TPN.Health Clinician Spotlight: “Feelings Doctor” Allison Palmisano, PsyD

“I’m basically a big kid.”

stuffed animals and canopy

This week, Dr. Allison Palmisano, better known as The Feelings Doctor, gave me the grand tour of her office, a term which does not do the space justice. It’s the finest playroom I’ve ever stepped into, set up with a toy kitchen, a sandbox, dozens of figurines, including the whole collection of characters from Disney’s Inside Out, a puppet corner, and a playhouse. That was just the front room. My personal favorite feature was the Calm-Down Cubby, stocked with pillows, blankets, lights, and stuffed animals. “I teach parents and kids to come over here when they have a big feeling,” says The Feelings Doctor.

little figurines in a sandbox

Dr. Allison is a Licensed Clinical Psychologist who practices play and talk therapy with her clients, mostly children and adolescents. She began her private practice a little over a year ago and shared with me her ongoing journey of navigating the world of being a licensed professional, opening her own business, and integrating herself into the mess of it. For Dr. Allison, the journey has been anything but linear. After eight years of intensive schooling and supervision, what she faced upon licensure was a sense of “imposter syndrome,” an internal sense of “Now that I am not a student anymore, who the hell am I?”

Up until this point, the work of moving through school and the licensure process was oriented toward meeting institutional requirements. In other words, other people were in charge of evaluating her every move. Now, she’s a licensed professional and the work is no longer about larger entities evaluating her. This, for Dr. Allison, prompted a reevaluation of how she was moving through life, no longer in the mindset of a student. Following licensure, she expressed feeling wholly paralyzed and depressed. The intensity of school was now absent, and present was a whole new space. Dr. Allison’s work was now to learn to move about this new space.

Allison Palmisnao holding her handmade collage

Creating solutions in this new space meant tapping into creativity and a toolbox of self-care measures, such as yoga, as well as just sitting with the state of paralyzation. From this time sprang the opportunity to tune into a sense of authenticity and self-trust, things that, today, directly influence how Dr. Allison operates in her life and work. This influence manifests in the way of showing up in earnest as herself in the work she does and not trying to put on a contrived persona.

Allison's head profile posed next to a tiny house

“Ever since I got my license, I’ve been doing creative stuff. It’s my true self coming at me!”

tiny house

Sprinkled on the shelves and walls are creations of Dr. Allison’s own hand, painted rocks, collages, paintings. In the back of the office, where clients sit down to chat with Dr. Allison, was her newest set of creative endeavors — tiny things. These are little spaces, small enough to fit on shelves, in diorama form decorated to be kitchens, libraries, and the like.

Next to the regular-sized sofa in the space is a child-sized seat, made to look like a traditional Freudian couch. Nestled atop the tiny Freud chair was a little monster. He is called “The Worry Eater.” He has a zipper for a mouth and spends his days collecting the worries that kids write on slips of paper. Fortunately, he eats them so the kids can let them go.

worry monster

Tapping into her own creativity and intuitive practices has allowed Dr. Allison to build a space where kids feel free to be who they are. Showing up as herself in this honest way allows her to keep focus on the essence of the work, that is, facilitating opportunities for the kiddos to feel safe and build their own self esteem through a strong therapeutic relationship and the therapeutic processes available in play and creating. “My strength lies in empathic communication — feeling what a kid feels, I feel it almost immediately.” Dr. Allison’s important work is cultivating and intuitively drawing from this strength to meet the clients where they are and work at their pace.

Disney's Inside Out Characters in an orchid plant

Any helping professional in a private practice knows that part of the work is building clientele. As a novice in the marketing world myself, I was curious about how Dr. Allison is building up her clientele. She has no formal training in this arena, so she relies on good old fashioned self-teaching. How? Mostly Pinterest boards, lots of them. Using DIY marketing tools, Dr. Allison is able to present to people who she is and attract the people that have the potential to be clinically fitting for her practice. The brand? Authenticity and Transparency…with neon colors and sparkle, of course.

"inspired" calendar in front of colorful frame

Dr. Allison’s honest sharing of her experience as an evolving person and practitioner sheds light on the realities of integrating life and work — the challenges, the questions, and the potential for transformative movement. It is with Dr. Allison’s transparency that we were able to talk about the challenges that clinicians really experience, that is, all the nuances of being human in the context of clinical life.

Let’s keep the conversation going.

