The time given us

I hope that you are well and that your loved ones are healthy, too.

I am meeting with patients and families via tele-health during this public healthcare situation and plan to keep doing so moving forward. I am using Doxy.me (secure portal) for most folks and recently upgraded bandwidth at home to accommodate working remotely. I’m also open to choosing a platform and format for how we conduct our sessions during this time period.

We will get through this together.

Meeting with patients and their families has been a balm and a blessing during this time, and I will do what I can with you to bring order and calm to whatever place you are at right now. This will involve creativity and flexibility to meet with each other digitally until further notice, and I believe that we can do this effectively and efficiently if we keep working at it together.

Beyond the work changes, my family is going through many of the same challenges others are going through now: children and parents home all day, everyday; working and schooling at the same time, often in the same space; adjusting to a new normal; and, coping with the loss of social activities, celebrations, and milestones we were working towards and looking forward to.

I am in this with all of you.

I am recommending a few things during this time to help us all get through:

I made my own AUggie named “Little B” to keep me company in my home office in the attic.

1. Be kind to yourself

2. Practice gratitude

3. Find rhythm in routines (see image of our dining room/school work space)

4. Get outside often

5. Read something fun (see quote below)

6. Connect with others in your community

For me, an example of #6 is continuing to support AutismUp in my role as Board Member. This means participating in virtual Board Meetings, reading the daily content in @Home with AutismUp they are sending to members and anyone who signs up for the emails, and even participating and sharing in efforts to keep everyone connected.

I see people rising to the challenge of the healthcare situation, and I am amazed at how well everyone is adjusting to this new version of everyday. I encourage you to do less, well and to be patient with the things you cannot hurry and gentle with things that do not move.

“All we have to decide is what to do with the time that is given us.”
J.R.R. Tolkien, The Fellowship of the Ring

Serving people with OPWDD

The Office for People with Developmental Disabilities (OPWDD) is an important state resource for many of our clients. Once an individual qualifies for OPWDD, they are eligible to receive supports for living a full life in our community. With each new client seeking guidance with OPWDD eligibility, their path and goals are as unique as their treatment plan and life plans are.

One of the most fulfilling aspects of our practice is helping connect clients with the services they need – services that will stay with them and provide comfort and support to those families.

I have seen OPWDD do this for many families.

My patients find me on their own and use their insurance plans or fee for service to be treated.

If they become qualified for OPWDD, they have a new menu of options for care. Once someone has OPWDD, they can receive health insurance and a care coordinator to connect them with providers for the services they need – it can even assist with transportation to appointments.

If a newly qualified OPWDD patient wants to continue with my practice, they had to stick with the payment channels they were using pre-OPWDD (e.g., Excellus, Aetna, or fee for service).

This has always bothered me.

The whole point is to get people the services they need. Once they have those services, they should be able to use them. So I spent the last year trying to figure out how to continue to see clients with OPWDD, using their OPWDD benefits for services. And, I finally learned of a solution… a new partnership with Presence Developmental Services. Here is a bit about them:

Presence Developmental Services and Presence Counseling Services are clinician owned and operated companies that were developed to provide Behavioral Support, Physical Therapy and Social Work services to Individuals with Developmental Disabilities in their homes and other community locations.

Presence Developmental Services allows us to see patients with OPWDD in our offices with our providers. The patient, their family, and the care coordinators can all work directly with our staff to receive therapy and services we already offer. They simply have to go through the referral process with Presence – easily found on their website – and request our practice. The referral can come from the patient, a family member, or even the care coordinator.

And, if transportation is an issue, we have gone through the process of making sure our office is recognized by the medical transport options available to persons with OPWDD. There is also a new program that Megan and I recently learned about called Go Monroe! that helps people with disabilities access transportation solutions. You can find out more information by going to reaching out to Maritza Cubi at Starbridge (mcubi@starbridgeinc.org or 585-224-7327).

I am excited to offer a creative option for people who have OPWDD.

