#9: In Practice: What is Skills-based Therapy?

Tametra Johnson, LCSW and Maritza Noriega, LMFT, from Jacob's Ladder Therapies, share what Skills-Based therapy looks like and how they help their clients develop Mental Wellness skills to achieve their goals: including managing anxiety and healthy relationships.

Learn more about Jacob's Ladder Therapies at https://jacobsladdertherapies.com/

Episode Transcript

(00:02):
Welcome to the Heart podcast Guilt forMental Illness. Thanks for coming, everybody.
We're glad to have you here.I have two amazing women who are
therapists and fantastic in their own righton skill based mental wellness, and i'd
like to introduce them to you today. Kimitra, can you go ahead and
introduce yourself and a little bit aboutyour background let our listeners know who you
are. Hi. Everyone, I'mTimitra. I am a licensed clinical social

(00:27):
worker. I am also the ownerand founder of Jacob's Ladder Therapies. We
are a therapy group practice and wespecialize in treating teens, tweens, young
adults, adults, parents, familieswho have mood and personality disorders, communication
problems, having issues with school stress, and we use individual therapy, group

(00:53):
therapy, family therapy as our modesof treatment. And we are trained in
Dialectical behavioral therapy or DBT, whichis a skills based format for mental illness.
Thank you brab for having me here. Absolutely, I should say I

(01:14):
forgot to say this earlier. Whois with us, Tomitor Johnson who is
a licensed clinical social worker, andMaritza Noriega and Maritza I don't know you're
a full title. I am thankyou for having me as well. I
am a licensed marriage and family therapist. Great, go ahead and introduce yourself
as well. So my name isManita Noriega. I'm a licensed marriage and
family therapist. I am currently thelead clinician at Jacob's Ladder Therapies, and

(01:38):
I specialize in working with teens andyoung adults who are struggling with depression and
anxiety. My form of therapy isalso a DBT trained so I do use
a lot of skill based in myindividual sessions and in group therapy, and
then I also use a little bitof cognitive be heoral therapy as well.
I am noting that's why I amby link and provide therapy in Spanish as

(02:01):
well. So I like to workwith diverse populations and cultures and supporting whatever
mental health challenges clients brings. That'sso awesome. We really really need that
that diversity in our therapy. Yeah, thank you all right. So question
for you guys is skill based mentalwellness? What does that mean for you

(02:23):
in general? Like? What doesthat what are those words actually connotates to
you in your head? What doesit bring up? I think, for
me, when I think of skillbased mental wellness, I think of all
of the things that people feel theyshould already know how to do, kind

(02:43):
of those every day like this shouldbe something you're taught as a kid,
Like everybody just sort of knows itand it absorbs it in their life.
And the reality is, if youhaven't been taught these skills, you really
don't know them. So all ofthose should statements about what I should know
or what you should be able todo kind of gets thrown out the window

(03:06):
when if you really don't know them. And I find that a lot of
the teens and young adults that wework with, they don't know the skills.
Their generation is different, and ifthey haven't been taught the skills,
they don't know them, and itcauses quite a bit of causes them to
have quite a bit of emotional distress. Right, I think when I think

(03:29):
about skill based mental wellness or mentalhealth, I think, in addition to
its interesting, I think also givingour clients the foundation of what they can
do when times gets tough, becausethe reality is that life is difficult.
We are all going to go throughchallenges, and it's more about what can
we do in the moment to helpus overcome those difficulties. So getting clients

(03:51):
a set of skills that they canuse not only in the moment when they
are in therapy, but that theycan continue to apply to everyday life at
school, with family, in ourjobs. So it's actually giving them foundational
skills that they can continue to implementin their day to day lives, whether
they are in therapy or not fora long period of time. Nice I
love that concept. We are totallyon board at that concept. Here at

