Inside La Ventana Teen Mental Health

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Speaker 2
We pivot with them always, always, because no client is the same, no families the same, no clients the same, and says something like, we might be doing something that works. Really what we actually just said to that we might be doing something that works really well for Amelia, like Alex will take them all on like jogs or hikes or do like a workout class.

00:00:17:12 - 00:00:24:04
Speaker 2
And some kids might love that, and that might be great for their mental health. And some kids may hate it and not love it.

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Speaker 1
You're listening to Beyond the Window, where today's episode, we pull back the curtains on teen mental health treatment.

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Speaker 1
We're taking you inside our residential program for teen girls, where healing isn't about one size fits all solutions,

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Speaker 1
But meeting each client exactly where they are.

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Speaker 1
today. Join Clinical Director Carla Fernandez,

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Speaker 1
primary clinician Alex Acerboni

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Speaker 1
And Director of Education Deanna Ruby, as they share what breakthrough moments really look like.

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Speaker 1
Let's listen in.

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Speaker 2
Welcome to Beyond the Window. My name is Carla Fernandez, and I am the clinical director for La Ventana Teen Treatment.

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Speaker 2
And in the studio with me today, we have Deanna Ruby, our director of education at La Ventana Teen. And our primary clinician, Alex Acerboni.

00:01:03:18 - 00:01:26:00
Speaker 2
All right. So we are here today to just kind of talk about teen mental health and navigate the mental health system for teens, which I think are huge common questions that we often get. One of the big ones that I think that we do get pretty often is just how, we navigate teen mental health at and, and what makes us stand out.

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Speaker 2
What's different about our program. So, I mean, I have all sorts of good things to say, but what do you guys think? What do you guys think about our program and kind of how we navigate on the day to day basis?

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Speaker 3
I think our approach stands out, because we meet the clients where they're at, and we are really flexible in the things that we do. Whether it's changing the groups to meet their specific needs, or be in the classroom as I'm.

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Speaker 4
Sure it is for me.

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Speaker 3
In the classroom, like just meeting the clients where they're at a meeting, the families where they're at.

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Speaker 3
Totally.

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Speaker 2
Totally. And I think even just navigating, like, the mental health system in general, a lot of the calls that I do get from parents, they have no idea what's going on. They have no idea, like where to start or if it is even at a level where they might need residential care. What is right essential care look like?

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Speaker 2
Is it like, a hospital? Is it, you know, an institution? I think that is is a big one. So I think being able to be the person that each parent like, speaks to and, and really do like a warm handoff as they come into our program, even though, you know, I'm there, but also just introducing them, giving them education and like helping them throughout the entire time, I think is huge for us.

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Speaker 2
Just because it's a scary time for a lot of families. So I think that's a huge, huge piece, but also just our education department.

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Speaker 1
I was thinking as a parent, you know, what is it that would make me? Where is the line? So when you said, you know what, as a parent, what would you take to get to a place where you'd want to put your child in residential? And I think that scary part about it all. Yeah, I think even before we opened the house and we were thinking about what kind of program we'd have, and, you know, the word I hear over and over again, I use it all the time in the classroom, and I hear you say it a lot is pivot.

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Speaker 1
So when you say we kind of change as we go and to meet their needs, I think that is like the most important thing that I could say with the program as well.

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Speaker 2
We pivot with them always, always, because no client is the same, no families the same, no clients the same, and says something like, we might be doing something that works. Really what we actually just said to that we might be doing something that works really well for Amelia, like Alex will take them all on like jogs or hikes or do like a workout class.

00:03:46:03 - 00:04:06:22
Speaker 2
And some kids might love that, and that might be great for their mental health. And some kids may hate it and not love it. And they might find like they just poetry. So now they want to, you know, do all of this like creative flow and poetry and kind of express their emotions in a really deep and meaningful way through different, different modalities.

