Podcasts about clinical director

SC Nealy, LPC, ACS, NCC, CCMHC (they/she) is a trauma-informed psychotherapist, educator, and advocate specializing in religious trauma, complex developmental and sexual trauma, couples and queer/nonbinary relationships, and neurodiversity-affirming therapy. With more than 15 years of experience, they founded the LGBT+ Counseling Collaborative in the Washington, DC area and serve as Clinical Director, leading a team of queer- and gender-diverse therapists.Their direct, compassionate approach supports clients in unpacking past harm, reclaiming identity, and healing across the gender and sexuality spectrum. Dr. Nealy brings a deep commitment to intersectional care that honors lived experience and the full spectrum of the self.In This EpisodeSC's websiteSC on IGBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-trauma-therapist--5739761/support.You can learn more about what I do here:The Trauma Therapist Newsletter: celebrates the people and voices in the mental health profession. And it's free! Check it out here: https://bit.ly/4jGBeSa———If you'd like to support The Trauma Therapist Podcast and the work I do you can do that here with a monthly donation of $5, $7, or $10: Donate to The Trauma Therapist Podcast.Click here to join my email list and receive podcast updates and other news.Thank you to our Sponsors:Jane App - use code GUY1MO at https://jane.appArizona Trauma Institute at https://aztrauma.org/

Our 3rd annual Listen to the Dissonance:songs and conversations about mental health event will take place on Friday, February 27th at The IceHouse in Bethlehem, PA.  The show starts at 7pm ET and features brave stories and powerful music from CLOVER, Judah Kim, Barney Cortez and Patty PerShayla.  Each have been on the show previously, so you can check out our interview with any and all of them at nextfavband.com.The doors open at 6pm so you can also have time to meet with the 9 mental health organizations that will be present and get to know them, their people and the services they offer.In this episode, we'll share a track from each of the performers and touch on the various organizations.Joining us to help co-host will be Hannah Taylor - who is a stunning visual artists who designed this year's promotional poster images.  She's also a phenomenal musician herself, and part of the band The Flying Vees, who also have an interview on our channel.We also have highlights of interviews share - one with Ari Jacobson, Clinical Director of Backline.care, the organization we always raise funds for and spotlight as a part of this event as they provide free mental health services to the music industry.  The other with Ed Schwartzman, father of Ben who was an incredible young musician who battled mental health issues and sadly took his own life back in 2007 at the age of 19 years old.  Ed seeks to keep his son's legacy alive by sharing his music and his story.We hope you enjoy this episode, and that you are doing ok.  Please join us on Fri 2/27 if you can, for what is always a special evening.Text us your thoughts on this episode, and who should be OUR #NextFavBand...As always, our hope is to bring you "your next favorite band". If you tuned in today because you already knew this musician - thank you very much! We hope that you enjoyed it and would consider following us and subscribing so we can bring you your #nextfavband in the future. And check out nextfavband.com for our entire catalog of interviews!If you have a recommendation on who you think OUR next favorite band should be, hit us up on social media (@nextfavband everywhere) or send us an email at nextfavband@stereophiliastudio.com.Thank you to Carver Commodore, argonaut&wasp, and Blair Crimmins for allowing us to use their music in the show open and close. It makes everything sound so much better! Let's catch a live show together soon!#nextfavband #livemusic #music #musicinterview #musician #singer #guitar #song #newmusic #explorepage #instamusic #bestmusic #musicismylife #musicindustry #musiclife #songwriter #musiclover #musicfestival

