Maggie McKay (Host): Welcome to Valley Vitals: The Pulse of Healthy Living in Our Community, brought to you by Carson Valley Health. We're going beyond the checkup to bring you real conversations with the experts you trust. I'm your host, Maggie McKay. And today, we're talking with behavioral health manager, Erin Dudley, and primary therapist, Michelle Miller, about Vitality for Life Outpatient Behavioral Health. Thank you both for being here today

Erin Dudley, LMSW: Thanks for having us.

Host: Absolutely. So Erin, would you please start. Give us a simple overview of the Vitality for Life Intensive Outpatient Program, who it's for, what it offers, how it helps seniors stay active, engaged, and emotionally well through different seasons of life.

Erin Dudley, LMSW: Absolutely. So, this program is exactly as you said, it's an intensive outpatient program, which means that our clients are in services with us at least nine hours a week. So, they do three group therapy sessions per day, three days a week. We also have a nursing education component so that we're checking into patients' overall health and wellbeing, not just their mental health, because they are so intertwined. And then, there's also lunch that is provided to make sure that these clients are getting a healthy meal at least once a day. We also have psychiatry services and individual therapy services available as part of the program. So, it's intended to help seniors, anyone who's 60 and older, to deal with typically depression, anxiety, trauma-related issues.

Grief and loss is a huge theme in the group, and it's intended for people who need a higher level of care than just seeing a therapist once a week. So if that's not enough for somebody, the Vitality Program is usually a good fit, and it is primarily group therapy. So, it's individuals who are in the same walks of life and dealing with similar struggles, and they interact in the group dynamics to be able to help each other to learn skills for coping, interactions and interpersonal relationships, and all kinds of things that I'm sure we'll get into as we talk about this further. But it helps seniors get connected, it helps them with their overall mental health, and it helps them get services that are hard to come by, especially in our rural communities.

Host: And Michelle, for listeners who might be searching "Is it normal to feel sad or hopeless as I get older?", how do you explain the difference between normal life changes and a mental health problem that needs some care?

Michelle Miller, LMFT: The short version of that is how impactful it changes their life. In terms of like normal life changes, they can be incredibly impactful for one person and not as impactful for others. So, big factors for our population is like losses within their lives, whether that's loved ones or friends. Their physical health decline can be a huge factor in that, loneliness, kind of navigating the perception of aging. So, all of those are factors that can kind of help us navigate kind of that normalcy. It really depends on support systems. So, that's what Vitality For Life can really be helpful for, is to create or help create that support system if they don't have that and/or create extra support systems if they're really struggling through those aging factors or just different changes in life that maybe they hadn't experienced prior.

Host: What a great resource. It sounds like you guys have thought of everything. Erin, your program includes a psychiatrist, licensed clinical social workers, and nursing staff. How do all of these professionals work together to create a safe, secure environment and a personalized plan for each senior?

Erin Dudley, LMSW: So, our staff, we do have some licensed clinical social workers. We also have marriage and family therapists that work together with our psychiatrists and our nursing staff to really look at the overall health and wellbeing of these clients who are coming in. We don't just want to look at what are their mental health needs. We also want to consider what are their physical needs, what are their medication needs, what are their family and interpersonal needs, and how can we utilize our team to provide for all of those in one environment. We do have multidisciplinary meetings where we all get together and we talk about case consultation and what's happening for our clients and how can we best serve them.

And then, we also have our nurse case manager who kind of does all of the coordination for the go-betweens of the therapist and the psychiatrist and anything else that the patients need in the community. So, we're able to utilize our teams and their strengths to meet their needs both here and then what other resources do they need and how can we help them get connected to them.

And then, we are also able to connect within our Carson Valley Health system as a whole. So if their primary care provider, for example, is part of our Carson Valley Health system, we're able to have communication with them and ensure that the primary care provider is aware of what's going on and can help engage in their overall care as it relates back to Vitality For Life.

Host: Michelle, would you please walk us through what treatment looks like in an intensive outpatient program like Vitality For Life? How often do people come, and what do they do during the day, and how is it different from regular weekly counseling or a hospital stay?

Michelle Miller, LMFT: Yeah, absolutely. So, the patients that come through Vitality For Life will come three days a week, so typically Monday through Wednesday, 9:30 to 1:00. So, they will typically start off with a mindfulness group, is their first group. They'll take about a 15-minute break, and they'll do a psychoeducation group where you'll go over various topics. We'll talk about like importance of mindfulness, importance of like connection. Another topic is self-compassion, boundaries. So, various topics will be taught in there. And then, they will have their nursing group where they'll get different nursing education, and then they'll take their lunch and finish their day with a processing group where they'll meet with a therapist to kind of process their day and any other things they feel like that will come up with them.

Each one of our patients that are in Vitality For Life will also get individual therapy once a week. So, they will meet with one of the clinicians either within the program or outside of the program that is still with Carson Valley Health for once-a-week therapy to be able to kind of focus on their individual needs and as well as the group. So, they get a lot more like personalized care with that as well. They also meet with a psychiatrist once every like two to three weeks too to discuss any needs there.

Host: It sounds like a great community also. I mean, all those resources, but also, you know, they have other people in their same boat that they can meet and socialize with. And, you know, families often notice changes, but they worry about "upsetting their loved ones," understandably, by bringing up the topic of mental health. So, how can caregivers start that conversation in a kind, respectful way that opens doors instead of causing conflict?

Michelle Miller, LMFT: I'd usually start with being curious. So, I would typically encourage someone to kind of talk out to their loved one about like maybe what they're feeling, how they might be feeling about what someone might be noticing. So, really using curiosity as a tool to navigate where they're at or what they're feeling, or if it's really even being as impactful to their day-to-day life as maybe someone around them might think that they will be feeling

Host: Erin, is there anything else in closing that you'd like to add?

Erin Dudley, LMSW: I just think that this program has been around for a little over 15 years, and it's shown over time just to be really beneficial for this population. We understand that people are not coming to us when they're feeling their best, and they're not always sure what to do about it. So, we really pride ourselves on having a team that is able to understand where people are coming from, meet them where they're at, and really provide them with a lot of education and a lot of tools to help themselves.

And our goal is always to, you know, have them feeling better and doing better than they came in when they're done with us. So, it's a 12-week closed program, which means they run every 12 weeks with the same group of people. And our hope is that, you know, within that 12 weeks, we can really provide them with some tools to feel like they can empower themselves to do better and feel better in their lives.

Host: Thank you both so much for being here. This has been so informative, and we appreciate you sharing your expertise. What a great program.

Erin Dudley, LMSW: Thank you. Thanks for having us.

Host: To learn more, visit carsonvalleyhealth.org. And as we wrap up another episode of Valley Vitals, make sure to subscribe to our podcast, share and connect with us on social media, and stay tuned for more engaging discussions. This is Maggie McKay signing off from Valley Vitals. Let's move mountains.