Our newest provider, Megan Benham, is accepting patients through Presence Developmental Services; you can request her specifically in your referral. If you have any questions, you can contact our office at admin@bryanharrisonphd.com. I also encourage you to contact Presence directly; their staff is friendly, responsive, and eager to help connect you with services.

We’re proud to be the first psychology practice to partner with Presence and hope to welcome clients who now have OPWDD in order to serve even more individuals in the community.

Meet our new provider Megan Benham

It’s been nearly a year since I moved into the new and larger office. Many people have asked about what I’m going to do with all the space upstairs and next door since it’s just me afterall. I’m thrilled to share that the practice is growing into a team of providers that bring a greater breadth of skills and specialities to better serve our community.

I’d like you to meet our first new provider, Megan Benham. Megan and I started working together while I was on my post-doctoral fellowship, and I am so happy to welcome her into our practice as a new provider offering therapy, assessments, consulting, and working with new patient intakes.

Megan is accepting new therapy clients through Presence Development Services (I’ll share more on this soon) and you can contact her at megan@bryanharrisonphd.com.

Megan works from the building we lovingly refer to as the “side office,” the stand-alone building next to the main office. She’s mixed our style with her own pops of personality (and board games!) to create a welcoming space for patients and their families.

So, in her own words, meet Megan.

I am an advanced doctoral student pursuing my Doctorate of Psychology (Psy.D.), and I am so excited to have the opportunity to become a part of Dr. Bryan Harrison's practice.

I moved to Rochester in 2007 to attend St. John Fisher College for undergraduate and quickly fell in love with Rochester. In 2011, I began my doctoral program at the University of Hartford.

After living in Connecticut while completing my coursework and beginning my clinical training, I moved back to Rochester and happened to link up with someone at Mt. Hope Family Center who put me in touch with Dr. Christie Petrenko at the Univeristy of Rochester. Dr. Petrenko took me on as a graduate student, and for the last five years I have been working with her on various projects for individuals with fetal alcohol spectrum disorder (FASD) and their families.

Through Dr. Petrenko’s research projects, I provided direct support to children and adolescents with FASD through a skills group for children and the FASD Family Night Program. I have also spent a lot of time working with the caregivers of individuals with FASD as part of the Families Moving Forward Program; those caregivers own a special piece of my heart. Raising and loving an individual with a developmental disability is a very unique (and sometimes overwhelming) experience, but also such a rewarding one. Working directly with those caregivers has been one of the best parts of my training.

In addition to gaining clinical skills in individual and group therapy, I gained assessment skills in the FASD Diagnostic and Evaluation Clinic run by Dr. Petrenko. I seized the opportunity to administer various educational and neurodevelopmental assessments and learned the process of recognizing and diagnosing children and adolescents with FASD. At the University of Rochester, I also worked within the Department of Developmental and Behavioral Pediatrics (DBP) - that was led by Bryan's long-time mentor Dr. Tristram Smith - doing assessments for adolescents with autism.

During my time at Mt. Hope Family Center, I also assisted with Project STRONGER doing trauma-focused work with children, adolescents, and families. I provided both individual and family interventions with a trauma-informed lens with a focus on parent-child relationships. Working with family systems is very important to me, as I think that understanding the family as a whole allows me to better support each individual. Over the years, I have also spent time advocating and consulting with different schools in the area. I really enjoy collaborating with school teams to help them better understand and support individuals with diverse neurodevelopmental differences.

This fall (2019) I ran a group for adolescent boys with refugee status here in the United States. I was truly inspired by the resilience and joy I witnessed during my time with them. I enjoy group work with adolescents and I even spent a short time working on a project whose intervention included providing group yoga sessions as part of a social skills group. This meant I actually had to do the yoga with them, as part of their therapy, which the teens found hiliarious given my natural clumsiness and inflexibility.

