Peplau's Ghost
Psychiatric-Mental Health Nurse Practitioners (PMHNP) discussing using psychotherapy within their practice. Four PMHNP program directors and a biostatistician from across the Unites States sharing their passion on how psychotherapy can help people with nearly all their emotional problems.
Peplau's Ghost
"Stop Making Excuses": How Hildegard Peplau Shaped a Mental Health Pioneer Dr Cheryl Forchuk
What happens when an internationally renowned mental health nursing expert shares stories of being mentored by the legendary Hildegard Peplau? Pure gold for psychiatric nurses and mental health professionals.
Dr. Cheryl Forchuk takes us on a fascinating journey through her remarkable career, beginning with her discovery that psychiatric nursing provided the perfect home for her talents. Unlike other healthcare specialties with clear diagnostic pathways, she was drawn to mental health precisely because "there's no clear right answer," creating space for creativity, flexibility, and truly patient-centered care.
The heart of this episode reveals Dr. Forchuk's unexpected mentoring relationship with Hildegard Peplau herself - complete with Christmas cards demanding "You didn't write me" and blunt directives like "Stop making excuses" when Forchuk hesitated to pursue her PhD. These personal anecdotes illuminate how powerful mentorship shapes careers and ultimately transforms patient care across generations.
From her groundbreaking work addressing homelessness through nursing principles to developing technology that enhances rather than replaces therapeutic relationships, Dr. Forchuk demonstrates how Peplau's concept of "constructive community living" remains revolutionary today. She shares insights about nurses as political advocates who have shaped healthcare policy, revealing how a coordinated campaign of telegrams from nurses across Canada helped close loopholes in healthcare access.
Whether you're a psychiatric nurse, mental health professional, or simply interested in how therapeutic relationships drive healing, this conversation offers wisdom that bridges theory and practice. Subscribe now to hear more conversations with leaders who are shaping the future of mental health care.
Let’s Connect
Dr Dan Wesemann
Email: daniel-wesemann@uiowa.edu
Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner
LinkedIn: www.linkedin.com/in/daniel-wesemann
Dr Kate Melino
Email: Katerina.Melino@ucsf.edu
Dr Sean Convoy
Email: sc585@duke.edu
Dr Kendra Delany
Email: Kendra@empowered-heart.com
Dr Melissa Chapman
Email: mchapman@pdastats.com
Yeah, just my take on things. My answer to number two decrease until they cease. Let's talk about a discovery, identify and challenge, and release.
Speaker 2:Welcome back everyone to Pep Lau's Ghost another exciting episode. I am so thrilled here at Pep Lau's Ghost we are going international today. We're thrilled to welcome Dr Cheryl Forchuk, who is internationally known as a world leader in mental health, psychiatric nursing and actually was mentored under Dr Hildegard Peplau. So, looking forward to her experiences and, you know, working with Dr Peplau and just everything she kind of has to share with us. So thank you again, dr Forchuk, for joining us, also joined with Dr Kate Molino from the University of California, san Francisco, and, as always, dr Melissa Chapman-Hayes, who is here as well.
Speaker 2:So I did have, you know, kind of a quick bio. But again, it's just, you know there's so much to say about Dr Forchuk and so I'm just going to kind of get into our conversation and just let her experience kind of show itself. So you know, in this podcast we really kind of focus a lot on the idea of psych mental health nurses, especially in advanced practice doing psychotherapy and, you know, obviously being mentored by Hildegard Peplau herself. You know, when did you first get interested in psychotherapy, either in doing psychotherapy or it's kind of it's as an intervention within psych mental health nursing?
Speaker 3:Well, it's when I first went to nursing school. I remember I actually thought I would like to work in pediatrics when I started. Started because I had done a lot of work previously in terms of summer jobs at camps and that sort of thing and and honestly I did not like it when I did it as a nurse because I hated hurting kids in the experience. But when I hit the psych mental health placement in my undergrad I knew that that was for me. And the other thing at our program at the University of Windsor in Ontario, canada, we had the option to do. I did a joint psychology and nursing degree when I started and honestly I was thinking of switching to psychology but when I hit mental health nursing it just really felt like that was home.
