Live Career Q&A (30 min)
U1 0:00
So one of the programs that we are spotlighting today is our Clinical Services program. To talk to us about this program, please welcome our Director of Clinical Services, Brittany Howell-Abbate, about.
U2 0:11
Hello everyone. As Vanessa mentioned, my name is Brittany Howell-Abbate. I am the Director of Clinical Services, and we'll be talking a little bit more about what that means and my role. I have been employed at all faiths for almost ten years. In June will be my ten year work anniversary. And so throughout my time at all faiths, my role has shifted a bit. I initially started in 2014 as a full time therapist and so I maintained the full caseload, uh, fully got immersed in our culture at all faiths, all of the amazing training that's offered. After being a therapist, I was promoted to a clinical supervisor. So shifting the role a little bit in providing direct supervision to clinicians who provide the direct service in outpatient therapy. And my current role now, as I mentioned, is the director of clinical services. And what that means is I oversee three programs, so it's the outpatient therapy program, our CSE program, which stands for Comprehensive Community Support Services and our Case Management program.
U1 1:24
Awesome. So as you mentioned, Brittany, the director of clinical services is part of those three programs. Can you elaborate? Tell me a little bit about those programs you ever see?
U2 1:33
Yes. So, uh, I will go ahead and start with our community Support Services program that the employees, the providers are called CSOs, community support workers. And they are providers who are able to go out into the community and support youth and families that might be in the school system, in a park, at a grocery store or in the home. So they're really able to target their treatment and intervention, depending on that client and family and what it is that they need. Our case management program is similar as well, so those providers are able to meet with the primarily adults, um, and, and family members and really address what needs what are their barriers to any kind of treatment. So that might look like, uh, financial support, legal support, housing support. And so the case managers can also go out into the community or in the home and provide those services. Now, our therapy program is a traditional outpatient therapy program, which means clients come to us for therapy. So they come to what we lovingly refer to as our moon office. And, uh, we, we have those sessions scheduled regularly and provide the therapeutic support at that time.
U1
3:00
Wow. Yeah, that's a lot. That and you oversee all of this, right? Yes. Oh, wow. Yeah, that's definitely a lot of responsibility Brittany. Thank you. Yeah. Well, Brittany, tell me about your team. So this it sounds like great progress, but tell me about your team members. Yes. We have an exceptional team. I will first share that every single provider at all faiths is trained under a trauma informed approach. And so not only the direct care providers and the team that I'll talk about shortly, but every employee and we can get to that in a little bit about how exciting that is for all faiths. But the team that I work with, um, I'll go ahead and describe them using a triangle, if you will. Yes. So the base of the triangle is the direct care providers. Without them, there's nothing, right. Like they are the heart of our agency, the foundation. Everything that we do is encompasses those direct care providers. And so again, that's the CSOs, community support workers, case managers and therapists for my team. We have other direct care providers. But for my team, that's that is who I focus on. And those are providers who are so creative. Uh, as I mentioned, the CSOs in case managers, they are like
U2 4:24
very relentless with being able to connect with those community resources. So if that's getting into the school system, if that's connecting and finding legal aid support. Um, recently we had a team and a client needed assistance with a moving cost. They were moving and finding this is a huge barrier. They can't move and live in a safe home if they don't have the the fees to provide that moving. And so working together as a team to be able to find those resources in the community, they are exceptional. They're extremely persistent but very creative, as I mentioned, well educated.
U1 5:06
Uh, and in that is also the therapist. And I will say, I love hearing down the hall the sense of humor that our therapists have. It is so vital to have this ability to still use humor when we're surrounded by trauma and to connect with one another. And so it's so it's so great to have our open door policy and hear our therapists walk and just connect and use humor. Um, and, you know, really, really find a way to make this work manageable. So that's really the the base is those direct care providers. In addition, yes, building up on this triangle is the clinical supervisors. So I am fortunate to be able to have five clinical supervisors that, um, directly report to me. And this team is like my backbone. I mean, they are not again, not only very skilled and creative, just like the the direct care providers, but their
U2 6:09
heart and passion for advocacy is so admirable. They are constantly pushing and thinking of other ways that we as an agency can not only support our clients, but support our providers. How can we really do the best that we can to make this environment sustainable and a healthy work? And so
U1 6:34
their passion
U2 6:36
for advocacy is just it's incredible. Um, they we are just very connected. We have, as I mentioned briefly, an open door policy. So if one clinical supervisor is out, it's like, don't worry because another person is going to come and have your back. So we really have this philosophy of supporting each other at that level and providing that clinical support to, to any of the direct care providers. Wow. And then then there I am. But then it's like another triangle above me that I can reach out to for support.