I first met Bryan when he was completing his postd-octoral fellowship at DBP (which was super reassuring to witness someone that close to being finished with grad school!) and I was training within DBP's Behavioral Intervention for Families (BIFF) program with Dr. Laura Silverman. Bryan and I would eventually go on to do some more work together with assessments once his post-doc wrapped up as he began working in private practice.

And a little about me personally: I grew up in the Adirondacks and love spending time in the mountains visiting family and taking in the fresh air. Sitting by the water is my happy place; I am thrilled that my office is right on the Erie Canal with an excellent view! In my free time (which is currently pretty limited while I work on my dissertation), I like to read, spend time outside, and watch The Golden Girls. Once I finish my dissertation, I promise I will take up some more interesting hobbies!

I am so excited to be welcomed into Dr. Bryan Harrison's practice and am looking forward to working with individuals with developmental disabilities and their families. I am excited to begin using my beautiful new therapy chair, too. - Thank you, Bryan!

Friends

The summer barrels toward its conclusion and the school years pulls us into its beginning.

I meet with a lot of adolescents who are preparing to transition to middle and high school, and other families whose loved ones are starting in a new school or a new vocational opportunity. I walk with caregivers as they doubt and deliberate over services and supports for their child. As many folks wonder and worry about the start of new routines, what we need are relationships.

Of all these, friends feel most important to me

The years roll by and the marks on the door frame grows higher reminding us of how time passes. But the glue that binds and holds the fissures tight are the relationships we forge with peers.

You are lovable and waiting to be loved

I wish more people knew this and felt this often enough to hear it in their heart from memory. All the quirks and intense interests are tinder for a burning flame of future connection. I wish I could cast a spell that lasted for years convincing children that what they like is really cool.

And that someone else will believe that, too

Common interests and shared time together in the same physical space; those ingredients are ones we all have in stock and can share with others. I wish you the confidence to share freely.

Your insects and your weather

Your Legos and your welding

Your astrology and your fairies

Your gems and your writing

Your coding and Your projects

They wait to be held dearly by another

Your joy is a gift to others

As summer sets and autumn wafts in through the cracked windows, I hope you meet someone this fall that prizes you and holds you as dearly as the ones who already love you do.

Losing an autism diagnosis

As a licensed clinical psychologist, I am an active member of the American Psychological Association. Every month I receive a copy of their publication/magazine, Monitor on Psychology. The magazine covers a variety of current topics in psychology, and I enjoy learning about developments in other areas of the field. In April 2019, Monitor on Psychology published an article titled, Losing an autism diagnosis. After reflecting on this article and thinking about what I think it missed, I wrote a response and my remarks were published in the the June issue.

Here is the original response that I emailed to the Monitor on April 10:

I am an APA member and avid reader of the Monitor. My primary specialty as a clinical psychologist focuses on the treatment and assessment of individuals with autism across the lifespan. Two points I would like to make regarding the News Feature on "Losing an Autism Diagnosis" (April 2019).

1. I believe that there is a substantial lack of training in the assessment of individuals with autism, particularly as they age into puberty and adulthood. I think that the lack of oversight at a broader health care level explains some of the variations in having and then later losing an autism spectrum diagnosis. I would refer readers to the work of Cathy Lord's clinical research for a better understanding of the evidence base and training for autism assessment.

2. The consequences of losing an autism diagnosis in adolescence or adulthood can be quite dire and drastic in terms of service eligibility and access. State offices for people with disabilities often require further substantiation of an autism diagnosis later in childhood, and a person losing their autism diagnosis can quite literally "flip the table" on what services a person and their family can access. I think there needs to be more cross-talk between health care and government systems to understand the consequences of losing an autism diagnosis.

I felt like the article failed to touch on how losing an autism diagnosis can adversely impact service eligibility and access. Moreover, it did not speak to disability identity in adults. I also think this piece missed an opportunity to speak more directly to how variations in provider training and experience can impact the reliability and validity of a diagnostic evaluation.

I am grateful to be able to voice this concern to a larger audience and hope that these reflections inform how professionals approach the process of evaluating patients for autism.