Sarah's 35-Year Journey Shows How Mental Health Care Has Evolved

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Speaker 1: Hello and welcome to another episode here of our 2 - > podcast. 3 - > Sitting in front of me is none other than Sarah from Relate 4 - > Center. 5 - > Sarah is an amazing, amazing, amazing therapist. 6 - > She has been in this space for quite a while 35 years of 7 - > experience working with individuals couples 8 - > professionals 35 years of experience working with 9 - > individuals couples professionals. 10 - > Sarah really takes a science-based approach, deeply 11 - > personal approach to creating lasting relationships that not 12 - > only work in your personal life but also in your professional 13 - > career. 14 - > Not only has Sarah's impact gone beyond the therapy room she 15 - > delivers workshops on teamwork, leadership, communication and 16 - > businesses all across the country. 17 - > Sarah, welcome to our podcast. 18 - >

Speaker 2: Well, thank you for having me, Blake. 19 - > I'm excited to be here. 20 - >

Speaker 1: Yeah, yeah, hopefully that does you some justice 21 - > there. 22 - >

Speaker 2: It's a lovely, lovely intro. 23 - >

Speaker 1: I had more, I could have kept going, but I wanted 24 - > you to get in. 25 - >

Speaker 2: Well, let's get into the meat of it. 26 - > That's good for me. 27 - >

Speaker 1: Yeah, so tell everybody. 28 - > I've told everybody what you do , but let's put your frame on it 29 - > . 30 - >

Speaker 2: Sure Well, you did a beautiful job, thank you. 31 - > I am a clinical social worker by training and have a specialty 32 - > in sex and relationship counseling, and we some of my 33 - > colleagues and I had built a business called Relate Center in 34 - > Austin, texas, where we're really putting together all the 35 - > new kind of data on what helps people have the best physical 36 - > and emotional intimate relationship. 37 - > So that means physical therapists, pilates 38 - > psychotherapistsists, physicians we really work to give people a 39 - > well-rounded sense of professional help where? 40 - >

Speaker 1: where did the need come for you guys to start 41 - > relate center? 42 - > And like, where was that burning passion? 43 - > Like, hey, we have to do this well, you know there were. 44 - >

Speaker 2: It was really hard to find people who had really 45 - > specific skills to help in this area and we kept finding that 46 - > people got dropped. 47 - > Like you would have a client you want to send her to a 48 - > physical therapist, but then that never happened, or we 49 - > didn't have any way really to come back and make sure that the 50 - > person was getting an individual kind of an experience 51 - > . 52 - > And we really wanted to make sure that we were all talking 53 - > and that we really had that kind of this bigger view for the 54 - > individual or the couple. 55 - > And so it just. 56 - > We just started working with a couple of people who had the 57 - > same philosophy and just said, hey, let's do this. 58 - > And we've now been in business about 16 years. 59 - >

Speaker 1: Wow, it sounds like you kind of got through a lot of 60 - > the ups and downs. 61 - > You know, obviously, working in healthcare, there's a lot of 62 - > fun stuff that you guys have to go through when you're dealing 63 - > with patient records. 64 - > I mean, health data is very sensitive data. 65 - > Talk about how you kind of got through some of those data 66 - > challenges that businesses do. 67 - >

Speaker 2: Well, you know, I think that's such a good 68 - > question because what we decided to do to protect people's 69 - > privacy was be out of network providers. 70 - > So in network I would have to prove that somebody was crazy 71 - > enough, sick enough to still get help, and I was often dealing 72 - > with administrators about trying to prove someone needed my care 73 - > . 74 - > So we decided as an out-of-network provider, even 75 - > though it was more costly, it provided people more protection. 76 - > We felt like people who were more famous, well-known, were 77 - > hesitant to come in because they didn't want those records to be 78 - > in anyone else's file. 79 - > So we thought about it from that point of view as well as 80 - > just generally wanting to help streamline the services. 81 - > Many times if you're just looking for a network, you are 82 - > more limited on who actually had the specialty you were looking 83 - > for. 84 - > So that helped us. 85 - > We all keep our own records, we all work with our own kind of 86 - > system. 87 - > So we're individual, we're an individual practice, we're a 88 - > group of individually minded practice people with the same 89 - > philosophy. 90 - > But that's how we ended up with it and it clearly has, you know 91 - > , limits, because we really want , you wish, for people to be 92 - > able to have access to insurance and to help that they should 93 - > have. 94 - > But we're just trying to deal with the real world here. 95 - >

Speaker 1: Yeah, since you started Relate Center to now, 96 - > how have you seen the business evolve? 97 - >

Speaker 2: Well, you know we went through COVID. 98 - > So I think the most important thing is we all learned how to 99 - > do online counseling. 100 - > So how do we try to reach people? 101 - > And you know that was a big advantage for many, many people, 102 - > not even after COVID because of I don't know what traffic is 103 - > like in Las Vegas, but in Austin it's crazy and you know it 104 - > would take people an hour to get to an office and an hour to get 105 - > home. 106 - > Hour to get home. 107 - > So it's really opened up people's ability to get help and 108 - > in that way it's it's all. 109 - > It's more cost effective for people and for us. 110 - > It's convenient and I can be in New Jersey and I'm still working 111 - > with people, because I can work with people from different, 112 - > because I also have a coaching certificate. 113 - > So I'm I have an international coaching certificate as well as 114 - > a license, and that helps me immediately have protection. 115 - >

Speaker 1: Yeah, with your background in psychology and 116 - > clinical social work, how did you kind of transition into 117 - > coaching and the thought leadership training? 118 - >

Speaker 2: Well, I've always had an interest in giving practical 119 - > help and working with entrepreneurs. 120 - > That's kind of my area of most enjoyment, really. 121 - > People who are kind of spared to try and do some of their own 122 - > kinds of things men and women, not necessarily businesses, but 123 - > that kind of personality, businesses but that kind of 124 - > personality. 125 - > So as I decided to move to a beautiful place, another 126 - > beautiful place, I needed to find ways that I could see more 127 - > clients that weren't just in my state, and so that has given me 128 - > the flexibility to do that. 129 - >