U1 7:13
Brittany, you have such love and such passion for your for your team. Like it's actually really refreshing to hear. I love listening to you talk about your team because you clearly have so much, so much admiration and so much, so much love for
U2 7:25
them. Thank you. Yes, it's a great team.
U1 7:29
So something that we have started to talk about at all phase is what is your why. So Brittany, why do you get out of bed every morning. Why do you come through those double doors every day and why do you keep coming back? So Brittany, I definitely wanted to ask you what is your why?
U2 7:45
So my, uh. My why of why I get out of bed every day is because I have two young kids who do not let me sleep in, so they forced me out of bed, even if it's much earlier than I want to. So that is my immediate y, but they are also my why as far as why I continue to do this work and my my passion, my goal. Uh, so as I mentioned, I have two kids. My family is in New Mexico. I'm born and raised in New Mexico. I'm a New Mexican at heart, and with the love that I have for this state, I still am aware that there is so much trauma in this state, the generational trauma that first childhood experiences. And so my kids are my why? Because anything that I can do to help make Albuquerque and the surrounding areas as safer place for children to live, then I will do it.
U1 8:43
Oh, that's a really good one to have. So all faiths is known for their trauma informed approach. And you kind of touched on that a little bit earlier. So talk to me about that. What is that. What does
U2 8:54
that mean. Yes, yes. So we are known in the community for being able to work with and handle the most acute trauma, the very, um, complex, difficult to work with trauma cases. And so being able to do that means that we as providers need to have this trauma informed approach. And this really started when I when I was employed ten years ago, my first step through this door, realizing, oh, wow, the agency at this culture feels different. And that's because of this trauma informed approach. In this culture, we are so fortunate to get to have incredible training here internally. Shout out to Donna Lucero, director of our training institute, um, who really, really instilled this into our agency of if we're going to do this work, we every employee, not just direct care providers, needs to know what it means, what it looks like, what are the signs of trauma. And so, so every employee, whether that's finance, team, HR, our client navigators, they are all trained in a trauma informed approach and nurtured heart approach. And so it's really the shift of not what's wrong with this person. Why is this parent continuing to do these things? Why can't they make their appointment on time? It's shifting that judgment of what's wrong with this person to seeing it as what happened to this person, what are all of the things that we can't see, all of that background that is that is creating all of these barriers and potentially, you know, making choices that are harmful or or not appropriate. And so that is really an exceptional thing that we do at this agency. Is this culture itself of having this trauma informed lens. It means direct care providers really tailoring their treatment and having an individualized approach to each person that's in front of them that day. So with trauma, it's really fascinating because two people can experience the exact same trauma and respond completely differently. And so to have a trauma informed approach, you know, you have to tailor treatment. You can't have this prescribed. Oh, I see this on paper. I'm going to do X, Y and Z for the next ten sessions. That's that's not a trauma informed approach at all. So it's really knowing, recognizing those signs of trauma, um, knowing how to respond appropriately, knowing what you can do, what not to do to avoid re traumatization and tailoring treatment accordingly.
U1 11:38
Oh, wow. Yeah, those are really important facets. Um, because not everybody is the same across the board. Is that why it's so important?
U2 11:47
Yes, absolutely.
U1 11:49
Okay. Sounds good. So can you give us an example of what does a trauma informed approach look like?
U2 11:55
So in as I mentioned it's very individualized. But I can give an example. So if a child is coming into services that means the provider is literally going to get on the floor with this child. Right. We're meeting them where they're at. And that's tailoring all the interventions. If they are not at the verbal capacity to speak about things, it's finding other creative interventions and modalities to to connect with this child. It's really slowing down the process to create that safety first, because we can't go anywhere if this child, family, adults in front of us does not feel safe. So we know building that therapeutic relationship and connection is key. And sometimes that means slowing it down and taking time. A lot of time. Parents or just community, um, providers want a rush. They want a quick fix, right? Here's this problem. Please come fix it. And we have to really start at the at the basic and help educate providers, help educate family members about why this process needs to be slow and why we're doing things the way that we are. So as I mentioned, the tailoring, the treatment individually, um, meeting the client where they're at, knowing to look out for signs of, oh, this a potential flashback. Is this a, um, you know, a dissociation that is being experienced and then our supervision is key. So for that provider to then take those things that they're seeing in this session to supervision, and then the supervisor can help to determine is this some transference or counter transference happening. Might you want to try this intervention instead. So it's it's also this notion of working collaboratively. Um the one provider is not an expert. We really want to put that expertise back to the client and family. Our goal always is for clients to successfully graduate from our services. And so we really want to diminish that power differential of providers being seen as the experts. And you tell me what to do and I'll do it. That doesn't help in the long run. We really need the client and family and adult to be able to know what choices they're going to make and make the answers. So having this, um, transparency and collaborative treatment is is vital.