Whether you (clinicians) are newly licensed, seasoned professionals, or anywhere in between, what are some of the challenges that you face in your stage of practice? How are you finding solutions?

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Connect with Dr. Allison on Instagram @feelingsdoctor.


TPN.Health is Recalibrating the Referral Process

TPN.Health is recalibrating the referral process

We at Trusted Provider Network talk a lot about the referral process and rightly so. We talk about it because TPN.Health is the professional tool for clinicians to make and receive referrals for clients based upon the best clinical fit. It’s a big part of why we’re here. The goal is to put the process in clinicians’ (your) hands so that it is easily navigable. After all, behavioral health is a field where there is not enough time in the day for clinicians to be caught up in search issues. So, I asked a few clinicians, each of whom use a referral process appropriate to their own practices, to share their experiences with the referral process.

TPN.Health member Taylor Farris, LMSW, works at the Lafayette Parish Correctional Facility. Her work at the jail is largely crisis management, getting people stabilized and maintaining that stabilization. Beyond the crisis management, Taylor herself often lacks the time and resources to provide clients what they need. It is at this point that the need to refer out surfaces; she says, “It’s imperative to have a good list of people. Once I know they (clients) are being released, I need to find someone that can really start the intensive therapy process…to try to break that cycle of incarceration.” She needs to know for sure that the people to whom she is referring can help the population she serves.

Some of you have expressed that you are in institutional or organizational settings where your place of work already has a solid referral system, so you never need to make referrals yourself. Even though you’re not making referrals, other clinicians can still search for you. The idea is that you are searchable, able to display the parts of your scopes of practice that are most important to you and the modalities, theories, and therapies you want to practice.

Others of you in the behavioral health space may not be in the business of seeing clients. Perhaps you are in a setting oriented instead to academia. For instance, Dr. Patrick Bordnick, LCSW, Dean of the Tulane School of Social Work, and Chair of the Board of Advisors for TPN.Health, does not himself see clients, but people often call him for referrals. Likewise, he notes the fringe benefit of being able to search for and find vetted providers for loved ones. In his experience, the referral process in the behavioral health space is presently “cumbersome, unclear, and unscalable,” and TPN.Health serves to address this issue.

At the recent TPN.Health sponsored “Teaching DBT Skills” training, I had an opportunity to speak with Mark Saucier, LPC. He works in the counseling department at a local behavioral hospital and owns a small private practice, for which the giving and receiving of referrals is necessary. Mark really spoke to the underpinnings of referrals when he expressed, “[I am] always needing them and always happy to give [them] because I don’t know everything, and I don’t know anyone who does, so maybe all of us together can figure it out.”

Underneath the referral process is the need for different human beings to practice, in honesty, what is uniquely theirs to practice. In a similar way, there is a need for a community of clinicians as diverse as the people it serves. TPN.Health Ambassador and member Parker Sternbergh, LCSW, touched on the subject of diversity when she noted how important it is for her to “bring herself” into practice. This means integration of creativity and nuances from her own lived experience into the role of clinician.

It is true that no one provider is clinically equipped to address all manner of things and people that happen to float, barge, slump, or dance into their office, but there is even more to it than that. Principally, a therapeutic encounter is a human encounter. This means it is quite possible that non-negotiable barriers come up when determining clinical fit. These barriers can take the form of differences in gender, communication style, energy level, perceived power, age, or any number of nuanced perceptions that influence how people exist in an encounter with another person.

So, part of the clinical fit is the human fit. Will clinician and client be able to relate to one another? Are there barriers that we can help remove to locate a better match between clinician and client? These are questions to consider when making a referral, and TPN.Health is giving you the tool to navigate to solutions, through access to a trusted, diverse community.

Click here to begin making and receiving referrals in TPN.Health!

Paying Attention: A Recap of “Teaching DBT Skills”

On Tuesday, September 17, TPN.Health took part in sponsorship of a “Teaching DBT Skills” training, which Imagine Recovery hosted. Thanks to the work of Eric Schmidt and Nicole Manwaring in their presentations, fifty clinicians gathered at the Tulane School of Social Work were able to have a day of in-depth training while achieving CEUs. This training was anything but surface as clinicians were given opportunities to practice and question the presented skills throughout the day.

DBT training- classroom view

We started the day bright and early with an exercise in letting go of resentment. The practice was mindfulness. Notice five things you can see. Five things you can hear. Five things you can feel. Notice you’re here. Then, bring your hands (holding the resentment) to your face. Look at it. Then, let your hands fall. Notice the trio of five things again.