Speaker 1: That is epic. 130 - > I'm curious as to your approach to healthcare. 131 - > Obviously, therapy is one of those things that's a very 132 - > catered, scientific, psychological intervention, if 133 - > we can use that term. 134 - > How is the approach that Relate Center takes to psychotherapy 135 - > different than you know somebody who you would stereotypically 136 - > sit down on a couch with and chalk it up? 137 - >

Speaker 2: You know, I think that's such a good question 138 - > because there are lots of different modalities and many 139 - > modalities have fit for many different kinds of people. 140 - > So we really I think who we attract are people who want a 141 - > lot of science-based studies and data. 142 - > So a lot of our practices around sexual health, so many of 143 - > our clients come from physicians who need to have 144 - > someone looking at a different kind of filling in what they 145 - > can't do medically. 146 - > So that's part of who I think we're attracting is people who 147 - > are referrals. 148 - > I think our approach is also practical. 149 - > So we want people to like why are they here? 150 - > What are your goals? 151 - > Are we meeting your goals? 152 - > We do long-term therapy some of us as well, but all really with 153 - > . 154 - > Are we helping someone get from A to Z so that they can really 155 - > see progress and feel it physiologically as well? 156 - >

Speaker 1: When obviously a lot of people use kind of COVID as a 157 - > transition period. 158 - > We've heard it so many times the way that businesses operate 159 - > immediately had to shift during COVID, especially now with the 160 - > prevalence of telehealth, like for Relate Center, getting 161 - > people comfortable kind of doing the telehealth. 162 - > Or were you guys already kind of ready to go when? 163 - >

Speaker 2: that happened. 164 - > Well, you know that's interesting that you're asking 165 - > me about that, because I had taken a part-time position while 166 - > I was out of town working with an online company, so I was 167 - > already starting to look at that to learn how to use the 168 - > computer, to learn, kind of, how to use different avenues. 169 - > So when COVID happened, I really already had a little 170 - > preview and a jumpstart to it. 171 - > That helped me a lot and I think we also just trying to 172 - > figure out how do we get services to people. 173 - > There was an organization, a national organization, that 174 - > offered free therapy to people in health care reach the people 175 - > in need. 176 - > And you know when, when you're talking to people in, you know 177 - > in the hospitals or watching people die all the time, you 178 - > want to be able to get them access right away to get some 179 - > help with that. 180 - >

Speaker 1: Yeah, I mean, that makes a lot of sense. 181 - > Um, and I'm assuming now that you've been so successful at 182 - > Relate Center and the way that you see patients, has your 183 - > approach to the way that you serve customers through 184 - > telehealth changed? 185 - > Have you shifted the business to accommodate? 186 - >

Speaker 2: Yes, absolutely, especially because now that I 187 - > have to do virtual work most of the time, unless I'm doing 188 - > workshops and I think it's worked really really well it's 189 - > nice that we still have people who can do in-person. 190 - > I think it's a great combination of some people who 191 - > want to be able to keep doing online, as well as the people 192 - > who really want to come and see someone in person. 193 - >

Speaker 1: Yeah, as well as the people who really want to come 194 - > and see someone in person. 195 - > Yeah, I'm curious as to you know, obviously when you start a 196 - > healthcare service company I mean especially when you're 197 - > handling, you know, patient records you know obviously HIPAA 198 - > comes to mind. 199 - > You have to deal a lot with HIPAA the way that you handle 200 - > data, the way that you transmit data. 201 - > What was your thought process to approaching HIPAA, to 202 - > approaching patient data, how is stored, how is transmitted, and 203 - > how did you bring some of those built-in compliance and 204 - > security mandates into your practice? 205 - >

Speaker 2: That is a complicated answer and so I'm going to tell 206 - > you my process. 207 - > So I did sign up. 208 - > I do an online scheduling credit card note taking service. 209 - > I limit what I actually put down in terms of my notes. 210 - > I keep my file drawer with notes. 211 - > I try not to actually write down anything that I think could 212 - > get my client in trouble because I don't really try. 213 - > I've had a bad experience with the courts, you know, getting my 214 - > notes and not being as careful as I should have been earlier in 215 - > my career when I didn't understand kind of the 216 - > consequences, but certainly it's been very. 217 - > You know, I don't know how you all or what you're finding out 218 - > about this, but it's really hard to find programs that are 219 - > geared for small businesses. 220 - > So many of these programs are really built for these big, big 221 - > companies with lots of therapists and do insurance that 222 - > are really kind of geared that way and can be very expensive. 223 - >

Speaker 1: So you know, we're always kind of struggling about 224 - > what's the best program that can give me what I need, protects 225 - > my clients, protects their them financially, but also is has 226 - > some kind of flexibility of how I work yeah, that makes a lot of 227 - > sense, um, and it's an, it's an interesting perspective and 228 - > thank you for being so candid and so honest and, um, and I'm 229 - > sure, obviously, in your entire amazing career, you've learned a 230 - > lot and you've changed a lot and you've grown a lot. 231 - > So, the way that you do business and the way that you 232 - > handle, uh, information, um, not only that too, but it's just 233 - > changed a lot over the years. 234 - > Like, if you look at HIPAA, like HIPAA, um, you know, it was 235 - > written in 1996, which was, you know, most people weren't doing 236 - > telehealth and things like that back then. 237 - > And then, you know, they had a new privacy rule that was 238 - > finalized in 2000. 239 - > And then in 2003, you know, of course, they came out with some 240 - > more rules around, like EPHI and administrative and physical 241 - > safeguards, and I mean 2006, 2009. 242 - >

Speaker 2: I've had a lawyer tell me that if anyone wanted to 243 - > look at anyone's books really closely, we'd all be in trouble. 244 - >