(04:15):
the heart present we talk about howthe skills help you get out of a
hole, you know, as wetalked about mental health issues, and also
help us climb a mountain so thatwe're thriving in the things that we want
to do, not just the stuffthat we need to do. Right,
So, life is full of challenges, full of struggles. I mean,
I feel like that's the whole pointof life. And somewhere along the line

(04:35):
in our society we came to thisidea that left should be easy and if
we're struggling, there's something wrong withus. What do you guys think about
that concept? I think that's definitelysomething that pops up a lot in therapy,
right, the stigma of what amI doing wrong? What is wrong
with me? Why can I notquote unquote the normal? Right? And

(04:58):
I think that's what makes it andchallenging or challenges people in accessing services,
but in also being able to kindof navigate these challenges, because it's very
easy to fall into this whole orto struggle with recognizing that it's okay for
me to not know it all orfor me to go through these challenges.
Right. But I think time weput on those the peach colored or rose
colored glasses and think that it's justgoing to be nice and easy, and

(05:21):
the reality is that it's Yeah,that's your thoughts. I also think,
like from a and a lot ofcultures, you are supposed to You're supposed
to just be able to do itall. You know, you have to

(05:42):
be the strong the strong woman,the strong man. And mental illnesses.
You know something that's wrong with youand you need to like put it to
the side and just you know,keep going and yeah you are. You
still have to make those good grades, you still have to get that good
job, You have to make thisamount of money, and without knowing the

(06:04):
skills on how to do that,you're just sort of lost following some roadmap
that it's making us to this,you know, into this abyss and you
don't know where you're going. Soit causes so much confusion and you start
having an identity crisis. So it'sabout just not really knowing where you're going

(06:25):
in life. So that's an awesomesegue about the skills and what are they.
We've been talking now about skills fora few minutes, and you know,
the things that we know that peoplefeel like they should know, but
they haven't necessarily learned all that thatwe're not teaching these skills explicitly anywhere in
their lives, whether it's in schoolor at work. So what are the

(06:46):
skills? What are some examples ofskills that we need to be mentally well.
I think one of the skills whenwe talk about when you have anxiety,
and we use a lot the tipskill, and the first part of
the tip skill is temperature, andit's about, you know, putting coldness
on your face, trying to getthat dive reflex to bring your heart rate

(07:11):
down. Well, I think historically, you know, if you're having anxiety,
people say go to the bathroom andsplash water, on your face.
Well, there is actually a methodto doing that. So it's not just
going to splash water on your face. It's not warm water, it's ice
cold water. And so if youdon't know that and it's just something that's
been passed down, I'll just gosplash water on my face and I should
be fine. Well, no,let me explain to you exactly how you

(07:34):
do this. It's ice cold water, and we do this because we're trying
to bring your heart rate down.Like, there's a complete method to doing
that, and if you don't knowthat, you're not doing it correctly,
so it's not working and it justbecomes kind of this you know, this
old wives tale. I guess,yeah, exactly. Yeah, you really
have to learn how to do itfirst. Yeah, So there's there's actually

(07:59):
method and rationale, like an operatingfunction behind you know, like a reflex
as you were saying that eyes reflectbehind the skills. So it's extremely scientifically
based, neuroscience based, physiology based, So it's not just oh, we're
telling you to do this thing andbecause it will make you feel better.
You know a lot of times whenyou see tips and tricks on the internet

(08:24):
for feeling better, they are exactlythat. They're like, oh, here's
the tip. Do this, dothat, you know, eat this,
go here, use this object andit will make you feel better. And
people try it and it doesn't work. And a lot of that is because,
as you describe, they're not doingit the right way right, and
when they do it the right way, it low and behold. It works
so fantastically because we're all human speciesand our bodies really function very much the

(08:48):
same in many capacities. And that'sthe thing that the skills very often are
drawing on. Is that based humanality? Yeah? Mer So what's another skill?
Yeah, I definitely agree with Tomitrin. I think the tip skill is
probably as DBT trained therapist, that'sone of our go tos. It's something
that we swear by that we sometimesend up using as well. So affective.