“What came up for you?” asked Eric to the participants in the room. Mikal Matton, LPC, spoke on cultivating self compassion; she says, “If I can move in close to it (the resentment) without judgment, maybe I can change my relationship with it.” Another clinician noted, “There is a lot happening right now that we’re just not paying attention to.”

clinicians at training sitting in their seats

There is so much happening both in our immediate worlds as humans and in the ecosystem of behavioral health. So, throughout the day, TPN.Health paid attention to several clinicians by tuning into their experience at the day of DBT.

Stephen Dacovich, LCSW, shares, “A lot of workshops are theoretical, and this is practical application where we are actually encouraged to do some of the roleplaying. This is a great application of learning a new skill set.”

Mark Saucier, LPC, works in a local behavioral hospital in the counseling department and owns a small private practice on the side. He learned some new approaches that he will take to the field. These include the ideas that we choose what irritates us and that we need context to understand life’s circumstances, asking the right questions like, “What happens when I feel this way?” He notes that a lot of the DBT skills will be immediately applicable in both of his workplaces.

Taylor Farris, LMSW, who works at Lafayette Parish Correctional facility, speaks to the necessity of the emotion regulation piece of DBT in her work setting: “The emotion regulation is extremely vital to what I do — trying to get people to emotionally regulate themselves because they’re in a stressful environment 24/7 until they’re released. So the more skills they are able to build up, the easier it is for them to get through their sentence.”

Jessica Gibson Kendrick--red shirt, white wall

Jessica Gibson Kendrick, LPC, pictured above, is partnered in opening a new private practice in Lafayette, LA, so she is thinking forward, “Hopefully starting in the fall, there will be a DBT skills group. There’s a big need for this in our community and just not enough of this type of practice to serve the community that we live in, so I’m excited to complete the DBT skills training so we can take this back to our community and start something new.”

TPN.Health is excited to be hosting and/or sponsoring more of the CEU events that clinicians (you) want to experience. Some of the CEU suggestions we’ve heard so far include training in ACT, more DBT skills-based workshops, mindfulness, clinician impact on mental health in Louisiana, incorporating spirituality into therapy, and undoing institutional racism.

3 DBT Training participants, presenter in the middle

So, what’s next on the agenda? We will officially sponsor the 2019 LCA Conference in New Orleans, happening from September 29th to October 1st. Find us on Instagram @tpnhealth and tag three Louisiana licensed clinicians for a chance to win free registration ($350 value) to the conference. See you there!

What other CEUs could benefit you the clinician and the TPN community of clinicians at large? As Christopher O’Shea, TPN Co-founder, said in his address to the room at the DBT training, “We are listening.”

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Touching the Transcendent in Practice

Hinging on our conversation with Christian counselor Robin Webster, LPC, NCC, TPN.Health is considering how religious and/or spiritual frameworks inform clinical practice, from both the client and the clinician’s perspectives.

It has been important in much of literature exploring religion and spirituality in psychotherapeutic practice to distinguish between the terms “religion,” and “spirituality.” In a literature review, Post and Wade (2009) identified religion as a matter of the transcendent having to do with doctrine and dogma; they defined spirituality as having to do with transcendent but disconnected from organized religion. Each one can carry with it unique obstacles or elements for support.

Can you think of a time when a client brought up religion or spirituality as a source of support? Was this source of support something which could have been helpful to explore and incorporate?

Likewise, has a client ever brought up religion or spirituality as a source of distress? If interventions were necessary, what interventions did you put in place?

Even if you as a clinician would not incorporate religious and/or spiritual interventions, it is important to be aware of your own personal frameworks around religion or spirituality. These have the potential to interact with how you address a client who has religious/spiritual frameworks with which you are unfamiliar.

Was there ever a time when you were unfamiliar with the religion and/or spirituality of the client? When your own religious/spiritual framework may have influenced how you perceived the religious/ spiritual framework of a client?

Likewise, it is important to be aware of the intersection of religious/spiritual and cultural identities. For instance, Robin in her practice and personal life within the African American community noted that religion has served as a means of support and sense-making in the absence of access to mental health services.

Reliance upon a faith framework, whether in religion and/or spirituality, has served to inform the community’s well-being in this lack of access to necessary services, like those of mental health. It is also her opinion that the lack of access to services over many years has contributed to the stigma around mental health for the African American community.