Speaker 1: Oh, totally, totally. 245 - > Yeah, I mean, it's weird. 246 - > A lot of the people that we talk to, they essentially try to 247 - > avoid handling patient record as much as possible so they can 248 - > skirt around HIPAA, or they use systems that are essentially 249 - > offload A lot of it, like Epic. 250 - > Like Epic is, you know, kind of the industry leader, um, in in 251 - > our opinion, and in patient record management, um, you know 252 - > obviously now, um, in 2020, well , in 2025, I guess now we were 253 - > expecting, you know, some changes to HIPAA. 254 - > You know around like multi-factor authentication it 255 - > had to be mandatory. 256 - > You know data encryption. 257 - > You know not only patient health information at rest, but 258 - > in transit. 259 - > And now, in 2025, patients and providers are going to have to 260 - > go through an annual risk analysis which is fun I was like 261 - > kidding like a colonoscopy every year, wow. 262 - > And not only that, too, but you know coming up with incident 263 - > response, disaster recovery plans, oh yeah yeah. 264 - > Internal audits. 265 - > You know compliance audits, and not only that too, but with the 266 - > 2025 proposed rule changes, they're going to be a little bit 267 - > stricter on vendor management and how you know sensitive data 268 - > gets out and how you respond to that Um, and they're going to 269 - > talk a little bit in some of these new proposed rules about 270 - > um, uh, like, uh, employee turnover. 271 - >

Speaker 2: You know so, like if somebody leaves your practice, 272 - > like how you suspend their access to you know phi, which is 273 - > fun so a lot of fun, a lot of fun stuff to prepare for right, 274 - > which is why I'm going to a coaching kind of model sure you 275 - > know I, what's happening is it's forcing out a lot of good 276 - > practitioners because, it's become more and more 277 - > administrative versus actually giving treatment. 278 - > And you know, I think that's. 279 - > You know you can kind of understand where it comes from, 280 - > but it's just overwhelming for most of us, especially unless 281 - > you know, unless you have your. 282 - > Maybe what it's going to do is make all therapists have to join 283 - > these big practices so that the administrators handle 284 - > everything and they don't have to do it. 285 - > But you know, when I joined this one online company, my, my 286 - > salary was a third of what I usually make. 287 - > So you know, I think that's. 288 - > The other thing is they're making it very hard for people 289 - > to actually provide treatment in my field. 290 - > It's very discouraging for me. 291 - >

Speaker 1: Yeah, I agree they're making it complicated to be in 292 - > healthcare. 293 - > If we had more of a starter kit , like if we gave and I hope the 294 - > government listens to things like these. 295 - > but if we had a starter kit. 296 - > Like a starter kit, like hey, look, here here's a starter kit 297 - > that you can use to get into healthcare, especially as a mom 298 - > and pop practice. 299 - > You know, with you know a handful of providers, um, where 300 - > it's not not expensive, a lot of the heavy lifting is done for 301 - > you. 302 - > Um, you know, out of the box, you're ready to kind of just 303 - > start seeing patients and treating and treating patients 304 - > and providing, you know, extra care, like you know amazing care 305 - > , like I wish we got there. 306 - > Yeah, because you know our health care system is is a wonky 307 - > one is a wonky one. 308 - > I've seen it from the other side . 309 - > I've lived in Europe and I've spent quite a lot of time in the 310 - > markets out there and in learning how they treat patients 311 - > . 312 - > And yeah, it's a very weird process here, especially 313 - > considering everything operates on a referral network. 314 - > So your primary care refers you to X Y Z, who then refers you 315 - > to X Y Z, and then it's just this snowball of referrals which 316 - > doesn't really exist in other healthcare markets that I've 317 - > been a part of. 318 - > Um, I'm curious to your approach. 319 - > So from what I read about you, I mean you're a very 320 - > accomplished individual. 321 - > First of all, let me say you also work with corporate teams. 322 - > Is that accurate? 323 - > Yes, wow, okay, so I'm curious to how. 324 - >

Speaker 2: Professional teams, so I would say, not big 325 - > corporations. 326 - >

Speaker 1: Sure, sure, sure. 327 - >

Speaker 2: Maybe I'm interrupting too soon. 328 - > I've worked a lot with the law school in Austin, helping train 329 - > young lawyers and helping them learn how they are on a team, 330 - > and some entrepreneurs, some small businesses that are more 331 - > that not some family businesses, but also just smaller kinds of 332 - > groups who are looking at how to do better leadership. 333 - >

Speaker 1: Would you say that, how you cater your curriculum or 334 - > your therapy services, how did you refine those? 335 - > You know, obviously it sounds like you came from seeing people 336 - > one-on-one in a patient setting , kind of graduating into 337 - > working with multiple people, kind of trying to to jump. 338 - > People learn differently. 339 - > People you know process information differently. 340 - > So how did you approach seeing somebody one-on-one to? 341 - > Then you know coaching teams and developing team. 342 - > You know team building. 343 - >

Speaker 2: So you know, a lot of this just like happens by 344 - > chance, where I think I had a client who worked at a law firm 345 - > who said, hey, would you come and give a talk to the young 346 - > women lawyers? 347 - > And we're like, sure, why not? 348 - > You know, I think a lot of opportunities is that as well. 349 - > I think I could do that, let's try. 350 - > In fact, I think that that tends to be one of the things 351 - > that women have a harder time doing, of just being able to try 352 - > something, even if you're not sure you have all the skills. 353 - > Started working and taking up some of those opportunities and 354 - > saying, hey, what about doing some some workshop? 355 - > Hey, what about me learning what are some different ways to 356 - > teach people about themselves? 357 - > So, for example, some people love working with some kind of 358 - > profiles, so we use different kind of behavioral profiles that 359 - > help someone see themselves better. 360 - > Then we would do, we do horse workshops where people learn 361 - > leadership skills from the horses who can't, you know, 362 - > can't tell you what to do, but they react and you kind of learn 363 - > from their reaction of you're connected or you're a leader or 364 - > not. 365 - > And I think that as I grew, you know, I wanted to share it with 366 - > different kinds of people, and then that grew from there. 367 - >

