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
Nursing Bridges the Gap When Therapists Aren't Available
What happens when mental health patients can't afford therapists, lack access, or have nowhere to turn? Enter the Psychiatric Mental Health Nurse Practitioner, uniquely positioned to bridge critical gaps in our mental health system.
In this illuminating conversation, host Dan Wesemann and Melissa Chapman welcomes Dr. Stephanie Bennett and Dr. Humberto Reinoso from Mercer University's nursing faculty to explore how PMHNPs are increasingly providing psychotherapy alongside medication management. Both guests share candid stories of "falling into" psychotherapy practice when faced with patients who desperately needed therapeutic support but had limited options.
The discussion reveals the distinctive nursing approach to mental health—a holistic perspective that considers the whole person rather than compartmentalizing care. As Dr. Reinoso poignantly describes, many patients feel "on an island," isolated with their struggles, and the nurse's therapeutic presence becomes the vital connection back to wellness. Dr. Bennett shares a particularly moving account of working with a patient weekly for over a year, initially feeling overwhelmed but ultimately witnessing profound transformation through small, consistent steps.
The conversation doesn't shy away from systemic challenges. Insurance models often discourage spending extended time with patients, with practitioners facing pressure to conduct brief medication management sessions instead of comprehensive therapy. Yet both guests remain optimistic about the future, emphasizing that nursing's inherent focus on presence and relationship offers a valuable template for truly integrated mental health care.
For students and practicing PMHNPs alike, this episode provides valuable insights into expanding your therapeutic toolkit beyond medication management. The guests highlight how nursing education is evolving to better prepare practitioners for this dual role, while emphasizing that sometimes the most powerful intervention is simply being present and listening deeply to a patient's story.
Have you witnessed the power of therapeutic presence in your own practice? Share your experiences in the comments, and don't forget to subscribe for more conversations at the intersection of nursing and 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 number two I think we're recording decrease until they cease. Stop out of discovery, identify and challenge and enjoy.
Speaker 2:Welcome back everybody to another wonderful episode of Pep Lau's Ghost. I am your host, dan Wiesman, and I am thrilled to have another couple of wonderful guests here from Georgia Mercer University. So just talking about, before we start recording, that we just happened to meet at one of our presentations at NOMF, which, again, melissa is probably going. Nomf, what is that? That's the National Organization of Nurse Practitioner Faculty. So those of you who may be listening and don't know that, but yeah, it's one of our big conferences that we have and that was in Denver right this year. So yeah, so hopefully got to kind of meet and connect with that conference and Umberto kind of jumped in and said, hey, would it be okay if we could kind of continue conversation and and definitely invited one of his esteemed colleagues, dr Stephanie Bennett, here.
Speaker 2:So at this time, you know I usually sometimes like to do some introductions, but you know what I'm gonna. Let you guys do that, if that's okay. Just, you know I usually sometimes like to do some introductions, but you know what I'm going to. Let you guys do that, if that's okay. Just, you know, I've actually had some guests who say they feel a little embarrassed by the intro that I do. So I'm just going to let you guys introduce yourselves. But again, really enjoyed you. Thank you for making the time to be here and, as you've known, you've mentioned you've listened to a couple episodes as well. This is really to focus a lot about psychotherapy and kind of the role that psych, mental health nurses and nurse practitioners kind of play. So maybe just let me throw that out for both of you and just kind of get us started. What got you interested, or where does your interest come from in doing psychotherapy or just kind of that in the role within the PMHNP.
Speaker 3:Sure, stephanie, you want to start us off?
Speaker 4:I think that it, just as far as doing psychotherapy, it just fell into my lap because there was people who didn't. They didn't have anybody, you know, and initially you go into being a psych and mental health nurse, practitioner and a lot of it's medication management, but so many of the people that came to me either one could not afford a therapist, didn't have a therapist, didn't have time, and so I fell into it kind of that way, not really anticipating that, that way, not really anticipating that. In addition, I do go and volunteer at a free clinic some, and so when they lost their therapist which I'm working diligently to get them one back, it's better than me, but I kind of fell into that as well. And so it was. You know, it was to meet a need, that's how it is.