(09:13):
But in addition to that skill,I think they identify and label emotion
skills. It's literally, I thinkthe foundation of most of my work,
initially in therapy. In order foranybody to be able to know what to
do in order to handle an emotion, you first have to know what you
feel, right, And it seemsso simple, and we say it so
easily. Like, yeah, youmight be feeling sad or worried or anxious,
but it actually takes a lot ofskill in practice to recognize what you

(09:37):
feel, what is actually coming upfor you. How do you tap into
that to then know exactly what youcan do to help you with that emotion,
Because if you don't know what youfeel, then we're not going to
know how to help, right oryou're not going to know what to do.
So I think identifying and labeling emotionsis super important in order to build
that foundation as to what do wedo from here on. Once you've been
able to recognize what you're feeling,then we can kind of help and regulate

(10:01):
that emotion. Excellent. So whatyou're describing as this kind of self assessment
or self awareness component of the skills, right, make sure what we're going
to say. I think adding tothat, So a lot of times clients
come in and they do talk therapyand they sit down and they talk and
they pour their heart out and they'relike, okay, like how was that

(10:22):
useful? And it's like, sothere was pieces in that where you identified
and labeled emotions, and let metell you which one do you identified and
labeled and so without that skills pieceand showing them how they use the skill,
they don't necessarily have that confidence evenwant to come back and engage in
therapy again. But when you showthem look at all the skills you just
use in this session, they're like, oh, I actually did something,

(10:45):
and so it gives them a holeto work towards as well. So it
is about using the skill, identifyingthe skill that you're using, and continuing
to use it over and over againso you know what you're doing. You're
not just sitting down talking, you'reactually doing something thing. Yeah, in
management speak, they talk about youcan't you can't manage what you can't measure,

(11:07):
right, So self awareness and selfassessment is that component of measuring where
are you right now so that youknow what to do to fix it,
to make it different. Because ifyou don't even know where you're at because
you're shutting it out, or youjust don't know how to read your own
emotions yet because you haven't learned theskills for it yet, you've not learned
the words, the vocabulary that youknow, the things that come along with

(11:28):
it, then it's really hard tofigure out what to do when you don't
even know where you're at, right, Yeah, do you think that we
where in our lives do we teachthose or do we learn or pick up
those kinds of skills currently without beingtaught explicitly, either in therapy or in
a curriculum like the Heart program.I think we have the opportunity to pick

(11:50):
up some of these skills in differentareas, right, And I think to
meet your how to mention culture earlieron, and I think that has a
lot to do with it, right, I think, and it can speak
for myself in the Latino culture.A lot of these things we don't tap
into because coming from a mentality ofyou gotta work, you gotta hustle,
let's prioritize, you know, beingproductive, being effective, we aren't given

(12:13):
the foundation to identify label emotions orto tap into those feelings. And yet
we do get another set of skills, right, which is that communication piece
of interpersonal effectiveness skills? Right?Like how do I build and foster positive
and healthy relationships? Because we viewour family as our support system, our
community as our support system. SoI think we may not get all the
skills, but I think we're ableto pick up some of these skills along

(12:35):
the way in different experiences, indifferent life situations that we come across.
Yeah, so what kind of taskthat learning? And stuff like being thrown
in the water and learning the dogpaddle. Yeah, I think schools nowadays
are starting to implement kind of awellness program for the seens. I'm not

(12:56):
sure in terms of this generation,how much of the skills, you know,
they're getting on a regular basis,at least not knowing knowing if they're
getting the skills. We get alot of teens that come in and we'll
say, okay, let's talk aboutself suit. Already know how to sell
south I pet my dog? Okay, great, And that's one sense that
you're using. Let me tell youabout the other five senses and the other