Speaker 1: How do you feel like psychology has evolved, I mean 368 - > since you got in the industry, you know, a while ago. 369 - >

Speaker 2: Yeah, wow. 370 - > Well, that's yeah, because I sat around in my college in one 371 - > of those early self-awareness groups in 1975. 372 - > So, wow, that's crazy. 373 - > It's changed quite a bit since then. 374 - > You know, for one thing, we have so much more data now of 375 - > what actually helps. 376 - > We have more of a sense of we have to deal with people. 377 - > Listen, when I first went to sex therapy school, they 378 - > believed that almost all sexual problems were in your head. 379 - >

Speaker 1: Wow. 380 - >

Speaker 2: And we've learned that that's just not true. 381 - > Have learned that that's just not true. 382 - > There are so many things that are about how you are, what 383 - > happens through trauma and how you are in your body, as well as 384 - > different kind of biological medical issues. 385 - > We just know so much more, so much more of what I do really in 386 - > my practices. 387 - > Tell people what we know about. 388 - >

Speaker 1: Let me tell you what we now know or what we don't 389 - > know about. 390 - > X. 391 - > Sure, I was thinking you would I mean, based off our, our 392 - > limited interactions that I was thinking you'd say something 393 - > also along the lines of um, the, the people's willingness to 394 - > participate, and it's, you know, like, like therapy. 395 - > You know it used to be kind of taboo, you know nobody would 396 - > talk about it, that you're in therapy and it was kind of like 397 - > one of those little secrets. 398 - > You know that like it's a really good point, you know you keep 399 - > under, uh, under like tight lock and key, but now people are, oh 400 - > , yeah, just, how do you know? 401 - > Just I'm, that's true, I'm going to therapy at at 1, like 402 - > you know, like people are more open, um, and with the rise of, 403 - > you know, digital, the digital infrastructure that we live in, 404 - > people have kind of embraced this and and, and you know the 405 - > lack of um, uh, I mean, access to physicians and patient. 406 - > I mean, I mean now, I mean I can connect with you who's in 407 - > New Jersey, I'm in Vegas and you know, I, you know not not have 408 - > access to your skill set here, because the health care system 409 - > in Vegas is absolutely terrible. 410 - > Besides, the point for therapy has changed and how people 411 - > interpret it. 412 - > And, and, yeah, I mean no shame here, I've, I've been in 413 - > therapy for multiple years, right, you know, because I've, 414 - > I've, I've watched. 415 - > I watched this one. 416 - > I don't know what it was. 417 - > It was like info doc or something, and they talked about 418 - > how the brain and you probably will love this but how the brain 419 - > has evolved to modern stress and modern scheduling. 420 - > Like our brain is not designed to process the amount of 421 - > information that we put through it every single day. 422 - > So burnout, right, I mean so many of the workforce industry 423 - > is burned. 424 - > I mean, at least in my field, I can tell you for sure. 425 - > Probably in others, but your brain was not designed to take 426 - > and use it the way that we use it in this modern world. 427 - >

Speaker 2: True, right, yeah, well, you know. 428 - > That's such a good point that we know now that part of the 429 - > reason that we started our podcast and we're also now 430 - > writing a book is to be able to get information out to people 431 - > that they may not have. 432 - > So many people need just information so that they can 433 - > live their life more effectively so that they can live their 434 - > life more effectively? 435 - >

Speaker 1: Yeah, what areas do you feel like of psychology are 436 - > evolving the fastest right now, or maybe even the ones that are 437 - > maybe the most misunderstood? 438 - >

Speaker 2: you know whether it's clinical or yeah, I think the 439 - > whole issue around body, around somatic training, trauma of you 440 - > know, ptsd, stress I think so much more is being studied about 441 - > that, about how to help people. 442 - > I've had multiple trainings in dealing with trauma and how to 443 - > integrate people, kind of a mind-body approach, positive 444 - > intelligence, emotional intelligence, how you really 445 - > kind of put together the different things Because one we 446 - > either had the idea that insight was enough. 447 - > Once I understand what happened to me, I will be completely 448 - > healthy, happened to me, I will be completely healthy. 449 - > That didn't seem to work Right Right. 450 - > Or if I just know all of my emotions, that'll work. 451 - > If it's really about how do you integrate, how do you 452 - > understand your history and your weight survival mechanism, how 453 - > do you live in your body in a way that helps it calm down so 454 - > it can respond to all this stress? 455 - > And how do you shift? 456 - > You know how do you shift to think more productively or act 457 - > more productively. 458 - > So that's to me, the magic that is making these things more 459 - > doable more access, right. 460 - >

Speaker 1: Do you feel like there's newer promising 461 - > approaches or maybe modalities that are more promising that 462 - > you've started to realize in the field you know? 463 - > I think the idea is we do need to be open to what are the new 464 - > things. 465 - >

Speaker 2: I just recently took a course in positive 466 - > intelligence which really was kind of taking all these 467 - > complicated ideas and making them more accessible on your app 468 - > . 469 - > You know it's how do you get people to start using the tools? 470 - >

Speaker 1: Yeah, something that I've noticed too, or maybe you 471 - > could probably talk on, is the type of persona that you know 472 - > generally we'll see a therapist is usually a higher um people. 473 - > A lot, a lot of underprivileged uh communities don't have 474 - > access to physical uh um or, I'm sorry, psychological uh therapy 475 - > . 476 - > Um, how, how do you feel like we can introduce psychotherapy 477 - > to these types of communities and how do you think we can kind 478 - > of get through that? 479 - > You know, this is life-changing . 480 - >

