TPN.Health Clinician Spotlight: Kyle Hankinson, PLPC, NCC

TPN.Health was able to connect with Kyle Hankinson, PLPC, NCC, at the 2019 Louisiana Counseling Association (LCA) Conference where he shared some insight into his experience in the LGBTQ+ community — personal, in professional practice, and the relationship between those two spheres.

“No one should have to feel alone.” 

Kyle self-identifies as a member of the transgender community. Reflecting on his adolescence, he recalled the experience of loneliness as well as other challenges resulting from an inadequate support system. Providing support for individuals who are navigating the world as a part of the LGBTQ+ community is the force that encompasses the clinical work he does today.

Within the LGBTQIA+ community, Kyle’s work is largely helping people to navigate marginalization and its repercussions, such as being mis-gendered and feeling an absence of belonging in the world. One of the processes which Kyle employs frequently with clients is the gender affirmation process. He describes this as a new term for gender transition in the LGBTQ+ community.

“You’re not really transitioning from one gender to another; you’re just reaffirming the gender you always were in your mind from birth.” 

In addition to supporting the client’s journey of interacting with the society-wide gender-role spectrum is helping the client’s family members to interact with the process. To do this, he provides psycho-education to the client’s loved o

nes as they witness the process in efforts to expand the client’s support system.

Kyle Hankinson, PLPC, NCC--his face on a blue water background

How does Kyle’s experience as a trans person interact with his practice?

In his words:

“It’s a fine line because I have my own personal experience, and people can have a similar one to mine or one that is completely different. Making sure that I don’t put my own experiences into theirs is something that I’m constantly aware of. Even though it’s a big umbrella of experiences, there are a lot of smaller little pieces that people can undergo, and so it’s important to me that I distinguish all of that from what I’ve gone through for myself.

I can also take some of my experiences and use them. I’ve had moments where I was reluctant to go out because I’d get called out in the middle of the street. I remember being at a pet store when someone walked up to me and said, “Are you a boy or a girl?” and my heart stopped. That was one of the most anxiety-provoking experiences that I could have experienced at the time. I’m aware that other people also experience those types of things.”

Kyle expresses gladness for the progression of resource availability and visibility for the LGBTQ+ community from the time of his adolescence to the present day, 2019. For instance, Facebook has been and is a digital resource for people in the LGBTQ+ community to connect and share experiences in the absence of a tangible community of people. Likewise, today, conversations surrounding gender identity and expression are becoming more commonplace than they would have been twenty years ago.

In the way of resources, Kyle emphasizes the need for more financial support from healthcare providers in the process of gender affirmation. As it stands, there is no one clinic in Louisiana to holistically address the physical and mental needs people who are transitioning. What happens is that transitioning people end up creating their own piecemeal healthcare plans from different providers, and this becomes expensive quickly.

Do you encounter LGBTQ+ issues in your practice and feel that it’s outside your scope? Connect with Kyle and other clinicians with LGBTQ+ experience using the “Filter by Focus Issue” filter.

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TPN.Health Clinician Spotlight: Jennifer Holmes, LCSW

On her work in recovery and stigma-reduction in behavioral health

TPN.Health connected with Jennifer Holmes, LCSW, at her home office in Metairie, where she operates a private practice. Jennifer has specialized training working with individuals facing substance use and/or addiction issues. Likewise, she herself identifies as a person in long-term recovery. She is a native of Metairie and has been practicing in the New Orleans area for the past twenty-five years. As she has spent most of her professional and personal life in and around New Orleans, the conversation naturally touched the drinking culture of the city.

Unquestionably, substance use issues know no bounds across geography, gender, race, socioeconomics, or any other arena. It’s everywhere. However, when considering these issues in a specific cultural space, such as New Orleans, it can be helpful to know how substance use is woven into people’s lives. In other words, one could ask, “Culturally, what is accepted and encouraged and what isn’t?” to learn how substance use interacts with people’s lives. It is deeply part of the social and economic fabric here in New Orleans, so considering the nuances of that as it relates to people’s lives could contribute to an integrated perspective.

Jennifer Holmes profile with a fluffy dog

“While most of my clients don’t come in specifically for a drug and alcohol problem, almost all of them are impacted by it in one way or another, either personally or through family or friends with substance use issues,” says Jennifer of her experience with clients. Not everyone has a substance use disorder, but it is helpful for clinicians to consider how drugs and alcohol may affect the lives of clients regardless. Jennifer expressed that it is important that there are professionals out there who understand this issue from as many different perspectives as possible.