Do you have experiences or insight to share on the topics of religion and/or spirituality in practice? You can contribute to the clinical conversation by sharing your questions and comments on the newsfeed at TPN.Health.

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Post, B. C., & Wade, N. G. (2009). Religion and spirituality in psychotherapy: a practice-friendly review of research. Journal of Clinical Psychology, 65(2), 131–146. doi: 10.1002/jclp.20563.

Helping the Self in the Helping Profession

Considering how clinicians approach self-care solutions

In honor of Self-Care Awareness Month, TPN.Health is tuning into how helping professionals help themselves. Drawing from recent conversations with clinicians and the running theme of clinician self-care at community events, we will explore how care for self informs clinicians’ life and work.

At the St. Bernard Recovery Rally, Captain Raul Vallacillo of the St. Bernard Fire Department spoke to the need of resources for first responders to find support and process the their work. Sanquinette Haynes, LMSW, of Metropolitan Human Services District (MHSD) shared how she approaches self-care with the imagery of putting on her oxygen mask first before helping others, relating to the familiar instruction in pre-flight safety presentations.

At MHSD’s presentation of Recovery-Oriented Systems of Care (ROSC) on September 11, I followed up with Sanquinette on how she breathes life into that analogy. For instance, if she recognizes the need for a reboot, she’ll ask for time off from work. Likewise, she finds it helpful to bring arising issues directly to her supervisor for resolution. She says that sometimes it can be helpful to collaborate with coworkers on specific issues to come to a solution, but often running it by a supervisor, who has a different scope of work and a different perspective, brings the solutions that are needed.

Sanquinette also spoke to the balancing act of fulfilling the “servant’s role” and meeting her own needs simultaneously. Under certain circumstances, such as in the face of natural disaster, this can be a challenge. For instance, during Hurricane Katrina, she recalls not having a house of her own while trying to direct clients to re-homing services. To her, it seemed counterintuitive to try to get a need met for people and not have that need met for herself, but the work had to be done. This example shines a light on how pressing circumstances may threaten the balance of attending to one’s own needs and tending to the needs of others.

Sanquinette wasn’t the only one talking about care for herself at the ROSC presentation. In fact, what prompted our conversation was that the main presenter, Dr. Ijeoma Achara-Abrahams, shared her own challenges in implementing self-care measures. For a long time in her career, she considered herself a workaholic and frequently overextended herself, a pattern which culminated in physical illness. For her, change only came about with the perspective shift that accompanied having a child for the first time. This prompted a re-evaluation of her own needs and the energy she was expending.

snapshot of someone speaking at event

Upon Dr. Achara’s testimony, others in the room began to share on the microphone. One behavioral health provider, Irene, said to the room, “We have to look at ourselves — our inner needs. We can project that onto the people we serve. We must look at our relationships with the people around us and our clients.”

Irene’s address prompts the consideration that clinicians’ work is inextricably linked to how they are orienting in the world. This orientation, springing principally from one’s inner world, consists of relationships to people, places, and things in the outer world. In an echo of Irene’s address to the room, how one is relating to oneself colors how one is relating to the world.

ROSC was all about considering what it would take for systemic change in the way institutions approach care — changing the script from care designed to keep people in maintenance inside the behavioral health system (sick-care) to care designed to integrate people in abundant living (health-care). The fact is that the systemic change begins with a fundamental orientation-shift in the providers that do the work in institutions.

Dr. Achara relates this system-transformation to “an internal heart transformation.” Any human who experiences transformation knows that change occurs when one has the willingness to see differently, an open mind and an open heart. This is an orientation that covers both personal and professional domains. It is a way of looking at life.

I also spoke to a fellow TPN.Health team member, Kathryn Pennings, Clinical Liaison, who is studying in the Loyola graduate program for Clinical Mental Health Counseling and will graduate with a masters degree in May. She currently practices at Creative Family Solutions as an intern. At the ROSC presentation, a speaker brought up something that rang true to Kathryn’s experience working with clients.

The speaker said, “You should not be working harder than your client.” For Kathryn, this means creatively channeling what energy she has where it is useful, instead of dipping into overextension which can lead to burnout. This requires the practice of awareness — to what you are giving and to what the client is giving. At the heart of this is “meeting a client where they are,” remembering that this is a partnership in which the humans involved have energy limits and needs.