Speaker 2:Yeah, I hear that you know it's one of those things and there is a huge need, right. I mean, I think that's one of those things that gets you know, maybe advertised more than it should, but it's, you know, there's a need obviously for people to be able to prescribe psychotropic medications, but doing therapy there's such a need as well and kind of getting people in there too. So I'm going to say too that, stephanie, that you probably I mean I think you saw the need, but maybe you kind of also there was something internal that kind of drew you towards that practice or that intervention as well.
Speaker 4:I do. I see, you know, and I think a lot of it, you know life experiences of myself not being a super young person that was what I think, a lot of it, you know, life experiences of myself not being a super young person that was what I think, you know, prepared me more than anything to do it and I found on myself primarily the people that I do more psychotherapy with, I would say, are younger women and you know who are, I would say, almost kind of the age of my own daughters in that category, or a little bit younger, and and then women my age, and you know, there's just, it's the need really that that drove me and just, you know, hearing people's stories and hoping that, even in some small way, just by listening and responding appropriately, I can help them move forward, even if it's just a little bit every now and then.
Speaker 2:That's awesome. Yeah, We've had our students on campus here and we're doing kind of some foundational communication. That's one of the themes that we always say. You know, that intervention of just being heard sometimes is so powerful. You know, it's more powerful than any medication I think I can prescribe. But I will offer this opportunity to you as well. Stephanie, I'm terrible at this. My wife will definitely say this. I'm terrible at introducing people. So maybe kind of a quick opportunity to introduce yourself, yeah, that would be great.
Speaker 4:So I've been a nurse for 40 years and went back to graduate school in my 40s Initially, was a family nurse practitioner, so I've been, you know, in love with the hospital. So this is really a change for me but moved did kind of an acute care position. But then it was really when I moved more into doing more of a family focus and it was really the free clinic that drove me in this direction. So I went back. I felt I was going to the free clinic, that the mental health needs were staggering. I felt quite inept, to be honest with you, so that drove me to go back for postgraduate. So so now we have started our program and so it's exciting, though Just the needs everywhere you see them I mean, that's one of my things is in primary care. Wow, there is so much to it and you just feel kind of equipped in this area.
Speaker 4:Awesome, thank you, and you're with Mercer University, right, I'm a full-time faculty and I practice one day a week in psych and mental health and I do some other things to my other interest for global health and population. So I take students to India every year.
Speaker 2:Oh, wonderful. Well, that's amazing. That's great. Yes, I'm the current president of the International Society of Psych Nurses and so we have an affiliation with the I think it's the India Society of Psych Nurses so we have continued relationship with them. But that's amazing. Thank you for that work that you do. So, Umberto, I don't mean to ignore you, I just love, I would love your perspective on that question. When did you get interested? Yeah, yeah.
Speaker 3:So, similarly to Stephanie, I kind of grew into not necessarily pushed into so I coordinate the NP programs at Mercer. So Stephanie and I work together. She is the lead for the Psych Mental health track which we just started. We're just graduating our first cohort and super excited to meet that need. Yeah, because Georgia does have a shortage, similar to other states, of providers, specifically psychiatric mental health providers in the state. So really trying to like step up and fill that need.
Speaker 3:And my background is completely different. I'm an emergency nurse, practitioner, emergency nurse. I was a clerk, a tech kind of like one up the ranks through um, through the ER, um, not not to to date, um, uh, we just, you know, observed, uh, september 11th, but that was kind of like the, the, the um, the catalyst to, kind of that got me interested in like nursing and kind of like pushed me into um, that service and um, I gravitated towards the ER. Um, uh, that adrenaline, uh adrenaline, you know, kind of fueled me for a couple of decades. And then, as time came by, like I just especially after COVID, I just felt that there was a huge need in that mental health like space with substance abuse as well as just like mental health overall and even though I felt like I wanted to flex some of that like therapeutic communication and some of those basic like nursing skills that we have, a lot of the times it was just the demand that kept me from really sitting and like talking to patients and getting to know and just being present. Right, we talked about, like you know, being therapeutic in our communication, but I think also that that that presence also speaks volumes and sometimes patients just that space to be able to kind of like open up and then just also have someone to hear their story.
Speaker 3:So I, similarly to Stephanie and in preparation for the psych mental health track, went back and got my postmaster's certificate and have been practicing here in Georgia.
Speaker 3:We have our full-time academic responsibilities but then we're also able to practice and give back to the community.