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Speaker 2
So I think and then they asked us, of course they can we do this some more. Is this okay? And yeah, of course we'll do that. Right. And even with parents, I mean, just thinking of a few clients that we have right now, we've had a client for quite some time, and it seems like every couple of weeks it's like a different chapter and something new and something different.

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Speaker 2
And this is not working. And what about this? And we're just pivoting with the parents to like assuring them, hey, that's okay. Like, this wasn't working. We're going to try something different. Or maybe it worked and it kind of took its time. It's it's all done now. And where do we go to next? And so having all of these can-do attitudes I think is really important for the parents, because they're coming to us at a time where they're so lost and they don't know what to do for their child.

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Speaker 2
I think also really stands out with us. I know a lot of the time they have questions about like the severity of their child's behaviors and also just calling us and being met with like normalization of this is what we do. Like this is no, but you don't get it. They're really, you know, they have a lot of attitude or they, they run or they get really like verbally aggressive.

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Speaker 2
This is what we do. Like we work with this and this is how we do it. And these are the modalities that we use. I think is a huge part that I like to emphasize.

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Speaker 3
Go ahead. I was going to say, I think the environment.

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Speaker 1
As I said, so.

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Speaker 3
Small, like just that it is a home and it's more intimate. It allows us to be very hands on, like you said, pivoting. We can meet the client's needs and it just feels like a home versus some other facilities that are much larger and have more kids. It's very, you know, we really get to know the kids on a personal level and like you said, finding out what they like, what works for them, what doesn't work for them, and making those adjustments as needed.

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Speaker 1
I was thinking the exact same thing, Alex, because it is a home.

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Speaker 4
It doesn't look like a home. It is a home.

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Speaker 1
Yeah, and not only that, you know the kids you do cooking with them and you're teaching life skills besides mental health. You know the.

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Speaker 2
Harmony. Yeah. They do like the money and an admin allowance.

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Speaker 1
Yeah. For doing the things they're supposed to do. And, and.

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Speaker 2
Then they have their little, receipts where they're like, they always have the next thing in mind. So they're like, how much money do I have left? And like how much is that? And when can I get that? And what if I do this many points? Will I get that? Like, there's so much more at play there.

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Speaker 1
And also seeing the clients interact with each other, they're like a family, you know, they bicker, they get along, they love each other. And when one leaves, yeah, they all are so sad. And don't forget to.

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Speaker 4
Write and call me.

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Speaker 2
You know?

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Speaker 5
And so yeah, they really do.

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Speaker 1
Make some deep connections on top of getting the help they need.

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Speaker 4
It's also really cool. Sorry. Yeah. Okay.

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Speaker 2
It's also really cool. I thank you for mentioning that because it's also really cool to help foster these relationships, because they're so used to having really negative relationships or, you know, for lack of better terms, toxic relationships, verbally aggressive relationships, domestic violence, relationships, like all sorts of relationships that they see at home or they see at school. And then in real time, we are able to hold conversations that are healthy and correct behaviors and kind of give them insight as to, hey, the way that you're speaking is not working and this is why.

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Speaker 2
And let's try it over and over and over again.

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Speaker 1
Boundaries with love.

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Speaker 4
Yeah, totally.

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Speaker 1
You know.

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Speaker 2
Totally gentle, all kind, respectful, loving approach, but still very firm on that. This is how we do it. And this is why.

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Speaker 1
And it's funny, it's almost like a hierarchy with them as well, because the clients know that you are the ultimate answer. So they'll sometimes go to people like other people that are working in the.

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Speaker 4
House first.

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Speaker 1
To test out, can I do this right? Yeah. No, no, no, we're going to have to ask Carla. And then they've asked, you know, they've go behind.

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Speaker 2
I've actually tried to I mean yes, absolutely. But I try to still be like, well, did you ask, you know, Marissa, did you ask Diana? Like, why are you asking me? Well, and I'm like, yeah, but we were all, you know, I don't totally you can see them doing what they do with their parents.

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Speaker 4
Absolutely. No.

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Speaker 1
Which is a healthy, healthy thing to see, you know, anyway, or.