On the topic of burnout, Dr. Allison Palmisano, also known as The Feelings Doctor, shares her experience and how she practices solutions:

“I found yoga soon after I became licensed to practice clinical psychology independently. I spent seven years of clinical training focusing on helping my clients give their complex feelings the acknowledgment they deserve. When I got my license and was able to pause for a moment, my conscious awareness flooded with how burned out I’d become. After overextending myself to my clients for so long, everything in my being was pulling for me towards focusing on my own self-care. Yoga gave me the permission to practice what I had been preaching. The inviting and warm yoga community gave me the perfect space to learn how to take care of my own feelings.”

From the shared experiences of the community of helping professionals, it is clear that the topic of self-care is worth the time to consider. As a clinician, what works for you? Is there room for reaching out for help when needed? What is a community in which you feel supported? How can you cultivate that community? Perhaps it is possible to consider that you are an evolving human seeking answers and pathways to wellness just like clients. You are partnering in the work of being human.

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TPN. Health Sets Up at the 3rd Annual St. Bernard Recovery Rally

“This is about community.”

Four years in the making, St. Bernard Recovery Awareness’ first step as a nonprofit organization was to get the St. Bernard Parish Council to proclaim National Recovery Month, and the nonprofit was successful in this endeavor. In line with the proclamation of National Recovery Month, on Saturday, September 7th, local behavioral health companies and organizations filled the space at Docville Farm to celebrate the 3rd Annual St. Bernard Recovery Rally.

“To utilize a consortium of community resources to identify and eliminate barriers within the mental health system that impede one’s journey of recovery,” is part of the mission statement at St. Bernard Recovery Awareness.

Kathryn talking about TPN to vendor

On Saturday, September 7, TPN. Health set up alongside event participants to partake in that consortium of resources. We spoke to fellow behavioral health service providers as well as members of the community seeking resources. Tia Serigne, team member at St. Bernard Recovery Awareness, in her opening remarks at the event said, “This is about community,” and the proceedings of the event reflected that statement, not only for the community of people seeking help in St. Bernard Parish but the community of behavioral health service providers in the area.

Over lunch I spoke to Dave, a recovering person who was born and raised in St. Bernard Parish. He spoke of his own journey in recovery and the resulting evolution of relationships within his own family, some of whom had accompanied him to the rally. He expressed that coming to events like this one was part of his personal recovery.

James T., also a local resident in recovery, addressed the entire room in telling his story as a recovering addict. The three hardest words he ever had to say to his wife were, “I need help.” Dave, sitting next to me, said quietly, “That’s hard to do.” I share the same experience; it is hard to do. Asking for help is something that I have to practice of my own volition. It’s not in the natural order for me, and the more I talk to people who are seeking solutions to their problems, the more I realize that other adult people the have the same sense of difficulty in asking for help.

Sanquinette Haynes in white MHSD shirt

When I asked Sanquinette Haynes, LMSW, representing the Metropolitan Human Services District, what she deems important for herself as a clinician and her community of clinicians, she references her experiences in pre-flight safety presentations on airplanes. Who gets the gas mask first? If you’ve been on an airplane, you know the answer. “Place the oxygen mask on yourself first before helping others who may need your assistance.” In her experience, this is a draining profession in which clinicians need to remember to care for themselves emotionally and physically.

Captain Raul Vallacillo of the St. Bernard Fire Department in his address to the whole room also spoke to the need of care for service providers, specifically first responders — firemen, policemen, and medics — in the community of St. Bernard Parish. This could take the form of support groups to serve as a safe place for members to process in community. Following Vallacillo’s address, I spoke with Robert Fezekas, LMSW, President of St. Bernard Recovery Awareness, who said that creating these resources for first responders in St. Bernard Parish is part of the next project for the nonprofit.

team at St. Bernard Recovery on stage

The St. Bernard Recovery Awareness efforts and successes in bridging the gaps in behavioral health for the community of St. Bernard Parish inspires TPN. Health and is in the spirit of our work to form collaborative connections with providers and professionals and innovate in the behavioral health industry.

What Robert Fezekas, LCSW, and team members are doing for this community should be a template for the providers of behavioral health resources everywhere. This work is actively bridging gaps among treatment providers and fostering open communication about the needs of those seeking help.

Felicia and colleague

How does bridging gaps work?

At TPN.Health, we believe bridging gaps — thereby forming connections — begins with honest conversations. What are the needs, concerns, and visions of the clinicians and communities we serve? What assistance can you use as humans in a helping profession?

We want to hear from you!

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