(13:18):
ways you can sell suit. Sowhat happens if your dog doesn't want to
pet you? So it's really divingin deeper and and like re challenging them
and too, you know something,Yes, let's build on that. Let
me show you the rest of it. And so I think little pieces are
you know, it feels like commonknowledge. So there's little pieces that you're

(13:39):
you know, teens in particular aregetting, but not necessarily the whole piece,
and that's what a therapist or awellness a coach can provide, right,
Yeah, I think those are excellentpoints that your best rides. But
you know, we adults in ourkids around us are picking up bits and

(14:03):
pieces here and there. But becauseit's not been explicitly told to them that
it's a skill until we do that, you know, in our own therapy,
they don't know that that's something todo in other places even right,
to translate that thing that they dohere in this place to this situation in
that situation or you know, believeand why this works is because here's the

(14:24):
underlying reason. And guess what youcan do it in these five different ways
depending on you know, if yourcat is not here in the room,
and you're at school and you haveother people watching you, and you know,
what else can you do in apublic setting? So I really like
the idea that skills the training isexplicit and it helps us think more intentionally

(14:45):
about this is I need to finda way to do this skill here I
am What do I have you knowavailable to me? Yeah? So you
think you bring up a good pointwith that intention piece, right, because
I think, like to meejor said, we have a lot of maybe teens
or just the older client too,will say, well I already do that,
or that's yeah, that makes makesense, that's common. But the
intention is what really matters, right, It's like, what are you using

(15:07):
that skills for? Are you recognizingthat you're using it to address this challenge
or this emotion? Yeah? Yeah, applying it, applying it more consistently
and more regularly in a variety ofplaces as supposed to just one or two.
Yes, yeah, right, Sowhat does that look like in your
what you guys gave some hints alreadyas to how you work with skills in

(15:31):
your practice. You know, likeyou said, somebody pours out, you
know, their emotions or what happenedin in a session, and then you
go back and you pick through itand sift out where they used various skills
that they get a sense of,Oh, I'm already doing it. Now
I can maybe do it more intentionallywhen I go back in the wild again.
What other things do you guys doin your practice around skills and skills

(15:52):
training and skills education that you couldtalk about here. So I think one
of the things that we do iswe try to incorporate activities, So we
try to do activity based skill building. So we may play a game,
Barbara, we've invited you to come, and you know, projects with our

(16:14):
teens and group, so they reallyget not just you know, we give
it. We do the written piece, right, so they have the paper
in front of them and they couldsee, so there's a visual. We
talk about it, so there's anaudio, and then we do activities,
so there's some sort of movement andthen we try to reinforce it with something
that they can take home with takehome to like really kind of remind them.

(16:37):
And then we continuously reinforce it.So when they come back, did
you use the skill? How didyou use the skill? Did it work
okay? How can we revise it? What other skills may be helpful?
Like it's a continuous constant saying skillskills, skill skills, skills, so
they like don't want to hear theword skills anymore. They're like, ah,
it's like no skill, skill skills, and then it just becomes a

(17:00):
language. So like teaching skills islike teaching a whole now their language,
and so we try to drive thatcontinuously. And I think in addition to
that, One of the things thatI also like to do is to set
goals, right treatment, what arewe working on, what is the reason
why we're here, what are thechallenges that you're having, and setting goals

(17:22):
that are going to help us addressthat specific challenge, and the way that
we're going to achieve those goals istheir skills. So you're going to take
something away that's going to help youaddress that challenge and that we're also able
to measure, right, We're ableto measure if there have been changes not
only by what the client is reporting, by what we're noticing, but are
we meeting our goals and if we'renot meeting our goals, and what do
we need to do differently? Maybewe need to increase the skill used,

(17:45):
maybe we need to be more intentionalabout skill us. So I think it's
that also gives this opportunity to havea vision for what we want out of
the sessions, but it also helpsthe client feel like I am working towards
something, I am getting something outof this. Right those are those are
super important concepts in therapy that Ithink are maybe kind of I don't know,