U1 14:33
Wow. Yeah. I really love how you talked about graduation. And so that's the the goal right. Like you want people. So that's the goal the end all that we really are trying to reach right. So in the beginning you talked about all the departments that you have. You have our outpatient therapy, our CSE, our CSE. So how do all these departments work together, especially with that trauma informed lens?
U2 14:58
Yes. So collaboration is key. We must work with each other in order to form, you know, an appropriate treatment. It's not uncommon for a client to or a family, a family system, to be enrolled in multiple services with us at all faiths. And again, that might be because of complex trauma. Not only have they experienced one traumatic incident, there might be two, three, four. Right. And so we we typically see multiple providers working with one client or family. So we have to work together. If provider A is trying to teach something that is contradictory to provider B, we're going nowhere and we're actually causing a disservice. So we we have intentional meetings that we schedule for our providers to have these collaborative meetings. We call it the Provider Mingle. And so this hour occurs every other week. It's it's put into their schedule. So it's not impacting client care. They don't have to worry about, you know, all of the other tasks because it's it's embedded into their schedule. And this is the hour that you have to mingle with any other provider working with this case. And of course providers can can look at other times, but having that dedicated time and space has been key.
We talk about consistency a lot for our clients and we as providers have to model that as well. So having those consistent times scheduled is really vital.
U1 16:34
Wow. Yeah. Definitely important. And thank you for highlighting that. Really explaining how it's really just important to be able to have that work together for the long term. Um, speaking of long term, um, so how does this trauma informed approach that you very beautifully and eloquently explained, um, affect the short term versus even how does it affect the long term?
U2 16:57
The short term prognosis like progress of the client.
U1 17:02
Yeah, absolutely. Let's talk about
U2 17:03
it. Okay. So immediate needs um, that can help when receiving therapeutic services is is one I mean having having a person who is connecting with you in a non-judgmental, safe manner that that really is the most important value and the biggest determiner of if someone is going to successfully complete services, they have to feel safe, have this connection. Right? So when we work with a child, I'll just give a child as an example who has experienced a traumatic event from an adult. An adult has caused harm to them that. 1s Flips their entire notion of the world, right? We're supposed to be born. And knowing that not only adults are safe, but our parents, they they are safe. They they keep me safe. When when a choice is made by an adult or a caregiver that harms that child, there's there's complete chaos and fear. And so the brain is like, oh, what? What just happened? This isn't this isn't what I'm supposed to be, you know, registering. And so when they come to seek services, it's so vital to have that connection and again, slowing it down to help rebuild their brain and like their neural pathways of adults, can be safe. I can have a healthy, appropriate in, um, connection with an adult so that safety is key. I can't stress safety enough really uh, long term is is again that the rewiring the brain. It's not as scary as that sounds. Uh, but we we that's really what, what therapy is, is it's really working to rewire the brain and help an individual make choices that are going to be more adaptive if they got stuck in this pattern of having choices that are harming themselves or others, we have to work to rebuild that and help them understand what other ways they can do. And again, that takes time. It's it's a long, relentless, continuous process. So long term effects of a trauma informed therapy is is exactly that for for an individual to have learned new skills, to have learned new behaviors, how to adapt in their environment, how to communicate, how to regulate themselves, and how to notice, like their own internal cues of something's going on. So I need to do something to calm myself when we see that we are just. It's the best news ever. Sure. I really love how you how you talk about that. It's a process and, you know, that's exactly what it is. But that trauma informed
approach, um, you really highlight how it's slowed down and it's really just highlighting those small processes so you can get to the end goal. Right? Awesome. So all face
U1 20:05
clinical services sees children. And you mentioned a lot of that. We oh the kiddos that we see. So what are the qualifications for a child to be seen. Adults.