When I asked Jennifer what she sees in the way of recovery resources in the local community, her answer was two-fold. For instance, there is no lack in inpatient and outpatient treatment programs; however, a barrier to that for many people is cost since a number of the places for treatment do not take insurance. There are also folks with a true barrier — the inability to pay out of pocket coupled with a lack of insurance. On the other side of the coin, 12-Step programs, of which Jennifer is a big fan, abound in the local community. These are free and available seven days a week to all people, so cost is not a barrier here.

Of 12-Step groups, Jennifer says that they foster opportunities for people not only to be helped but to help others, to be a part of a community through forming connections. This along with the opportunity to tap into spiritual practices creates opportunities for dopamine stabilization. Although the 12-Step programs did not set out intentionally to regulate dopamine, Jennifer notes that this is exactly what they end up doing in practice.

What Jennifer often sees as a barrier with her clientele and 12-Step programs is the stigma clients associate with being in a program, such as Alcoholics Anonymous or Narcotics Anonymous. What comes up are preconceived notions about what it means to the outside world to be a in a 12-Step program, principally a sense of shame. Talk of stigma among clientele led us to discuss Jennifer’s passion project, that is, stigma and fear reduction in the behavioral health community at large.

The project comes to life for Jennifer through advocacy work. For instance, in 2015 she served as the co-chair of the UNITE to Face Addiction National Rally in Washington, D.C. The event included a day-long concert of groups who were either in recovery themselves or felt very strongly about recovery. It also encouraged recovering individuals and their families and friends to become civically involved to celebrate the community’s national recognition. Jennifer noted that the event coincided with the release of Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, a piece of literature that she believes should be required reading for anyone in the field.

In addition to interaction with news outlets to change their language around addiction over the years, Jennifer was also instrumental in changing the language of the application and license renewal application form for the Louisiana State Board of Social Work Examiners (LABSWE). Prior to the language change in 2015, the forms asked applicants if they had participated in drug or alcohol treatment. Because this question inquired about a diagnosis, it violated the Americans with Disabilities Act (ADA), which includes substance use disorders as valid impairments.

If applicants answered “yes,” to the question, they had to jump through a series of hoops, which meant submission to an assessment, releasing records of their treatment, and entering LABSWE’s Impaired Professional’s Program. At the end of the process, Jennifer and colleagues were successfully able to convince the board to change the language so that it no longer violated the ADA and, therefore, did not impose burdensome professional consequences on those who had received treatment in the past.

Ultimately, what stigma creates is a sense of disconnect between those with alcohol and drug issues and those without. For instance, people often think that issues with drugs and alcohol are synonymous with frivolous people “being selfish” by simply seeking out opportunities to be high or drunk. Jennifer explains her experience of the reality of what goes on with addiction, “I think what really fuels the use is the sense that ‘I don’t want to feel the way I’m feeling.’”

In other words, substance use can serve as a way for people to tolerate existence in their bodies, a temporary solution to a chronic sense of not feeling connected or whole. Really, from this perspective, all humans are trying to make sense of being in their bodies and, naturally, seek solutions to discomfort. I mused that the solutions from person to person just look really different. Some solutions are temporary and turn into problems with visibly life-altering consequences. Other solutions, temporary or not, may be invisible to the outside world and therefore not arouse stigma.

The reality is that every person is navigating solutions to the problems of existing in a body. Jennifer’s work to reduce stigma is rooted in the belief that if people could frame things in this line of thinking, it would create opportunities for education and empathy, which are bridges over a chasm of misunderstanding.

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TPN.Health Clinician Spotlight: Shannon Huertas, LPC

Happenstance: a circumstance especially that is due to chance

Happenstance is a term that Shannon Huertas, LPC, uses to describe her journey of professional meandering in the behavioral health field. At the start of her undergraduate years, Shannon intended to major in accounting as she was good with numbers, and her father suggested it. While in college in Atlanta, she began working for the Atlanta Bar Association. This position required Shannon to listen to potential clients’ legal issues over the phone and refer them to the proper attorney based upon the information they provided in the consultation. It was in this work of listening and interpreting that she began to consider pursuing a direction in the behavioral health field.

“I really like hearing people’s stories and figuring out where do we go from here. What are your needs? How can I help you find that?” 

Shannon explored an array of psychology courses in undergraduate studies, and, after considering her options, she eventually enrolled in a graduate program. With marriage, three children, and a move from Atlanta to Louisiana, the pathway through school was anything but linear. Right after completing undergraduate studies, Shannon recalls a chapter of her story in the small farming community in Ragley, LA where her husband was a pastor at the local church. The community (not town) consisted of the church, a gas station, two schools (elementary and high), and a hair salon where one could buy pecan candy.