Blood cancers are the fifth most common group of cancers in the UK. But for a small number of people, the condition may have an inherited genetic cause.  In this episode of Behind the Genes, we explore the role of genetics in blood cancer, and what an inherited risk means for patients and their families. Our guests explain what blood cancer is, how inherited factors can increase risk, and why multidisciplinary teamwork is key to supporting families. They also look ahead to future advances, from whole genome sequencing to prevention trials.  Our host Amanda Pichini, Clinical Director at Genomics England, is joined by:  Dr Katie Snape, Principal Clinician at Genomics England and Consultant Cancer Geneticist  Bev Speight, Principal Genetic Counsellor Dr Sarah Westbury, Consultant Haematologist “By doing whole genome sequencing we get all of the information about all of the changes that might have happened, we know whether any are inherited, but importantly, we're certain of the ones that have just occurred in the cancer cells and can help guide us with their treatment.”  You can download the transcript or read it below. Amanda: Hello, and welcome to Behind the Genes.  Sarah: When we think about blood cancers, it's a whole range of different conditions and when you talk to patients who are affected with blood cancers or are living with them, their experiences are often really different from one another, depending in part on what kind of blood cancer they have.  We also know that blood cancers affect not just the cell numbers but also the way that those cells function, and so the range of symptoms that people can get is really variable.  Amanda: I am your host, Amanda Pichini, clinical director at Genomics England and genetic counsellor.  Today I'll be joined by Dr Katie Snape, principal clinician at Genomics England and a consultant cancer geneticist in London, Bev Speight, a principal genetic counsellor in Cambridge, and Dr Sarah Westbury, and haematologist from Bristol.  They'll be talking about blood cancers and the inherited factors that increase blood cancer risk.  If you enjoy this episode, we'd love your support, so please subscribe, rate and share on your favourite podcast app.  Let's get started.  Thanks to everyone for joining us today on this podcast, we're delighted to have so many experts in the room to talk to us about blood cancer.  I'd love to start with each of you introducing yourself and telling us and the listeners a little bit about your role, so, Sarah, could we start with you?  Sarah: Sure.  It's great to be here.  My name's Sarah Westbury, and I'm a consultant haematologist who works down in Bristol.  And my interest in this area is I'm a diagnostic haematologist so I work in the laboratories here in the hospitals, helping to make a diagnosis of blood cancer for people who are affected with these conditions.  And I also look after patients in clinic who have different forms of blood cancer, but particularly looking after families who have an inherited predisposition to developing blood cancer.  And in the other half of my job, I work as a researcher at the University of Bristol.  And in that part of my job, I'm interested in understanding the genetic basis of how blood counts are controlled and some of the factors that lead to loss of control of those normal blood counts and how the bone marrow functions and works.  Amanda: Thank you.  That's really interesting, we'll be looking forward to hearing more about your experience.  Bev, we'll come to you next.  Bev: Thank you.  Hello everyone, I'm Bev Speight, I'm a genetic counsellor, and I work at Addenbrooke's Hospital in Cambridge.  I work with families with hereditary cancers in the clinical genetic service, and for the last six years or so have been focused on hereditary blood cancers.  So we've been helping our haematologists across the region to do genetic tests and interpret the results, and then in my clinic seeing some of the onward referrals that come to clinical genetics after a hereditary cause for blood cancer is found.  I'm also part of the Council for the UK Cancer Genetics Group.  Amanda: Thank you, Bev.  And Katie, over to you.  Katie: Hello, I'm Katie Snape.  I'm a genetics doctor and I am a specialist in inherited cancer.  So we look after anyone who might have an increased chance of developing cancer in their lifetime due to genetic factors.  I am the chair of the UK Cancer Genetics Group, so that's a national organisation to try and improve the quality of care and care pathways for people with inherited cancer risk in the UK.  And I have a special interest in inherited blood cancers through my work at King's College Hospital, I work in the haematology medicine service there seeing individuals who might have or have been diagnosed as having an inherited component to their blood cancers.  So it's great to be here.  Amanda: Excellent, thank you for those introductions.  I'd like to then dive right in and understand a little bit more about blood cancers.  So, Sarah, could you tell us a little bit more about what blood cancer is?  Sarah: Yes, sure.  The term blood cancer is used to describe a whole range of different kinds of cancer, all of which affect some part of the blood or sometimes parts of the immune system that kind of gets represented as part of the blood.  So it's really describing a big group of conditions rather than one single kind of condition or entity itself.  But like any form of cancer, we understand blood cancers as being conditions where because cells as part of the blood system are rapidly dividing and normally doing so under really well controlled circumstances to produce just the right balance of blood cells and just the right number of those cells.  In a cancer affecting those cells, we see that that loss of control results in either too many of one type of blood cell being produced or too few, or that balance being lost.  And like any form of cancer, this is because of genetic changes that happen in individual cells that then go on to grow in a way that is not controlled and well regulated.    And because when we talk about blood cancer we're talking about such a wide range of different kinds of cancer affecting different cells within that blood system, there's a really wide range of different conditions.  From conditions that we might think of as being like a form of acute leukaemia, so something that produces often symptoms and signs in patients very quickly and they can often feel quite unwell quite soon and then get picked up with having this condition because they present feeling unwell.  All the way to chronic and slow growing cancers that can be found completely by chance and serendipity when blood tests are done for other reasons.  So when we think about blood cancers, it's a whole range of different conditions.  And when you talk to patients who are affected with blood cancers or are living with them, their experiences are often really different from one another, depending in part on what kind of blood cancer they have.  We also know that blood cancers affect not just the cell numbers, but also the way that those cells function.  And so the range of symptoms that people can get is really variable, again depending on which of the blood cells are really affected by that.  And it may be that during the course of some of the conversations we have today in this podcast, we'll perhaps focus on particular kinds of blood cancer.  But like any cancer, it's that disruption of the normal growth and development of cells that means that the number and function of those blood cells has been disrupted in some way.  Amanda: Thank you so much for explaining that, Sarah, that's really helpful.  In terms of across the range of blood cancers, is that something that people can get at any age, and how common is it?  Sarah: It does depend, as we were sort of talking about that really wide range of different disorders that make up that group of blood cancers.  And individually each of those blood cancers is reasonably uncommon compared to cancers that we might typically think of, like breast cancer or colon cancer.  But actually, if you group blood cancers together, they make up quite a sizeable proportion, and they're actually as a group the fifth most common form of cancer that's diagnosed in people in the UK.  In adults in particular we think that perhaps people diagnosed with leukaemia would make up about 3% of the new diagnosis of cancer made in any year.  Amanda: So coming to you, Bev, when we talk about inherited blood cancers, what are the differences between those and blood cancers more generally?    Bev: So at point of diagnosis, it may not be obvious that somebody with a new blood cancer diagnosis is one of the minority of people in that big group as Sarah has described, who has an inherited cause.  So it may not be immediately obvious.  However, in the last few years certainly, it's become more and more routine to do quite broad genetic testing.  Often on a bone marrow sample or blood, because that is done looking for genetic changes, which are part of all cancer and we find within cancer cells, that can help with treatment planning.  It can also find that there is an inherited cause to that new blood cancer diagnosis.  Sometimes that might not be clear cut, sometimes that might be inferred from the genetic tests that are done on the blood or the bone marrow. And the proportion of blood cancers in that huge group which do have an inherited cause is fairly small, the actual proportion will depend a bit on the age of the patient and the specific subtype of blood cancer.  Amanda: Okay, and could you talk us through how some of those inherited genetic factors can increase the chance of a person developing blood cancer, how does that work?  Bev: Yes, so if we know that there is an inherited cause for blood cancer, then what we mean by that most of the time is that a change in a single gene has been found.  And that there is enough research evidence and enough known about that specific change in that gene to say to the person who's been diagnosed, there is at least in part or perhaps a full explanation for why that blood cancer has developed and this could be shared in the family.  So at that point it's information that not only has implications for the person in treatment, but also their relatives.  Depending on what sort of gene alteration it is and which gene it's found in, there are different inheritance patterns, and that changes the sorts of information that we give about risks for relatives.  So for lots of the genetic tests that detect an inherited cause in adults when they're diagnosed, that's most often what we would call an autosomal dominant inheritance pattern.  Essentially that means you only need to have one gene alteration which is in that person's normal non-cancerous DNA inherited from a parent and can be passed onto a child.  And for people in the family who have inherited this one genetic change, then they are likely to be at increased risk of developing blood cancer.  Sometimes with particularly the children's blood cancers, if an inherited cause is found, it can be a different pattern, which we call autosomal recessive.  And that's where two gene changes are found and one has been inherited from each parent.  So parents might be what we call carriers and have one each just by chance, both have been passed onto a child who has developed blood cancer either in childhood or possibly later on, and that's the pattern we call autosomal recessive.  There are other inheritance patterns too.  The third one that we come across being X-linked, and so that has a gender component.  That's where there's a change on the X chromosome, women have two X's, and men have one X and one Y.  So sometimes with the X-linked conditions we're more likely to see the clinical signs of a condition in boys and men because they've only got that one X chromosome.  But those are less common in the context of talking about hereditary blood cancers.  Amanda: Thank you.  That's really helpful to understand.  So it sounds like you're saying that these forms of blood cancers that are caused by a single gene are relatively rare.  And also by having one of these changes, it's not a given that that person will develop a blood cancer, but it makes them more likely, and how likely that is might depend on the inheritance pattern or the type of condition.  Bev: That's right.  So what we're saying is it can give either part of full explanation for the blood cancer diagnosis, and it could confer a risk to family members, but that doesn't mean they definitely will develop it.  We're talking about an increased risk compared to the population risk.  Amanda: Right.  I can imagine for those families to some extent it might be helpful to know the underlying reason why they had that blood cancer, but again, that's just a small proportion.  So, Katie, could I come to you next?  What about the rest of all the blood cancers, how do they occur?  Katie: Yes, thanks, Amanda.  So most blood cancers will occur just by chance.  We also know that there are some environmental factors that can increase the risk of blood cancers, so, for example, serious radiation exposure, something like that.  What Bev has described is where there is this sort of quite rare condition where there is a kind of single gene that's really important for the blood cells in terms of keeping those control mechanisms that Sarah described.  And that's not working properly, which has increased the risk of a blood cancer.  But we also sometimes see some families where there is more blood cancer, or the same type of blood cancer in that family than we might expect by chance.  We think that's probably not due to a single high risk genetic factor, but might be due to kind of multiple lower risk genetic factors that are sort of shared by close family members and can add up together to increase the risk a little bit.  And we call that familial risk or polygenic risk.  We don't have a test for that at the moment.  We wouldn't offer usually any extra screening or testing to those families, but we would just suggest obviously family members are aware of any signs of symptoms of blood cancers and seek any advice if they're concerned.  But, you know, the majority of blood cancers are not due to genetic factors, and it's sort of environmental or chance or bad luck. Amanda: Okay, so it's clear that obviously blood cancer is almost an oversimplification, within that category there's so many different types, so many ways that it could happen in a person.  So, Bev, if we're dealing with that type of blood cancer that is inherited or has some heritability, can you tell us more about what that means for the family?  What kind of impacts do you see that having for them?  Bev: Yes, of course.  So clearly this is another layer of information that's often coming at a family during a time where somebody is often recently diagnosed with blood cancer of one sort or another and is having to take in a lot of information about treatment and all of the uncertainty and anxiety that goes with that.  So for this minority of patients and families where there is new information about an inherited cause, that needs conveying in a timely but sensitive way, bearing in mind what else is happening.  And for some people it can come as a major shock and really an additional burden at that time.  I think the reaction to that will of course depend on lots of factors.  And what we also see is that this question about a new cancer diagnosis of any sort, including blood cancers, can generate the question in people's mind, particularly if they've got children, about does this change the risk for relatives?  So sometimes this new information that, actually, there is an inherited cause is an answer to a question that families have already got.  And that might be because of what Katie's described as familial clustering, there might already have been this known history in the family. So sometimes this information can feed into that and actually be quite a helpful answer.  But it's quite normal for families to feel quite mixed about this and for different family members to have a different approach to it.  When there's the offer of what we would call predictive testing, if we found a change in a single gene in somebody with blood cancer which we're saying is a hereditary cause for that, that might open the door for relatives to access predictive testing.  I.e., the opportunity to discuss and possibly take up a genetic test for themselves when they haven't had cancer themselves, but there's an opportunity to try and quantify whether or not they're at increased risk.  We know in families the uptake of those kinds of tests is different, and a lot of it is to do with timing and the way people respond to this in families might depend on their response to the cancer diagnosis in their relative, and of course what else is going on in their life at the time.  This aspect for the family is where clinical genetic services come in, because these initial tests in the person with blood cancer are done in their haematology/oncology setting, and normally the results about an inherited cause has been found are conveyed through that service.  That's when a referral to clinical genetics happens.  And in our specialist service we're addressing those additional concerns for the family which arise because of this diagnosis. Amanda: Thanks, Bev, for explaining that.  Sarah, coming back to you.  Could you tell me then if someone has an inherited blood cancer does it also change the way that the patient is treated? Sarah: Well, it certainly can do, and again, it does depend a little bit on the specific circumstances of that particular person and the form of inherited blood cancer predisposition that they have.  But certainly if we think about treatment as a whole, then for a lot of people it does affect the way that we might recommend treatments or look after them and their families.  So, for example, for some patients who have a diagnosis of an inherited form of blood cancer, we know that some treatments might be more or less effective for their particular set of circumstances.  And so that can sometimes influence the specific treatment recommendations that we would make, particularly thinking about, for example, the risks that the cancer might come back again after it's been treated.  Or thinking about whether or not some of the typical drug regimes that might be used might be perhaps more likely to cause them side effects or problems with tolerating that treatment.  So it can certainly make some changes in that respect. For some people, to be fair a minority of people with blood cancers, they may need a stem cell transplant as part of their treatment to hopefully cure them of their blood cancer.  And this as I say is a treatment that's required for a minority of patients as a whole who have a diagnosis of a blood cancer.  But for those people who have got an inherited predisposition and who might be recommended a stem cell transplant as part of their treatment, then knowing about a familial risk for this condition can also be really important.  For making sure that if a family member is being considered as a donor for example that we're being really careful to make sure that we're not choosing a donor that might also be affected by the same underlying blood cancer predisposition.  Because this can obviously cause problems for the person that's receiving the stem cells if it turns out that the person they're receiving them from actually has the same inherited condition as them.  So in that respect knowing about the underlying predisposition and genetic cause for their cancer can be helpful.  But in a more sort of general sense, yes, the other thing that it can have a big difference for is that some of these inherited cancer predispositions and syndromes also have other health conditions associated with them.  So it might be that that genetic diagnosis predisposes somebody not only to a form of blood cancer but to other health conditions as well.  And so actually knowing about that diagnosis can help their haematologist then make sure that they're linked in with the right other medical teams to make sure that those other health conditions are identified if they're present and taken care of.  And then I think really coming back to what Bev has already touched on, there's the sort of bigger picture of just how people are looked after in their own right but also as part of their family unit.  And making sure that they're given the right information and advice about their health, but also thinking about other family members.  And particularly for younger patients who perhaps either are just starting their own families or for whom that's not yet a consideration, making sure that they've got the information to understand what might be relevant for future family members, if that makes sense.  So it's not necessarily true to say that for every individual patient knowing that there's an inherited blood cancer present will necessarily directly affect the way that the treatment is offered.  But you can see that as a part of a bigger picture for a lot of patients, it will make a difference to their care as a whole.  Amanda: And you can really see how the impact is very sort of multigenerational and is going to affect people at all ages and stages of their life, so that's really interesting.  Katie, Bev spoke a little earlier about the fact that there are genetic tests that can help tell us if blood cancer is inherited.  Could you tell us more about what the tests involve, and some of your experience taking families through this?  Katie: There's sort of two main different ways that we might identify somebody has an inherited cause for their blood cancer through testing.  So traditionally what has happened, as Bev and Sarah sort of discussed before, is that when a person is diagnosed with a blood cancer, we either take a sample of their blood or bone marrow.  To try and look at what are the changes within those cells that have driven that cell to become a cancer cell and have driven this blood cancer to develop.  And a lot of the time, as we've said, it's not inherited, it's not genetic, so they're what we call acquired changes, they're changes that have just happened in the bone marrow or to the blood cells that have caused that kind of particular cell to become a cancer cell.  And it's really important that we look at those because that can help both diagnose the blood cancer, it can give us information about how serious that blood cancer might be, and it can also help us guide our treatments and therapies.  And so if we do those testings, they're primarily done within haematology for those sort of diagnostic or prognostic or treatment purposes.  We do sometimes see then a change that looks a bit suspicious that it might be inherited for various reason.  And if we see something that is in the cancer and it looks like there's a potential it could be inherited, we would go on and do a second test.  So usually because we can't do a blood test because the cancer's in the blood, we would take a skin biopsy.  And then we would look and see, well, is this change also present in the skin?  And if it is, then that indicates that that change is in all of the cells of the body, because it's in both the blood cancer and it's in the skin, and therefore it's likely to be inherited.  So that's one thing that we do.  And I think that that can be quite challenging for patients.  Because they go in to have a test for their blood cancer and then suddenly were being told, “Well, actually, we've also found something that might be inherited,” and it is something then that other members of the family might have.  And as Sarah said, potentially that means that even if your relative was offering to be a bone marrow donor for you, they might not be able to if they also carry the same thing.  And so that can be quite tricky just in terms of making sure that we're guiding the patient and their family members through that process.  And then thinking about the work that Genomics England does, particularly with whole genome sequencing, and this is particularly offered for children and young adults in the paediatric setting.  But I think we're also increasingly, as we progress we'll perhaps talk about this a bit, moving towards whole genome sequencing for adult blood cancers more routinely as well, that that is offered as a sort of standard of care.  And what whole genome sequencing is, is it is looking at the entire genetic instruction manual in both the blood cancer cells and in the cells that we're born with, to look at the inherited or germline genome as well.  And the reason that we look at both the cancer cells and the inherited or germline genome is because what we're trying to understand is firstly, are there any inherited changes that have led to the blood cancer developing?  But also, what are the changes that have just occurred in the cancer cells that are going to help us to diagnose and treat that blood cancer?  So by doing whole genome sequencing we get all of the information about all of the changes that might have happened, we know whether any are inherited, but importantly, we're certain of the ones that have just occurred in the cancer cells and can help guide us with their treatment.  And so, again, when we're talking to patients, we have to explain to them that we're going to be looking at their entire genetic information.  And what's interesting about that is it might find things that are not only relevant to blood cancer, but very rarely other findings, incidental findings as well, or we might find things that we don't know about.  But I think certainly that's something that patients often feel very comfortable with having because it gives them the maximum amount of information.  Amanda: Thanks, Katie.  So it really sounds like there's a lot of advancements that are being made in genetic technology which potentially brings a lot of new things for you and Bev as genetic specialists, but also for you, Sarah, as a haematology specialist.  What does that kind of change for you, and I assume it's really important then for you all to be working together as a multidisciplinary team?  Katie: Yes, I mean, I think for clinical genetics, we were not involved in sort of haematology pathways for a really long time, and the haematologists are absolute experts in the genomic factors that drive blood cancers.  And certainly in my practice, it's really only been as the technology advanced that we really started finding more and more of these inherited factors, particularly in the adult setting.  Because I think in the paediatric and childhood setting, the haematologists again have been managing those conditions very well for years.  And I think there's places that we really interface and we really need to work together as a multidisciplinary team, understanding the genetic information, really understanding when something that we've seen in the blood cancer or the bone marrow could be inherited.  Do we need to check that?  What should that pathway look like?  But I think as you've said, a lot of these are actually really quite new conditions, particularly in the adult setting.  And we don't yet 100% know why do some people get blood cancer and some people don't when they have the same inherited factor.  What's the actual risk?  Are there any other factors modifying it?  What makes some people progress to develop a blood cancer and some people not?  And for that we really need to work together to try and gather the data and sort of capture people that have these inherited changes.  And hopefully develop a system and an infrastructure that we can follow it long-term and get a lot of information about long-term outcomes, both for individuals with cancer but also their families.  And also from looking at doing population studies.  Because I think we know that lots of people in the general population might carry some of these inherited changes and never develop a blood cancer as a result of this, certainly ones that seem a bit lower risk.  So we really need to work together to understand all of that.  But I'd be really interested in Sarah's views on that as well.  Sarah: Yes, sure.  So I think, as you say, Katie, haematologists have got a long history of understanding and interpreting genetic findings in the sort of acquired or somatic changes that we know are what occurs in some blood cells to drive the cancer forming in the first place. But this kind of newer integration of that with the germline testing is something that is becoming much more mainstream in haematology now, and I think something that people have had to sort of acquire new skills in this area to interpret that alongside.  I think as you say, that multidisciplinary working, where we're able to benefit from both sides of our expertise and knowledge and put that together is so valuable, particularly in those circumstances where there is some uncertainty.  And I think as a haematologist, one of the things that I really find a benefit both personally and professionally to help me navigate these tricky questions but that I also think patients benefit from is your expertise and ability to have those really quite tricky conversations with people who are not haematology patients, if that makes sense.  So they may be the relatives of patients who have a haematological diagnosis for example.  Who at the moment are entirely well and were just going about their daily business, and they're now told that they may or may not potentially have this inherited predisposition.  And I think that as haematologists, we're very used to dealing with potentially quite poorly patients, potentially quite scared patients who find themselves, you know, the recipient of all this quite difficult information.  But we're not necessarily so skilled and experienced at holding conversations with people who don't yet have that diagnosis.  And I think that that's a really rich area of mutual aid to one another as haematologists and genetic doctors, if that makes sense.  And I think your points about understanding actually the real risks and the nature history, as we would call it, of what happens to people who carry these variants that predispose them to blood cancers is something that we can probably only work out by working together.  And of course, working with the patients and families that are affected by these conditions so that hopefully for both sides in the future we'll be able to give much better advice to patients and their families.  Amanda: So, Bev, from your experience and as a genetic counsellor, what do you feel are the important things that patients and their families should know as they're going through this testing and diagnosis process?  Bev: The things I think families where there is a hereditary cause found should know is that with this new information comes a whole new referral to a dedicated service.  Who want to help patients and their family members at risk to navigate this, to adjust the information, and to make decisions that fit with them, about whether to have testing and the timing of that.  As we already said, where there is a hereditary blood cancer risk, that risk in family members is rarely 100%.  Depending on what the hereditary predisposition is in the family, we may be able to quantify that risk, sometimes we can't always.  And the other thing to know which links to that is that there is growing interest in research in this area.  That will really help us to improve care in terms of, for example, being able to quantify the risk of developing a blood cancer in relatives who are perfectly well that may have inherited these predisposition gene changes.  Or, for example, the other obvious place where we want to make improvements in terms of some sort of evidence-based surveillance for those people who want to find out that they have inherited the genetic change and are at increased risk.  Amanda: Thank you.  And overall there's been a lot I think we've been covering today that's probably going to be very new to many people.  Why do you think it's important to raise public awareness of inherited blood cancers?  Bev: There have been lots of public awareness campaigns about other cancers, as listeners probably can think about, in terms of for women checking their breasts and breast cancer awareness.  And perhaps there's been a bit less of that in general for blood cancers.  As we've already talked about, clinical genetics were not so involved in all of the genetic testing happening in blood cancers.  Because it wasn't so long ago in the history of how we think about inherited cancers in general that our suspicion of inherited causes in leukaemia was much lower than it is now.  So I think that awareness in the public probably will take a bit more effort to bring up.  But clearly public awareness about blood cancers in general, symptom awareness, and the fact that occasionally it can be something that is running in the family, clearly better public awareness of that means that people are empowered to ask the right questions.  And the questions that might already be in some way going through their minds of their haematology doctors or perhaps of their GP, if they've got a family history but are not affected themselves.  Amanda: Wonderful.  So, looking now to the future, Katie, what genomic advancements are we seeing or are we likely to see that could impact on the care of people with an increased genetic risk of blood cancer?  Katie: We touched a little bit, I think that whole genome sequencing is expanding.  And as we can turn that test around and get it back more quickly that might become more commonplace.  And I know Genomics England and the UK Haemato-oncology Network of Excellence have been doing a lot of work in that area.  We are very lucky now we have a national inherited cancer predisposition register that NHS England have set up with the National Disease Registration Service.  So that will enable us to capture individuals that have these sort of rarer but single gene disorders or conditions that increase the chance of developing blood cancers.  And that will enable us to do that sort of longer-term follow-up and get really more information.  We've touched on this already but I think there's really amazing research happening, why do some people develop blood cancers and some people don't, even though everyone carries the same underlying change that increases the risk?  And then I think really importantly, we're seeing now in some conditions, clinical trials of certain medications to see if that can actually prevent people who carry these inherited changes from progressing to developing blood cancers.  So I think all of those things are really exciting and will give us lots more information that we can then help patients and their families, particularly the sort of treatment and trials aspects.  Amanda: And, Sarah, on treatment and trials, how do think genomics might improve the treatment, but also the diagnosis of people with inherited blood cancers in the future?  Sarah: I think, you know, hopefully when we are able to accrue more information about these underlying genetic predispositions and how they actually then affect people's likelihood of developing blood cancer, we'll be able to build on what we have so far to make that just feel much more robust and evidence based.  And it feels like at the moment there are many of us struggling to bring together small threads of evidence that have been accrued in the UK but in other centres around the world that are also interested in understanding this inherited blood cancer risk.  In such a way that we can actually give patients and their families more clear information and advice about what that means to them.  And I think that in terms of the diagnosis of blood cancer, I think this is something that Bev alluded to.  If we could better understand who might benefit for example from having regular screening or monitoring blood tests performed to see whether we can detect an emerging blood cancer.  Versus identifying those people who actually, the chances of them developing a blood cancer are so small that doing those tests is likely to do them more harm than good.  Perhaps by just causing them to be anxious or have other sort of unintended consequences of that kind of testing.  So understanding something more about that natural history, as we've already alluded to, will hopefully improve our ability to go from the diagnosis of the predisposition condition to working out how to then diagnose the blood cancer on the back of that.  And with time, I think as Katie has alluded to, thinking about more specific treatments and more tailored treatments to the individual predisposition condition and the blood cancer.  So whether it's that you're intervening before the blood cancer has developed to try and reduce that happening, or whether it's that you're then treating the blood cancer after it's developed.  Understanding the genetic basis and what it is that causes that transition would be really helpful and I think that is something that will come but will take time.  And I think on a sort of national level what I would really hope to see over time is that we're able to use that improvement in evidence base to then be able to bring together perhaps more defined patient pathways.  So that if you're diagnosed with a particular condition, one of these leukaemia predisposition syndromes or another form of blood cancer predisposition, there's a recognised strategy and set of steps that should be taken for all of those patients.  To make sure that they're getting equity of care and make sure that everything is being done in a way that feels safe, sensible and appropriate across the country.  While still then enabling us to give really personalised treatment to that individual person and what that diagnosis means for them.  But I think until we've gathered more information and more evidence we are just in the process of trying to do that to then bring about those changes.   Amanda: If you enjoyed today's episode, we'd love your support.  So please subscribe, share and rate us on wherever you listen to your podcasts.  I've been your host, Amanda Pichini.  This podcast was produced by Deanna Barac and edited by Bill Griffin at Ventoux Digital.  Thank you for listening. 