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Speaker 2
Even doing things like.

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Speaker 4
Oh, they.

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Speaker 2
Would, she wouldn't like that. Yeah. Or that Alex would be upset if I did. Like, they start to really think, you know, and and grow connection with us, which I think is important. But then also we are able to hold like that professional boundary and then just have these really like reparative and experiential moments with them, which I think is important.

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Speaker 3
What I think I love about our house as well as like some of the life skills you talked about, like the chore wheel that we. Yeah. And those are things that they are not doing at home. Yeah. Like we're helping facilitate that constant practice. And you know, sometimes their mental health is impacting their ability to complete those, you know, functional things.

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Speaker 3
And we're allowing a space for them to consistently practice that and build that are habits that they can take at home. And yeah, that's a lot of what we do with the parents. Right? Is yeah, giving them that coaching and helping them set the boundaries and expectations for when they return home.

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Speaker 2
A big part of that too, I think like, for example, I had an assessment earlier today where the dad was basically like warning me about this. Like she just gets really triggered by A, B and C and and then she won't do what I'm asking her to do. And so basically I held space for that of course.

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Speaker 2
But also then like educated like we do follow through. Right? We have so many women in the House that are involved, clinicians, mental health techs, myself. So we have obviously like the, the woman power, and also the patients and, and the modalities that work. So it's like, yeah, maybe they don't want to do it. And then we're going to give them space, meet them more.

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Speaker 2
They add do some coping skills, explore what is. So trigger some and then revisit it again every single day. Where of course, like a parent is not always going to have all this time and energy to do that or even more so educate them on the reason this triggers you so much. In some traumatic event, we're going to piece that through and then get back to the behavior, you know, so it's I think slowing down with them and providing them that too goes a long way.

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Speaker 2
Then they go home and they are able to readily like take that on with their parents because they now understand themselves better or, you know, have the skills to do so.

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Speaker 4
Yeah, absolutely.

00:10:19:14 - 00:10:27:16
Speaker 2
and of all of the modalities that we use, like obviously we use CBT, we use DBT, we've tried narrative therapy, we've tried somatic therapy.

00:10:27:16 - 00:10:40:14
Speaker 2
We we bring basically anything that feels like it would work for the clients and tailoring to where they are. What do you think is your favorite to run like in a in a group setting? What is like just your favorite?

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Speaker 3
That's a good question. I really enjoy CBT. Yeah, because I think, getting them to understand the connection between like how I'm thinking and feeling and then how that's impacting your actions and seeing their, their process and like reframing some of the negative thinking patterns that they're having and like making the connections with how I'm feeling, is directly impacting the way I'm behaving.

00:11:05:19 - 00:11:23:18
Speaker 3
And then I'm in control of that. I think it's empowering to them, to recognize that just because they're feeling this way does not mean that they have to act this way, and that they have power to change that. Yeah. So I really, I really enjoy running that group and just seeing like from the day that they get there until the end, the progress in their ability to like reframe

00:11:23:18 - 00:11:24:15
Speaker 3
some of those negative.

00:11:24:15 - 00:11:26:18
Speaker 2
Thoughts on their own. Yeah. Yeah.

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Speaker 4
Very.

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Speaker 3
Yeah.

00:11:28:05 - 00:11:37:07
Speaker 2
I love that. Like the empowering piece to me is I think we try to instill that in them, like every day with every choice. It's like we're empowering them to take this on for themselves.

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Speaker 3
Yeah, I think a lot of them, when they come to us, they feel very much like this is out of their control, but in reality they have. So yeah, like, what are you doing with that control?

00:11:44:16 - 00:11:46:23
Speaker 2
Yeah. Shifting the perspective. Totally,

00:11:46:23 - 00:12:09:21
Speaker 2
totally I love trauma, I love I love trauma and trans generational. Or intergenerational trauma. I love it because it's almost like there's like a light bulb that goes off and they're like, oh, like, this is why I act this way or yeah, you're right. This makes me feel this way. And then I do this and, you know, like it's it's like a beautiful connection.