Speaker 3:So I when I graduated I did not even get a uniform because I would never wear a uniform. I'd work community health and I would work mental health and with mental illness. But uh, and my first job was in, um, in the addiction field and working in alcoholism. So I had the opportunity, uh, to do both individual and group psychotherapy, was it was simply part of the role. Uh, at that time, and I will say too, um, when I was working in the summers and was working with youth, I in Canada we had a provincial not probably a federal thing where we could start our own businesses and get a grant as a summer job, and so I had actually set up a program for vulnerable youth that were dealing with sexuality issues and addiction issues. So, even as a nursing student, we had that project. I was working with other people and then it sort of led, naturally, to working in that field, but I liked, I enjoyed doing that.
Speaker 3:When I went back for my master's, though, I decided I in some ways overly focused in in the addiction area and so I wanted to have a broader experience. Um, but but basically I would say I started doing it very early on in my career, like I, I say even in nursing school, just knew that this is where I belong. This is where I feel comfortable. I love the fact, compared to other areas of nursing, that there's no clear, right answer. Right, we don't know so often what's going on, and so it really calls for creativity and flexibility. And we talk about patient centered care in almost every area, but it's I think it's truest in this area and I really appreciated those aspects. Sorry, that's no, no, that's great.
Speaker 2:You know and I just was having this conversation the other day, I think you know, either people get it or they don't. In psychiatry, and there's kind of no in between. I mean, I, I, people, either like the gray, you know, because, you're right, there's no lab, there's no scan that we can kind of just hold our hats on and kind of say, you know, you have this, you have that, or you know, and this is going to work, it's, it's a lot of, unfortunately, trial and error and it's a lot of that sort of thing, and so so, yeah, no, I appreciate that kind of you know, just finding it and falling in love right away, it's, it's one of those things.
Speaker 3:Great Right. I remember I was working with colleagues in the UK. We were, we were looking at this proposal. Unfortunately didn't get funded. We were trying to have a joint program and we were looking at the issue of depression and we found and there's research evidence of about 200 different causes of depression and so we were thinking it would be a really good course, just because you could look at things at the molecular level you know the neurotransmitter.
Speaker 3:just because you could look at things at the molecular level, you know the neurotransmitter, the, you know the hormonal, the intrapersonal, the interpersonal, the community. It doesn't matter what level you look at, you could find causations. But I think it's just a beautiful example of the complexity of the field we work with. At the complexity of the field we work with and yeah. So if you're not comfortable with complexity and you want clear cut answers and knowing exactly what you're doing at 10 am, on whatever shift, you know like I agree.
Speaker 3:It's like if you either really like that ambiguity which leads to creativity, right Like you have to be flexible, you have to be flexible, you have to be creative, or you hate it. You want a recipe book.
Speaker 4:Absolutely, and I just want to say, dr Portek, it's such an honor to meet you. I know I shared with you over email before we recorded, but you know I'm a fellow Canadian, I'm now a dual citizen and I did my Bachelor of Science in Nursing at the University of Toronto and your work, you know very much, was the foundation for our mental health nursing class, in particular your work around. You know applying Peplau's theory and the nurse-patient relationship, and I understand that you know Hildegard Peplau was actually your mentor, so I would love to hear a little bit about you know how working with her informs, or has informed, the way that you see things.
Speaker 3:Well, it was interesting because I learned about her in my undergrad. I never thought I would meet her. After I graduated with my master's, I went and worked at a psych hospital. As I said, I wanted to have a broader background and go beyond addiction, even though I love working in the addiction field, and I still today I'm working on bringing harm reduction practices into our hospitals in London, ontario, where I'm situated now. But I was the first full-time clinical nurse specialist. This is quite a while ago we're talking about early 80s here and the hospital I worked at actually was for psych-and-mental health nurses.
Speaker 3:You should all know about this hospital. It was really foundational in many ways. It was actually the first hospital in the world that was established and this is back in the 1860s with a policy of no restraint. So there are other hospitals, like in France most famously, where they got rid of the restraint. This hospital never had them. So we have people come from around the world to the hospital and they were really well known for being innovative. It was originally called the Ontario Hospital, hamilton Hamilton, because we had provincial hospitals in different areas. When I was there it was called Hamilton Psych. It's now part of St Joe's in Hamilton.