(18:08):
I want to say they're kind ofnew. I just feel like they
haven't. They haven't been as much. The BBC has been around for like
thirty forty years now, and Ifeel like very few therapists actually use BBT
or have this idea of having goalsand you know, measuring the outcome.
But it's it's so important because Ithink people have gone to therapists for years

(18:30):
and not really been super clear aboutwhat is it that they're getting out of
the therapy, and it it's almostlike, you know, being a physical
therapist. I'm going to equate thisto some kind of physical issue because it's
easy to see. You know,it's like having a crutch and using that
crutch all the time, or havinga brace and using the brace all the

(18:52):
time that you know, you standardtherapy where you don't know what is it
you're trying to do with that braceor that crutch and supporting you, but
you aren't gaining the skills on yourown, you know, the strength on
your own, the flexibility on yourown to do the things that you want
to do. So I love thefact that you guys are focused on goals
and outcomes, and so that wasactually one of my questions is how does

(19:17):
your kind of therapy differ from moretraditional therapy in terms of outcomes and what
can people expect to achieve and howlong? You know, do you have
time boundaries on your therapy? Howdoes it all work? So the thing
with skill based therapy is that it'stime limited. So we fully believe that

(19:38):
therapy should not be forever. Therapyshould not be a chit chat session with
your best friend. It really needsto be, like Maritza said, setting
goals, achieving those goals and movingon from therapy and then coming back if
you need to access you know,services again. But with skill based training
you can do that. So wedo look at you know, do three

(20:02):
months. Every three months, we'restarting to look at are we getting closer
to our goal? Are we gettingcloser? We hit that six months mark
and we haven't made any progress.We need to look as a therapist,
as the client, and we needto sit down and figure out what's going
on because that's a really long timeto learn all these skills and nothing has
changed. So it helps us oneto be able to help multiple people,

(20:26):
so we're not bogged down with clientsthat we're seeing for years and years and
years. It's like like for me, I just in terms of my philosophy,
being in therapy for years and yearsand years probably means that you're not
making progress or the roles have gottenkind of enmeshed where you know, it's

(20:47):
like you enjoy being with them asa therapist, they enjoyed being with you.
So this is just kind of thehighlight of your day. Nobody's really
making progress. We're just kind ofyou know, it's just a nice part
of your day where it's supposed tobe to me, supposed to be learning
something. And like, you don'tstay in school forever. You go to
school, you get the skills,and you get out and get a job.
So like yet student, yeah,probably means that you're stuck and you

(21:11):
don't want to move on to thenext level. And so having skill based,
like everybody comes in with the problem, there's always going to be a
new problem, but having the skillsmeans that you can address whatever problem comes
up. It's you know it,you can shift no matter what. So
it's not like with your therapists youhave to talk about every single problem.
You just have to talk about theskills you need to address whatever comes your

(21:33):
way. Yeah, and I thinkone of the things that I am very
mindful of is. I tend todo what we would call like that traditional
talk therapy, right, and Ialso incorporate skills based So I try to
maneuver it in there in the senseof my client comes in they have these
challenges, providing that safe place processingand also giving them the tools to then
handle or address that challenge. SoI do a little bit of both in

(21:56):
my session, where yes, wecan process, yes we can talk about
feelings, we can talk about thatchallenge, and then also giving them the
skills to continue to work through thatchallenge and to empower them, because that's
what therapy is also about, right, empowering our clients. We are giving
you tools that maybe you didn't havebefore. We are letting you kind of
learn new ways to address these difficulties, and then we are giving it to

(22:18):
you to go out into the realworld quote unquote and do these changes.
So I think I am able tonavigate both, but like to meterested always
bringing it back to the skills andworking towards our treatment goals. Yeah,
I love that concept of empowerment.That's so critical. I mean, skills
are all about empowerment, or empowermentis all about skills I can't. I
don't know which way is twitter becausethey're so intertwined. Right, to be