In this episode, Alicia discusses her work with Dialectical Behavior Therapy and Radically Open DBT. She explains that she was first exposed to DBT in her predoctoral internship at Marin General Hospital, where part of the rotation was to run a DBT group and fell in love with its practicality and giving people real tools they could take away. She explained that it was great to see clients using the tools and finding success, so she got went and got trained with Marsha Linehan, Ph.D. and Behavioral Tech and made DBT her focus. She explained that DBT is especially helpful for clients who describe themselves as emotionally sensitive or struggle to “ride the wave” of emotions that feel overwhelming. Alicia discusses the five modules of DBT that she works from, including mindfulness, distress tolerance, affect regulation, interpersonal skills, and “walking the middle path,” (which is related to validation and reinforcement in family emotional dynamics). Alicia goes on to explain the use of the modules in working towards emotional awareness, getting through emotional crises, and radical acceptance of emotions. We also discuss coping skills and exposure therapy and how there are tools to expand one's window of tolerance as well as self-soothing skills utilized to sit with one's emotions. We speak on what dialectics in DBT refer to: holding two truths at a time, as opposed to relying on rigid, black-and-white thinking, which can exacerbate feelings of distress and overwhelm. Alicia discusses Radical DBT, or Radically Open DBT, and how it is different from regular DBT as it expands radical openness, self-inquiry, and accepting imperfection in oneself in treating emotional OC (overcontrol) disorders such as Anorexia Nervosa, OCPD, and chronic depression. We discuss how RO DBT benefits clients who experience rigidity in their overcontrol as well as shame, anxiety, and hypervigilance in their daily life. Alicia discusses her website, Therahive, which provides DBT skills online for clients as well as training for therapists to make DBT accessible throughout the world. We discuss how important having a supportive community is for clinicians who are providing DBT and how DBT's model includes a therapist consultation group. Lastly, we discuss phone coaching with clients and how it is utilized with clients who are struggling with self-harm and other behaviors and how therapists navigate personal boundaries around time with family and time off, while also being available for clients in need. Alicia Smart, PsyD is a licensed clinical psychologist in California with over 20 years of clinical experience providing evidence-based mental health care to children, adolescents, adults, and families. She began seeing clients during graduate training and has worked across community mental health, medical, and private practice settings throughout her career. Alicia earned her B.A. in Psychology and Chemistry from New York University and her Doctorate in Clinical Psychology (PsyD) from the California Institute of Integral Studies. She is a DBT-Linehan Certified Clinician and has extensive experience treating mood and personality disorders, trauma, anxiety, grief, ADHD, autism-spectrum presentations, and chronic emotion dysregulation. Her work frequently integrates DBT into suicide risk management, neurodivergent-affirming care, and complex relational systems. She is the Founder and Clinical Director of Guidepost DBT in Corte Madera, California, where she oversees a team of therapists providing comprehensive Dialectical Behavior Therapy (DBT) and evidence-based care. In addition to clinical leadership, Alicia provides training, supervision, and consultation to clinicians seeking advanced education in DBT and related approaches. Alicia is also a co-founder of TheraHive, an innovative online DBT skills and learning platform designed to make high-quality DBT education more accessible to individuals and clinicians worldwide.

What happens when you turn the microphone on the man who's spent years behind it? In this episode of the NAIL-IT podcast, Rana and Bav get Payman Langroudi — host of Dental Leaders and Clinical Director at Enlighten — firmly in the hot seat. It's a wide-ranging, refreshingly candid conversation that moves from the origins of Enlighten and the relentless pursuit of world-class quality to the very real mental health pressures that underpin life in dentistry. Payman reflects on leaning into his strengths, trusting his instincts, and why, after 320 episodes, the Dental Leaders podcast has become the thing he's most proud of. Find Rana on Instagram at @drranaalfalaki, and on Facebook and LinkedIn as Dr Rana Al-Falaki. Follow Bav on Instagram at @drbav83. You can also follow the NAIL-IT podcast at @nailit_podcast.In This Episode00:01:05 — Introductions and the Dental Leaders origin story00:02:10 — Why Payman started a podcast — and what it's become00:05:20 — Leaning into strengths, owning your quirks00:07:00 — Starting Enlighten at 28 and the philosophy of doing one thing brilliantly00:10:25 — The sacrifices behind world-class quality00:14:10 — Being number two — and the decision to become the best00:16:15 — Favourite quote: Oscar Wilde and the art of being yourself00:20:25 — Identity, self-awareness and shedding the layers00:21:50 — Dentistry as a kingdom — and why practices are anything but the same00:23:10 — Mental health in dentistry: burnout, suicide and the stress bucket00:27:40 — The emotional drain of being "on show" all day00:30:20 — Kids, careers and the realities of dentistry as a profession00:35:40 — Knowing yourself before you can lead others00:36:10 — Intuition as a leadership skill — and how to train itAbout Dr Rana Al-Falaki and Dr Bhavin PatelDr Rana Al-Falaki is a periodontist and internationally recognised pioneer in the use of lasers in periodontal treatment, having presented her research to audiences from the British Society of Periodontology to the American Academy and European Federation. After pushing herself to the point of chronic illness in pursuit of excellence, she channelled that experience into developing the NAIL-IT programme — a performance and leadership system built around optimising energy and helping dental professionals truly thrive. Dr Bhavin Patel is a dentist and educator who ran a practice on Wimpole Street for nearly eight years before stepping back to prioritise family life. Together, they host the NAIL-IT podcast — a show dedicated to helping dental professionals live fully, lead better, and laugh more.

This week on the Chamber Podcast, Rob sits down with Jessica Pomerville, speech-language pathologist and Clinical Director of the new Brighton location of Thrive Therapy Center. Jessica shares Thrive's mission of supporting families and helping children build communication skills and daily living independence through evidence-based speech and occupational therapy. The conversation highlights Thrive's family-owned roots, their whole-person approach, and the importance of creating a safe, supportive space for both children and parents. Jessica reflects on the deep bonds formed with families, the emotional impact of the work, and what it means to bring Thrive's 40-year legacy into her hometown of Brighton. With locations in Davison, Clarkston, and now Brighton, Thrive is focused on growth, connection, and helping more families truly thrive.  Timestamps 00:00 Welcome Jessica Pomerville 01:10 Journey to Speech Pathology 03:38 Thrive's Diverse Client Base 04:45 Brighton Expansion and New Role 06:33 Impact and Family Bonds 07:59 Future Growth and Outreach   Show Links Learn more about the Brighton Chamber by visiting our website. Website: https://www.brightoncoc.org/  Guest Links Website: https://thrive-therapycenters.com/brighton Phone Number: (810) 206-3801

What if the mood swings, the sleepless nights, the sudden irritation, and the loss of joy aren't signs that something is wrong with you…but signals that your biology is quietly staging a dramatic takeover? Kate Mason sits down with Dr. Joanna Bruce, GP of over 25 years, clinical director of Myma Health, and passionate advocate for women's hormonal wellbeing, to talk openly about perimenopause and menopause. Together they unpack why this decade-long hormonal shift is so often missed, dismissed, or misdiagnosed, and what women (and the people who love them) can actually do about it. From understanding the science of estrogen and progesterone fluctuation to debunking the damaging 2002 WHI study on HRT, this empowering conversation gives parents and partners the insight they need to understand what's really going on… in their bodies, their relationships, and their homes. Listen For2:00 What does the history of menopause research tell us about why women have been so underserved?8:20 How do you distinguish perimenopause symptoms from everyday exhaustion and stress?11:00 What are the early signs of perimenopause that women most commonly overlook?16:55 Is HRT actually safe, and why has the fear around it lasted more than two decades?25:10 What practical steps should women take if they think they are entering perimenopause? Leave a rating/review for this podcastwith one click  Connect with guest: Dr Joanna Bruce, GP & Clinical Director, Myma HealthWebsite | LinkedIn | Instagram Contact Kate:Email | Website | Kate's Book on Amazon | LinkedIn | Facebook | X

Dating apps and websites are booming right now as people look for ways to leverage to find love or even just companionship. Liesel Sharabi of Arizona State University compiled a meta-analysis of a huge number of studies about the connection between online dating and mental health and the results? Kind of bad news. People who use the apps compulsively, swiping all day long, are much more likely to be depressed and anxious. But were they depressed because they used the apps or did the use the apps because they were depressed? We'll get into that, plus the terrifying imminent AI dating revolution.Then we talk to Dr. Sarah Jerstad, the Clinical Director of Psychological Services at Children's Minnesota about what kids are going through amid the ICE presence, what the short and long term effects of this activity have been and will be, and how parents and other adults can best help them.Thank you to all our listeners who support the show as monthly members of Maximum Fun.Check out our I'm Glad You're Here and Depresh Mode merchandise at the brand new merch website MaxFunStore.com!Hey, remember, you're part of Depresh Mode and we want to hear what you want to hear about. What guests and issues would you like to have covered in a future episode? Write us at depreshmode@maximumfun.org.Depresh Mode is on BlueSky, Instagram, Substack, and you can join our Preshies Facebook group. Help is available right away.The National Suicide Prevention Lifeline: 988 or 1-800-273-8255, 1-800-273-TALKCrisis Text Line: Text HOME to 741741.International suicide hotline numbers available here: https://www.opencounseling.com/suicide-hotlines

Today I'm joined by Dr Courtney Raspin, a Chartered Counselling Psychologist and Clinical Director of Altum Health, a specialist eating disorders and mental health clinic in London. Courtney has over 25 years of clinical experience, including a decade in one of the NHS's largest eating disorder services.She's just co-authored a book called The Weight Loss Prescription with psychiatrist Dr Max Pemberton (available 26th Feb!) - a book about the psychology of GLP-1 weight loss medications like Wegovy and Mounjaro. Given her background in eating disorders, Courtney has a nuanced perspective on weight loss medications, which I think is really important to hear.If you're in eating disorder recovery and feeling unsettled by the rise of GLP-1 medications… if you've noticed feelings of jealousy, confusion or fear around them… or if you're trying to understand where health support ends and diet culture begins, this conversation is for you.Key Takeaways:How Courtney's work in eating disorders shaped her approach to weight managementThe warning signs of high drive for thinnessWhy weight loss doesn't automatically improve body imageThe difference between body neutrality and body positivityWhy GLP-1 medications aren't inherently harmfulThe risks of unregulated access, online prescribing, and counterfeit medicationThe various causes of “food noise” and why GLP-1 medications may helpWhat psychological support in weight management actually involvesCourtney's guidance on GLP-1s and eating disorder recoveryTimestamps:00:00 Courtney's journey into weight management05:00 Body neutrality and realistic body image work08:30 Understanding GLP-1s: benefits, risks and misconceptions12:00 Food noise and why context matters16:00 The psychological work behind lasting change21:00 Health vs the thin ideal27:00 Tensions within the ED field and professional responses31:30 What to consider before starting GLP-1s34:30 Courtney's book and final adviceResources & LinksFollow @drcourtneyraspin on InstagramConnect with Us:Subscribe to the Full of Beans PodcastFollow Full of Beans on InstagramCheck out our websiteListen on YouTube⚠️ Trigger Warning: Mentions of eating disorders (anorexia, bulimia, binge eating), restriction, weight loss, GLP-1 medications, and body image. Please take care when listening.If you enjoyed this episode, don't forget to subscribe, rate, and share the podcast to help us spread awareness.Sending positive beans your way, Han

There's growing calls to find pathways to bring CAR-T cell therapy to New Zealand. The current trial of the life changing cancer treatment is set to end at later this year, but there's no clear path to making it available through the public health system. Malaghan Institute Clinical Director Rob Weinkove says this treatment will improve many people's outcomes. "Much of the infrastructure is there and I think one of the main motivations of setting up this trial here is just to skill up, because it's clear the big international pharmacies weren't going to come to New Zealand, we're a small market." LISTEN ABOVESee omnystudio.com/listener for privacy information.

GLP-1s like Ozempic and Wegovy are dominating the conversation around weight loss — but what happens when the prescription ends? In this episode, Shana sits down with Lindsay Venn, PA-C, RD, and Clinical Director of Insulin IQ, to unpack how to reverse metabolic dysfunction without relying on lifelong medication. They explore why insulin resistance is the real root issue, how to safely taper off GLP-1s without losing your progress, what labs can reveal your true healing status, and why many chronic diseases — including cancer — are deeply tied to your metabolism. This episode is a must-listen if you're struggling with fatigue, weight, hormonal chaos, or feeling like your body just isn't responding anymore. What We Covered: Why GLP-1s may help but not heal your metabolism The most important labs to run before tapering off Common mistakes when weaning off Ozempic & Wegovy How insulin, mitochondria, and inflammation connect to cancer The role of fasting insulin, meal timing, and light in true healing The #1 lifestyle shift to calm your hormones and burn fat naturally Links & Resources: Learn more about Lindsay: vennintegrativemedicine.com Reverse insulin resistance, fatty liver, and cholesterol issues: https://shanahussinwellness.com/fattyliverguide/ Join my 90-Day Insulin Reset: https://shanahussinwellness.com/programs-courses/reset/ Connect with Shana: Instagram: @shana.hussin.rdn Facebook: Shana Hussin Wellness

Are you ready for a real behind-the-scenes look at what it takes to build, lead, and grow a thriving multi-location brick-and-mortar private practice? I'm thrilled to introduce you to Carla Willock, founder and Clinical Director of Victoria's Speech and Language Centre in Victoria, British Columbia. Here's what makes this episode a must-listen: Carla pulls back the curtain on hard leadership decisions, scaling from solo-practice to a powerhouse team, and what it means to create real impact in her local community (including reaching underserved First Nations kids and managing government-funded autism care). She also shares bravely about growing pains including contract breaches, international hiring challenges, and the personal growth required to step fully into the CEO role. Connect with Carla Willock Facebook Instagram Private Practice Website Responsive Feeding Website Connect with Jessie Ginsburg on Instagram Work with Shelli Warren: Book a call with Shelli to talk about how coaching can help you elevate your leadership capability. Apply to join the Leadership Lab. Free Resources: Click here to grab our NEWEST resource that guides you through a firing framework that protects your culture and your credibility. Download the companion workbook for our 7 most-popular podcast epiosdes. Check out more free resources here. Shop: Grab your Leadership Brief Tear Sheets. Connect with Shelli Warren: Email: leader@stackingyourteam.com Instagram LinkedIn Subscribe to the Stacking Your Team Newsletter    

In this episode of Practical for Your Practice, hosts Jenna Ermold and Carin Lefkowitz sit down with Dr. Randy Martin, Clinical Director of the Employee Assistance Program (EAP) for the New York Presbyterian Hospital System. Despite being a fixture in most large organizations, EAPs often remain "under the radar" for many behavioral health providers. Dr. Martin demystifies the "ABC of EAPs," explaining how these programs serve as the "mental health equivalent of a primary care physician" by providing short-term counseling, assessment, and organizational support.The conversation explores the parallels between EAP work and military mental health, the importance of proactive outreach during life transitions, and how providers can partner with EAPs to expand their own practices.Dr. Randy Martin is a highly accomplished licensed psychologist and Clinical Director of the New York Presbyterian Hospital System's Employee Assistance Program. As a dynamic thought leader, executive, and training specialist, he has impacted the productivity and profitability of Fortune 1000 companies, educational institutions, and healthcare systems through psychoeducational webinars, seminars, and on-site crisis management interventions. A frequent media contributor seen on CNN Radio and in the Wall Street Journal, Randy is a recognized expert in short-term counseling, assessment, and organizational wellness. His career is defined by a passion for mentoring professionals and improving client well-being, earning him the Caron Foundation's EAP Award. Resources mentioned in this episode: Employee Assistance Professionals Association (EAPA): Link to EAPA Website Calls-to-action: Subscribe to the Practical for Your Practice PodcastSubmit your comments or questions on our social media pages or via https://www.speakpipe.com/cdpp4pSubscribe to The Center for Deployment Psychology Monthly Email

