Courtney Collen (Host): Hello and welcome. You are listening to the health and wellness podcast brought to you by Sanford Health. I’m your host Courtney Collen with Sanford Health News. This series begins new conversations and continues the important ones, all designed to keep you well, physically and mentally featuring our Sanford health experts. We are continuing our conversation all about mental health, how to find a provider and where to get the help when you need it. So I’m sitting down with Kate Andal, PhD and Kayla Nalan-Sheffield, PhD, both are psychologists here at the Sanford Psychiatry and Psychology Clinic in Sioux falls. Thanks so much for joining me, both of you.
Dr. Andal, you’ve been here at this clinic for a little while. I want to know a little bit about your philosophy of care.
Dr. Andal (Guest): So my primary role is I am a neuropsychologist. So the bulk of my job involves testing people who are having cognitive changes either because of head injuries or possible dementia or other neurological issues. And so I make I perform testing and then make recommendations about care. And my philosophy of care, which is on my bio card on the website is really about the intersection of science and compassion. And we have to really use good evidence-based practices, but also remember that people are struggling, even if they don’t understand why they’re struggling.
Host: Talk about some of the patients that you’re working with this year right now and what you’re seeing most.
Dr. Andal: Well, anecdotally, because I haven’t done much research, but anecdotally I have noticed an increase, particularly in our older population. People who’ve real concerns and have noticed some memory changes and really, it seems to be related to loneliness and isolation and anxiety about all of the things going on in the world and less about dementia, which is good news for them. But there definitely has been an increased need, I think, in, especially in our older folks. Yeah.
Host: And how does that correlate to the COVID-19 pandemic that we’re experiencing right now?
Dr. Andal: Well speculatively of course, it seems to me that a lot of our older folks are following guidelines, which tell us to isolate and to stay away from crowds and to not go out and do the things we normally do. And when you’re an older person who isn’t working and your entire social life has now been cut off, you’re pretty much stuck at home all the time, lonely and isolated and not all, but some older folks are less technologically savvy and haven’t necessarily made the leap to doing like zoom Hangouts and those kinds of things. So it does seem to be since, since last March or April with the pandemic, things have really increased in terms of older folks,
Host: Kayla, you’re new to the clinic. Tell us about what you do and some of the specialty care you provide.
Dr. Nalan-Sheffield (Guest): So I’ve been with Sanford since middle of September of this year. So just about two months now. Whereas Kate does mostly testing. I primarily do therapy. I also do some psychodiagnostic testing as well for personality functioning and just diagnostic clarification. Most of the work I do though, does involve individual therapy, treating things like anxiety, depression, post-traumatic stress disorder just adjustment difficulties. Other really, I do a wide range of treatments. I’m seeing a couple people now for eating disorder, panic disorder, things like that. I also do couples therapy as well.
Host: What is the difference between anxiety and depression?
Dr. Nalan-Sheffield: So there’s a lot of overlap in anxiety and depression symptoms, people with both will report, just difficulties concentrating, sleep problems, sometimes feeling a bit more restless. They do differ in some aspects, people who experienced depression tend to, you know, be a, be a bit more slow to move around, have a hard time motivating themselves to get out of bed or do the things that they might otherwise enjoy doing or give them a sense of accomplishment. They might also experience an increase in suicidal thoughts have a bit more kind of hopeless outlook or pessimistic outlook on the future. Then somebody with anxiety people with anxiety might feel even more so restless than what is typical for them. Might have a lot of worry about the future and just what that might hold as opposed to kind of that more pessimistic thing. Just more worry and anxiety in that regard.
Host: So in the few months you’ve been here, what are you seeing most often in your patients? What are you hearing from them? What are their concerns? Sure.
Dr. Nalan-Sheffield: Similar to what Dr. And also had a lot of just difficulties with isolating and not having those supports around them anymore. A lot of parents struggling with just managing school at home and how to help their kids with math problems that they haven’t done in ages. Just a lot more difficulties just managing everyday stressors that they, you know, pre pandemic might have had an okay time managing on their own
Host: Tele-Health comes into play. This year in a large, I mean, a lot of providers, physicians are, are offering the video visits. How does that play a role in what you guys are doing here? Are you offering video visits?