Speaker 2: Well, you know, I think that that's so important 481 - > and such a big problem and you know, I think we're losing the 482 - > middle class more and more, not gaining it, so there are more 483 - > and more people who don't have access to any health care or 484 - > mental health care. 485 - > That's part of why I've always liked coming from social work, 486 - > because I think it's trying to reach all people versus limited 487 - > but um, I don't know how we're going to do that yeah you know I 488 - > don't know how people you know what I've always tried to do is 489 - > offer some low-fee services along in my practice. 490 - > I try to do so. 491 - > I used to. 492 - > I'm clearly not doing them now that I'm not in Austin. 493 - > But some free talks where people can come in, but some 494 - > free talks where people can come um. 495 - > I think I've worked in doctor's offices where I would be a part 496 - > of the team, so we were doing that early on and I think that 497 - > you know help people be able to get some access because, again, 498 - > it's information a lot of people just don't know. 499 - >

Speaker 1: Right. 500 - >

Speaker 2: And men are afraid to ask. 501 - >

Speaker 1: Totally. 502 - > It's almost like embarrassing for people to ask for help these 503 - > days, which is a shame. 504 - > Yeah, I'm curious. 505 - > It's something that I've thought a lot about, and maybe 506 - > there's no answer, maybe you have the perfect answer, but it 507 - > seems like people and I can only speak from my personal 508 - > experience. 509 - > I got into therapy when I was like the glass was overflowing 510 - > of life and I'm like I need to see somebody, I need to talk to 511 - > somebody, I need to see some, I need to talk to somebody. 512 - > Do you think there are kind of like do you think there is a 513 - > preventative approach to therapy , to psychotherapy, instead of 514 - > just saying, oh shit, I'm here and now I need to talk to 515 - > somebody? 516 - > Like, like, how do you get ahead of needing therapy? 517 - >

Speaker 2: Well, you know, yes, absolutely yes. 518 - > And I have had some families where they have their kids come 519 - > in, not because they're having problems but because, hey, 520 - > they're a teenager, let's get you in so that you know, you 521 - > start getting some self-awareness. 522 - > And you know, I think more and more people are aware that they 523 - > need to help their kids have skills, especially now you think 524 - > of what kids are going through. 525 - > Young people have so much pressure on them and there's so 526 - > many limitations that are put on them now in this world with 527 - > what's happening. 528 - > So, you know, I think that that takes us, it takes our 529 - > generations, to help these new, these new generations come in. 530 - > That would give them tools so they can say, hey, are you 531 - > reaching close to that point? 532 - > Then it's time to go back in and talk to somebody. 533 - > Sure, I'm working right now with a kid who's doing a junior 534 - > year abroad and, um, her parents are like we're still gonna have 535 - > you talk to her. 536 - > So, even though she's in south america, she's we're doing 537 - > therapy. 538 - > Yeah, just because they knew they were gonna, she was going 539 - > to be in some new experiences that she wasn't sure how to deal 540 - > with. 541 - >

Speaker 1: I mean, yeah, that is amazing that parents are that 542 - > supportive of her mental health. 543 - > I'm curious and this is going to be a huge pivot. 544 - > But you know we've talked. 545 - > We've talked a lot about transitioning Relate Center, you 546 - > know, from seeing patients in person to, you know, covid, to 547 - > the online boom, to telehealth. 548 - > We've touched on a lot of that, something that I can speak from 549 - > , to my personal experience, and that's a lot of the stuff that 550 - > I try to bring into the podcast. 551 - > You know, because I'm a patient , we're all patients. 552 - > You know, because I'm a patient , we're all patients. 553 - > But with the rise of telehealth , you've also seen the decline 554 - > in the quality of care. 555 - > So how does Relate Center address that? 556 - >

Speaker 2: Well, I'm not sure how each one of us would say 557 - > that, how each one of us would say that I miss not being able 558 - > to have some personal contact. 559 - > You know, I think what's best is you mix the two so you have 560 - > some real contact with somebody and then you can work virtually. 561 - > I don't have that opportunity right now. 562 - > Part of what I'm doing to try to stay more connected is I use 563 - > my text and email more so that I try to let people know if 564 - > they're having a hard time. 565 - > You know, we can check in with each other, we can do a short 566 - > call. 567 - > There are lots of ways to try to kind of get past that. 568 - > I just have an hour once a week or every other week, because 569 - > that's the other thing. 570 - > That's happened a lot because the costs have keep going up. 571 - > A lot of people are now coming in every other week and that's 572 - > much harder to keep the thread of how are you doing? 573 - > Are you making progress? 574 - > Where are you getting stuck? 575 - > So you know, I think you have to just up your communication in 576 - > different kind of ways. 577 - >

Speaker 1: That makes a lot of sense. 578 - >

Speaker 2: You know, I had people who are like driving in 579 - > their car and doing therapy and like that's not a good idea. 580 - >

Speaker 1: Pull over, sit down and enjoy this. 581 - >

Speaker 2: Enjoy our discussion good idea pull over, sit down 582 - > and enjoy this, enjoy our discussion. 583 - > I had someone who was doing a garage sale while she was trying 584 - > to do a therapy session. 585 - >

Speaker 1: I'm like no, let's reschedule. 586 - > Well, if she cleans out all that junk, then you know, maybe 587 - > she'll feel you know some release there um, something that 588 - > I've noticed and you know just a little bit more about my 589 - > personal life is therapy is about what you get out, what you 590 - > put in to therapy, and it comes back down to how you 591 - > communicate. 592 - > You know how honest you are, but a lot of during that process 593 - > it's more about self-realization, like when 594 - > you're trying to break down your problems to somebody who just 595 - > knows a few things about you and you're trying to distill it. 596 - > In that process you simplify your complicated problems and it 597 - > changes the way that you feel about your problems and, 598 - > additionally, it gives you a new perspective. 599 - > So I've noticed, at least in my therapy, a lot of my session is 600 - > like this this realization, like I made this out to be such 601 - > a big deal, but it wasn't, or like you know, um, it's, it's, 602 - > it's a realization process. 603 - >