Speaker 3:But one of the other things that they did prior to my arrival they were also so I say always very innovative. They had a working farm, they uh, instead of restraints, they like. Even back in the mid 1800s, uh, they, they were working with patients rather than uh like it was very much um a collegial kind of the whole way it was set up, right, uh, it was uh about having that kind of supportive environment. Uh, so this hospital, um, prior to my my joining there, which I joined in 1980, uh, they were the first uh hospital in canada that actually required nursing theory based practice, uh, for all nurses. Uh, now, that was originally done with itagino orlando. It was the first one there, but we had moved to the idea of theoretical pluralism that the nurse could use whatever theory was important and worked for the particular patient, but they had to actually document it which theory they were using, and it was part of the evaluation when you had your annual evaluation, it was. You had to be very clear which theories you were able to use, and so, as a consultant, a clinical nurse specialist, when I would get a request to you know, usually in the sticky situations where usual care isn't working, I had to do that consultation based on the theory that the nurse was using. So it was quite interesting and what I found, despite the fact we'd had IDG in Orlando there first, the PEPLOS theory was the most common theory. So I was using that theory quite a lot and we did try to get in various guest speakers from around the world to come in, various guest speakers from around the world to come in.
Speaker 3:So I wrote her out of the blue and just said would you mind coming to our hospital? And I described the hospital like this would be really good. And we had some of the other provincial psych hospitals were going to do it to, you know, so that she could go to some of the other areas, and we were going to sort of televise out some of the events. And she was going to come for three days. Is what we were proposing. So when I sent that request she was 78 years old, um, and she did not have an opening for a year, for a year. And then, uh, she was so booked, uh, and, and then she was so booked and then she was saying, now that I'm getting older, I'm trying to put a day of travel in between my speaking engagements rather than doing them in sequential days. But as a result, I'm having to book them so much further out than I used to, which I kind of thought was hilarious, and I have to, which I kind of thought was hilarious, and I have to say too, so I'd.
Speaker 3:When this happened, I'd returned from maternity leave with my first son and I was planning on having the next baby two years later, so I literally delayed the birth of that child. I delayed getting pregnant so that I would be there 18 months, so I had to delay by three months to make sure I wouldn't miss this event when she came. And so anyway, she visited for three days. We had some presentations we had.
Speaker 3:I had had different nurses with tough clinical situations that we had had on various units, and it was marvelous. You could just see her clinical excellence, like it was just absolutely amazing. But I was seven months pregnant, keep in mind too, which does does relate to the rest of the story. So anyway, it went really well and at the end of the visit she said to me write me, you know, gave me her address. She says I want to, I want, I want to, and she said that she was so impressed that, so, like, she was one of these funny way Sometimes, the way she say things that she's she can't remember having been in a hospital where so many nurses were approaching competence. Yes, yes, like, like, anyway, I I found that that funny.
Speaker 2:Um, I think I laughed when she said it that's, that's, um, that's funny and sad all at the same time, right? I mean, it's one of those things like it's sad that she's just seeing that now, but uh, oh, it's amazing.
Speaker 3:Yeah, yeah. So anyway, um, the next month I went off on maternity leave and in canada, keep in mind, we have long maternity leaves and we have parental leave, so, uh, husbands as well as wives can get paid maternity leave. So it meant I was going to be like kind of out of commission in that way for a year. Um, and uh, anyway, christmas came, uh, so my son was born in may. She was there in april. My son was born in may, uh, and at christmas I got a call from the, from the hospital, say we got a christmas card from you here, from hildegard peplau, we're going. Oh, that's weird, and and so I live out of town. So somebody came, dropped it off and it was Merry Christmas. You didn't write me.
Speaker 2:She's holding you to the fire. That's great, that's awesome.
Speaker 3:And you know it was a little bit intimidating. Oh, you know, the mother of modern psychiatric nursing and plus, like I'm kind of, I had these two youngsters I was dealing with and I didn't do it, honestly, I was a bit intimidated. So I wrote her back and I said well, you know, I apologize. I said I'm still on maternity leave but got the letter and, you know, wrote her a nice note back. And then she writes me back again in the first and she says so, when are you going to do your PhD in nursing? And so I wrote her back and I said oh well, I am planning on doing that. However, at this point in time, because we're again, my son was born in 1984. We don't have doctoral programs in nursing in Canada. At that point we were just at the point of planning them and I have two kids under three age three. So I thought those were really good reasons, right? Uh, so she writes me back and says stop making excuses.