Dr. Nalan-Sheffield: So we are offering video visits either via zoom or via my chart. I have been doing them for a therapy for doing assessment. That’s not, not inappropriate means of doing, doing that type type of treatment, but certainly therapy is appropriate over video. And actually we see that it’s equally or comparable in effectiveness as doing an in-person session.
So unfortunately we can’t really do testing over video because there’s a lot of, excuse me, manipulating like objects and stimuli and things like that. But we do do like feedback sessions we can do over video. I think we’ve got a pretty robust my chart program, which is been really great for people. And then FaceTime is the other one we use a lot. But I know that therapy for therapy, that’s been just really, really a lifesaver, I think for people.
Yeah. It’s been really nice for people who have unexpectedly had to foreign teams, so they can maintain their progress in therapy by being able to attend their appointments, even if they had been coming face to face, they can just switch that to a video visit by simply calling the clinic and we can still meet as planned during their, their weekly appointment. So that’s been a nice, a nice service to be able to offer.
Host: Yeah. Yeah. It sounds like it. And you had mentioned it doesn’t really, it’s not like you’re sacrificing quality, you know, versus being here in the clinic. Yeah.
Dr. Nalan-Sheffield: The research would suggest that it’s comparable in effectiveness. There are certainly some things that you miss out on and things that are easier in, in person to do like reviewing homework assignments or things like that. But for the most part, I’ve found it to be a pretty seamless process for people have, you know,
Host: I noticed more this year that this is a really challenging time for a lot of different people of all ages. Are you seeing kind of an uptick in people wanting to get help or at least wanting to come talk to somebody? And do you think it, you know, it is related directly to the pandemic?
Dr. Nalan-Sheffield: I think so, like I had mentioned just a lot of the coping skills that people would otherwise do, hanging out with friends, spending time with family going to the park and taking a stroll or just having coffee dates with people. They’re not able to do that anymore. And so that social outlet in that support system is just lacking for a lot of people. And so that’s certainly something that’s increasing stress and symptoms.
Dr. Andal: And I think there’s also a lot of increased stressors just in the environment around us. There’s a lot of very strong opinions that are very loudly voiced and a lot of confusion and there’s economic challenges that come with either having to take, you know, leave work to stay home with kids or just because you’ve been furloughed. And so I think a lot of challenges like environmental challenges happening that, and then we reduced their coping skills. And I think in general, there’s a lot more people struggling.
Host: And with that in mind, maybe somebody doesn’t realize when you’re actually in that situation or maybe you think it’s not for me, not right now. I’m, you know, I’ll just push through it. Not a big deal. Everyone has bad days. How do you respond to that? At what point do you reach out for help? If you don’t think maybe you’re one who needs it, but you do.
Dr. Nalan-Sheffield: I think what you said everybody had has bad days. That’s absolutely right. There are certainly, it is normal to feel sad and anxious and worrisome at times. When it becomes a problem is when it lasts for quite a while for weeks, or it’s really impairing your ability to function like you would, if you’re not able to perform at work because you can’t concentrate or you just can’t get out of bed, if you are isolating from people, that’s really when we would encourage people to seek out some more support.
Host: And where do you start? I mean, I feel like we talk about therapists, counselors, psychologists, psychiatrist, where do we begin?
Dr. Andal: Oh, that’s a good question. So I will start. So here, here are the differences you need to know, psychiatrists have prescription pads and they are very helpful and they, but they, as a rule are going to prescribe medications. I’m a psychologist have a doctoral level degree in psychology. It’s in, it’s the only term that is actually regulated therapists and counselors can really be anything, but in general, in this state, you need to have a master’s in counseling or a master’s in social work and are likely either licensed as an LPC, which is licensed professional counselor or a CSW, a clinical social worker. So those are kind of what you’re looking for when you’re trying to find someone and to just kind of address, like when do you decide one of the things I hear often is that people feel like their problems aren’t, can’t possibly be bad enough to warrant wasting a therapist time. And since we’re on the, you know, on a podcast that was sarcasm case, it wasn’t clear cause it would never be wasting your time. Right. I think when you seek help is when you feel like you can’t manage your current circumstances on your own and that’s okay. There’s nothing wrong with getting help. In terms of where to look for help. There’s lots of places. Obviously I am kind of partial to our clinic. We have fabulous and amazing providers here, but there are lots of providers in the Sioux falls area that are, are well-skilled and are very good at what they do.