While pursuing a Master of Arts in Counselor Education at LSU, Shannon requested placement at an inpatient hospital for her internship. She recalled, “I could have stayed onsite, but I wanted something very different.” Because of the acuity of the inpatient hospital setting, fellow graduate students believed this was a bold request for someone new in the field, but Shannon found herself thriving there.

After having completed her Masters degree, Shannon began working with underserved communities at Family Plus, the counseling center at the Louisiana Methodist Children’s Home, in Shreveport. This facility opens their door to women who are victims of human trafficking through their program Purchased, Not for Sale, which provides trafficked women the opportunity to receive affordable counseling services and education on a sliding scale or free basis. While working with trafficked women, she was able to receive training in EMDR, a modality that works to process trauma, and became passionate about the treatment of trauma.

“I think one of the gifts of working with people who’ve experienced trauma and studying trauma is an understanding that underneath unhealthy human behavior is a story of experiencing hard things and not having the safe spaces to make sense of that.” 

Shannon’s experience working with women who have been victims of human trafficking has played a major role in both her therapeutic orientation and navigating life outside of the counseling center. It has given her the ability to connect to clients by asking the right questions, springing from a place of empathetic curiosity rather than judgement. In a similar way, Shannon finds that the experience of navigating client relationships has supported her ability to engage with herself and personal communities with more empathy. Today, she pays attention to the sound of her own voice, one of gentleness and guidance, toward clients and sees the guidance as applicable and necessary for her own life.

Shannon Huertas, LPC

What’s next for Shannon? Presently she works at Teche Action Clinic in Houma, LA and is slowly moving, with mixed feelings, toward opening her own private practice. Over time, Shannon has developed a passion for working with underserved populations and feels that everyone should have access to mental health services. At Teche Action Clinic and most of the other places where Shannon has practiced, people were typically never turned away for lack of monetary resources. She realizes it will be difficult to live the passion of serving those with limited resources by choosing the path of private practice.

She also shared on the challenge of creating the business side of the practice:

“Private practice is scary and exciting for the same reason — there’s no boss except yourself. I’ve worked in salaried positions for so long, and of course, I work, but if you don’t see clients, you still get paid when you’re working in a salaried role. There’s a certain level of risk in that area that can be scary and, although I’ve grown a lot in that area, I’m not a big risk-taker. I like to kinda play it safe, so this is definitely a growing edge for me — learning the nuances of advocating for and [marketing] myself in the community.”

This is no textbook chapter. Finding one’s niche as a behavioral health professional can be full of big lessons and challenges, a lot of gray areas, and very little black and white. It was clear from conversing with Shannon that she is bravely paving her own path in her corner of the behavioral health field — considering all the options, intuitively moving, and learning through the discomfort. TPN.Health is thrilled to have Shannon in the network to begin making connections to support her as she moves to the next stage of serving people in her community.

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TPN.Health Clinician Spotlight: Robin Webster, LPC, NCC

“I’ve always been a believer.”

Robin Webster, LPC, NCC, reflected on her upbringing in faith traditions. She grew up, initially, in the faith tradition of Judaism, which then transitioned to Christianity when she was a preteen. For Robin, the practice of bringing comfort to the people in her life was commonplace throughout childhood into adulthood. She recalls always having a natural ability to meet people when they came to her with troubles. This orientation, intersecting at faith and the ability to be a natural helper, has informed Robin’s life and brought her to the work she does today.

Presently, Robin serves as the CEO of Tower of Refuge Christian Counseling, LLC, where she weaves together a Person-Centered approach to counseling with a collection of Christian practices, such as prayer, use of Christian language, and reading of the Bible. However, integration of Christianity into therapeutic practice was not always a given. In fact, for a long time, she never thought the two could meet.

Before Robin practiced privately, she worked for institutions in which she kept faith largely separate from her work with clients. What prompted her to make the leap toward integration was a series of interactions with others where she acted intuitively and saw positive results. For instance, she would often spend more time with clients than was allotted to make sure they walked away with a completed therapeutic experience and feeling lighter than they had upon entering the space. Likewise, if she felt prompted to do so, she would offer to pray with a willing client. What she found was that when she acted intuitively, the clients benefitted.

Robin Webster, LPC, NCC

In making the full transition to Christian counseling, Robin was concerned about having enough clients, that people might not be interested in the service. What Robin sees today is the opposite of her initial concern as she has substantial clientele. Interestingly, she finds that the Christianity piece brings a sense of familiarity and can thwart wariness in clients who are initially wary of therapy. In this way, she meets people where they are by appealing to a worldview that is already a part of the frameworks of their lives.

