clients

Wind, Snow, Time, & Faith

These last two weeks (March 7 to 16) have been full of weather and safety-related concerns, and it's led me to take stock of what drives me these days and how I want to live my life now.

For those readers living outside the Rochester metropolitan area, we experienced a windstorm on March 7 that left over half of the region without power for days followed by a cold weather snap with daytime temps in the 20's. As many of the trees were cleared and power was mostly restored by the start of the next week, we were hit by Winter Storm Stella that dumped approximately two feet of snow in an on-going two day snow shower starting on March 14. 

I had a full caseload every day these last two weeks, but the windstorm and emerging snow storm prompted me to shuffle my schedule and cancel a full day of patients on March 15.

Now I'll be honest: I do not like it when anything prevents me from doing what I had planned. Yes: this is the pot calling the kettle black coming from this here clinical psychologist.

But the truth is I needed this dose of reality that was served up to me over the last two weeks.

It gave me a chance to meet people near us who took us in while our power was out.

It gave me a chance to be present for my daughter during and after outpatient eye surgery.

It gave me a chance to connect with people deeply because there was space and time for it.

I wish I could say that I’d never been here before
— Chris Stapleton, Fire Away

That's how I feel right about now as I realize I would've missed my daughter's surgery had the weather not laid to waste my plans to focus on my work instead. So many times before I've been so driven that I don't even see the road I'm driving the car of my life on. And for that, I feel compelled to reflect on how I can align my priorities more consistently with my values.

I had planned on my previous post (UnReal InstaLife) being the final one in a series about digital communication and re-framing our experience with it. After my daughter's surgery, I am reassessing how my digital existence impacts my reality as a parent, partner, and provider. I have such an intense, unrelenting desire to improve things that I very often forget to slow down, turn off the phone, and make the time to reflect rather than react to the moment I'm in.

So the weather gave me cause for pause and the opportunity to be present for my family, but another thought snuck in without my realizing it until the past weekend turned into this week.

When I think it could be therapeutically helpful and when I feel it logistically necessary, I have shared with my clients a bit about my personal life. Many folks know that My Better Half and I are expecting our third child in May and have showed such care and interest in her well-being. 

Knowing that my client's think and care about my family is something that moves me in a way I can't really describe in words, which is saying a lot given my predilection for hearing my own voice.

And on more than one occasion in the past two weeks, I've had clients look me in the face or tell me sincerely in writing that they have prayed for my wife's health and my daughter's. Now my faith is something I have generally regarded as a private matter, but the deep gratitude I feel toward my client's in sharing their faith with me has led me to re-examine mine in my work.

This then is a long-winded thank you to my clients, my family, my friends, and my community for calling my faith to mind during this unexpectedly trying month of March. So in the spirit of sharing more of myself, here is a picture of my family, in our comfy clothes, celebrating St. Patrick's Day by appreciating our warm home, our health, and some much needed time together.

Unreal InstaLife

Following up on my last two blog posts regarding social and electronic media, My Better Half shared this video with me:

The way this video represents a range of social media behaviors feels raw and real by focusing on the actions and nonverbal forms of communication in the physical presence of each person. I thought this was worth sharing in so far as it's evocative and can help facilitate a discussion. 

I have a few guidelines I've implemented in my daily life - and recommended to clients - that I think could be helpful to incorporate into everyone's daily routines:

Zero tolerance for technology during meals.

This can be delimited and brief (even 5 to 10 minutes) with no one looking at their phone. The ritual of breaking bread with others is so valuable for a variety of reasons, and I think that is a routine worth establishing as often and as early as possible with children and families.

Now, what I would encourage people to do is to have a fairly elastic definition of meal times. I get to meet with a number of children and adolescent clients who are working on skills like sitting during meals or eating a variety of food. It's not cheating if you change the definition. A meal could be a snack your kid likes to eat after school. Or meal planning time when you pick out what you're going to eat for breakfast or pack lunches for the next day together.

Keep the phone out of the bed. Literally.

Don't bring your phone in bed when reading stories to your children, talking with your partner, or transitioning to sleep. Even if you're a medical provider who needs to be on call at night, the psychological distance of putting it on a night stand that is a few feet away can be very real.

Be intentional about how & when you use your phone.

Rather than mindlessly and passively scrolling into the oblivion of your Facebook feed, go on a mission to find something or connect with someone through direct messaging. Messaging with intent is very different than just liking the buh-Jesus out of every witty or contrarian thought.

Reward yourself and your children for setting and sticking to technology limits.

If your 7-year-old child can go from 5 to 7 PM with a focus on playing outdoors or building something with their hands or their imagination, praise them like they're walking on the water. It's a big damn deal in this day and age to occupy ones self without the aid of technology. Pay attention to what you want to see more of and bring on the parade when you see the good behavior in action.

Take your teen's access to technology seriously.

A paper I read yesterday highlights the complexity of adolescents' access to social media and how it impacts their well-being. The catalytic effect of one post or accidental share can alter the trajectory of a child's academic year or self-concept without caregivers' even knowing.

This line in particular rung most true for me and ties in nicely with the video above:

...the social exclusion and comparison resulting from vast amounts of time reading large social media feeds and seeing friends doing things without you and comparing your inner emotional experience to everyone else’s highly groomed depictions of their seemingly marvelous lives.

While this run-on sentence may seem a far cry from the reality of parent- or adult-hood, I'd bet the farm that the so-called average adolescent could speak to the truth of this point of view. The world is both bigger and more constrained than it's ever been, making the boundaries harder to find and more difficult to delineate during times like these...

New Year, New Health Insurance Plans

It seems like none of us are immune to the ever-changing landscape of healthcare insurance. Like many others, my family and I are going through new plans, rules, and deductibles effective with the New Year. I think these insurance changes can be confusing and overwhelming.