This episode is lovingly dedicated to the memory of Chaplain Ilisia Kissner, BCC (1953- 2026)Chaplain Ilisia Kissner, of blessed memory, served the Jewish community as an educator for over 25 years, both as a teacher and principal in synagogue schools. Her B.A. is from Queens College in New York, M.A. from New York University and Principal's Certification from the Jewish Theological Seminary of America.After completing four units of Clinical Pastoral Education at Overlook Hospital in 2011, Chaplain Kissner worked as a hospice chaplain and as a group home chaplain for Jewish Services for the Developmentally Disabled. In 2013 she became the Jewish Chaplain at Greystone Park Psychiatric Hospital in Morris Plains, New Jersey, where she served until her death on February 6, 2026. She became a Board Certified Chaplain with NAJC in 2016. Chaplain Kissner also provided religious services and pastoral care at Village Apartments in South Orange, one of the facilities of the Jewish Community Housing Corporation of the Federation of Greater Metrowest New Jersey.Chaplain Kissner, z"l, approached Rabbi Ed Bernstein, NeshamaCast producer and host, in May 2025, and proposed an episode on mental health. She then became an active member of the NAJC Social Media Committee and was intimately involved in the planning of this episode. This episode was in the final stages of production at the time of Chaplain Kissner's death on February 6, 2026. May the memory of Chaplain Ilisia Kissner be for a blessing.  Cantor Rabbi Rob Jury, PhD, BCC, CRADC, LCPC, NCC, is the Founder and Clinical Director of the Tikvah Center for Jewish Recovery & Healing, a state licensed and JCAHO accredited, Jewish addiction treatment program in Northbrook, Illinois. His Rabbinic ordination is from the Hebrew Seminary for the Deaf in Skokie, IL. Rob is also the senior rabbi at Congregation Anshe Tikvah. Rob serves on the faculty of The Family Institute of Northwestern University where he is the course lead for Research Methods in Counseling, in addition to teaching Assessment in Counseling, and Addiction Counseling. His article on Jewish metaphors in narrative practice with people resisting addiction can be found in the International Journal of Narrative Therapy & Community Work. He has a PhD in Counselor Education & Supervision, a Masters in Narrative Therapy and Community Work from the University of Melbourne, and an MA in Counseling from Northwestern University. Rob is a board certified chaplain with NAJC, and in 2026 was installed as President-Elect, with expected election as President scheduled for 2028.. Rob is also a BCC member of the Association of Professional Chaplains. Rob is a member of the Chicago Board of Rabbis and the Cantors Assembly. Rob is a Licensed Clinical Professional Counselor in Illinois and a Certified Reciprocal Alcohol and Drug Counselor.  Rabbi Benjamin Perlstein, BCC (NAJC), is a staff chaplain at NewYork-Presbyterian Hospital, serving primarily in psychiatric andacute care settings on the Weill Cornell Medical Center campus and as site leader for spiritual care and chaplaincy at Gracie SquareHospital. Ben received rabbinical ordination from the Jewish Theological Seminary, where he also completed an M.A. in JewishThought, focused on mysticism and ethics. He graduated summa cum laude from Tufts University with a B.A. in Political Philosophy and has worked in a range of international contexts, especially involving Jewish history and the Holocaust. He is passionate about creative,multidisciplinary and multifaith applications of spiritual wisdom and practice to issues of public concern and pastoral need.  About our host:Rabbi Edward Bernstein, BCC, is the executive producer and host of NeshamaCast. He serves as Chaplain at Boca Raton Regional Hospital of Baptist Health South Florida. He is a member of the Board of Neshama: Association of Jewish Chaplains. Prior to his chaplain career, he served as a pulpit rabbi in congregations in New Rochelle, NY; Beachwood, OH; and Boynton Beach, FL. He is also the host and producer of My Teacher Podcast: A Celebration of the People Who Shape Our Lives. NeshamaCast contributor Chaplain David Balto is a volunteer chaplain at Washington Hospital Center in Washington, D.C. and Western Correctional Insitution, Maryland's maximum security prison. He coordinated the annual National Jewish Healing Conference. Support NeshamaCast and NAJC with a tax deductible donation to NAJC. For sponsorship opportunities as either an individual or institution, please write to Rabbi Ed Bernstein at NeshamaCast@gmail.com Thank you to Steve Lubetkin and Lubetkin Media Companies for producing this episode. Transcripts for this episode and other episodes of NeshamaCast are available at NeshamaCast.simplecast.com and are typically posted one week after an episode first airs. Theme Music is “A Niggun For Ki Anu Amecha,” written and performed by Reb-Cantor Lisa Levine. Please help others find the show by rating and reviewing the show on Apple Podcasts or other podcast providers. We welcome comments and suggestions for future programming at NeshamaCast@gmail.com. And be sure to follow NAJC on Facebook to learn more about Jewish spiritual care happening in our communities.

In this episode we speak to the 2024 winners of the IASLT Postgraduate Research Award for submissions to the IASLT journal Advances in Communication and Swallowing. David O'Shea and Dr Dominika Lisiecka worked on this paper called: Speech and language therapy services for autistic children in Munster: An interpretative phenomenological analysis of parental experiences and expectations” . This work was based on David's MSc that was supervised by Dominika and Dr Patrick McGarty at Munster Technological University, Kerry Campus.David is the Practice Manager Kerry Speech and Language Therapy Clinic in Tralee, Co. Kerry. and Dominika is the Clinical Director at the clinic where they both work as Senior SLTS, with a mixed caseload of children and adults.

Today, I am thrilled to connect with nurse practitioner, Dr. Lisa Chism. Lisa is the Clinical Director of the Oakland Macomb Center for Breast Health in Michigan. She has over 25 years of experience, specializing in breast health, menopause, sexual health, and breast cancer survivorship. She is also an author and a faculty member at a local university. In our conversation, we discuss the breast cancer risk for women with dense breasts, family history, or prior biopsy, diving into supplemental imaging, lifestyle modifications, HRT, and breast risk, and the changes that occur after a breast cancer diagnosis. We also explore the genitourinary syndrome of menopause and screening, permanent versus non-permanent changes occurring in the genital urinary area, and anticipatory informed care guidance for patients with a history of trauma. This is one of those conversations you will definitely want to revisit. With Lisa's thoughtful advocacy, deep commitment to patient care, and powerful insights, it is clear why sharing her message is so critically important. IN THIS EPISODE, YOU WILL LEARN: The different levels of breast density and their implications for cancer detection Various risk assessment tools used to determine breast cancer risk  How alcohol impacts the risk of breast cancer  Why weight management essential for post-menopausal women The importance of having detailed conversations with providers about menopause symptoms and the available treatment options Lisa shares her approach to evaluating and educating patients  How trauma impacts women's sexual health Permanent and non-permanent changes that occur in the vaginal area during menopause Can older women still do HRT? A simple breast-examination habit for all women Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia's Menopause Gut Book is on presale now! Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Lisa Chism Instagram (@DrMommyPoppins) Instagram (@TheAdoptedNurse)  Oakland Macomb OBGYN Center for Breast Health-Rochester Hills

Host: Jennifer Caudle, DO, FACOFP Guest: Mansi R. Shah, MD The latest International Myeloma Working Group (IMWG) guidelines emphasize immune function, relapse timing, and therapeutic intent to guide the sequencing of T-cell-redirecting therapies in relapsed/refractory (R/R) multiple myeloma. Hear key updates as Dr. Jennifer Caudle and Dr. Mansi Shah discuss how we can integrate T-cell redirecting therapies into patient care more intentionally. Dr. Shah is an Associate Professor and the Clinical Director of Multiple Myeloma at the Rutgers Cancer Institute.

Today's episode is a special one.I'm joined by longtime client Jessica Ponn, LCSW, who helps parents support their adult children through addiction recovery with strategy, clarity, and confidence — not panic. Her work fills a critical gap for families navigating one of the most emotionally charged and high-stakes situations imaginable.Jessica shares her honest journey from therapist to coach — including the fear, hesitation, mindset shifts, and breakthroughs that came with betting on herself. We talk about trusting the process, building a meaningful niche, navigating business dips, and what actually creates momentum when things feel stuck.If you've ever wondered whether pivoting is worth it, felt scared to invest in yourself, or questioned whether you're really cut out for the next level — this episode will meet you exactly where you are.In this episode, we cover:What it really feels like to transition from therapist to coachThe fear of success vs. the fear of failureHow Jessica found a powerful, underserved nicheWhy parents play a critical role in long-term recovery outcomesWhat causes inevitable dips in business — and how to reboundHow one coaching session led to a $12,000 weekThe 80/20 rule and letting go of perfectionismWhy strategy and mindset must work togetherWhat Jessica wishes she'd known when she startedAbout Jessica Ponn, LCSWJessica Ponn, LCSW, specializes in guiding parents to effectively help their adult children get and stay sober. She has over 15 years of experience in the addiction field, having worked as a therapist and Clinical Director at a premier South Florida dual-diagnosis treatment center while also running a successful private practice.Jessica is deeply passionate about supporting parents who often underestimate the powerful influence they have on their child's recovery — and who are too often left without clear guidance when making critical parenting decisions. She has empowered hundreds of parents to make strategic changes that promote sustained recovery and deter relapse. Jessica now offers her support nationwide through her one-of-a-kind virtual coaching program.Resources & LinksConnect with Jessica Ponn on InstagramJoin her Facebook group: Parenting That Promotes RecoveryClick here to explore different options to work with CarlyQuote from this episode: “It works if you work it — but you don't have to do it alone.”

After a white supremecist killed his father at a Sikh temple outside of Milwaukee, Pardeep Singh Kaleka pairs up with a former neo-Nazi to teach students about overcoming hate and finding forgiveness. Today's episode was produced in collaboration with Pauline Bartolone, and was funded in part by UC Berkeley's Greater Good Science Center, as part of its "Spreading Love Through the Media" initiative, supported by the John Templeton Foundation. Pauline can be reached at paulinebartolone.org and on Instagram @pmbartolone Today's episode featured Pardeep Singh Kaleka. If you'd like to reach out to Pardeep, you can email him at Pardeep.S.Kaleka@gmail.com. Pardeep is on Instagram, Facebook and LinkedIn @pardeepsinghkalekaPardeep is the Clinical Director at Mental Health America–Wisconsin, a senior anti-hate advocate, and co-author of The Gift of Our Wounds. After losing his father in the 2012 Oak Creek Sikh Temple attack, he became a leading voice for community healing, resilience, and faith. With over 25 years of experience in law enforcement, education, mental health, and supporting hate-crime survivors, Pardeep has served with the U.S. Department of Justice–CRS and led the Interfaith Conference. He specializes in communal trauma and helps public health professionals, educators, and law enforcement develop community-oriented strategies to address conflict, hate, and rising targeted violence.Producers: Whit Missildine, Andrew Waits, Pauline Bartolone Content/Trigger Warnings: Mass shooting / gun violence, Murder / death, Hate crime / domestic terrorism, White supremacy / neo-Nazi ideology, Racism / religious persecution (anti-Sikh bias; Islamophobia mentioned), PTSD / trauma responses, Suicidal ideation (students mention feeling suicidal), Bullying, Addiction / substance abuse, Graphic violence / execution-style killing details. Police shooting / officer shot, explicit language Social Media:Instagram: @actuallyhappeningTwitter: @TIAHPodcast Website: thisisactuallyhappening.com Website for Andrew Waits: andrdewwaits.comWebsite for Pauline Bartolone: pmbartolone.org Support the Show: Support The Show on Patreon: patreon.com/happening Wondery Plus: All episodes of the show prior to episode #130 are now part of the Wondery Plus premium service. To access the full catalog of episodes, and get all episodes ad free, sign up for Wondery Plus at wondery.com/plus Shop at the Store: The This Is Actually Happening online store is now officially open. Follow this link: thisisactuallyhappening.com/shop to access branded t-shirts, posters, stickers and more from the shop. Transcripts: Full transcripts of each episode are now available on the website, thisisactuallyhappening.com Intro Music: “Sleep Paralysis” - Scott VelasquezMusic Bed: KPM Main Series (KPM) - Barely There ServicesIf you or someone you know is struggling with the effects of trauma or mental illness, please refer to the following resources: National Suicide and Crisis Lifeline: Text or Call 988 National Alliance on Mental Illness: 1-800-950-6264National Sexual Assault Hotline (RAINN): 1-800-656-HOPE (4673)See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Roy Barsness is the author of the text, Core Competencies in Relational Psychoanalysis: A Guide to Practice, Study and Research (Routledge, 2018) and author of the text: Psychodynamic Supervision: In a New Key (Routledge, 2025). He has published several professional articles, presents frequently at professional conferences and teaches nationally and internationally on relational psychoanalysis. He is the Founder and Executive Director of the Contemporary Psychodynamic Institute, former Professor of Psychology and Academic Dean at The Seattle School of Theology and Psychology and served as the Clinical Director of the Clinical Psychology Program at Seattle Pacific University and Clinical Associate Professor at the University of Washington-School of Medicine. You can find out more by visiting his lecture series at the Contemporary Psychodynamic Institute:    / @contemporarypsycho   or by visiting his website: https://roybarsness.com/ ***The Mind Mate Podcast explores the human condition at the intersection of philosophy and psychotherapy. Hosted by counsellor and psychotherapist Tom Ahern, the podcast engages deeply with questions of meaning, anxiety, freedom, identity, death, love, and what it means to live authentically in the modern world. Find out more here: https://ahern.blog/

In this episode of the ABA Business Leaders Podcast, April Smith, co-founder of 3 Pie Squared, hosts an expert panel discussion featuring: Alecia Barrett BCBA, COBA, LSW and owner of A. Barrett Academy, LLC located in Holland Ohio Brooke Schneider, M.S.Ed., BCBA, LBA is the Founder and Clinical Director of Orange Pediatric Therapy, which she opened in 2015 Mallory Stinger, BCBA, CEU Coordinator, IEP Advocate, Sleep Consultant. Mallory has been in the field since 2010. Jennifer Helten, the CEO and Founder of Unique Pathways LLC. The panel explores the risks of micromanagement, the challenge of delegating before you feel “ready,” and why most owners are never fully prepared for the next level of scale. Plus, each founder answer one of the most pressing questions ABA Business Owners ask: What one move can I make to drive my business forward? Key themes include: Identifying decisions that unlock operational momentum rather than adding complexity Letting go of control without sacrificing quality or outcomes Choosing your “hard” as a business owner and accepting that growth always comes with trade-offs The long-term impact of training, developing, and growing alongside your BCBAs Why background work and infrastructure matter just as much as visible leadershipHave a question for Stephen and April? Call the ABA Business Leaders Hotline: (737) 330-1432 Join our ABA Business Owner Support Group here for Free: Sign up here Resources & Links Business Essentials List https://www.3piesquared.com/blog/the-essential-list-for-a-successful-business_24 Schedule a Consultation with Stephen https://3piesquared.com/stephen-booking-page Free ABA Business Readiness Assessment https://3piesquared.com/aba-business-readiness-assessment ABA Billing Tips Guide https://3piesquared.com/productDetails/ABA_Billing_Tips ABA Business Leaders Podcast CEUs https://3piesquared.com/productDetails/ABA_Business_Leaders_Podcast_CEUs

What is the deadliest item in London’s Vagina Museum? Why are drug addiction rates in Australia spiking by over 30% post-pandemic? And if you’ve already had two surgeries for inherited bunions, is “third time’s a charm" actually possible? What makes a substance addictive, and why is it so hard to just "quit"? In this episode, Claire Murphy and Dr. Mariam dive into the complexities of drug addiction in Australia, from the alarming rise of vaping among teens, to the shifting chemistry of the brain. We are joined by Dr. Shalini Arunogiri, an addiction psychiatrist, Associate Professor at Monash University and Clinical Director at Turning Point. She breaks down the "reward" chemicals like dopamine and serotonin that hook us, the reality of relapse, and why alcohol remains the most harmful drug from a population health perspective. Dr. Shalini also addresses the cannabis debate - exploring the link between high-potency use and psychosis - and why the term "addict" is being replaced by more empathetic, health-centered language. But first, we take a field trip to London’s Vagina Museum to look at its deadliest item…We discuss the history of Toxic Shock Syndrome (TSS), the biology of the vaginal wall and why "retained tampon smell" is a more common clinic visit than you’d think. And, in our Quick Consult, Dr. Mariam helps listener Simone navigate the tricky world of "inherited bunions". EPISODE RESOURCES: If this episode has raised concerns for you, or if you are considering your own substance use, the following resources are available for confidential support: Counselling Online: The recommended first port of call for those questioning their drug use or looking for help. It features a Self-Assessment Quiz, a national directory and 24/7 access to online chat or telephone-based support. National Alcohol and Other Drug (AOD) Hotline: For free and confidential advice, call 1800 250 015. SMART Recovery Australia: A network of evidence-based support meetings for people seeking recovery. And if this episode triggered anything for you and you need someone to talk to, please call Lifeline on 13 11 14. GET IN TOUCH Sign up to the Well Newsletter to receive your weekly dose of trusted health expertise without the medical jargon. Ask a question of our experts or share your story, feedback, or dilemma - you can send it anonymously here, email here or leave us a voice note here. Ask The Doc: Ask us a question in The Waiting Room. Follow us on Instagram and Tiktok. Support independent women’s media by becoming a Mamamia subscriber CREDITS Hosts: Claire Murphy and Dr Mariam Guest: Senior Producers: Claire Murphy and Sally Best Audio Producer: Scott Stronach Video Producer: Julian Rosario Social Producer: Elly Moore Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.Information discussed in Well. is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++Support the show: https://www.mamamia.com.au/mplus/See omnystudio.com/listener for privacy information.