00:12:10:02 - 00:12:30:20
Speaker 2
And then with intergenerational trauma, it's a little something. It's a hidden mess depending on kind of the milieu and their development, both chronologically and emotionally and their age obviously. But I think when they get it, they're like, wow, this has been going on in my, my line, you know, or my lineage for years. And it could stop with me.

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Speaker 2
Or I could be the difference or I can I can change or I can help and, you know, just change their narrative and kind of where their life is going down. I think it's huge. But then also, I wanted to kind of just talk about, like, the modalities that you all use in our classroom because we, they go to school with you every day.

00:12:50:01 - 00:12:58:05
Speaker 2
There's like a chunk of time with the director of education and the school liaison that they get with you all, which also works really well.

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Speaker 1
That piece, you know, that's my heart. I've been teaching forever, and I end up falling in love with these clients and they start off with whatever they can do and whenever they can't. But when we first opened, if you remember back, we would just go. I mean, the benefit of having a classroom teacher, I was in the classroom forever.

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Speaker 1
If we were taking a walk and they were interested in the leave. So I did a whole unit. I remember in photosynthesis and.

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Speaker 4
Everything, but.

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Speaker 1
I think for me, watching them open up because a lot of them have been really hurt in school, that's been a really triggering place. They don't feel seen by their teachers. They may have conflict with their friends. And in our classroom, which is a classroom, because we have to know all the things that would be in a classroom.

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Speaker 1
Yeah. They're safe, you know, there's no judgment. And they're girls that are, you know, almost 18, 17 and they don't know how to multiply or divide or they have trouble reading and no one's making fun of it. So again, back to that pivot. We just start wherever they need and we work with them. And the beautiful thing about it really is same thing if they're interested in art, we explore big units and art or they like science or whatever it is we add to that.

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Speaker 1
So school does go year round with us. Yeah, but our program during the holiday seasons are, much more driven by their interest.

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Speaker 2
And it's so fun. And I remember last year a lot of, like, creative things too, or like, I mean, creative. Yes. But also math is known and they're like, I remember you all did the, the, like, build a restaurant, and and then make you also like cooked into the pizza. And then you also did like the menu but they got to like decorate it.

00:14:46:20 - 00:14:50:18
Speaker 2
But then also like what is the prices like. It's incorporating all of these different pieces.

00:14:50:18 - 00:15:05:13
Speaker 1
Well that's what we try to do is make it as hands on as possible. Yeah. Because it's like going back to foundational skills really and making it meaningful for them. And I mean, that's what you're doing all day, right? Yeah.

00:15:05:15 - 00:15:05:21
Speaker 4
And I.

00:15:05:21 - 00:15:28:16
Speaker 2
Think like, they maybe don't see it as like this is like also mental health work, right? Because it is at the educational part of the day, but also like from the outside looking in, I see a huge increase in their like self-esteem and, and then in their confidence and I like feeling good about it being in the classroom.

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Speaker 2
Like right now we have that the client that just wants to work all the time. Yeah. And I work in the morning and I work today.

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Speaker 4
I don't.

00:15:34:19 - 00:15:43:14
Speaker 2
Have to I don't have to go to lunch right now. I'll do this first. Or can I work in the nighttime? Like she feels so empowered and able, and she wasn't even going to school.

00:15:43:16 - 00:15:45:06
Speaker 4
She's going to school.

00:15:45:08 - 00:15:51:00
Speaker 1
And she's making up many years in a very short amount of time. Yeah. So that's an accelerated. And she's so.

00:15:51:00 - 00:16:01:14
Speaker 2
Excited she'll like come and tell all of us like, oh, I just finished my test and I did so good. Or last week she had like this CPR and she went and told all of us about it and was just like so excited, very.

00:16:01:14 - 00:16:04:17
Speaker 1
Proud of their accomplishments. That's what's really wonderful.

