this stuff out.
You know support employees,mental health.
We know it's a problem, we knowwe have challenges and I do
(33:00):
really appreciate your solution.
Do you have any closingthoughts for our listeners?
Anything that I should haveasked you that I didn't?
Dale Cook (33:10):
Well, I think I would .
You know, one thing I would sayand this is maybe a lesson
learned for me and for ourcompany, but also an
encouragement to the listenersis that you know, as we've
talked a little bit about Lacey,you know, as we've talked a
little bit about Lacey, you knowmental health is health and you
know, I think this part of thestigma is you hear the word
(33:32):
mental health and you think of aproblem versus just being
healthy like we would withwatching our weight or getting
exercise.
And so I think one lessonlearned for us internally and in
our service, and encouragementto all of your listeners, is
think proactively about yourmental health.
You know you don't have to beclinically depressed to get
something really meaningful outof the depression program.
(33:54):
You don't have to be anxious toget something out of a
progressive muscle relaxationaudio.
So that's one thing I would sayno-transcript, to not forget
(34:27):
that your mental health is tiedto so many other things.
I heard a snippet of a reallygreat podcast you did with Hinge
Health, and I think one of theopening statements in Hinge
Health, which is really aboutmusculoskeletal issues and right
and joint health, is mentalhealth and how closely they're
tied together, and so I thinkthe last thing I would say is
(34:49):
please remember that your mentalhealth and your physical health
and your relational healththey're all inextricably tied
together, and so the more, evenfor myself, that I can remember
that every day, a meditation orevery day logging in whether
it's our app or a different appproactively can have an outsized
impact on your life.
(35:10):
I think is a really criticalmessage to provide for all of us
as we go.
Lacy Wolff (35:18):
That is great closing thoughts and I am so
appreciative of your time, dale,and I look forward to getting
this out to our listeners.
Dale Cook (35:26):
Thank you so much, lacey, great to talk to you.
Lacy Wolff (35:29):
Thank you so much for joining me on this special
episode of the ERS Walk Talkpodcast.
As my last episode for 2024, Iwant to thank you for walking
with me this year and being apart of these important
conversations.
I hope you enjoyed learningmore about Learn to Live and how
it's helping to make mentalhealth resources more accessible
and effective.
(35:49):
If you'd like to explore thisplatform or share with someone
else who might benefit, pleasecheck out our show notes for all
the details for eligibilityrequirements and how to enroll.
As we look ahead to 2025, Iencourage you to keep
prioritizing your well-being,one step at a time.
Don't forget to subscribe tothe podcast and share it with
(36:10):
others.
It's a great way to shareinformation and inspiration.
Take care and keep movingforward.
I will see you in the new year.
Take care everybody.
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