This week is Cervical Cancer Prevention Week, a national and international campaign highlighting how cervical cancer can be prevented through HPV vaccination, regular screening and early awareness of symptoms. In Ireland, around 250 women are diagnosed with cervical cancer each year, despite the fact that most cases are linked to HPV and are largely preventable. To discuss this further, Alan Morrissey was joined by the Clinical Director of CervicalCheck, Dr Nóirín Russell. Photo (c) Pixelshot via Canva

Can Therapists Start a Union? The Antitrust Trap, the Shadow Committee, and the Economic Strangulation of American Psychotherapy Analyzing America's Healthcare Regulations and Their Effect on Us: Why the Law Prevents Therapists from Organizing While Allowing a Private Committee to Fix Prices for the Entire Medical System https://gettherapybirmingham.com/can-therapists-start-a-union-spoiler-alert-they-cant/ The Monthly Rage Thread If you hang around therapist forums long enough, you will see it happen. It operates with the regularity of the tides. Someone posts a thread, usually after receiving a contract from an insurance company offering 1998 rates for 2025 work, and asks the obvious question: “We are the ones providing the care. The system collapses without us. Why don't we just all go on strike? Why don't we form a union and demand fair pay?” It is a logical question. In almost every other sector of the economy, workers who feel exploited band together to negotiate better terms. Screenwriters shut down Hollywood to get paid for streaming residuals. Auto workers walk off the line. Teachers fill the state capitol. Nurses at major hospital systems have successfully unionized and won significant concessions. So why, in the midst of a national mental health crisis, does the mental health workforce remain so politically impotent? The answer is not that we lack will. It is not that we lack organization. The answer is that for private practice therapists, forming a union is a federal crime. This is not a political manifesto. It is an analysis of the bizarre regulatory environment that governs American healthcare, a system of antitrust laws, shadow committees, and bureaucratic classifications that effectively strips clinicians of their bargaining power while empowering the corporations that pay them. If you want to understand why corporate tech monopolies are ruining therapy, or why the corporatization of healthcare feels so suffocating, you have to understand the legal straitjacket we are all wearing. And you have to understand the one group that is allowed to set prices, the one group exempt from the rules that bind the rest of us. Part I: You Are Not a Worker, You Are a Standard Oil Tycoon The primary reason therapists cannot unionize dates back to the era of oil barons and railroad tycoons. The Sherman Antitrust Act of 1890 was designed to prevent massive corporations like Standard Oil from colluding to fix prices and destroy the free market. It prohibits “every contract, combination… or conspiracy, in restraint of trade.” The law was a response to genuine abuses: companies buying up competitors, dividing territories, and coordinating prices to gouge consumers who had no alternatives. Here is the catch: In the eyes of the federal government, a private practice therapist is not a “worker.” You are a business entity. Even if you are a solo practitioner struggling to pay rent in a subleased office, seeing clients between crying in your car and eating lunch at your desk, the law views you as the CEO of a micro-corporation. You are classified as a 1099 independent contractor, not a W-2 employee, and that distinction makes all the difference in the world. If two workers at Starbucks talk about their wages and agree to ask for a raise, that is “collective bargaining,” which is protected by the National Labor Relations Act. But if two private practice therapists talk about their reimbursement rates and agree to ask Blue Cross for a raise, that is “price-fixing.” It is legally indistinguishable, in the eyes of the Federal Trade Commission, from gas stations conspiring to raise the price of unleaded. It sounds absurd, but the FTC takes it deadly seriously. When independent contractors organize to demand higher rates, when they share information about what they are being paid and coordinate their responses, they are engaging in horizontal price-fixing, one of the most serious violations of antitrust law. The Sherman Act provides for criminal penalties, including fines and imprisonment. The law that was meant to break up monopolies is now used to prevent social workers from asking for a cost-of-living adjustment. The irony is crushing. The same regulatory framework that prevents two therapists from discussing their rates allows massive insurance conglomerates to merge repeatedly, concentrating buyer power in fewer and fewer hands. UnitedHealth Group, for example, has acquired dozens of companies over the past two decades, becoming the largest healthcare company in the United States. When they offer a “take it or leave it” contract to providers, they do so with the full knowledge that fragmented, legally prohibited from organizing therapists have no counter-leverage. The antitrust laws, designed to prevent monopoly power, have created a system where sellers are atomized and buyers are consolidated. Economists call this “monopsony,” and it is precisely the market distortion the Sherman Act was supposed to prevent. Part II: The Day the “Learned Profession” Died For a long time, doctors and lawyers thought they were exempt from these laws. They argued that they were “learned professions,” not mere tradespeople, and therefore above the grubby laws of commerce. They believed that their ethical obligations to patients and clients set them apart from the rules that governed steel mills and meatpacking plants. Medicine was a calling, not a business, and surely the government would not regulate the sacred doctor-patient relationship as if it were a commercial transaction. That illusion was shattered in 1975 by the Supreme Court case Goldfarb v. Virginia State Bar. The case involved lawyers, not doctors, but its implications cascaded through every licensed profession in America. The Goldfarbs were purchasing a home and needed a title examination. The Virginia State Bar had established a minimum fee schedule for such services, and every lawyer they contacted quoted the exact same price. They sued, arguing that this fee schedule was illegal price-fixing. The Supreme Court agreed. In a unanimous decision, the Court ruled that professional services, including legal and medical advice, are “trade or commerce” subject to antitrust laws. The “learned profession” exemption, which had been assumed but never explicitly established in law, was declared a myth. “The nature of an occupation, standing alone,” the Court wrote, “does not provide sanctuary from the Sherman Act.” This ruling was intended to lower prices for consumers by preventing lawyers from setting minimum fees, and in that narrow sense it was a good thing. But in healthcare, it had a catastrophic side effect: it made it illegal for doctors and therapists to band together to resist the pricing power of insurance companies. The “learned profession” exemption is dead. We are now just businesses, and businesses are not allowed to hold hands. This creates the illusion of progress: we have “free market” competition among providers, but monopsony power among payers. It is a market where the sellers are forbidden from organizing, but the buyers are allowed to merge until they are too big to fail. The result is not a free market at all. It is a market designed to transfer wealth from one class (providers) to another (insurers and administrators), with the law itself serving as the enforcement mechanism. Part III: The Cartel in the Basement If therapists cannot collude to set prices, surely nobody else can, right? Wrong. There is one group in American healthcare that is allowed to meet in a room, decide what every doctor's time is worth, and set prices for the entire industry. It is called the RUC, the AMA/Specialty Society Relative Value Scale Update Committee. And understanding the RUC is the key to understanding why talk therapy is dying in the medical model, why psychiatrists abandoned the couch for the prescription pad, and why your insurance company offers you a ghost network of providers who never answer the phone. The Birth of a Shadow Government To comprehend the current crisis in mental health economics, one must excavate the foundations of the physician payment system. Prior to 1992, Medicare reimbursed physicians based on a system known as “Customary, Prevailing, and Reasonable” charges. Under this system, physicians were paid based on their historical billing charges. It was inherently inflationary; it rewarded those who raised their fees most aggressively and created wide geographic disparities for identical services. In response to spiraling costs, Congress passed the Omnibus Budget Reconciliation Act of 1989, mandating a transition to a fee schedule based on the resources required to provide a service. This birthed the Resource-Based Relative Value Scale. The intellectual architecture for this system was developed by a team of economists at Harvard University, led by William Hsiao. Hsiao's team sought to create a “unified theory” of medical value, attempting to quantify the “work” involved in disparate medical acts, comparing the cognitive intensity of a psychiatric evaluation with the technical skill of a hernia repair. The Harvard study was revolutionary. It promised to level the playing field, suggesting that cognitive services, the thinking and talking that comprises primary care and mental health, were vastly undervalued relative to surgical procedures. Had Hsiao's original recommendations been implemented purely, the income gap between generalists and specialists might have narrowed significantly. But the administrative complexity of assigning values to over 7,000 Current Procedural Terminology codes overwhelmed the Health Care Financing Administration. Into this administrative vacuum stepped the American Medical Association. The AMA, fearing that the government would unilaterally set prices, proposed a “partnership.” They would convene a committee of experts to maintain and update the relative values, providing this labor-intensive service to the government at no cost. The government accepted. Thus, in 1991, the RUC was born, not as a government agency, but as a private advisory body with unparalleled influence over public funds. The Architecture of Control The RUC's claim to legitimacy rests on its status as an “expert panel.” But a structural analysis of its composition reveals a profound bias that mimics the governance of a cartel designed to protect incumbent interests. The committee consists of 32 members, but power is concentrated in the 29 voting seats. Of these, 21 seats are appointed by major national medical specialty societies. The distribution is not proportional to the volume of services provided to Medicare beneficiaries, nor is it proportional to the physician workforce. Instead, it is frozen in a historical moment that favored high-technology specialties. Primary care physicians, who perform roughly 45 to 50 percent of Medicare work, hold approximately 4 to 5 seats, giving them about 17 percent of the vote. Procedural and surgical specialties, including surgery, radiology, and anesthesiology, hold 15 to 18 seats, giving them roughly 60 percent of the vote despite performing only 35 to 40 percent of Medicare work. The American Psychiatric Association holds a single seat. One seat. This lone representative must negotiate with a supermajority of specialists, neurosurgeons, cardiothoracic surgeons, radiologists, and ophthalmologists, whose financial interests are often diametrically opposed to the valuation of cognitive work. The cartel dynamic is enforced by a statutory requirement of budget neutrality. The Medicare Physician Fee Schedule is a zero-sum game. If the total relative value units projected for a given year exceed the budget, a “scaler” is applied to reduce the conversion factor, effectively cutting everyone's pay. Therefore, any proposal to increase the value of psychotherapy, which would increase the total RVU spend, effectively asks every surgeon in the room to take a pay cut to fund the raise for psychiatrists. Given that a two-thirds majority is required to pass a recommendation, the procedural bloc holds absolute veto power over any redistribution of wealth. The Secret Chamber A hallmark of cartel behavior is the restriction of information. For nearly two decades, the RUC operated in near-total secrecy. While recent years have seen minor concessions to transparency, such as the publication of vote totals, the core deliberative process remains opaque. RUC meetings are private. The public, the press, and even non-RUC physicians are largely barred from attending the deliberations where billions of tax dollars are allocated. Participants, including the specialty advisors who present data, must sign strict non-disclosure agreements. These agreements prevent them from discussing the specific tradeoffs, deals, or arguments made within the chamber. A former RUC participant described these agreements as “draconian,” designed to insulate the committee from public accountability. The Government Accountability Office and the Center for American Progress have noted the inherent conflict of interest. The individuals setting the prices are the same individuals who receive the payments. Unlike a regulatory agency, where officials are salaried and divested of industry assets, RUC members are practicing physicians whose personal incomes are directly tied to the decisions they make. This secrecy serves a functional purpose: it allows for “logrolling.” A representative from Orthopedics might support an inflated value for a Cardiology code in exchange for Cardiology's support on a Knee Replacement code. This “I'll scratch your back” dynamic creates an upward pressure on procedural values that excludes those outside the dominant coalition, specifically primary care and mental health. The Antitrust Shield Why has the Department of Justice not broken up this cartel? The legal shield is the Noerr-Pennington Doctrine. This Supreme Court doctrine establishes that private entities are immune from antitrust liability when they are petitioning the government. Because the RUC technically only “recommends” values to CMS (that is petitioning), and CMS “decides” (that is government action), the RUC is protected by the First Amendment right to petition. This legal loophole allows the RUC to operate with monopolistic characteristics without fear of prosecution, provided CMS continues to go through the motions of “reviewing” the recommendations. And CMS accepts those recommendations over 90 percent of the time. Because private insurance companies generally base their rates on Medicare, this private committee effectively sets the price of healthcare for the entire country. If independent therapists did this, if they gathered in a room and agreed on what their services should cost, they would face criminal prosecution. But because the RUC operates under the fiction of “advising” the government, it is protected. The same regulatory framework that criminalizes therapist solidarity provides cover for industry-wide price coordination by the most powerful medical specialties. Part IV: The Mechanics of Suppression To control a market, one must control its currency. In American medicine, that currency is the Relative Value Unit. Every medical service, from a 15-minute therapy session to a heart transplant, is assigned a total RVU value. This value is the sum of three components: the Work RVU, which accounts for physician time, technical skill, mental effort, and judgment; the Practice Expense RVU, which covers overhead costs like rent, staff, and equipment; and the Malpractice RVU, which reflects professional liability insurance costs. The Work RVU, which comprises roughly 50 to 55 percent of the total value, is determined by RUC surveys. When a code is flagged for review, the relevant specialty society distributes a survey to a sample of its members. These respondents are asked to estimate the time and intensity of the service compared to a “reference service.” This methodology violates several principles of statistical validity. The surveys are voluntary and distributed by the specialty societies themselves. The respondents are typically those most active in the society and most invested in maximizing reimbursement, advocates rather than neutral observers. The sample sizes are often shockingly small; RUC surveys frequently rely on fewer than 50 or 70 respondents to set the price for services performed millions of times annually. A sample of 30 orthopedic surgeons might determine the value of a procedure costing Medicare billions. The Time Arbitrage The most critical variable in the RUC equation is time. The Work RVU is conceptually derived from the formula: Work equals Time multiplied by Intensity. Therefore, inflating the time estimate is the most direct route to inflating the price. Independent studies by RAND and the Urban Institute, often using objective data like Operating Room logs, have consistently shown that the RUC overestimates the time required for surgical procedures. A procedure valued by the RUC as taking 60 minutes may, in reality, take 30 minutes. This creates an arbitrage opportunity. If a gastroenterologist can perform a “60-minute” colonoscopy in 20 minutes, they can effectively perform three procedures in the time allotted for one. They bill for three hours of work in one hour of real time. This “efficiency gain” is captured entirely by the physician as profit. Psychotherapy cannot utilize this arbitrage. CPT codes for psychotherapy are explicitly time-based in their definition. Code 90832 requires 16 to 37 minutes. Code 90834 requires 38 to 52 minutes. Code 90837 requires 53 minutes or more. A psychiatrist cannot perform a 60-minute therapy session in 20 minutes; doing so constitutes fraud. Therefore, the revenue of a psychotherapist is capped by the linear passage of time. They can sell, at maximum, roughly 8 to 10 units of labor per day. A proceduralist, aided by RUC-inflated time assumptions, can sell 20 or 30 units of “RUC time” in the same day. This structural discrepancy creates a widening income gap that no amount of “hard work” by the therapist can close. It is not a market failure. It is market design. The “Thinking” Penalty The RUC's bias is not merely structural; it is philosophical. The committee, dominated by surgeons and proceduralists, consistently values “doing things to people,” cutting, scanning, injecting, far more highly than “talking to people,” diagnosing, counseling, managing complex chronic conditions. This creates a regulatory environment that functions as a de facto wealth transfer from cognitive care to procedural care. In 2013, a major revision of psychiatry codes exposed this bias in stark relief. Previously, psychiatrists used codes that bundled the medical evaluation with the psychotherapy. The new system required psychiatrists to bill an E/M code for the medical management plus an “add-on” code for psychotherapy. While intended to improve transparency, this change exposed psychotherapy to the raw mechanics of the RUC's valuation bias. By isolating the “therapy” component, the committee could subject it to rigorous cross-specialty comparison. And the committee, dominated by surgeons, views “talking to a patient” as low-intensity work compared to “operating on a patient.” The economic signal was clear. This created the 15-minute med check culture not because psychiatrists stopped caring, but because the regulatory environment made relational care financial suicide. It effectively “illegalized” the practice of deep, slow psychiatry for anyone who wanted to take insurance. Part V: The “Messenger Model” and Other Legal Fictions When therapists ask about collective bargaining, lawyers will often point them to the only legal loophole available: the “Messenger Model.” In this model, a third party (the messenger) acts as an intermediary between a group of providers and an insurance company. The messenger takes the insurance company's offer and conveys it to each therapist individually. Each therapist must then make a unilateral, independent decision to accept or reject it. The messenger is strictly forbidden from negotiating. They cannot say, “The group rejects this.” They cannot say, “We want 10% more.” They cannot advise the therapists on what to do. They can only carry messages. This is why “Independent Practice Associations” are often toothless. In the 2008 case North Texas Specialty Physicians v. FTC, the Fifth Circuit Court of Appeals made clear that if an IPA actually tries to leverage its numbers to demand better rates, it violates antitrust laws. If it follows the messenger model, it has no leverage. It is a “heads I win, tails you lose” regulatory structure designed to protect payers, not providers. The only exception is “clinical integration,” where providers genuinely merge their practices, share infrastructure, and accept joint financial risk. But this requires substantial capital investment and essentially means ceasing to be an independent practitioner. It is a legal pathway available mainly to large physician groups and hospital systems, not to solo therapists working out of rented offices. Part VI: Market Distortions and the Flight to Cash When a cartel sets a price below the market equilibrium, suppliers exit the formal market. This is precisely what has happened in psychotherapy. Mental health providers generally have lower overhead than surgeons. They do not need MRI machines or sterile surgical suites. And they face high consumer demand; the national mental health crisis ensures a steady stream of people seeking services. This gives them an “exit option” that proceduralists do not have. They can refuse to accept insurance and operate as cash-only businesses. The statistics are stark. Nearly 50 percent of psychiatrists do not accept commercial insurance, compared to less than 10 percent of other specialists. A 2023 survey indicated that 64 percent of private practice therapists planned to increase their cash-pay rates. Research published in Health Affairs Scholar found that patients are 10.6 times more likely to go out-of-network for mental health care than for medical/surgical care. This mass exodus is a rational economic response to RUC-suppressed rates. If the RUC says an hour of therapy is worth $100 via the RVU-to-dollar conversion, but the market demand is willing to pay $250, the provider will leave the RUC-controlled sector. They are not abandoning their profession; they are abandoning a pricing regime that values their work at less than half its market rate. Ghost Networks The RUC's pricing failure creates “Ghost Networks,” directories filled with providers who are ostensibly “in-network” but are functionally inaccessible. They are either full, not accepting new patients, retired, have moved, or simply do not respond to inquiries from insurance-based patients because the administrative burden of prior authorizations and clawbacks outweighs the suppressed fee. This is not a “shortage” of providers in the absolute sense. There is no shortage of therapists in private practice. There is a shortage of therapists willing to work at the RUC-determined price point. The insurance directories are graveyards of phantom availability, creating the illusion of access where none exists. The Cost Paradox The central thesis of the RUC's defenders is that they “control costs.” By strictly managing RVUs, they claim to save taxpayer money. In psychotherapy, this logic backfires catastrophically. By suppressing reimbursement rates to a level that drives providers out of the network, the RUC forces patients into the cash market. The theoretical in-network cost might be a $20 copay with the insurer paying $100. The actual out-of-network cost is $250 cash out-of-pocket, paid in full by the patient. Thus, the “cost of therapy” for the consumer skyrockets. Therapy becomes a luxury good, accessible only to those with disposable income. For the poor and middle class, the “cost” is effectively infinite, because the service becomes inaccessible. The RUC's cost-control measure for the system becomes a cost-multiplier for the patient. It shifts the financial burden from the risk pool, where it belongs, to the individual, where it causes maximum harm. The Signal to Students The RUC sends powerful economic signals to medical students making career decisions. When a student observes that a dermatologist or radiologist can earn $500,000 working regular hours, while a psychiatrist earns $240,000 handling emotional trauma and on-call emergencies, while a primary care doctor earns even less, the choice is clear for those motivated by financial security. The undervaluation of cognitive codes discourages the best and brightest from entering mental health and primary care. The cartel's pricing structure creates a perpetual labor shortage in the fields most needed for public health, while creating a surplus in high-margin procedural specialties. We then wonder why there are not enough psychiatrists, why primary care is in crisis, why mental health access is collapsing. The answer is in the price signal, and the price signal is set by a committee of proceduralists meeting behind closed doors. The Hands Are Tied The question “Why can't therapists start a union?” is not just a labor question. It is a window into the broken soul of American healthcare. We have built a system where a secret committee of proceduralists can legally fix prices to favor surgery over therapy, but a group of social workers cannot band together to ask for a living wage. We have utilized laws meant to break up Standard Oil to break up the solidarity of caregivers. The same regulatory framework that criminalizes therapist coordination provides legal cover for industry-wide price coordination by the most powerful medical specialties. The result is a regulatory environment that drives doctors crazy, burns out therapists, and leaves patients navigating a fragmented, assembly-line system that was never designed to heal them. It was designed to process them. Until we confront the legal architecture of this system, the RUC, the Sherman Act, the 1099 trap, we will remain powerless to change it. And the reality of therapy is that quick fixes, whether in treatment or in policy, usually end up costing us more in the end. Some states are beginning to push back. New York and California have implemented strict network adequacy standards requiring mental health appointments within 10 business days. These regulations force insurers to expand their networks, which means they must attract providers, which means they must raise reimbursement rates above the RUC/Medicare floor. It is effectively a state-level override of the RUC cartel, forcing capital back into the mental health labor market. The Medicare Payment Advisory Commission has long advocated for stripping the RUC of its power, proposing the use of empirical data, tax returns, payroll records, practice invoices, to set values automatically. But these are patchwork solutions to a systemic problem. The fundamental issue remains: we have created a healthcare system that knows the price of everything and the value of nothing. We have engineered a system where the only way to survive is to stop acting like a healer and start acting like a factory. And we have wrapped this system in a legal framework that criminalizes resistance while protecting the status quo. The hands are tied. But at least now we can see the ropes. Bibliography For those interested in the primary sources and legal texts that underpin this analysis, the following external resources provide high-trust verification of the claims made above: Goldfarb v. Virginia State Bar, 421 U.S. 773 (1975): The Supreme Court decision that ended the “learned profession” exemption from antitrust laws. Read the Oyez Summary. The Sherman Antitrust Act (15 U.S.C. §§ 1–7): The foundational text of US antitrust law prohibiting restraint of trade. Read the Document at the National Archives. North Texas Specialty Physicians v. Federal Trade Commission (5th Cir. 2008): A key ruling establishing that independent physicians cannot collectively bargain on fees without financial integration. Read the Court Opinion. FTC/DOJ Statements of Antitrust Enforcement Policy in Health Care (1996): The federal guidelines explaining the “Messenger Model” and the narrow exceptions for clinical integration. Read the Guidelines (PDF). The RUC (AMA/Specialty Society RVS Update Committee): The AMA's own description of the committee structure and its role in valuing physician work. Visit the AMA RUC Page. “Special Deal” by Haley Sweetland Edwards (Washington Monthly, 2013): An investigative deep-dive into how the RUC operates and its impact on primary care vs. specialty pay. Read the Investigation. The National Labor Relations Act (NLRA): The law governing the right to unionize, which specifically excludes independent contractors. Read the NLRA. Laugesen, Miriam J. Fixing Medical Prices: How Physicians Are Paid. Harvard University Press, 2016. The definitive scholarly analysis of the RUC's history, structure, and influence on American healthcare pricing. Government Accountability Office. “Medicare Physician Payment Rates: Better Data and Greater Transparency Could Improve Accuracy.” 2015. GAO's critical analysis of RUC methodology and conflicts of interest. Center for American Progress. “Rethinking the RUC.” 2015. Policy analysis of the RUC's structural bias against primary care and cognitive services. Health Affairs Scholar. “Insurance Acceptance and Cash Pay Rates for Psychotherapy in the US.” 2023. Empirical research on out-of-network utilization in mental health care. Medicare Payment Advisory Commission (MedPAC). “Report to the Congress: Medicare and the Health Care Delivery System.” 2024. Annual policy recommendations including proposals for reforming physician fee schedule methodology. Joel Blackstock, LICSW-S, is the Clinical Director of Taproot Therapy Collective in Hoover, Alabama. He specializes in complex trauma treatment and writes at GetTherapyBirmingham.com.  