00:16:04:17 - 00:16:06:01
Speaker 4
Yeah. It's huge.

00:16:06:01 - 00:16:22:01
Speaker 1
And yeah, I love seeing that as well. And they like to share what they're doing. And most of them I would say the biggest portion of clients that come to us have had a really bad experience. We've had a few that are super smart and, you know.

00:16:22:01 - 00:16:22:14
Speaker 2
Going, yeah.

00:16:22:14 - 00:16:45:08
Speaker 1
They just do. They do what they need to do or they don't. But I think when you said choice every day, that kind of rang for me as well, because there's no consequence. If they don't do their work, there's no consequences if they just sit. They're not going to be sent to the principal's office. You know, we just give them the time out and then they can, or they want to see you.

00:16:45:08 - 00:16:55:10
Speaker 1
Yeah. Or you and then they come back in and whatever. So I mean, it's the best situation for education because they're getting, all the help that they could get.

00:16:55:11 - 00:16:56:22
Speaker 2
I also think with that.

00:16:57:00 - 00:16:57:13
Speaker 1
Yeah, that's.

00:16:57:13 - 00:17:15:13
Speaker 2
I think with that too, what we do or what I've often done with clients that are having a hard time, I can think of a few of the yeah, going to school and they don't want to go right then turns into a conversation, not about like consequences in terms of like the house, but like your own natural consequences.

00:17:15:13 - 00:17:32:20
Speaker 2
Right. Like it's like, okay, how come? What's going on? What do you lose out on? You know, what do you have to do now if you miss all of these days, what are your parents going to say? Like what's going to help? How do you make this up? And then it's like, just shoot. You know, like, maybe I should go or maybe I should ask and usually it's a different piece.

00:17:32:20 - 00:17:51:22
Speaker 2
It's like, I don't know how to ask for help. I feel really dumb in there. Or like, I just, I shut down because what they're talking about, I don't understand. And then it turns into, let's use their communication. And as soon as they can use it, they want to be in there. Yeah. But it's, it's we have the time to then address in that moment what's going on and then get them right back into the classroom setting.

00:17:52:03 - 00:17:59:09
Speaker 1
And we've had some times where they've come in fighting from before and come into the classroom still fighting amongst themselves. Right?

00:17:59:11 - 00:18:01:00
Speaker 2
Yeah. Ready to go? Yeah.

00:18:01:02 - 00:18:02:03
Speaker 1
That's always been fun.

00:18:02:03 - 00:18:03:19
Speaker 4
But

00:18:03:21 - 00:18:19:14
Speaker 1
Yeah, I mean, I think they I really do feel like they love the program and I feel like they're very appreciative and I feel like they come into class wanting to do what they can, as much as they can to make up whatever they might have missed as well.

00:18:19:16 - 00:18:36:04
Speaker 2
And I think, like how you said, I really do feel like they love the program. Like, obviously we love our program. So we're like, everyone loves it. But I can really tell, like, we're doing something and we're doing really good work when I have repeat parents. Yes. Or repeat clients, yes. They're like, they will not go anywhere else.

00:18:36:04 - 00:18:52:23
Speaker 2
Like we tried A, B and C after. Or you know, they did so much better. However, they're still struggling with this piece, but they just want to go to you guys. They missed so-and-so. They missed this and that. Yeah. And then they come. And it's so much love. Like they're like so excited to be there with us. And they know like the rules in the group.

00:18:52:23 - 00:18:57:04
Speaker 2
And there's a lot of work to be done. But they really appreciate being there.

00:18:57:04 - 00:19:02:15
Speaker 1
And they and they tell all the other clients as well. This place is great. Yeah. You know, you're going to love it here.

00:19:02:15 - 00:19:03:21
Speaker 4
And you know it.

00:19:03:21 - 00:19:07:10
Speaker 2
Works out great with like the other client is struggling and they're like I don't want to be here. I hate.

00:19:07:10 - 00:19:07:14
Speaker 4
It.