Speaker 4:oh, my goodness, back and says stop making excuses. Oh, my goodness.
Speaker 2:That's great. Wow, there's. There's no excuse he's going to take that's great.
Speaker 3:How are you supposed to get doctoral programs in nursing in Canada? Some of you don't leave the country to do it and kids under three are so much more portable than as they get older. This is the ideal time. If you because I said I'm going to wait until they're both in school she says you wait until then they're in sports teams. Their schedule is going to dictate.
Speaker 2:If you go before that, you can just carry them around anywhere, so was she offering you a slot in her?
Speaker 3:program. Is that what she was doing? Theoretically retired right.
Speaker 2:Oh, that's right, that's right yeah.
Speaker 3:I say she was 70. And so by this time, like, she's like 79 or something. So anyway, we, I ended up, I did go back with them quite yet I went to Wayne State but we maintained a correspondence, like every week we maintained a correspondence. My doctoral thesis was on testing her theory and she was very involved. Like, for example, we didn't have, she didn't have a picture model for her theory, which is something that normally theories have, Like they're written in a certain style, but because she had actually written it in the late 1940s, it took her a few years to get it published, because she refused to get a physician co-author and just about everything at that point, for a nursing program required a physician co-author, and she said this is supposed to be a theory for nursing I'm program required a physician co-author, and she said this is supposed to be a theory for nursing I'm not getting a physician co-author, and so it delayed the actual publication by a few years.
Speaker 3:Um, anyway, so, um, so we worked, I worked back and forth with her on a picture model of the theory which, and then we decided what were the most important things in order to test the model. Um, and, as I say, uh, we were able to get together in person a few times particularly. Uh, we'd plan it like at conferences, that that sort of thing. Like she, if she was asked to speak, um, she was very generous and sometimes suggesting I should also come and talk about the practical implementation and then that would be an opportunity uh to to get together. So, um, anyway, so we maintained a weekly course. I I have binders like this thick of the that I've kept in terms of well, I'm sorry you can't see that uh say several inches, I don't know.
Speaker 2:That's great yeah.
Speaker 3:Yeah, so, anyway, that, yeah, so she and the other thing she did. That was really important and very consistent with her theory, because it's all about relationships, right, she also connected with me, with other people and, uh, in in many different ways. Like she would say, oh, so, and you know, like, uh, you know phil barker and scotland is doing something similar. You should connect with them. You should connect with bill reynolds is doing work on empathy. That's related, um, grace sills, uh, you know, has done this review. You need to, you know you need to connect with her. So, um, uh, so, so she was really and she would, and sometimes I would just get letters from people saying hildegard peplau said I have to contact you, uh, and ask you about this, or that I wonder if they got the nasty letters too, like why haven't you reached out to cheryl yet?
Speaker 3:yeah, like I, like I would say nasty, so much as firm, which I and I remember saying to her. I says well, your, your theory is very much about being patient centered and going, going with the flow, like the nerve sets, the sets, the process, but but, but it's very patient centered, that I said. But so so how come, you know, like a sort of joke, but yet you're kind of bossy, which kind of goes in a different direction, right?
Speaker 2:yeah, and thank you for correcting me. I, I think you know, I think this is, uh, what very driven people are. They just kind of, they have a passion and and it's like nothing gets in the way. They're just like that. That's, they're gonna get it done and and and either you get on that bus or you don't. And if you don't, you she might kind of drag you along for a while and until you get the idea that you need to be on that bus.
Speaker 3:So that's awesome yeah, but yeah yeah. But I yeah, anyways, it, it, it. It was great to to have that opportunity and it is like she she was very supportive in so many ways, like the different connections with other people, et cetera was really foundational allowed us to really create a community of people working on similar areas and a lot of those people I'm still in touch with, the ones that are still alive.
Speaker 5:This is so fascinating. Thank you, and given you know your experience and these experiences, I'd love to hear more about how you see nursing being a leader in performing psychotherapies.