Host: Where do they begin? Do they go through a primary care provider? Do they just pick up the phone and call the phone number and get an appointment with you? Walk me through that process.
Dr. Andal: So you can do either. My understanding is that for most insurances, you don’t actually need an official referral for therapy. If you want to see a psychiatrist, you do, but for therapy, you don’t need a referral. You can just call up a clinic and say, I need an appointment for, because I’m feeling depressed or I need an appointment because I’m feeling anxious or, or you can even be more vague and just say, because I’m struggling and I don’t know why. And that’s okay. But yeah, when it comes to picking a therapist, the most important thing is really finding someone you connect with.
Host: And, you know, as we mentioned earlier, Dr. Nalan-Sheffield, you are new to the clinic. And one thing that I liked what Dr. Andal said was, there’s nothing wrong with getting help, obviously being new to the clinic. You know, we want people who are listening to realize that they can come talk to somebody. What would you want the community to know?
Dr. Nalan-Sheffield: Yeah, I think that’s very much Midwest mentality is that, you know, we are raised to handle things on our own. But you don’t have to do that. We are trained in helping people get through whatever struggles they’re dealing with now. So sometimes it’s just kind of pushing past what’s been ingrained in us is that we can handle things on our own, but again, we don’t have to. So it’s like Dr. Andal said is simple as just reaching out to somebody and meeting with them, seeing if there’s somebody that you think you could feel comfortable working with. And if not, we have many providers here who might be a better fit. So just because you meet with somebody wants doesn’t mean that it’s like fate forever, that you have to follow with them. You know, we hope that you feel connected with them and comfortable following up with them, but that’s not always the case. And that’s totally fine.
Host: So would you suggest going on the website for the clinic and researching the different psychologists on staff before making an appointment? You obviously want to be able to kind of jive with the person that you’re sitting down with in your appointment, right? So how do you do your research beforehand? Or do you come in, see who’s available and then see if you mesh, if not, you can move you to somebody else…
Dr. Nalan-Sheffield: I think that’s very much a generational thing. So I think a younger individuals are very much more interested in doing background research on their providers, not just for mental health, but many mental or medical professionals. I don’t know that that’s necessarily true for older population. So some people might want to do research. Some people might not. It’s totally a matter of personal preference.
Host: Like what would be some of the characteristics someone would look for to match themselves with somebody to talk to?
Dr. Nalan-Sheffield: Yep. So there’s a couple ways in which people typically search for a provider, so it could be by a specialty or what they specialize in treating. So let’s say they want to work on PTSD symptoms. Obviously they should seek out a provider who does PTSD treatment. Or they just want to meet with somebody who they think share some sort of similar life experience. Maybe that’s their age, maybe that’s their gender. Maybe that’s life things that they as a therapist went through, some people wants to know those things. Some providers are more or less open in sharing that just because it can sometimes take, take away the focus on the patient. So really it’s just a very individual process for people and finding what, what they’re comfortable with in a provider.
Host: If something doesn’t feel right there are providers here who are here to help. Right?
Dr. Andal: Absolutely. And, you know, just kind of like Dr. Nalan-Sheffield said, they’re the web websites of our organization and other organizations usually provide a fair amount of information in terms of what types of diagnoses they treat and the types of techniques they use. There’s also a community-wide resource. It’s the two, one, one help desk, which you can find online that lists all of the organizations in this area. Well, at least those that were included and what types of disorders they treat and what types of techniques they use. But I would also say when you see your therapist be, feel free to ask them questions about the types of therapy they do, because ultimately the most important thing is the relationship between the patient and the therapist. Because that’s what accounts for something like 60% of improvement in, in people.
Host: If you’re looking for somebody and you live in the Sioux Falls region, Dr. Nalan-Sheffield would be a great place to start here at the Sanford Psychiatry and Psychology Clinic.
Dr. Nalan-Sheffield: I am certainly taking new patients.
Host: Yeah. Perfect. Well, thank you both so much for your time and your expertise. I think this is a great addition to the continued conversation about mental health and behavioral health topics. It’s always good to really shine a light on what kind of care that folks can find at Sanford and, and getting to that care. Thanks for having me. This was another episode of the health and wellness podcast series by Sanford Health. I’m Courtney Collen. Thanks for being here.