Adolescent Treatment

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In 2009, I began my vocation in psychiatry by volunteering on an inpatient pediatric psychiatry unit for school-aged children and adolescents. At this time, I was also working as a preschool teacher, volunteering with older adults at Meals on Wheels, and studying developmental psychology and attachment theory.  These beginnings inspired the pursuit of a psychiatric nursing career.  I was awarded a full tuition scholarship to Johns Hopkins University.  While in nursing school, I trained with Dr. Karen Schwartz, MD, developer of the Adolescent Depression Awareness program.  This program is a curriculum taught in local high schools by nursing students to reduce teen suicide rates.  Upon graduation, I began my role as nurse therapist on a child psychiatry mobile treatment team.  Treatment visits took place in the child's biological or foster home for therapy or caregiver support and at the child's school when IEP advocacy support was required or the child earned recreational therapy for goal completion.  I owe much of my understanding of child and teen development, family systems theory and family therapy technique to the mentoring I received in this role.

 

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Teens are a special patient population and they require a special understanding of developmental psychology.  Adolescents are working through Erikson's developmental stage of Identity vs. Role Confusion. In short, they often ask themselves existential questions such as "who am I?"  "what's normal?"  "what has meaning? "where do I fit in?"  "what's my/our purpose?" "what is good?" "who is good?".  When a teen is diagnosed with a mental illness or difference, they may have difficulty with understanding how to maintain a positive self-image.  Working through self-differentiation and ego attainment with teens can foster self-acceptance, treatment engagement, and hope.   As teens learn who they are and are not, what they do and do not want to be like, they also provide opportunities for humility, mental flexibility, transparency, and patience as they test the egos of those around them which can lead to some interesting insights!  Teens can also have a witty, keen, or sardonic observational humor that I appreciate.  

 

Working with older adolescents and adults on a dual diagnosis (co-occurring substance use disorders and mental illness) unit and separately at a residential psychiatry unit developed my non-confrontational crisis resolution skills and exposed me to principles of dialectical behavioral therapy.  However, I much prefer providing outpatient psychiatric care to inpatient crisis stabilization or residential treatment.  Outpatient providers are afforded the opportunity to witness and celebrate the patient's progress and symptom remission over time.

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I'm grateful to now open a practice with the autonomy to see patients in-person and with less rush.

I enjoy working with children and teens so much that when I first began working as a doctor of nursing practice, psychiatric nurse practitioner, I only accepted pediatric patients!  However, I found that the time I was allotted for patient and family visits was not sufficient to cover medication response, academics, family dynamics, physical health nor enough time or real presence to connect with the patient on an developmental level as visits were online only.  Thus, I began limiting the number of children and teens on my caseload.  I founded Otter Integrative Psychiatry to allow myself the autonomy to provide patients more of what they need; time and attention to detail. 

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Adult and Family Treatment

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We are all sharing this world together and OIP aims to be a judgement free zone for healing and health to meet you where you are. Erikson's psychosocial development theory and Maslow's Hierarchy of Needs are used to inform therapeutic practice.  After all, tasks of psychosocial development morph as we move from early adulthood (self identity) through middle age (intimacy) and older adulthood (generativity).  And, the hierarchy of our needs at anytime may shift depending on our level of stability--we must prioritize our own safety before our own self-actualization and greatest purpose. We must be able to feel foundationally safe in our homes and bodies before we can feel safe in the spaces outside of our homes and bodies. 

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