University Hospital Limerick's Emergency Department is expected to remain under intense pressure into next week amid a spike in presentations. HSE Mid West is once again urging the public to consider all options before attending the facility, following a 27% year-on-year increase in presentations between January 2nd and 11th. A total of 127 patients were waiting for a bed at the hospital this morning, which was up from 125 yesterday. Consultant in Emergency Medicine and Clinical Director in Urgent and Emergency Care at HSE Mid West, Dr Damien Ryan, has been telling Clare FM's Seán Lyons continued high numbers are expected to come through the doors in the coming days.

Wasanga Mehana host Dr Nhlamulo Hlungwane, a Family Doctor and Clinical Director of the Myclinic Group to discuss how you can prepare children for a healthy and successful school year. Tags: 702, Aubrey Masango show, Aubrey Masango, Bra Aubrey, Wasanga Mehana, Dr Nhlamulo Hlungwane, Back to school, Health tips for children, Antibiotics, Probiotics, Multi vitamins The Aubrey Masango Show is presented by late night radio broadcaster Aubrey Masango. Aubrey hosts in-depth interviews on controversial political issues and chats to experts offering life advice and guidance in areas of psychology, personal finance and more. All Aubrey’s interviews are podcasted for you to catch-up and listen. Thank you for listening to this podcast from The Aubrey Masango Show. Listen live on weekdays between 20:00 and 24:00 (SA Time) to The Aubrey Masango Show broadcast on 702 https://buff.ly/gk3y0Kj and on CapeTalk between 20:00 and 21:00 (SA Time) https://buff.ly/NnFM3Nk Find out more about the show here https://buff.ly/lzyKCv0 and get all the catch-up podcasts https://buff.ly/rT6znsn Subscribe to the 702 and CapeTalk Daily and Weekly Newsletters https://buff.ly/v5mfet Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702 CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/CapeTalk CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567See omnystudio.com/listener for privacy information.

In this episode of Loral's Real Money Talks, Loral explores the powerful connection between mental health and wealth with Nikki, clinical director and founder of Mind People in Ontario, Canada.Nikki brings decades of experience in psychoanalytic psychotherapy, cognitive behavioral therapy, and trauma-informed care to explain why mental health and wealth cannot be separated, especially for entrepreneurs, high performers, and legacy builders.This conversation bridges psychology and money in a way most financial podcasts never do. If you're building businesses, chasing growth, or creating generational impact, understanding mental health and wealth as a unified system is essential.Be sure to grab Nikki's Ultimate Mental Health ToolboxLoral's Takeaways:Nikki's Background and Specialties (01:26)The Importance of Self-Regulation and Mental Health (05:02)Building Self-Confidence and Overcoming Fear (06:31)Practical Steps for Self-Improvement and Mental Health (18:13)Challenges Faced by Entrepreneurs and Strategies for Success (18:30)The Role of Evidence and Confidence in Achieving Goals (20:01)Meet Nikki:Nikki is the Clinical Director & Founder of The Mind People. She works with adults 16+ who struggle with trauma(s), personality disorders, and/or eating disorders. She has extensive training in psychoanalytic psychotherapy, cognitive behavioural therapy, dialectical behavioural therapy & humanistic therapy.Nikki believes in taking a psychoanalytic approach to treatment as it addresses the underlying root causes which manifest as real world issues in a person's daily life.She is one of only a small number of clinicians in Canada that specializes in treating eating disorders with focus on a psychoanalytic treatment approachMeet Loral Langemeier:Loral Langemeier is a money expert, sought-after speaker, entrepreneurial thought leader, and best-selling author of five books.Her goal: to change the conversations people have about money worldwide and empower people to become millionaires.The CEO and Founder of Live Out Loud, Inc. – a multinational organization — Loral...

What if your diagnosis is not a life sentence, but an invitation to rebuild your health, identity, and purpose from the ground up? Josh Trent welcomes Dr. Ryan Lazarus, Functional Medicine Practitioner, to the Wellness + Wisdom Podcast, episode 788, to reveal how surviving a near death experience without a pancreas shattered medical labels, reshaped his beliefs about healing, and led him to a holistic blueprint that integrates mindset, food as medicine, trauma stored in DNA, mental fitness, connection, and purpose as the true foundations of lifelong health.

In this episode, I'm joined by two pioneers at the forefront of reshaping our understanding of human consciousness - Professor Donald Hoffman and Dr Iain McGilchrist. Despite coming from very different backgrounds, they've both arrived at surprisingly similar conclusions about some of life's biggest questions and the nature of reality. This conversation explores the parallels—and differences—in their thinking, covering topics like: — The growing scientific evidence that consciousness may be fundamental — The shockingly complex structures that physicists are now discovering beyond spacetime and what this implies — The power of silence for creating breakthroughs in scientific and creative work — The need for both a rigorous scientific and embodied approach to understanding consciousness. And more. You can dive deeper into Iain's work through his book: The Matter with Things, and Don's via his book: The Case Against Reality. — Dr Iain McGilchrist is a Psychiatrist and Writer, who lives on the Isle of Skye, off the coast of North West Scotland. He is committed to the idea that the mind and brain can be understood only by seeing them in the broadest possible context, that of the whole of our physical and spiritual existence, and of the wider human culture in which they arise – the culture which helps to mould, and in turn is moulded by, our minds and brains. He was formerly a Consultant Psychiatrist of the Bethlem Royal and Maudsley NHS Trust in London, where he was Clinical Director of their southern sector Acute Mental Health Services. Dr McGilchrist has published original research and contributed chapters to books on a wide range of subjects, as well as original articles in papers and journals, including the British Journal of Psychiatry, American Journal of Psychiatry, The Wall Street Journal, The Sunday Telegraph and The Sunday Times. He has taken part in many radio and TV programmes, documentaries, and numerous podcasts, and interviews on YouTube, among them dialogues with Jordan Peterson, David Fuller of Rebel Wisdom, and philosopher Tim Freke. His books include Against Criticism, The Master and his Emissary: The Divided Brain and the Making of the Western World, The Divided Brain and the Search for Meaning, and Ways of Attending. He published his latest book: The Matter With Things, a book of epistemology and metaphysics. You can keep up to date with his work at https://channelmcgilchrist.com. – Prof. Donald Hoffman, PhD received his PhD from MIT, and joined the faculty of the University of California, Irvine in 1983, where he is a Professor Emeritus of Cognitive Sciences. He is an author of over 100 scientific papers and three books, including Visual Intelligence, and The Case Against Reality. He received a Distinguished Scientific Award from the American Psychological Association for early career research, the Rustum Roy Award of the Chopra Foundation, and the Troland Research Award of the US National Academy of Sciences. His writing has appeared in Edge, New Scientist, LA Review of Books, and Scientific American and his work has been featured in Wired, Quanta, The Atlantic, and Through the Wormhole with Morgan Freeman. You can watch his TED Talk titled “Do we see reality as it is?” and you can follow him on Twitter @donalddhoffman. --- Interview Links: — Dr McGilchirst's website - https://channelmcgilchrist.com — Dr McGilchirst's book - https://amzn.to/3oOSFIW — Prof Hoffman's profile - https://sites.socsci.uci.edu/~ddhoff/ — Prof Hoffman's book - https://bit.ly/3SCwTTA

Teachers in England are to be trained to spot early signs of misogyny in boys and teach them the difference between pornography and real relationships.To discuss this, and whether it's something that should be considered for Irish schools, Ciara is joined by Richard Hogan, Family Psychotherapist, Clinical Director of Therapy Institute and author of ‘Home is Where the Start Is' and Padraig Curley, President of the ASTI.

Ireland is continuing to experience a surge in children presenting with flu-like symptoms. 11 sick children were waiting for beds across the three main children's hospitals today according to the INMO. Dr Ike Okafor, pediatric emergency medicine consultant and Clinical Director at Temple Street Hospital, told Cian about the current situation.

This week on BA Core Values, hosts Dylan Rivera and Superintendent Chuck Perry are joined by Kelsee McCutchen, Clinical Director at Grand Lake Mental Health, and Twyla McCarty, BA Options Academy counselor and Teacher of the Year. Together, they explore how schools and families can partner intentionally to support student well-being and build resilience that extends beyond the classroom.