Speaker 3:Oh, absolutely, because I think we have, because, like her form of psychotherapy, as you know, it's not as purely insight driven as many forms are. It's really very much about competency development. You know, this idea of creative, constructive community living is the goal and the person who does the work, of course, is the person who gains through the work, and that they're identifying're identifying um, what, what to work on, uh. But in some ways it's like insight is more the side effect of that growth versus being kind of flipped around in another way. In many models, I think the idea is the focus is on insight and then the insight will create the, the growth, um, but but it's about this learning and problem solving and and helping them develop these confidence, these competencies of constructive community living, um, I, I think it, um.
Speaker 3:It like, when you look at a lot of her work I think a lot of people have done similar things, like even her issues around use of language is very similar to, say, aaron Beck's work that came after Right, that you're looking for patterns in the language and reflecting, reflecting back on the, on the use of language, but, but as a learn, like, as a learning tool. But I say like, I think it's. It's very flexible in that way because I've worked with people with a wide range, like in some of the programs I would work with, I'd be working with people with developmental handicap, but yet we could still work with where they were at and and look at learning and look at constructive community living, or or be working with people who also had a PhD and and had and were at a very different. So I think it's very flexible, uh, in that way. But also this idea of it being very much about growth I think that's so much about nursing is this idea of growth, interpersonal growth, um, and and this development of competencies, uh, as I say, that's why it was funny given that being a main part of her theory when, when she was talking about that, after she met the staff and I think we actually did have very excellent staff at that hospital Of all the provincial hospitals, we had the shortest length of stay, which in Canada is a good thing, and you know, most of our work was actually in the community, um, like we have so many more community community patients than inpatients, we we had the the fewest per capita uh number that were actually hospitalized, because our, our goal was around constructive community living Um so, so like, as I say, it was just all in all a really good fit.
Speaker 3:So I don't know, did that answer your question, melissa?
Speaker 5:Yeah, thank you. I've just had as the non-nurse constructive community living. I've heard you say a number of like that phrase I haven't heard before.
Speaker 3:Yeah, yeah, it's in her 1952 book, thanks, yeah, when she talk about the purpose of nursing.
Speaker 2:Yeah, thank you. I know it was one of the things that's, you know, coming to fruition too, because I was kind of looking kind of with your past work and one of the videos I ran across was the doc talks from St John's and your talk about homelessness and I think that constructive community type of involvement with PEPLAO, you know, just really kind of connects that and I wondered if you could kind of again for our audience just kind of share that connection with PEPLAO and how that really does address homelessness.
Speaker 3:Yeah, and on different levels. Again, because one of the things that peplab talks about, uh, and again this is important in psychotherapy generally it's about self-reflection as well, it's about understanding there's more than one party, uh. So one of the things peplab always said was that if you are assessing the patient without or client, depending on the context without equal assessment of yourself, at least you're not using her theory. So the person providing the care and the person receiving the care both need assessment. So what I've done with my research from a research methods, I always include the people providing direct care as well as the patient experience, and I do a lot of systems-related work. And certainly I have been doing some other work around the transitional discharge model, which is very consistent with Pat Klaus model, which was given by the World Health Organization as an example of a model that respects patient rights, because it very much was co-designed with patients and frontline staff. But also my work on homelessness is very much the same and I was seeing an over-representation of people with mental illness, including addiction, in that population and again, exactly as you're saying, because that runs contrary to this idea of constructive and productive community living. So we've done a number of projects to look at specific subgroups to end it, but all of those include people with a lived experience and frontline staff to co-create what the solutions are. So it's very similar to what we do on a one-to-one basis in therapy, but doing it more on a larger group basis, but it's the exact same process. It's the exact kind of dual involvement with the same kind of goal of this living and the same thing. I have a process in place, but the actual ideas and the design and what is required actually to set that agenda comes from the people with the lived experience. So we've come up with models like for youth homelessness, people with chronic addiction, family homelessness. I'm right now working on projects related to women veterans who've experienced homelessness.
Speaker 3:But I always use that same approach. And I was talking about you know, the study in terms of addiction, what I've been working on in the London Ontario hospitals around bringing in harm reduction strategies, but again the same thing. There we talked, we were focusing on methamphetamine because there's not a clear substitute and hospitals are often the hole in the middle of the donut when it comes to harm reduction. I don't know what it's like in the States, but it's very well accepted in the community settings and then you go to hospital. It's no, by the way, don't use while you're here, you might get kicked out, which goes contrary. So we were trying to address some of those issues. So we talked to people with a lived experience. What would you want in place? Talk to the staff, what do you see as the issues, and then kind of plan together how we can make the things that happen that are based on what people actually want no-transcript underestimate the advocacy role of nurses and we do that on multiple systems levels.