“This is not just a job for me. This is my ministry.”

It took time for her to decide to make the leap into full integration of Christian and psychotherapeutic practices, and she is grateful that she did. Robin’s life and work are woven together into a vocational calling. She expresses that the long hours are worth it, and she loves what she does.

In the way of challenges, Robin spoke to the present stigma around receiving mental health services in the African American community. What she sees in her clients and personal communities is the pervasive belief that receiving mental health services means that there must be something inherently wrong with you as a person, that you are crazy.

It is important to Robin to combat this stigma actively in the work she does. One way she does this in practice is to reframe the whole notion of therapy by defining it in terms to which people can relate. So, what’s actually happening? People — all people — go through processes and at some point will need support in going through processes. The therapist or helping professional provides a safe context for a person to do that processing.

“I know that at some point, I’m going to need someone else on board.”

Looking forward, Robin’s goal is to incorporate a team of other Christian counselors into her practice. The reality is that the need for her services is growing, and she wants a team of other professionals providing similar services to whom she can refer. It is the hope of TPN.Health to connect Robin with clinicians who practice similarly for collaboration and referral-sourcing. You too can showcase your specific clinical expertise on your TPN.Health profile to begin collaborating with other like-minded clinicians.

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Storied Scapes: The Narrative in Play Therapy

TPN.Health reflects with the Feelings Doctor on how the practice of play therapy works on personal narrative construction

Story-telling is ubiquitous in that people across time and cultures have had a constant working relationship with the story-making and telling process to make sense of life experiences. The concept of story-telling as a vehicle for making sense of experiences has been expanded upon and implemented for years in the world of psychotherapy and is a commonly used mechanism in therapeutic modalities, such as Narrative Exposure Therapy (NET), bibliotherapy, play therapy, and other expressive therapies.

Daniel Taylor in his The Healing Power of Stories: Creating Yourself Through the Story of Your Life discussed the working whole of a story as it relates to the way in which humans make meaning of life experiences. Essentially, when humans make sense and meaning out of discord in personal living, they are engaging in the process of making their own stories and, thus, living their own stories. Taylor (1996) states, “Knowing and embracing healthy stories are crucial to living rightly and well. If your present life story is broken or diseased, it can be made well. Or, if necessary, it can be replaced by a story that has a plot worth living” (Taylor, 1996, p. 1).

Ultimately, when people are engaged in creating a narrative that works for them from moment-to-moment, they’re not engaged in the narratives that no longer serve them. The ways in which story-telling elements and narrative construction are incorporated into therapeutic modalities are vast, so today we will zoom into a box, that is, a box full of sand and figurines.

figures in sandbox

TPN.Health reconnected with the Feelings Doctor, Allison Palmisano, PsyD, to explore how the mechanisms of story-telling appear in the processes of play therapy. Specifically, what happens in play therapy that allows people to begin to change or make sense of the narratives that comprise their lives? Perhaps we can approach these questions by looking at the different ways that clients play.

In the sandbox portion of Dr. Allison’s playroom, clients can make a world! That’s right — they can create any world they want with any assortment of figures from Kermit the Frog to a police station-painted rock. They can use different figurines to represent different parts of the world and then name the parts as they choose. Naturally, the world they create externally in the sand will speak to their scope of inner experiences or what they want to experience.

figures in a sandbox

When the Feelings Doctor asks members of a family in session to describe what goes on in the home from their individual perspectives, they can use figurines to act out scenarios. They communicate with one another through the figurines by using puppetry. In moments where clients or guardians of clients are not keen to speak, they can make their way to the dollhouse. Here, the only task is to set up their home-life inside the playhouse, with the objects and people that populate it. The choices that they make in placement, type, inclusion, and exclusion reveal what is happening in their perceived worlds. The house tells the story.

Although each part of the playroom has its own specific use tailored to each client’s needs, what happens in all areas of the room is that the feelings and perceived realities within the client’s realm of experience can move from the inside to the outside. It’s what happens in this movement that is of value here. The same thing can happen with talking, that is, a movement from inside to the outside. However, the framework of play offers an opportunity unique from talking.