In this episode of the Food Junkies Podcast, Clarissa and Molly sit down with psychologist Dr. Carrie Wilkens to unpack what it really means to help people change without shame, stigma, or power struggles. Drawing from decades of work in substance use, eating disorders, trauma, and family systems, Carrie invites us to rethink "denial," "relapse," "codependency," and even the disease model itself, while still honoring the seriousness of addiction and the depth of people's pain. Together, we explore how self-compassion, curiosity, and values-based behavior change can transform not only individual recovery but also how families, helpers, and communities show up for the people they love. In this episode, we explore: Lived experience & professional work How Carrie's own long-term healing around food and her body continues to shape the compassion and curiosity she brings to her work. The idea that our relationship with food and our bodies changes across the lifespan—and why "lifelong relationship management" matters more than perfection. Do you have to be "in recovery" to help? The pressures clinicians face when they're asked, "Are you in recovery?" and how that question can be loaded with judgment and assumptions. Why personal experience with a specific substance or behavior is not a prerequisite to being deeply effective as a helper. How Carrie talks with clients and families about her own history in a way that's honest, boundaried, and clinically useful. Rethinking 'denial' and harmful language Why words like "denial," "addict," "codependent," "chronic relapser," and "it's a slippery slope" can shut people down rather than open them up. A more curious approach: asking "What do you mean by that?" and unpacking the real story underneath labels. How language can either invite people into self-understanding—or reinforce shame, fear, and disconnection. Softening the disease model without minimizing the problem Nuanced ways to honor addiction as a serious, complex disorder without collapsing everything into a rigid disease frame. How fear (of overdose, loss, chaos, or death) drives a lot of rigid thinking in systems and professionals. Why behavior change is slow, non-linear, and rarely a straight line—and how accepting that can actually make care more effective. Relapse as an "old solution that once worked" Carrie's reframe of relapse as returning to an old behavior that, at one time, made sense and worked on some level. How naming the function of a behavior (soothing, numbing, regulating, connecting) opens the door to new, less harmful solutions. The difference between "You didn't want it enough" and "Your brain reached for an old strategy that once helped you survive." The Invitation to Change Approach (ITC) The core elements of ITC: Motivational interviewing–informed curiosity and ambivalence exploration. Acceptance and Commitment Therapy (ACT) and values-based living. A deep commitment to self-compassion as a foundation for behavior change. Why ITC was originally developed for family members and then adapted for people with substance use concerns themselves. How the "wheel" of ITC lets people step in wherever they are—self-awareness, values, behavior strategies, or compassion—and build over time. Families, shame, and staying engaged without "tough love" Inviting family members to ask: "How does my loved one's behavior make sense?" instead of "What's wrong with them?" How this shift helps parents and partners move from fear and control into strategy, support, and skillful engagement. Concrete examples of how families can respond to return to use with curiosity, concern, and clearer communication instead of lectures or ultimatums. Codependency and other overused labels Why Carrie has never formally diagnosed anyone with "codependency." What often lives underneath that label: trauma histories, cultural norms, attachment dynamics, fear of loss, and learned survival strategies. How flattening all of that into "codependent" erases nuance and blocks meaningful change. Neurodivergence, trauma, and substance use/eating behaviors The high rates of PTSD and ADHD among people seeking help for substance use—and why that matters for treatment design. Carrie's reflection on her own undiagnosed ADHD and how it likely drove much of her earlier eating disorder behavior. How binges, purging, and substance use can function as powerful nervous system regulators, especially for neurodivergent and trauma-impacted brains. Why we need more ground-up, neurodivergent- and trauma-informed approaches that focus on emotion regulation, executive functioning, and skill-building. Self-compassion as a behavior change superpower Carrie's journey from skepticism ("this sounds too woo") to seeing self-compassion as essential, research-backed behavior-change work. How self-compassion reduces shame, helps people tolerate slow progress, and makes it safer to look honestly at their own behavior. Using both "tender" and "fierce" self-compassion to choose boundaries, seek support, and keep moving through discomfort. Reimagining 'expert' roles and community care Why Carrie is skeptical of rigid expert hierarchies in addiction treatment. Inviting families, community leaders, and lay helpers into the work through accessible tools like ITC groups and trainings. The power of giving non-clinicians simple, evidence-based language and frameworks so they can respond with compassion instead of panic or shame. About Dr. Carrie Wilkens Carrie Wilkens, PhD, is a psychologist with more than 25 years of experience in the practice and dissemination of evidence-based treatments for substance use and post-traumatic stress. She is the Co-President and CEO of CMC: Foundation for Change, a nonprofit dedicated to bringing evidence-based ideas and strategies to families, communities, and professionals supporting people struggling with substances. Carrie is a co-developer of the Invitation to Change (ITC) Approach, an accessible, skills-based framework that helps families stay engaged, reduce shame, and effectively support a loved one's behavior change. ITC is now used across the U.S. and internationally in groups, trainings, and community programs. She is co-author of the award-winning book Beyond Addiction: How Science and Kindness Help People Change, which adapts the Community Reinforcement and Family Training (CRAFT) model for families, and co-author of The Beyond Addiction Workbook for Family and Friends, a practical, evidence-based guide for loved ones who want concrete tools to support change without sacrificing their own wellbeing. Carrie is also Co-Founder and Clinical Director of the Center for Motivation and Change (CMC), a group of clinicians providing evidence-based care in New York City, Long Island, Washington, DC, San Diego, and at CMC: Berkshires, a private residential program for adults. She has served as Project Director on a large SAMHSA-funded grant addressing college binge drinking and is frequently sought out by media outlets including CBS This Morning, the Katie Couric Show, NPR, and HBO's Risky Drinking to speak on substance use and behavior change. Resources Mentioned CMC: Foundation for Change – Family-focused trainings, groups, and resources: cmcffc.org The Invitation to Change Approach – Overview of the ITC model and its core topics. Beyond Addiction: How Science and Kindness Help People Change (Book) The Beyond Addiction Workbook for Family and Friends (Workbook) The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.  

Dr. Jason Yaun, Clinical Director of ULPS General Pediatrics at Le Bonheur Children's, joins the conversation to explore the growing trend of parents turning to artificial intelligence for guidance on their children's health. As AI tools like ChatGPT and Claude become increasingly embedded in daily parenting routines—from meal planning and emotional support to answering developmental questions—Dr. Yaun weighs in on the benefits, risks and ethical implications of using AI as a substitute for professional medical advice.  Learn more about Jason Yaun, MD 

Are you wisely using your genius energy? In this episode, Michael reconnects with Diana Hill, a therapist and author who has recently explored the concept of focusing your genius energy on what matters most through her book Wise Effort.Their discussion spans from insights from ancient Buddhist wisdom to the application of commitment therapy to the practice of finding one's unique 'genius energy.' If you're interested in practical ways to maximize your strengths, handle emotional challenges, and cultivate a meaningful and balanced life, you'll want to join them to unearth actionable tips and exercises for making the most out of your efforts and ultimately enhancing your well-being.Listen and Learn: What is “Wise Effort” and how can this practice reshape your energy, choices, and well-being?Identifying and using your unique “genius energy” while also recognizing how overusing those strengths can become a stumbling block, and how cultivating awareness, curiosity, and context helps direct those strengths with wisdomPractical self-reflection questions to uncover your geniusA simple four-question “energy audit” for knowing when to dial your genius up or downWhere true wisdom really comes from, and what if rethinking how growth happensAdopting “Wise Effort” helps you understand your struggles in context, align your actions with your values, and transform both self-judgment and relationshipsBringing mindful intention to even mundane tasks to transform how you use your time, connect with yourself, and balance structure with flexibility in a meaningful lifeResources: Wise Effort: How to Focus Your Genius Energy on What Matters Most: https://bookshop.org/a/30734/9781649633361 Diana's Website: drdianahill.comConnect with Diana on Social Media: https://www.linkedin.com/in/drdianahillhttps://www.facebook.com/drdianahill/https://www.youtube.com/drdianahillhttps://www.instagram.com/drdianahill/https://insighttimer.com/drdianahill FREE Energy Audit guide: https://drdianahill.com/energy Wise Effort: The Business Of Therapy Program: https://drdianahill.com/wise-effort-the-business-of-therapy Michael's Real Play Episode on The Wise Effort Podcast: https://wiseeffortshow.com/episode/living-life-on-your-own-terms-with-michael-herold-real-play About Diana HillDr. Diana Hill, PhD is a clinical psychologist, author, international trainer, and recognized expert in Acceptance and Commitment Therapy (ACT), compassion-based interventions, and psychological flexibility. With a background that bridges neuroscience, mindfulness, and behavioral science, she is known for making complex psychological concepts both practical and inspiring.A summa cum laude graduate of the University of California, Santa Barbara, where she majored in Biopsychology, Dr. Hill earned her doctoral degree in Clinical Psychology from the University of Colorado at Boulder. She later collaborated with Dr. Debra Safer at Stanford University, researching Dialectical Behavior Therapy and Appetite Awareness Training (AAT) for bulimia nervosa. She completed her clinical internship at the University of California, Davis, followed by a postdoctoral fellowship at La Luna Intensive Outpatient Center, where she later served as Clinical Director and developed their ACT- and AAT-based treatment program.A leading voice in the evolution of ACT and Process-Based Therapy, Dr. Hill works closely with pioneers in the field. She co-leads ACT BootCamp Training for Therapists with ACT founder Dr. Steven Hayes and is actively involved in shaping the future of therapy—including applications of AI, advances in diagnostic systems, network modeling, and process-based approaches. She serves as a senior meditation teacher and curriculum developer for the University of California's Climate Resilience Initiative, integrating ACT and mindfulness into interdisciplinary environmental education.Dr. Hill has contributed to publications in the International Journal of Eating Disorders and co-authored a seminal article on Process-Based Therapy, advancing evidence-based clinical practice. She is a contributor to PsychFlex, a digital platform that helps clinicians incorporate ACT into their work and track client outcomes in real time through ecological measurements. She also speaks regularly at global conferences including the Association for Contextual Behavioral Science (ACBS) World Conference, Innovations in Psychotherapy, and the Evolution of Psychotherapy Conference.In addition to her clinical and academic work, Dr. Hill teaches at organizations and retreat centers such as InsightLA, Blue Spirit Costa Rica, PESI, and PraxisCET. She serves on the clinical advisory board of Lightfully Behavioral Health and is a board member of the Institute for Better Health.She is the author of Wise Effort: How to Focus Your Genius Energy on What Matters Most (Sounds True, 2025), The Self-Compassion Daily Journal, I Know I Should Exercise But…, and ACT Daily Journal. Her insights have been featured in NPR, The Wall Street Journal, Psychology Today, Mindful, Prevention, Real Simple, Woman's Day, and other leading media outlets. She is also the host of the Wise Effort podcast.With more than 20 years of study and practice in yoga and meditation—including training in the tradition of Thich Nhat Hanh—Dr. Hill integrates contemplative practice into her approach to healing and growth. She lives in California, where she raises two sons, cares for bees, and embodies the Wise Effort principles she teaches—living a life guided by presence, purpose, and compassion.Related Episodes:48. Practical Wisdom with Barry Schwartz349. The Hunger Habit with Judson Brewer188. Unwinding Anxiety with Judson Brewer122. Taking in the Good with Rick Hanson138. Exploring Existence and Purpose: Existentialism with Robyn Walser320. Anger and Forgiveness with Robyn Walser346. Self-compassion Daily Journal with Diana Hill301. Seven Daily ACT Practices for Living Fully with Diana Hill and Debbie SorensenSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Priscilla Ward joins Dr. Sandie Morgan as they explore how true healing happens not through fixing or rescuing, but by learning to sit in discomfort, lead with curiosity, and create consistent communities where survivors can feel safe enough to begin their journey at their own pace. https://youtube.com/shorts/Jsi6YO3zobw?feature=share   Priscilla Ward Priscilla Ward, LCSW, is the Founder and Clinical Director of Compass Rose Psychotherapy in Fullerton, California. With over 18 years in the helping profession and 15 years of clinical experience, she has dedicated her career to supporting youth, young adults, and families through trauma, anxiety, substance use, and grief. A graduate of the University of Southern California with a Master's in Social Work, Priscilla brings extensive experience from nonprofit agencies, community mental health clinics, correctional facilities, and school-based programs. She has led mental health teams for the Orange County Department of Education, developing trauma-responsive programs and training professionals in high-stress environments. Her bilingual Spanish fluency and cultural responsiveness make her a trusted ally across diverse communities. Beyond direct practice, Priscilla serves as a consultant and trainer, equipping educators, faith leaders, law enforcement personnel, and mental health professionals with trauma-informed, harm reduction, and motivational interviewing frameworks. Key Points People heal in community and relationship, not in isolation, and this healing process is rarely linear—it's complex and messy, especially for those who have experienced trauma. The shift from "what's wrong with this person" to "what happened to this person" is foundational to trauma-informed care and creates space for dignity and compassion over judgment. Harm reduction is a philosophy grounded in meeting people where they are, honoring their dignity even when they aren't ready to stop certain behaviors, and recognizing that small steps matter because keeping people alive and safe creates opportunities for future healing. Faith communities can love people well by learning to sit in discomfort and resist the urge to fix or rescue, instead focusing on building belonging without requiring behavioral compliance as a prerequisite. Understanding the stages of change (pre-contemplation, contemplation, preparation, action, maintenance, and sometimes relapse) helps helpers meet survivors appropriately at each stage rather than imposing expectations they're not ready for. Secondary trauma and burnout are real costs of caring, and taking care of our own wellness is critically important because we need to be healthy people in the room to truly serve others without reinforcing harm. Trust is the bridge for change, and consistency creates safety that literally rewires the brain—centering connection over correction leads to systemic change in how we support survivors. Listening to voices of lived experience is essential; helpers should ask "what do you need" rather than assuming they know what survivors need. Resources Compass Rose Psychotherapy Transcript [00:00:00] Priscilla Ward: what harm reduction looks like in my community might be very different than yours, but the spirit of harm reduction can be applied. Anywhere and everywhere. [00:00:11] Delaney: You know that uncomfortable space where things aren't neat or solved, what if that's where the real healing starts? Today's conversation leans into that gray area. The space where our instinct to fix meets the deeper need to simply be present. [00:00:25] When we let go of control and step into curiosity, we make room for safety, dignity, and real connection. That kind of community can change everything. Hi, I'm Delaney Menninger. I'm a student here at Vanguard University and I help produce this show. Today, Sandy talks with Priscilla Ward, a licensed clinical social worker who trains faith leaders and community team...