(22:41):
empowered is to have the confidence tofeel like you can do what you need
to do. And really that's allabout do I have the skills to do
what I need to do? Andwhat are some examples of, like a
goal that somebody could could imagine workingtowards it in a three or six months
period. Work, you know,give people an example of what you might

(23:03):
be working towards. I was goingto say one of my typical or like
common goals at science will say islike, I want to learn how to
handle my anxiety better. Great,So within the next three months, we
are going to identify five skills thatyou will be able to practice and implement
in order to decrease anxiety. Soit's not that we're saying that anxiety is
going to go away, right,We're going to be realistic. We're going

(23:25):
to decrease and we're also going togive you a set number of skills are
you're gonna be able to implement andpractice, right, So it's about managing
stuff, right, Yeah. Ithink for me, I do work with
a lot of a lot of clientswho have borderline features, borderline personality disorder,

(23:45):
or borderline features if they're younger,and the biggest complaint I hear is
I don't understand why I don't haveany friends and why people always leave me.
And so the we identify, likewhat is it, why you know,
why do you think it's this way? And re look at how do
you relate to people? And thenbringing it back to the skill, there's

(24:07):
a set of interpersonal effectiveness skills thatwe can teach that and that you can
use and see how this works,see how that skill works, and trying
to pinpoint exactly why they're not ableto maintain relationships. What are they doing
that's sabotaging these relationships, what's gettingin the way. So once we can
identify that, we can throw theseskills at them and like, okay,

(24:30):
try this, try that. Imean, there's like eight interpersonal effectiveness skills
and we're going to try these andwe're going to practice these on your family
who is a safe person. Trythese on mom, Try these on dad,
Try these on your siblings and seehow it works for you, and
then try them outside the home soyou know it's again it's about skills and

(24:51):
not just it's not necessarily I needto know exactly what they're doing. It's
that I need to be able tohelp them identify which skills may improve their
reality to maintain relationships. Yes,I think that actually that is becoming increasingly
common. I don't know, meritsaif you deal with teams or people in

(25:15):
general who are having trouble with relationshipsmore and more. But I feel like
there are things in our society thatare pushing us to pick up the characteristics
and traits and borderline personality disorder.And I wonder if maybe one of you
could just kind of define what borderlinepersonality is and what are the characteristics,
and then maybe we couldn't we coulddabble in that conversation a little. I

(25:37):
will defer to Timitra, who hasI do. Okay, So what is
so? BPD is a personality disorderthat in which people have a very hard
time with maintaining relationships. They feellike they can't be alone, and they

(25:57):
will literally do almost anything to holdon to a relationship. They're typically referred
to as toxic, and they tipoften will even resort to life threatening behaviors
such as suicidal behaviors and our ideationthoughts self harm, and it becomes this

(26:19):
perpetual cycle of if I don't havethe relationships that I want in the way
that I want them, then Ijust want to kill myself. And they
tend to be in treatment for along time when they don't, especially if
they don't have the skills to managerelationships. And you know, typically you

(26:42):
can't be diagnosed with borderline personality disorderinto your age eighteen or over. However,
like you said, Barbara, itis becoming increasingly common to see teens
and even tweens with these borderline traits. And I do think it a lot

(27:03):
of it's related to social media,and you know, your your popularity.
It's not just the people you knowat school anymore. It's about what your
social capital is online, and that'svery hard to get and maintain. The
level in which these kids have tobe on all the time, there's no

(27:26):
downtime, makes it a very pressureto maintain this perfect person, and so
if they're not up to the standardsof other people, it becomes it's it's
really hard, and so a lotof them then end up turning to these
characteristics to just I have to maintainthis relationship, you can't leave me,