Talking, for many people, becomes the primary method of negotiating with the world outside one’s own skin once a person has learned to do it. Although speaking can often be an adequate mode of expression, it has a framework with some limitations. Dr. Allison and I mused on the limitations of the speech framework, such as the practiced tendencies to filter details and react to strong feelings. Those practiced tendencies can often limit a person’s choices in relating to the world and keep people inside stories that are not serving their lives.

play therapy figures on shelf

What happens in play is that people gain space from those practiced tendencies and have the opportunity to engage in a different method of ordering and relating to the world. Likewise, the nature of play is that there is no right or wrong, so things that can be filtered in speech now have a way into the outside world. Here the role of metaphor is principle. The characters and structures that clients choose represent and literally re-present inner experiences in a new framework.

The nonbinary nature of play not only allows for the absence of filtration but also the space for story frameworks to shift and change, free of rigid absolutes. For instance, just as easily as someone named a character or put a structure on the ground, that character can be renamed, and that structure can be removed. What’s happening here? Change, with relative ease.

What seems impossible or deeply uncomfortable in real life is now possible and encouraged in the arena of play. In this way, play practices can introduce the possibility that rigid frameworks and ways of doing things can be shifted with ease. Likewise, with the inconsequential flow of play, a person can gain a more helpful perspective by personifying a feeling that may have felt all-consuming, for example, in animating the figurine of Sadness (from Inside Out).

“Stories animate human life; that is their work. Stories work with people, for people, and always stories work on people, affecting what people are able to see as real, as possible, and as worth doing or best avoided” (Zipes, 2013, p. 1).

We’re made of stories, and so it goes that they move in us and through us. You are helping to facilitate the client’s work in and about their own stories, whether that is in reframing or simply settling into them. How are the therapeutic modalities you practice working on clients’ narratives? We’d love to hear your experiences.

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References:

Zipes, J. D. (2013). The irresistible fairy tale: the cultural and social history of a genre. Princeton: Princeton University Press.

Taylor, D. (1997). The healing power of stories: creating yourself through the stories of your life. Alexandria, N.S.W.: Millennium Books.

TPN.Health Clinician Spotlight: Dildred Small Womack, LPC-S, LMFT, Mediator

What is the most important thing to you in your practice?

“The most important thing is for individuals to be able to see the beauty of their internal strength and to learn ways to explore a sense of belonging inside them[selves].” -Dildred Small Womack, LPC-S, LMFT, & Mediator

At Wonderful Works Consulting Agency, LLC, Dildred Small Womack offers both counseling and mediation services in Greensburg, LA. Essential to Dildred’s practice is her hopefulness in the people whom she serves. She articulates that to do the kind of work she does, one has to be able to believe in people. It is her role is to make the space for people to access themselves, their capabilities, and strengths as individuals. The belief that all people have the ability to access this inherent goodness within themselves is an indispensable piece of this role.

Dildred supplies hopefulness in client interaction in her dual roles of LMFT and Mediator. Although the two roles are distinct from one another, mediation in the form of conflict resolution in relationships can often be a precursor to the counseling services she provides as an LMFT. These roles allow Dildred to work with a variety of populations, including prisoners, military veterans, geriatric people, and students. Speaking to her role as a contracted Mediator, Dildred expressed gratitude that the organization with whom she is in contact has given her opportunities “to shape and be shaped.”

Dildred Small Womack in red shirt and rainbow plaid jacket

Dildred, having grown up in rural Louisiana, was a first generation college student with a high school-educated mother and a tenth grade-educated father. Her parents instilled in her that if you have a passion for people, then it is ok to love, serve, and reach out to them. It is from this early instillation that Dildred first began to navigate reaching out and using her gifts to help people. In tandem with reaching people in her work, Dildred understands the importance of feeling comfortable in her own skin. This, for Dildred, means cultivating the ability to meet herself exactly where she is, in the spectrum from pain to joy. She meets the pain in herself and cultivates the ability to bring understanding and compassion to that.

“If it doesn’t work for me, it’s not gonna work for you. If I have a misperception of you, and I’m not able to meet you where you are, then I’ve contributed to your pain, and I’ve not liberated you, and I’ve held myself back as well.” 

Examining what is inside of herself is necessary when meeting other people and upholding them in her practice. This examination has to happen in order for Dildred to meet clients in experiences of pain and in experiences of solutions.

The collection of cups reading “Trust me, I’m a clinician.” on TPN.Health’s table at the LCA 2019 Conference caught Dildred’s eye, so she stopped by to take a closer look. After chatting for a bit, she agreed to share more of her story with us, and we’re grateful she did. Find Dildred in the TPN.Health community!

“I’m also a follower…because great leaders have to be great followers. Ya’ll said it (TPN.Heath) was good, so here I am!” -Dildred Small Womack

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