Speaker 2: So I don't know, maybe I'm thinking about it 604 - > differently, but yeah, no, I think that that's a really good 605 - > way to say that. 606 - > You know, I think about so much of the time. 607 - > We have to see that we are not our problems. 608 - > We are a whole perfect self and we have problems and challenges 609 - > and when it feels like it's all one, it feels terrible. 610 - > But when you can say, oh, I'm having a problem with blah, blah 611 - > , blah Me and my ex, my job, Tell me about your job and then 612 - > what you know, you get some distance. 613 - > Like you said you can. 614 - > That's part of simplifying it, but it's also getting some being 615 - > able to look at it from a different point of view. 616 - > You know that whole idea about the elephant. 617 - > You know where you look at the elephant. 618 - > It's a different thing yeah you, you want to be able to do that, 619 - > to really understand and shift yeah right, because we're really 620 - > helping you shift your physiology from that fight or 621 - > flight kind of anxious place to more of a relaxed kind of calm 622 - > place, because that's where we really think best. 623 - >

Speaker 1: Yeah, and then you get in there and do your thing. 624 - > I'm curious and, as I started um in cyber security and my 625 - > career has been, you know, 10 years plus in cyber security, 626 - > now something that I never really thought about and now 627 - > that I'm in this industry, I think a lot about ethics, right, 628 - > you know like what? 629 - > Like what's ethical, what's unethical? 630 - > So this might be an interesting question, but what do you see 631 - > is the biggest ethical challenges in psychology, 632 - > especially in the digital age? 633 - >

Speaker 2: So I had a mentor who said was kind of reading the 634 - > tea leaves and said eventually the good therapists are going to 635 - > be called something like psychics or something because, 636 - > you won't be able to be an effective therapist under all 637 - > these rules. 638 - > won't be able to be an effective therapist under all these rules 639 - > , and so I think that's going to be. 640 - > The biggest ethical problem is when we start feel like, okay, 641 - > let me give you an example. 642 - > I treat trans people and women and men too, but in Texas if a 643 - > neighbor heard I was treating that neighbor's kid who was 13, 644 - > because they had trans issues, they could turn me in, they 645 - > could take away my license and charge me $10,000. 646 - >

Speaker 1: That's crazy. 647 - >

Speaker 2: If I told a woman she could go to another state to 648 - > have an abortion, I could lose my license that's embarrassing, 649 - > so you know you you're having to . 650 - > How do you be really helpful to people who need help? 651 - > right and I'm talking about really crazy things that are 652 - > happening, those examples. 653 - > But then you're just talking about if I'm, if I'm spending 654 - > all my time following the rules, how much time is left for me to 655 - > actually do the therapy. 656 - > So right, there's two kinds of ethical issues in that way. 657 - > You know, I'm giving you the crazy thing that's happening in 658 - > our world. 659 - >

Speaker 1: Yeah. 660 - >

Speaker 2: Politically, but I'm also just talking about all the 661 - > rules and regulations that are coming in. 662 - >

Speaker 1: I feel like that's a mic drop moment right there. 663 - > I feel like that's a mic drop moment right there. 664 - > Like you know, like you know, therapists, doctors, whatever 665 - > nurses like, should be focused on quality of care and that's 666 - > the most important thing, you know, instead of you know, 667 - > tiptoeing around policies or legal challenges or all these 668 - > things, it just eats into the quality of care, the experience 669 - > that you get from your practicing physician or 670 - > psychologist or whatever. 671 - > It just takes away from everything and it's embarrassing 672 - > . 673 - > It's embarrassing that we from everything. 674 - >

Speaker 2: Yeah, and it's embarrassing. 675 - > It's embarrassing that we're here. 676 - > Yeah, and you know, of course we want to protect people from 677 - > bad treatment. 678 - > Sure so you understand where these things come from, but when 679 - > they've kind of gone over the top. 680 - >

Speaker 1: Yeah, no, that makes sense. 681 - > This is. 682 - > This is another interesting question. 683 - > I came to some hard questions. 684 - > In case you, can't tell so for our listeners out there. 685 - > You know we have a lot in the tech space. 686 - > You know we have a lot of, you know, systems administrators. 687 - > You know people that serve and wear multiple hats and they're 688 - > juggling all these different things that life has thrown at 689 - > you or your boss has thrown at you. 690 - > You know, not everybody is going to be able to go directly 691 - > to you. 692 - > You know maybe a couple of them . 693 - > You know right, but how do you separate a good therapist from a 694 - > bad therapist and how do you know this is the right therapist 695 - > for me? 696 - >

Speaker 2: Well, I think our job as therapists is trying to 697 - > teach people how to make how to how to make those decisions. 698 - > So I know that there's some, I think psychology today does it, 699 - > but I on the website for therapists, they, I think they 700 - > talk a little bit about how do you choose a therapist? 701 - > I think one of the things I say to people is the research at 702 - > least the research a couple years ago is that within like 703 - > eight to 10 sessions, a client should be making some progress. 704 - > If not, it's the wrong therapist or the wrong technique 705 - > . 706 - > So I always tell people I want you to let's talk about what 707 - > your goals are. 708 - > We're going to be checking in to see if we're actually making 709 - > progress, if I'm the right match for you. 710 - > I think that's our responsibility is to help people 711 - > think about if they're getting what they want from the process. 712 - > Now, clearly, not everybody does that, but that's what I do 713 - > and I like. 714 - >

Speaker 1: Yeah, amazing response. 715 - > This is kind of a next generation. 716 - > I kind of want to talk a little bit about the next generation. 717 - > I feel like you have so much insight that you know I mean 718 - > maybe somebody out there might be listening who's interested in 719 - > psychology, or you know, maybe getting into the field, or maybe 720 - > somebody's daughter, son, niece , nephew, you know what I mean. 721 - > That's how podcasts work right. 722 - > How do you think psychology education and training need to 723 - > evolve to prepare future therapists? 724 - >