U2 20:15
So a child can be seen actually starting at birth. Technically, even. Um, while a mother is still expecting. So we at all faiths, it's very exciting. We have a team of clinicians that are trained in something that's called parents. Um. CPP child parent psychotherapy. Okay. Wow. And that is a modality of evidence based modality that is intended for the 0 to 5 population. So those providers have gone through a two year, very extensive training process to be able to be rostered in CP and
U1 20:58
work with that 0 to 5 population. And why that population is so crucial. We often times will get the misbelief from an adult. Really, I think it's it's their desire of and hope. They say, oh, this horrible thing happened. But thank goodness my child was only two. They're not going to remember it when we hear that as trauma informed clinicians were like, actually, the younger child is when they experienced trauma, the more difficult and the longer adverse child like experiences that person might experience, because that 0 to 5. Timing is when your brain is really developing. So if a traumatic event happened, it really impacts how the brain is formed and modeled. So the younger into us is actually we need to intervene now. Um, but it can be challenging because a child might be non-verbal, they might not be able to say what happened or to remember it, but their body remembers it. So part of that trauma informed approaches is having, um, this training of the body keeps the score, which is a very popular book. Uh, but knowing that notion that even if you can't verbally say or remember, your body remembers. And so these clinicians, these clinicians are so trained to notice these non-verbal cues to help the parent say, oh, this might be what your child is trying to communicate. How might you be able to respond? So it is those very small moment to moment interactions that the CP provider is very skilled to assess and then help teach the parent or caregiver how to respond. Because, again, we don't want to be the person forever. This formal support, we want the parent to be able to step in and help to heal those wounds or, um, repair that relationship. So the CP model is it's amazing. It's very time consuming and in depth. Um,
U2 23:11
and we were just very excited to have providers who have this specialty. Now, in addition to, you know what? Child age, weight, age range it really is. We really see children through adulthood. Um, so in addition to that 0 to 5 population, the vast majority of the clients that we see for children are in that late elementary age range. So that's that's very typical that we have, uh, clients in that age range. We can work with children, middle school, high school. We also work with youth who have caused
sexual harm. And so that's also a very strong, um, highlight that I want to acknowledge for all faiths because of that terminology that I just used. We do not say a perpetrator, a sex offender, um, you know, for, for youth, because they're still children and something happens to them, they're learning these behaviors. And then now, unfortunately, our mimicking it, we again have this, uh, group of therapists and providers. We have a CSE as well, who has gone through an extensive training to work with that population. And the effectiveness of that treatment is is actually really high. Um, we see really good, good progress. And, and it's that is a very collaborative type of treatment where we're working with juvenile justice. Often we're working with.
U1 24:47
Um, attorneys, lawyers, judges to really help conceptualize this case and target our interventions. To what? What was going on. We also offer groups for teens, which is exciting. So we have a body image and self esteem group for teens because oh my goodness, to be a teen in this day and age, I can't even imagine. Um, and so that really highlights the effects of social media and how everything is through a filter. But yet you see this and then compare yourself to that group. I just see that group taking off, really. Um, and we have a teen art based group, which is, which is really exciting. That is going through adulthood. I know we are called All Faiths Children's Advocacy Center because children are the heart of our program and our focus. And at that same time, we realize that we cannot work with a child, only send them into a home setting where nothing is changing. If the adult or parent or caregiver isn't receiving any support or services, how can we expect this child to really thrive and make changes? So we have we have outpatient services for adults. Our focus when we work with adults is always looping it back to how it is. Whatever's going on in your life impacting your ability to parent, that might just be normal. Stressors. Work stressors. Often what we see is if a child is coming to us because they have experienced a traumatic event, this is bringing back a past trauma that the parent experienced that they either forgot about,
U2 26:38
they never informed anyone or talked about it, or they worked on it. But now as a parent, it's impacting them different. So we see that often where the the parent is able to come to us and say, you know what, this this is now impacting my ability to parent my, my child or look at my child in this manner. Um, or I'm remembering all these things I didn't get as a child and now I'm stuck. Now I can't parent my child. 1s Well, it's I love that it's, as you mentioned, like all the way from the beginning to all the way into adulthood. We are a children's advocacy center, but we really just span development as a whole. That's really beautiful to hear.
U1 27:24
Yeah. Um, so let's say that I'm a brand new therapist. Brand new master's degree, brand new license. What does that look like for me if I wanted to start at all things? Yes, it's a great question. So we do not expect ever for a brand new candidate to be trained in everything. Or to say I can work with every population. Uh, being the jack of all trades is not our goal, right? So we we want someone who is open to learning. We want someone who might naturally have that inclination of that trauma informed lens. Maybe they haven't been through a formalized training, but their nature is
is having them think of the world of all of these other factors that you can't see, right? The the what happened to this person versus what's wrong with this person. So looking for that is always a positive sign for us. We really want providers who want to work with other people and collaborate. Opposite of that right is private practice, which is is a great opportunity for providers once they're independently licensed and can practice privately and independently. And we always support providers once they're at that stage. When we're first starting, that natural inclination of wanting to collaborate and work together as a team is really important. We really look for that and, and honor that. Um, and someone who, who is, is comfortable working with children and adults. I when I first started um, I will share it's it's like the morbid joke. I was like, I'm gonna choose just to work with children. I don't really want to work with adults, so I'm gonna I'm just gonna focus my my profession on working with children. So. Cool. Yeah, I like this. Oh my goodness. Do you realize when you work with children, you are working with the adult? The same, if not more. 1s And so working with children does not mean you're only going to work with children. In fact, you're going to work with that parent caregiver at all. Um,
U2 29:43
quite a bit. So we're also looking for someone who who doesn't have a specific focus of, I only want to work with adults, or I only want to work with children because it ends up being both.
U1 29:55
Wow, what a great story.
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