I wanted to use this transition to the New Year as an opportunity to highlight the healthcare coverage options available to my clients.

  • I accept health insurance, health savings account (HSA), and fee for service clients.
  • I am an approved provider with:
    • Excellus Blue Cross Blue Shield
    • Aetna
    • Other insurance companies (as an out of network provider)

If your insurance provider is not listed, you may be able to pay for fee for service with a pre-tax healthcare savings vehicle, such as a Flexible Spending Account or HSA. Consult with your employer or health insurance company to learn more. 

Last year, I worked with several clients to maintain their level of care while effectively navigating the health insurance landscape. This included seeking out pre-authorizations or offering more tailored, focused sessions prior to families having met their annual deductibles.

My mission has and will remain the same as stated on the homepage of this website

I will work with you to improve your quality of life

Being on both sides of the health insurance system as a provider and a patient, I understand how challenging it can be to read the tea-leaves of ever-evolving health insurance coverage.

At the beginning of a New Year, I don't want client progress hindered or halted because of insurance changes. So let's work together in 2017 to focus on quality of life through behavioral change rather than getting bogged down in details while perseverating on the fine print.

I'm on the news!

Each day during the "Week of Miracles," 13 WHAM News profiles a 2016 Golisano Children's Hospital Miracle Kid. Earlier this summer, I had the opportunity to talk with Norma Holland about my work with Fauna and her son Daniel. Their story aired on Wednesday, September 14: 

You can read more about the story here. I also previously wrote about my time with Fauna and Daniel in the BIFF clinic at URMC in my blog and on the website. The work Fauna and I did together is quite literally why I do what I do for a living. I would not be who I am if it were not for the amazing opportunities I have to work with families like them everyday.

Product Review: Teach Me Time Clock

Last week I posted about Bedtime Routines. I wanted to share an accompanying product review of something I have and use daily in my home, along with some ideas on how I use it to improve my kid's sleep. 

Sleep can be challenging at different stages of development for a variety of reasons. Sleep can also be a sensitive subject for caregivers and healthcare providers alike when it comes to improving the onset (how long does it take to fall asleep) and increasing the duration (how long do they stay in bed asleep). At the end of the day, we all need sleep to function, so I’ve talked about it often with my friends and with families I have worked with over the years.

So...my cherubic first born child learned to sleep through the night at a young age. This is something we took relatively for granted until our second child arrived 22 months later. Just about the time our 2.5 year old transitioned to her big girl bed, she started developing the fabulous habits of A) getting in and out of her bed repeatedly and B) waking up too early. By my math, she was losing anywhere from 60 to 120 minutes of sleep on the front and back ends.

We needed to shore this issue up in a hurry since it was ratcheting up the household stress.

Like most things in my life, my Better Half deserves a lot of the credit. She read about this product, we purchased it, and had it all set to go atop the dresser in our daughter’s bedroom:

Teach Me Time Clock can be purchased on Amazon. This is the nightlight ("stay in bed") mode.

Teach Me Time Clock can be purchased on Amazon. This is the nightlight ("stay in bed") mode.

 

Here’s what the Teach Me Time Clock can do:

  • Tell time
  • Work as a traditional alarm
  • Provide touch-button voice-over to speak actual time
  • Serve as a nightlight
  • Change colors at different times (this is the key ingredient).
  • Here are our current settings:
    • 7:30pm - soft yellow light comes on (serving as a nightlight)
    • 8:00pm - soft yellow light continues on (time for bed)
    • 6:45am - soft green light comes on (indicating time to get up)
    • 8:00am - soft green light turns off (nobody is asleep at this time...)

So our daughter used to wake up around 6:30am, but was now waking up at 5:30am. She used to go to bed around 8pm with little fuss, but now was getting up and down until close to 9pm.

This is what we needed to do:

  • Talk about the clock to her, the colors, and what she could earn for following the rules
  • Identify a strong motivator soon after the light changes (morning tv show)
  • Tell her what she would get for staying in bed until the light turned green (tv show)

The careful reader will likely notice that I have said nothing about getting her to stay in bed in the evening without getting up and down a bunch. I believe the the venerable Sun Tzu put it best when he said, in different words, “never fight a war on two fronts.” Sage advice here.

It would’ve been amazing if this took only one evening to do the trick. Of course, it did not.

What we needed to do was set the clock to 5:45am (close to her new 5:30am awake routine) and then gradually move the time toward our 6:30am goal in 10-15 minute increments over a few weeks. In addition, she would often wake at 5:30am, come get one of us, and then want to go watch her tv show. I would take her back to her room, lay her back in bed, and then lay with her until it turned green. I praised her to holy heck, got her dressed, and took her to tv time.

Then we worked on having her lay by herself until the light turned green. Then once this new behavior of laying in bed on her own until the light turn green appeared firmly established, we moved the time forward. This would often reset the level of support back to her needing to be taken back to bed, me laying beside her, then fading my physical presence, and her staying in her bed on her own. Then we’d move the clock forward another increment toward our goal.

Green light means time to get out of bed. "I slept until the light turned green" - parenting win!

Green light means time to get out of bed. "I slept until the light turned green" - parenting win!

What happened if she refused to stay in bed until the light turned green? This is where we would "ride the lightning."

She just didn’t get tv time that morning. And yep, it was not fun for either party.

But she got the hint relatively quickly because we also were not doing tv time in the evening, so this increased the reinforcement value of tv time.

This is one of those parenting battles where I feel like we fought the good fight and won. It wasn’t a one week or even a one month slam dunk, silver bullet sort of deal for us or her. But I do think this alarm clock provided a nice level of cuing and support that we still use with her.

Now we are preparing to transition our son to a big boy bed and will be ordering a second Teach Me Time Clock soon.