Speaker 2: Well, I hope we have young people who are interested 725 - > in doing this, because I love what I do. 726 - > It's a powerful thing to feel like you're making a difference 727 - > in people's lives and offering something that helps you know 728 - > versus something else. 729 - > So you know, I love what I do. 730 - > You know, I think that you had a great idea. 731 - > And why don't we get some kind of a in school? 732 - > So when I went to school, they didn't train us about how to be 733 - > a therapist. 734 - > They, you know, they expected us to go into agencies and not 735 - > do something on our own. 736 - > There should be classes on how do you build a business? 737 - > How do you think about this? 738 - > How do you streamline it so you can do the best job you can? 739 - > How do you think about what kind of ongoing training you 740 - > should be doing to keep up with what's happening in the field? 741 - > How do you do that? 742 - > How do you put together a support system? 743 - > So it would be really great because we have to. 744 - > Right now you're just kind of scrambling around to find those 745 - > answers. 746 - >

Speaker 1: Right. 747 - >

Speaker 2: You know, fortunately you have to be in supervision 748 - > right now and good supervisors are going to help people cobble 749 - > that together. 750 - > But but again, it would be so nice if you had some systems 751 - > that were really thinking about that in a better way. 752 - >

Speaker 1: I couldn't agree more . 753 - > Let's frame that also towards, maybe, psych students who are 754 - > just coming out of the university. 755 - > Hey, I don't even know what type of therapist I want to be. 756 - >

Speaker 2: Yeah, they're not supposed to know. 757 - > They don't need to know that, they need to know. 758 - > I like this field, I like learning and I'm going to take a 759 - > smattering of different things and get a direction. 760 - > Hopefully, people start out more general. 761 - > That's what you want to do and say, oh, I really like working 762 - > with x yeah so, um, that people also have personality or 763 - > behavioral traits that help lead them right. 764 - > So if you're a really analytic person who likes lots detail, 765 - > you might want to go more into some of the testing. 766 - > They're doing some incredible kinds of testing these these 767 - > days so that you're really looking more at that data or 768 - > research. 769 - > You know a research person or or if you really more a 770 - > generalist, you know you're going to like to do more, you 771 - > might want to be more a generalist. 772 - > You know you're gonna are I'm like to do more. 773 - > You might want to be more a therapist. 774 - > Like you know, there's so many things now that are available 775 - > once people get kind of the basics that makes a ton of sense 776 - > . 777 - >

Speaker 1: Um, this podcast has just we've done. 778 - > You know we've covered so much and you know something that you 779 - > know, I guess before our discussion, you know I had never 780 - > really thought about, but you know, we talked a bit about 781 - > coaching, we talked about about therapy, we talked about 782 - > psychology. 783 - > Right, and to somebody like me, like those are pretty much the 784 - > same thing, but they're not. 785 - > So do you see a future where the lines are blurred between, 786 - > like, coaching, therapy, psychology, like do you see 787 - > those merging together? 788 - >

Speaker 2: Well, I think certain groups are. 789 - > So I think psychiatrists are becoming more and more giving 790 - > medicine. 791 - > They're getting more into the medical verse. 792 - > Used to be. 793 - > Psychiatrists were great therapists. 794 - > Some of the best therapists in history were psychiatrists. 795 - > You know Jung Freud, you know they were great therapists. 796 - > Some of the best therapists in history were psychiatrists. 797 - > You know Jung Freud, you know they were great. 798 - > So now I think psychology, social work, clinical coaching 799 - > they're more and more coming together. 800 - > More and more of us therapists are getting coaching training 801 - > and more coaches are getting therapy training. 802 - > So we're kind of seeing the skills of sometimes you want to 803 - > be very practical help people with a particular problem. 804 - > They've identified a problem. 805 - > We're going to solve that problem. 806 - > Some people are here for more how to understand their life and 807 - > how to help explore what the problems are in there that's 808 - > holding them back, that they may not be able to describe. 809 - > So I think that's all kind of coming together. 810 - >

Speaker 1: Let's get out the crystal ball and in. 811 - > In 10 years, what do you think therapy will look like? 812 - > Like psychology? 813 - >

Speaker 2: Psychics. 814 - > What do you think therapy will? 815 - >

Speaker 1: look like like psychology, psychics. 816 - > The crystal ball is the difference. 817 - >

Speaker 2: Yeah, well I think it's going to continue to get 818 - > two-tiered, that people who can't afford it are going to get 819 - > the agency six sessions, take medicine and we're done. 820 - > I mean it's going to be and then people who have money are 821 - > going to have better health care and better mental health care. 822 - > I think that's the sad thing. 823 - >

Speaker 1: That's terrible and tragic. 824 - >

Speaker 2: You know, the only thing we can try to help do is 825 - > add, get people to be aware and vote for what they need yeah, 826 - > 100 um. 827 - >

Speaker 1: And this again we talked a little bit about, you 828 - > know, like doing a new business starter kit and all these like 829 - > these, these amazing things that could happen If you could 830 - > redesign one part of the psychology field, whether it be 831 - > licensing, education or even, you know, delivery. 832 - > What do you think it would be? 833 - >

Speaker 2: Okay, what holds me back is the threat of being sued 834 - > . 835 - > So there are many horror stories of someone who's decided 836 - > they don't like the therapist and they, you know, put in a 837 - > complaint and it can ruin the therapist's life. 838 - > So so much of what I having a license. 839 - > Even though they say it protects you, it also doesn't 840 - > protect you. 841 - > So you know, I have to think about is this person who wants 842 - > treatment going to be the kind of person that I can trust and 843 - > worrying about that? 844 - > And so there, you know that that you hate to have to make 845 - > that kind of be thinking about that, yeah, or mine, oh my God, 846 - > from what you were saying is like, oh my God, I'm going to be 847 - > sued. 848 - > I don't have any of those kind of things in place that you're 849 - > talking about. 850 - > You know, like it's overwhelming. 851 - >

Speaker 1: Yeah. 852 - >

Speaker 2: So I think that's the biggest concern I have in my 853 - > field. 854 - >