(27:51):
and you know, they don't knowhow to maintain relationships anymore. But like
examples of like you know, thisreal strong need for approval externally like other
people, social acceptance and that kindof thing. I mean, I think
teams go through that anyway, becausethey're at that time in their life when
they're moving away from their family andthey're looking to find their tribe, and

(28:12):
so they they're looking for approval fromother people. But the social media component
just exacerbates it. And you know, the whole concept of likes and you
know, dislikes that exacerbates it.And then also they as far as borderline
personality traits go or characteristics go,I think that the impulsivity and the black

(28:33):
and white thinking are two of thosecomponents that are also exacerbated by social media.
Because we don't have time on socialmedia to have nuanced conversations. We're
just supposed to respond rich emotion.That's a totally impulsive, emotionally driven behavior
that is very borderline and it's actuallywhat we're trying to teach people not to
do, and yet social media drivesjust to do that very thing. So

(28:56):
our generations are being taught or tryto behave in this way that is associated
with a order, with a personalitydisorder. I'm kind of crazy. Yeah,
And that impulsivity in a in abrain that's not fully developed, that's
really hard to you know, tocontain and skills, like really concrete skills,

(29:18):
and you have to drive that intothem so that that's the forefront in
their mind. Yeah, so thatthey're thinking about that all the time.
I also want to add that Ithink the pandemic affected of our teens and
tweens, and it definitely took atoll on relationships, and I think it

(29:40):
also led to a lot of thatimpulsivity. Right, clients aren't feeling or
just people in general feeling really lonely, really isolated. Our world completely stopped.
Yeah, and I think that alsohas played into, you know,
us seeing more clients who present withBPD traits. M h Yeah, I
for sure. What based on yourexposure and your experience during and after the

(30:07):
pandemic, what have you noticed ofwhat's going on in the population because of
the pandemic. What kind of concernsor behaviors or thoughts and fears are are
people experiencing I think I noticed abig increase in anxiety, social anxiety,

(30:33):
and depression. Do you think that'slike a lack of practice kind of thing,
like like teams are going through thatperiod. Because I know I saw
this. I started to interrupt you, but I know I saw this with
my daughter. She went her lastyear of middle school was during the pandemic,
and then she moved to high school, and the whole switch from middle
school to high school, not knowingpeople and being in that uncertain stage of
you know, your own development,who you are, she got really shy,

(30:55):
Like she's shy to begin with,but it was even more exaggerated because
she hadn't been practicing and like exercisingher muscle for dealing with shyness as it
were. Yeah, yeah, Ithink it definitely has to do with that.
Right, we take them out ofthe natural kind of just day to
day life and we completely shifted tothere's going to be no interaction or your
action interactions are very limited, right, It's going to be the only family

(31:17):
or like these two friends that youcan see compared to being at school or
my sports and my activities. Right. And I think also what added to
that was the online school schooling rightwhere we a lot of schools are requiring
for kids to have their cameras on, for your mic to be on.
And now I'm self conscious because I'mconstantly staring at myself on this screen and

(31:37):
my peers are all looking at me. Whereas before it was maybe like that
one class or those two classes whereI didn't know a lot of people,
and now it's like I'm face toface and having these interactions. And I
think it made teams more aware.M yeah, to be staring in a
mirror all day long time. Yes, yeah. I also see that the
are high functioning teens who were doingso well in school then they went online

(32:06):
and they you know, completely justbombed you know, that school year,
and they come back and they justdon't have that self confidence anymore. It's
like this is the first time thatthey've ever failed, and they failed for
a whole year, and it's likethey don't have that confidence and they don't
have the skills, like it's like, like you said, Barbara's kind of

(32:27):
this all or nothing and it's likeI was good, now I'm not anymore.
And so there's no sense of redemptionor being able to understand that we
were in the middle of a pandemic. You didn't actually fail. Let's rethink
about what happened and how can wemove forward from here. There's just this
sort of and I see this withparents. It's like, well, they