00:19:07:18 - 00:19:12:11
Speaker 2
But then there's like a person that has already been here. They're like, just give it a minute. Like you're going to love it.

00:19:12:12 - 00:19:16:03
Speaker 1
It's like the sibling that's gone away for college or something, you know?

00:19:16:04 - 00:19:16:18
Speaker 4
Yeah.

00:19:16:18 - 00:19:19:06
Speaker 2
Which is super cool to see. Yeah.

00:19:19:06 - 00:19:38:12
Speaker 3
I think that's the biggest thing to like when clients leave our facility, it's like change their perspective on school and therapy. It's like therapy doesn't have to be a scary thing. School doesn't have to be a place that they hate to go to. It be positive experience. And I think that's what I see a lot of the clients like with like their desire to continue therapy and their desire to go to school and change.

00:19:38:12 - 00:19:41:20
Speaker 3
And yeah, I think that's because of the type of environment that we foster.

00:19:41:22 - 00:19:42:23
Speaker 4
The it's

00:19:42:23 - 00:19:43:02
Speaker 4
it.

00:19:43:02 - 00:19:44:17
Speaker 2
Changes the narrative. I think like.

00:19:44:17 - 00:19:48:04
Speaker 4
A lot of the, I would say maybe a little.

00:19:48:08 - 00:20:08:08
Speaker 2
Less than, you know, half of the like the people that we get that come to us, they're coming to us. Having already had a really negative experience with therapy, it was either court mandated or they are a foster youth or they were removed, or there's an active cat or something, right? Something that was forced upon them, and then they're just thrown into this therapy and they're like, what?

00:20:08:08 - 00:20:27:08
Speaker 2
What is this even? Right. So I think when they come to us and we kind of just like shift it a little bit and, and meet them again where they are, but then also do the really heavy work. They're like, oh, this is, this is nice. This will I feel hurt, I feel seen, I feel safe, I feel good and and then when they leave, they're like, can I take you with me?

00:20:27:08 - 00:20:28:12
Speaker 1
And it's like they always say that.

00:20:28:12 - 00:20:32:04
Speaker 2
Yeah, but there's a bunch of therapists like this everywhere. You can continue with.

00:20:32:04 - 00:20:33:05
Speaker 1
And or can I email you?

00:20:33:05 - 00:20:38:18
Speaker 4
Can I, can you come stay with me? Yeah, yeah. Totally.

00:20:38:18 - 00:20:43:01
Speaker 2
So when we were on our way over here, one of our clients obviously was like, can I be part of it?

00:20:44:02 - 00:20:46:15
Speaker 2
I want to be in there. Can I see it? You better. Shit. Well

00:20:46:15 - 00:20:48:23
Speaker 2
She told you this? That you better shout us out.

00:20:49:00 - 00:20:50:06
Speaker 4
Yeah. So.

00:20:50:07 - 00:20:54:09
Speaker 1
Well, we want to give a great big shout out to our clients.

00:20:54:11 - 00:20:57:14
Speaker 2
Who are amazing, amazing.

00:20:57:16 - 00:20:59:11
Speaker 4
Funny, silly.

00:20:59:13 - 00:21:03:16
Speaker 2
Compassionate and so smart. Clients back at the house.

00:21:03:18 - 00:21:06:03
Speaker 1
Yes. And we couldn't do this without you.

00:21:06:03 - 00:21:07:11
Speaker 4
We could not. No, not at all.

00:21:07:11 - 00:21:14:11
Speaker 3
They. They make the house what they do. So fun to come to work every day. Yeah. They're going to be there. Yeah. To work with them every day.

00:21:14:17 - 00:21:15:11
Speaker 4
So.

00:21:15:23 - 00:21:20:04
Speaker 1
Thank you for joining us inside, Beyond the Window, a love and Turn of treatment podcast.

00:21:20:04 - 00:21:22:11
Speaker 1
more insights and adolescent mental health treatment.

00:21:22:11 - 00:21:24:00
Speaker 1
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