Speaker 1: That's crazy, like I mean you're out here trying to 855 - > help people and you know, just because you're out here helping 856 - > people, I mean usually that's rooted right. 857 - > You think about nurses, you think about doctors, you think 858 - > about therapists, right, like you're all mission driven to 859 - > help people have a better life, to live a safer life or, you 860 - > know, to to be healthy or whatever it is Like you know 861 - > there should be adequate protections in place for people 862 - > like you where you can focus on, you know, patient satisfaction. 863 - > Yeah, you know, like if you know , god forbid, you know a surgeon 864 - > cuts off the wrong leg. 865 - > We actually had somebody that that, that talked about that on 866 - > one of our other podcast episodes and he, you know, made 867 - > a medical robots, you know, and we were talking about he was 868 - > talking about some type of the way that it drills through parts 869 - > of the skull and you know there used to be a like. 870 - > There's a very small margin of error, because if you hit a 871 - > nerve here, like, you're paralyzed for like the rest of 872 - > your life and you, so you have one thing and they made some 873 - > type of technology where you know you can I don't know what, 874 - > it very complicated, but you can see where that nerve is on the 875 - > patient. 876 - >

Speaker 2: So you can go around it which is crazy. 877 - > It is yeah, and you know as we're talking, you also want to 878 - > make sure that bad treatment. 879 - > You know as we're talking, you also want to make sure that bad 880 - > treatment. 881 - > You know people don't get bad treatment. 882 - > They'll get the long leg taken off or traumatized with their 883 - > therapist because they did a bad job. 884 - > I mean, again, there are so many things we're trying to 885 - > balance here about having good treatment and you know how do 886 - > you and, of course course, what's the difference of bad 887 - > treatment, and sometimes people make mistakes that sure yeah 888 - > aren't on purpose but are still could be devastating. 889 - > I mean there's right we go from. 890 - > There's black and white, there's so much gray yeah, I got 891 - > two more questions for you. 892 - >

Speaker 1: This has been a crazy fun episode. 893 - > It's been great to talk with you too, or I mean you talked 894 - > about dealing with. 895 - > You know even the educational space of dealing with students 896 - > and up and coming entrepreneurs and things of that. 897 - > How do you feel like psychologists can better 898 - > collaborate with other disciplines in the future? 899 - >

Speaker 2: Well, it would be really nice if we had some kind 900 - > of a space, you know, an online space, where we could safely, 901 - > could, could, can, could connect with each other. 902 - > That would because you know we have to we end up leaving 903 - > messages for physicians trying to get let them know that we've 904 - > seen their patient or give them some update. 905 - > It's always hard because everybody's so busy trying to 906 - > find some kind of a space that we could all connect with each 907 - > other yeah, yeah, I mean that would be kind of like linkedin, 908 - > but for just doctors, yeah, where there's no spam and no bs. 909 - >

Speaker 1: Um, so we we talked a lot about, you know, 910 - > entrepreneurship. 911 - > I feel like we talked about, you know, starting a business, 912 - > growing a business. 913 - > You know licensing. 914 - > I mean therapy, I mean psychology. 915 - > I mean we've touched on a lot Um, what role do you feel like 916 - > psychology will play in solving you know, bigger global 917 - > challenges? 918 - > And something that comes to mind is, like you know there's 919 - > people that I mean, dare I say it are deranged in this modern 920 - > world, but also you have a lot of anxiety in this world. 921 - >

Speaker 2: You also have a lot of loneliness. 922 - > Well, I think it's all about the nervous system. 923 - > I think you've got to go back to the body. 924 - > You have to help people recognize when they're in that 925 - > sympathetic part of our nervous system which is fight or flight. 926 - > You have to help them recognize how to shift into a 927 - > parasympathetic state and it's. 928 - > I think it's all about that and how you co-regulate. 929 - > So you know you co-regulate. 930 - > I can help regulate somebody if I'm in a good spot, or my 931 - > animals. 932 - > I have my standard poodles who are part of my practice, you 933 - > know, petting the animals, working with the horses. 934 - > There's ways that we help co-regulate each other and I 935 - > think that's how we're going to have to help people. 936 - >

Speaker 1: That is an absolute epic, epic response. 937 - > I can't thank you enough for spending so much of your time 938 - > with us. 939 - > I feel like I got a free therapy lesson out of this. 940 - > So much of your time with us. 941 - >

Speaker 2: I feel like I got a free therapy lesson out of this 942 - > Blake it's been great talking to you. 943 - > Thanks, and I'm so sorry I missed the first time we had. 944 - >

Speaker 1: No, you made up for it this time. 945 - > No, of course you made up for it this time. 946 - > Let people know where they can find you, how they can connect 947 - > with you, you know, let them know. 948 - >

Speaker 2: So there are two different websites that's Relate 949 - > Center in Austin, Texas. 950 - > That's relatecentercom, or beyondboundariescoachingnet, 951 - > which is a bummer. 952 - > That it's net Sarah. 953 - > It's Sarah at Relate Center. 954 - > It's the easiest way to go and I'd love to hear from anyone 955 - > who'd be interested in either just talking more about this or 956 - > coming in for some work. 957 - >

Speaker 1: Sure. 958 - >

Speaker 2: We'll make sure to leave. 959 - > And our podcast yeah, we have a podcast on Beyond Boundaries 960 - > Coaching. 961 - > You can find us on Apple on all the major podcasting services. 962 - >

Speaker 1: We will certainly in our show notes here link 963 - > everything where you can find Sarah. 964 - > Thank, you, everybody, she. 965 - > This was a fun one. 966 - > This was a fun one. 967 - > Again. 968 - > I can't thank you for spending so much time with us sharing 969 - > your you know your opinion on psychology. 970 - > I mean, we talked a lot about entrepreneurship and I mean you 971 - > know the future of therapy. 972 - >

Speaker 2: Thank you so much, thanks for you Great to talk 973 - > with and good luck and I can't wait to hear it. 974 - > Yeah, podcast, it sounds really interesting. 975 - >

Speaker 1: It'll be out before you know it. 976 - >

Speaker 2: Okay. 977 - >

Speaker 1: Bye. 978 - >

Speaker 2: Bye.