About Diana:Short Bio:Diana Hill, Ph.D. is a clinical psychologist, international trainer, and a leading expert on Acceptance and Commitment Therapy (ACT)—a revolutionary approach to psychology that is changing our understanding of mental health. Drawing from the most current psychological research and contemplative wisdom, Diana bridges science with real-life practices to help people grow fulfilling and impactful lives. She is the author of four books including I Know I Should Exercise, But…, The Self-Compassion Daily Journal, ACT Daily Journal, and her latest Wise Effort: How to Focus Your Genius Energy on What Matters Most (September 2025). She's the host of the Wise Effort Podcast and her insights have been featured by NPR, Wall Street Journal, Psychology Today, Real Simple, and other national media.Long Bio: Dr. Diana Hill, PhD is a clinical psychologist, author, international trainer, and recognized expert in Acceptance and Commitment Therapy (ACT), compassion-based interventions, and psychological flexibility. With a background that bridges neuroscience, mindfulness, and behavior science, she is known for making complex psychological concepts both practical and inspiring.A summa cum laude graduate of the University of California, Santa Barbara, where she majored in Biopsychology, Dr.Hill earned her doctoral degree in Clinical Psychology from the University of Colorado at Boulder, in collaboration with Dr. Debra Safer at Stanford University where she researched Dialectical Behavior Therapy and Appetite Awareness Training (AAT) for bulimia nervosa. She completed her clinical internship at the University of California, Davis, followed by a postdoctoral fellowship at La Luna Intensive Outpatient Center, where she later served as Clinical Director and developed their ACT and AAT-based treatment program.A leading voice in the evolution of ACT and Process-Based Therapy, Dr. Hill works closely with pioneers in the field. She co-leads ACT BootCamp Training for Therapists with ACT founder Dr. Steven Hayes, and is actively involved in shaping the future of therapy—including the applications of AI, revolutionizing the diagnostic system, network modeling, and process-based approaches. She serves as a senior meditation teacher and curriculum developer for the University of California's Climate Resilience Initiative, helping integrate ACT and mindfulness into interdisciplinary environmental education.Dr. Hill has contributed to publications in the International Journal of Eating Disorders and co-authored a seminal article on Process-Based Therapy, advancing evidence-based clinical practice. She is a contributor to PsychFlex, a digital platform that helps clinicians incorporate ACT into their work and track client outcomes in real time with ecological measurements, and she regularly speaks at global conferences, including the Association for Contextual Behavioral Science (ACBS) World Conference, Innovations in Psychotherapy, and the Evolution of Psychotherapy Conference.In addition to her clinical and academic work, Dr. Hill teaches at organizations and retreat centers such as InsightLA, Blue Spirit Costa Rica, PESI, and PraxisCET. She is on the clinical advisory board of Lightfully Behavioral Health and a board member of the Institute for Better Health.She is the author of Wise Effort: How to Focus Your Genius Energy on What Matters Most (Sounds True, 2025), The Self-Compassion Daily Journal, I Know I Should Exercise But…, and ACT Daily Journal, and her insights have been featured in NPR, The Wall Street Journal, Psychology Today, Mindful, Prevention, Real Simple, Woman's Day, and other leading media outlets. She is also the host of the Wise Effort podcast.With over 20 years of study and practice in yoga and meditation, including studying in the tradition of Thich Nhat Hanh, Dr. Hill integrates contemplative practice into her approach to healing and growth. She lives in California where she raises two sons, cares for bees, and embodies the Wise Effort principles she teaches—living a life guided by presence, purpose, and compassion.Links:Connect with her at drdianahill.com or on Instagram, Facebook, LinkedIn, YouTube, and Insight Timer @drdianahill.

In episode 159 of The Intentional Clinician Podcast, Paul Krauss, MA LPC, interviews Cezary Pietrasik, author of Homo Idioticus: Why We Are Stupid and What to Do About It to unravel the paradox of human intelligence and folly. Through engaging dialogue, they explore why, despite our vast cognitive abilities, humans repeatedly make irrational and self-sabotaging decisions. Pietrasik discusses psychological, evolutionary, and cultural factors that explain recurring lapses in judgment, and offers practical frameworks for recognizing and overcoming our mental blind spots. Listeners are challenged to reflect on their own thinking patterns and are encouraged to adopt new strategies for greater self-awareness and wiser decision-making. Cezary Pietrasik is an economist, entrepreneur, and investor with a diverse background spanning investment banking, private equity, digital health, and behavioral AI. He is the president and co-owner of Synerise, a leading behavioral AI company, and the founder of The Butterfly Effect Foundation, which supports education for underprivileged children. Pietrasik is also the author of several books, including Homo idioticus, and is committed to making a positive difference through both business innovation and charitable work. Get involved with the National Violence Prevention Hotline: 501(c)(3) Donate Share with your network Write your congressperson Sign our Petition Preview an Online Video Course for the Parents of Young Adults (Parenting Issues) Unique and low cost learning opportunities through Shion Consulting Paul Krauss MA LPC is the Clinical Director of Health for Life Counseling Grand Rapids, home of The Trauma-Informed Counseling Center of Grand Rapids. Paul is also a Private Practice Psychotherapist, an Approved EMDRIA Consultant , host of the Intentional Clinician podcast, Behavioral Health Consultant, Clinical Trainer, Counseling Supervisor, and Meditation Teacher. Paul is now offering consulting for a few individuals and organizations. Paul is the creator of the National Violence Prevention Hotline as well as the Intentional Clinician Training Program for Counselors. Paul has been quoted in the Washington Post, NBC News, Wired Magazine, and Counseling Today. Questions? Call the office at 616-200-4433.  If you are looking for EMDRIA consulting groups, Paul Krauss MA LPC is now hosting a weekly online group.  For details, click here. For general behavioral and mental health consulting for you or your organization. Follow Health for Life Counseling- Grand Rapids: Instagram   |   Facebook     |     Youtube Original Music: ”Alright” from the album Mystic by PAWL (Spotify) “Sandy Legs” from Sandy Legs by Kolumbo (Spotify)

Taken as a group, blood cancers are the fifth most common type of cancer in New Zealand - affecting around one in twenty people during their lifetime. But some patients are forced to seek help overseas because a treatment that could save them isn't available here. The Wellington based Malaghan Institute of Medical Research is working to change that. Winner of this year's Breakthrough Project category in the KiwiNet Awards, Malaghan is currently conducting phase two of its CAR-T cell therapy clinical trials. The therapy essentially uses the body's own immune system to target and kill cancer cells. Professor Robert Weinkove is the Clinical Director and he speaks to Mihi about the next major step in their push to make it a standard part of cancer care in New Zealand.

Professor Michael Barry, Clinical Director for the National Centre for Pharmacoeconomics, on the cost of making the weight loss drug Mounjaro available to public patients.

Stay ahead in NSCLC management with our accredited podccast! HER2 alterations, including gene amplifications, mutations, and protein overexpression, are critical therapeutic targets, but their heterogeneity can complicate treatment strategies. In Module 2, Dr. Julia Kathleen Rotow, Clinical Director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute and Assistant Professor of Medicine at Harvard Medical School, explores advanced testing methodologies and strategies to navigate HER2 complexities and optimize patient outcomes. Listen now! Click here to claim CME/NCPD credit: bit.ly/405xEJO

Many families may not realize how overwhelming Thanksgiving can be for kids with autism. Greg and Holly talk to an expert about simple ways to make your holiday sensory-friendly, so every child feels calm, comfortable, and included. Above & Beyond Therapy's Clinical Director of Operations in Utah, Magan DiMartino (MS BCBA-LBA COBA), joins the show. 

Sponsored by Berries: Use code TherapyShow50 for $50 off your first month - CLICK HERE.   If you are a therapist or counselor looking for continuing education, check out my NBCC Approved $5 Podcourses and other continuing education offerings. Plus, get your first Podcourse half off. I'm thrilled to welcome back my good friend and brilliant multi-passionate entrepreneur, Kym Tolson. If you've ever wondered how therapists can use AI to streamline their work, generate new income streams, or simply stop drowning in admin tasks, you're going to love this conversation. Kym and I dive deep into her newest creation, The Thera AI Hub, a growing collection of over 35 done-for-you AI tools built specifically for therapists. From custom GPTs, to newsletter-building agents, to niche-finding and scalable-offer creators, Kym shows how therapists can reclaim their time, reduce burnout, and finally move toward the ideas they've been sitting on for years. We also explore the evolving role of AI in mental health care including the big news about Cigna using AI as a first-line support tool, and talk candidly about what this means for the future of our field. Kym shares how therapists can stay relevant, adapt intentionally, and develop specialties AI can't replace. Plus, she gives us an exciting look at upcoming features inside Berries, the AI-powered therapy note scribe where she serves as Clinical Director. Think smart treatment plans, automatic session summaries, homework suggestions, and even telehealth and EMR capabilities on the horizon. If you're curious about leveraging AI to enhance your clinical work, build new offers, or simplify your business systems, this episode is packed with inspiration, practical tips, and plenty of "oh wow" moments. I can't wait for you to listen. Kym always brings so much clarity, creativity, and encouragement. I know you'll walk away with at least one idea you're excited to try. Links mentioned in the episode:  Get my CE Course Builder for Mental Health Clinicians for FREE Thera AI Hub + Clinical AI Club: https://kymtolson.kartra.com/page/AI-Tools-for-Therapists AI Newsletter Opt In/Mastering AI Prompts for Therapists: https://kymtolson.kartra.com/page/Join-AI-Newsletter AI Powered Private Practice Giveaway: https://kingsumo.com/g/m88558m/ai-powered-practice-giveaway Check out all my Counselor Resources. 

“A compelling, radical exploration of psychedelics' healing potential.”—Kirkus ReviewsExplains how psychedelic experiences offer a way to reconnect with the body, reclaim pleasure, rekindle joy, and reawaken to loveExplores how psychedelics can support our sexual healing and offers a range of psychedelic integration techniques and somatic exercises to help release trauma and foster insightShares recent research on trauma and case studies from more than a decade of professional clinical work as well as lessons from the author's own healing journey from sexual trauma and PTSDIn this groundbreaking book, psychotherapist and psychedelic integration expert Dee Dee Goldpaugh shows how the profound healing and restorative effects of psychedelics can help us heal our sexuality, reconnect with pleasure, find wholeness, and feel good again.Sharing recent research on trauma and case studies from more than a decade of professional clinical work, Goldpaugh explores specific ways psychedelics can heal sexual trauma, enhance sexual pleasure, and deepen our interpersonal connections. Goldpaugh looks at MDMA, psilocybin, ayahuasca, mescaline, 5-MeO-DMT, and other psychedelics and offers a range of integration techniques as well as somatic exercises to help foster insight and apply the lessons learned during psychedelic experiences to everyday life. Goldpaugh also examines the methodology behind psychedelic-assisted therapy and how readers can safely navigate risks and explore their own healing at home.Revealing the transformative power of embracing pleasure for healing sexual trauma, this book provides an essential guide to psychedelic sexuality as a path to healing and love.Dee Dee (they/them/theirs) is a psychotherapist, educator, consultant, clinical supervisor, author, and activist. They are the Clinical Director of Chrysalis Integrative Psychotherapy. Dee Dee has taught and published widely on the topics of psychedelics, sexuality, trauma, gender, and spirituality. They have been a leading voice in the development of Psychedelic Integration Psychotherapy techniques, specifically with survivors of trauma and have published the first article to appear in an academic journal, Sexual and Relationship Therapy, exploring the intersection of sexuality, spirituality, and psychedelic healing. Dee Dee is a clinical supervisor for the EMBARK psychedelic-assisted therapy approach. They offer Ketamine-Assisted Psychotherapy as part of the team at the Woodstock Therapy Center and facilitate ketamine-assisted psychotherapy retreats. They have also completed the MAPS training in MDMA-assisted psychotherapy. Dee Dee is the author of the forthcoming book Embrace Pleasure: How Psychedelics Can Heal Our Sexuality being published by Inner Traditions in Summer 2025. The are a member of the Chacruna Institute for Psychedelic Plant Medicine's working group for Women, Gender-Diversity, and Sexual Minorities. Dee Dee has been a presenter in the Sex Therapy Collaborative and a faculty instructor in the Trauma Therapy program at the Institute for Contemporary Psychotherapy. They have presented at the Interdisciplinary Conference on Psychedelic Research (ICPR), The Alt Sex Conference Speaker's Series, The Center for Optimal Living, Ante Up! and are contributing author in the book Queering Psychedelics. They have been featured in articles by Vice Magazine, Chacruna, The Albany Times Union, Medium, Brides, Psymposia, Refinery 29, and Psychology Today. Dee Dee runs therapist consultation groups in Psychedelic Integration Therapy. Dee Dee holds a Master's Degree from the Hunter College School of Social Work. They have received training at the C.J. Jung Foundation and the Institute for Contemporary Psychotherapy. They are fully trained in EMDR through the Parnell Institute and offer EMDR in their practice and have additional training in Internal Family Systems Psychotherapy. They have years of professional experience in the LGBTQ community and in community mental health in Brooklyn, NY working with an extremely diverse client population.  Dee Dee has additional training in shamanic healing, bioregional herbal medicine and has attended intensive guide training through the Association of Nature and Forest Therapy guides. When not in the office, Dee Dee is a painter, musician, activist, hiker, meditator, and voracious reader (in no particular order!)https://www.deedeegoldpaugh.com/Become a supporter of this podcast: https://www.spreaker.com/podcast/earth-ancients--2790919/support.

In this episode, Kathleen Hickman, RN, BSN, MS, CASC, Administrator and Clinical Director of Dutchess Ambulatory Surgical Center, shares insights on ASC growth through higher acuity cases, the impact of new CMS codes, and how innovation and culture are shaping the future of surgical care.

In episode 512 I chat with Dr Steven Phillipson and Sarah. Steven is a licensed clinical psychologist who specialises in Cognitive-Behavioral Therapy for OCD. Steven is the Clinical Director at the Center for Cognitive Behavioral Psychotherapy in New York. He is joined by one of his patients, Sarah, who has kindly agreed to share her story. We discuss what is metaphysical themed OCD, what is metaphysical contamination OCD, trauma, Sarah's OCD story, her sticking points in recovery, getting the wrong diagnosis, how her husband supported her, and her therapy with Steve. Hope it helps. Show notes: https://theocdstories.com/episode/steve-sarah-512 The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Join many other listeners getting our weekly emails. Never miss a podcast episode or update: https://theocdstories.com/newsletter 

Christy Hinnant is a US Army Combat Veteran and survivor of sexual assault.  Today we hear her story of survival and how she arrived at the point in her life to become Founder, CEO, and Clinical Director of Voices Against Sexual Assault.Our library of shows can be found at www.veteranscornerradio.comJoin us on Facebook at the page Veterans Corner RadioYou can contact our host Joe Muhlberger at joseph.muhlberger@gmail.com

Episode 10 - Stephanie Karzon Abrams: Heart and Science This episode takes on a wide ranging ride inside Stephanie's wildy diverse experise on the science of psychedelics to the importance of music and community. Stephanie is a profound and powerful voice in the psychedelic community and her work represents the best of the modern psychedelic movement.  Intro: Ann Shulgin takes on a brief exploration of the shadow.  Stephanie Karzon Abrams is a neuropharmacologist, founder of Beyond Consulting—powering the integrative, psychedelic and plant medicine spaces, and is the co-founder of the Public Secret music label and artist collective.  She serves as Clinical Director at Modern Medicine Services, is a prescriber of MDMA and psilocybin therapy under Canada's SAP, and is the Research Director at the Microdosing Collective non profit.  Stephanie believes in the undercurrent of joy woven into the fabric of our existence and thus co-created the talk and event series "The Chemistry of Joy", where the human experience is explored through the lens of ritual and celebration.  With experience in neurology, intensive care, and medical device at Johnson & Johnson, she is a recognized leader in innovative healthcare. Her work bridges neuroscience, women's health, plant medicine, and the healing power of music. A musician, writer, and speaker, Stephanie also builds community through gatherings rooted in music, meaning, and mycology. Web: https://www.stephaniekarzonabrams.com  Www.Beyondconsulting.Life  Social: @steph__k @public.secret  @microdosingcollective @thechemistryofjoy @mod_meds

In this episode, Dr. Sasha Blaskovich, Owner and Clinical Director of the Whiplash & Injury Clinic, discusses the critical connection between head and neck injuries, the importance of diagnosing upper cervical instability, and how his work is changing the way physicians understand and treat concussions.

What is an Instinctual Stack? Do you know yours? We all have three instincts. None of us are absent one. However, one does tend to be dominant.  But what are instincts and how do they influence how each type shows up in the world?  In today's episode, we revisit our conversation with Elan Benami, creator of the EnneaApp and author of  Enneagram Patterns & Poetics, to provide you with a great overview of Instincts, Subtypes, and the Instinctual Stack and how they can play out in your personal and professional life.    About Elan: Elan is an LPC with a MA in Transpersonal Counseling Psychology and BA in Philosophy. In addition to his own private counseling practice, Elan is the Clinical Director of People House - a non-profit that provides affordable counseling in Colorado. Elan was introduced to the Enneagram in 2008 by his first therapist. He then did intense studying with Lori Ohlson, who was his supervisor. Claudio Naranjo was Lori's primary teacher, so there is a deep kinship with his work. Other major Enneagram teachers who have shaped Elan include Helen Palmer, Russ Hudson, Don Riso, and Sandra Maitri. Elan and Lori Ohlson have co-facilitated many Enneagram classes/workshops, most of them in the narrative tradition. Through Lori's Enneagram material (of over 25 years of teaching the Enneagram), Elan created the EnneaApp, initially for the purpose of having something to quickly reference between sessions. Through the years, he has adapted the content to be more reflective of his own experience while also preserving Lori's lineage. The app has over 1.5 million downloads.