Speaker 3:And again, when we're thinking of that constructive community living, again we have to right. We have to do that. We have to speak with our patients and support them to also speak out so that we're not taking their voice from them but amplifying it with them. Right, but like Canada as well, I would say, like our nurses are incredibly politically involved. It's something that we do a really good job of.
Speaker 3:Um so have have a huge influence on health care policy. As, as a result of that was quite a few years ago around that way, back when I was doing my phd we were revising the canada health act, um, and at that point, one of the things like because there was the possibility at that time of physicians extra billing over and above um the the free health care that everybody's entitled to, paid through taxes I mean, it's not free-free and the nurses wanted to close that gap and say no, no one should be able to jump the queue. And of course, all the physicians wanted the ability to earn extra money and the provinces thought that would be okay. But the nurses lobbied very strong In fact, during the one meeting we had strategically across the whole country where every five minutes we sent telegrams, that everybody was receiving these telegrams from different nursing groups across and all day, all day.
Speaker 3:So at the end of the day that was essentially made illegal, that the if, if a physician, let's say, charges you an extra hundred dollars to get some proceed medically necessary procedure earlier than someone else, someone else, um, that means the province, for the federal funds to go from the federal government to the province, gets a hundred dollars less. And they know who it is. That did it. Uh, so, uh, you know so, so they're in trouble. So, so like it. So it really, um, it really closed that. It really closed that gap. It really closed that gap. But it was nurses that did that. And you know, some people say, and we, when we were making those changes, we had little buttons made up saying nurses, nurses, no, nurses care, nurses vote, because in Canada nurses are one of the groups that have the highest voting rates of almost any other profession. And then we would say about you know for each province how many voters are nurses. So it makes a very clear message you better pay attention to the, to the nurses.
Speaker 4:I love this piece about. You know how important the advocacy is, and nurses as a formidable political voice. I think that's so important, yeah, and so, dr Porchak, I'd like to ask you, which I think is maybe our final question, which is you know, given everything that you, you know, have learned, that you know, that you've shared with us, how do you see sort of the future of, you know, mental health, nursing, psychotherapy, unfolding, given all of the challenges that we have in today's world, some of which you've talked about already?
Speaker 3:Yeah, I. Well, some of the challenges that I've worked on as well is the issues related. I would say, well, there's two issues. One of them relates to short length of stay because, like, our length of stay is not based on an insurance program but it's still, it's more similar to an HMO. So you get up, the hospitals have a blanket amount for the area they serve. So if you have a fast admission, then it's, it's, it's better for them. And so sometimes you'll hear people say well, you know, if they're in on a short admission, it's difficult to form relationships, but but you know. So that's some of the some of what I find when I'm talking to staff now that we have to really look at, and sometimes it's about setting the person in a position. Maybe that long-term relationship is going to be with the community nurse, maybe it may not be with the hospital nurse, but you can still set them up in a position where they trust nurses because of what you started with them, so that they can transition that relationship to the community.
Speaker 3:The other thing is around technology, uh, and so I've been very involved, some of our projects looking at how do we have technology, uh, for solutions that support the therapeutic relationship rather than get in the way, uh, and so we've been looking at and, and I think that's really, really important and if we do not, if we're not involved with that, then these tools will be developed that that do not support the relationship. Um, you know, for example, uh, you know we were uh. One of the things we had done is we'd worked on a phone app and and, like we, I remember we were looking at like mood monitors. There was like over 200 uh, uh out there at the time. I'm sure there's many more now, but only six had ever even been tested. But most of them focus on introspection, like you're doing this in isolation. You're focusing on the scale, and we know that introspection and depression without a connection with another person is not really a good thing, but that's not how they're being evaluated. So what we've done is look at things where the client can be empowered by seeing all their own data, by seeing all their own data, but it connects with that healthcare provider with the nurse most often, but also could be a social worker or someone else so that it supports the relationship. And so, for example, if they're doing a self-assessment for depression, for example, that it's negotiated between them.