(32:52):
did terrible that year, so nowwe need to like kick in the high
gear and like they need to makeup for everything that they didn't do before.
And it's like that's a huge responsibilityno matter how functioning you were,
that's you know, unrealistic that they'rejust going to be able to make up
for a whole last year and itwasn't even their fault. So I think
like the confidence has decreased, andthe ability to even the drive to even

(33:16):
want to be functional or as functionalas they were before has decreased. Some
motivation also, Yeah, so weare thank you very much for all everything
that you guys have been talking abouttoday. We're coming converts at the end
of our time, but we havea few more minutes lesson. What I

(33:37):
really want is to get from eachof you, Like what do you want
listeners to take away from this conversation? What is if they could only remember
one nugget, what would that nuggetbe for you? Oh, that's a
loaded question. We talked a lotabout so many interesting things and really important

(33:59):
thing you know, But if therewas one thing that people walked away from
this conversation with, what would youwant them to know and like have in
their heads and their hearts help themgoing forward. I think what I would
want listeners to take away from thisis that it's okay to not be okay,

(34:21):
and that we're not okay. Thereare things that we can do to
help us address those challenges. Andthat's why skill based mental wellness is so
important, because it allows for usto build tools that we can continue to
use throughout time. Yeah. Iwould like the parents of the audience to

(34:43):
take away from this that skill basedmental wellness is a family wellness plan,
not just a teen mental wellness plan. Like we've said, learning skills is
like learning a whole new language.If your whole family is not speaking the
same language, are going to behuge communication gaps. So just as important

(35:05):
it's as important for you to learnskills as it is for your team to
learn the skills. Absolutely, Yeah, that whole immersion concept right in order
to do well. So there's thiscompet that knowledge is a rumor until it
lives in the muscle. Have youheard this quote? And I think Burnet
Brown has made it super popular,but it comes from the Sorrow tribe in

(35:29):
Papua New Guinea, and it's thisidea that you know, until you actually
do something, you don't really knowit. Like you can study all you
want about juggling or swimming, butuntil you actually get in the water or
like throw the balls around you,you don't know. You don't know what's
going to go wrong, you don'tknow hot fields, you don't know how
you know you get after doing itfor an hour or anything like that.

(35:51):
So the having to do it andpractice it with skills it's critical. And
then this idea that everybody needs tobe involved is also really important. And
that's what we noticed when we wereworking with just the high school students that
they were like, well, youknow, this is great information, but
the adults around me aren't modeling this. They're not doing what you say we
should do, so what's up withthat? Right? And that's a lot

(36:14):
of why we talk with other adults, you know, teachers in middle school,
administrators and parents to try and teachthem how important it is that they
also learn and use the skills sothat the teams pick it out. Team
here, Yeah, immersion, Yes, Well, is there anything else you
guys would like to add right now? I just want to say thank you

(36:37):
for inviting us of course podcast,and I really do appreciate being able to
share, you know, our experiencewith skills. Yeah. I'd like to
echo that and say thank you forallowing for us to have this important conversation
because I think it's not very commonfor therapists to talk about skill based therapy

(36:58):
or mental wellness, and I thinkit's important for people to hear what it
is and that you know, we'reout here and we're trying to help,
and that things can be different andwe're willing to kind of work as a
team. My teenager said, it'snot just the therapist, it's not just
the client. It's kind of thatsupport system that can also benefit from the
skills. Yeah. Absolutely, so. Can you guys remind the listeners where

(37:20):
they can find you? Yeah?So again. Our group practice is called
Jacob's Ladder Therapies. You can findus online at www dot Jacob's Ladder Therapies
with an iees dot com and wehave clinicians who are available to take new
clients both in person in our officein San Jose and also virtual anywhere in

(37:45):
California. Nice. Excellent, Sowe'll put that in the show notes so
the people can have it and theydon't have any type of thank you so
much for your time, ladies,Thank you, I appreciated it.