Speaker 3:At what point should the care provider get an alert right? So you know, some people are depressed all the time and maybe it's when it starts going up that you need the alert right. So it's a negotiated thing and there would be these alerts, but it would be completely transparent. So it's a negotiated thing and there would be these alerts, but it would be completely transparent and it gave them things such as it was updated twice a day, so if they had a medication change at 11, they could see that on their phone at noon. It was noon and midnight that it would get updated. So they had complete control. They had their crisis plan was on their phone, their medications, their various treatment objectives, and they could create their own scales of what they were monitoring. But it would be all in communication with their care provider rather than purely them focusing on their own.
Speaker 3:And this was people with serious mental and schizophrenia and major mood disorders, right. So you don't you want it to be this, you know? So I think that's an example. I think, with the technology, um, my fear is that that if we aren't involved with that, uh, and do it in these very therapeutic, supporting of therapeutic relationship ways, we're going to end up with these things that are going to going to interfere with those relationships. So that, and I say the short length of stay and those transitions between services, I think we have to pay attention to as well.
Speaker 2:Yeah, I love that. You know that technology kind of adds to the relationship. You know there's a way of kind of doing that without just kind of making it. You just kind of making it. You know for for lack of a better term kind of just more medical model, where we're just kind of checking boxes, we're looking at symptoms and and making diagnoses and such so. So yeah, thank you yeah, sorry.
Speaker 3:Yeah, yeah, no, no. I say like we, we have a. A lot of people would say there when they would have the therapeutic meetings. It was more focused because instead of saying, well, how's it been going, they had that information and the patients were able to look at patterns themselves. Like, hey, you know what I noticed? I'm most depressed on the days I'm not doing activities, or the day I talked to my mother or whatever, and I remember a couple of them said, because they were also looking at things like blood, every time my blood glucose goes down I'm depressed. And then realizing that that's in fact what they had to deal with. So they could have like this little experiment of one, because they could plot those two things together and say, oh, my goodness, there's my blood glucose level and there's my depression level. And then when they come in it was very focused saying you know what? I've totally been missing this.
Speaker 2:Yeah, yeah, something you know, they they feel seen, they feel heard, they feel a sense of control. There's something I can do to ameliorate these symptoms and that's, and that can be a real sense of power for a patient.
Speaker 3:So yeah, and very focused discussions when they would get together there. You know they both have the same information and they're saying oh, I want to talk about this.
Speaker 2:Yeah, yeah, excellent.
Speaker 2:Well, I love that future. That's awesome. Thank you, dr Forchuk. Thank you so much and thank you for those listening. I hope everybody's learned a little bit. Something had some fun.
Speaker 2:I, you know I definitely you know for me kind of going back and what we talked about a little bit today. You know, I definitely you know for me kind of going back and what we talked about a little bit today. You know I, um, you mentioned, dr Forchuk, about the idea of these open units and that's something that I actually experienced, uh, in Iowa city here. You know we have, we had, I should say, unfortunately the hospital shut it down, but it was this open, uh, open psychiatric unit which was just kind of mind blowing at the time that you would actually have a psychiatric unit that wasn't locked and so didn't use restraints. Yeah, so very, very novel and I hadn't seen or heard of anything else, at least in the United States. So I'm interested that they've had that in other places and around the world.
Speaker 2:1860s, yeah, right, I know, yeah, it's a blast from the past at the very least. So, but that's great. And thank you again for sharing your stories about Dr Hildegard Peplau. You know I love the idea that we, you know, family planning, got involved with your first meeting with her and how you, you know, just kind of kept connecting with her, and so I'm hoping that that's what this podcast does for people is continue to connect. You know, like-minded people that we, you know, can all kind of stay connected. So my last plug will be to subscribe like comment. Please put comments and let us know who you want to hear from next, or if you want to hear from Dr Forchuk again, maybe kind of make that plea and see if she's available again. So thank you so much and look forward to another episode coming soon on Pep Lau's Ghost. Take care.
Speaker 1:Bye leaving so you can be. You Got a discovery Identifying challenging your beliefs, reframing your mind Negative thoughts. Release these cognitive distortions, decrease until they cease. Yeah, got a discovery Identifying challenging your beliefs, reframing your mind Negative thoughts. Release these cognitive distortions, decrease until they cease.