Speaker 3:So in my current practice I see patients that are in recovery in uh partial hospitalization, intensive outpatient uh type of like setting um and then some virtual um uh visits as well, um to try to to do that med management. And I think that that's really where our specialty um definitely comes into play, especially given the um, the family nurse practitioner, like that medical knowledge that we've practiced like for so many years and seeing the interplay of, like some of those medications on mental health. But I have noticed in my current role how patients do benefit from that therapeutic alliance and that ability to share that space, to be able to go ahead and tell the story and point out those coping skills those positive as well as sometimes those negative coping skills to get them on the path of recovery and feeling better about themselves. Right, and yeah, that's kind of what has drawn me and I've really been grateful for the opportunity to kind of spend that time with the patients that I'm currently like working with.
Speaker 2:Thank you. Yeah, no, I don't know if even Melissa knows this. I mean, I, you know, spend a little time in the ER myself. It's not as long as you and so definitely not that level of expertise.
Speaker 2:But as an RN, you know, I was kind of drawn to it. It was, you know there was for me, you know the duality of you know, because in psych, you know it's it's a lot about seeing small changes over time, right it's, you know, and sometimes we have to really look hard for those changes that we see, whereas kind of with the ER it was a nice kind of balance of kind of that. I hope I can say this you know that street and you know treat and street kind of thing where you get in, you provide some quick interventions and then you move on to the next level of care or or sort of thing. So I so I really like that duality, but I obviously kind of continue to be drawn more to this kind of relational kind of role and such but. But no, it's, thank you for sharing that and really kind of seeing where that goes. I'm going to turn it over to Melissa now for the next question. Thanks.
Speaker 5:Thank you. Yes, it's nice to hear how you have your academic duties as well as you're able to practice and give back to the community. We'd love to hear a little bit either about the first time that you performed psychotherapy, if it was memorable, because often it may be or if there's a session that really taught you something. You could opt for that too, which may not be. You know your first session, and either one of you can jump in I suppose Stephanie or Umberto.
Speaker 4:I'm gonna say my this is not just one session, but it was the first person I had a long-term relationship with that we actually met not for just medication management but for psychotherapy every week. And it wasn't, you know, I think at first, when she started sharing I was like, oh, you know, I felt overwhelmed myself. Do I even know where to go with this. But over time, with that constant development of our relationship, my life experience and me doing some reading, you know, I, I felt we, we began to move forward, and when? But it wasn't until, you know, a year and a half into it, that one day I sat down and I I looked at her in my mind where she got, and I looked back a year and a half ago and I was like, wow, because, like you say, the steps seem very small and sometimes when you're doing that, you feel like, am I getting anywhere? Are they moving forward? Am I helping them? And then it was, it felt, it was amazing to look back and see, wow, we have come so far in a year and a half and we reached a point about two, two and a half years into this that I got pardon me, just somebody else, because I think I thought it was time, not because we weren't doing well, but I thought it was time for a new perspective for her.
Speaker 4:But we still talk for medication management and she is. But it was there's a couple of instances like that when I first thought, okay, I don't know if I can do this. And then, as I really you know, with her, I started listening to her story. I went and read the CODA book you know the Codependence and Honest book to try to get myself really engaged in what she was doing. You know that was part of my own personal education with that particular patient. But I learned that I think it's a harm so much for my patients, yeah, yeah.
Speaker 2:That's what I love about this role too. And yeah, that was that, you know, made me think of you know, a time too when I worked with a patient that was in a nursing home and and same kind of thing. It was, you know, kind of working with her and just kind of wondering after each session, what did I do, and did I do anything that was anything positive? But yeah, over time you kind of look back and you're like, oh, wow, yeah, we did, we did make some changes. So thanks, Stephanie, that's great.
Speaker 3:So I guess one thing that stands out. I do have an example of a patient that I've been able to follow through now for a good six or seven months. Patients do at times get confused on the role of the MP. This is common in the emergency room as well as like common as a psych nurse practitioner, where they're not sure exactly what services you're able to provide. So I've had patients that have actually come for therapy specifically and you know when I tell them that's that's not really like my area of strength. That is an area that I do practice and we can definitely offer like some talk therapy and we can talk about like cognitive behavioral therapy and so forth. That's not my, my area where I really like flex, flex.
Speaker 3:My area is like that med management and the two I try to get the patients to understand the two complement each other, um, as, like the medication management is one piece of that puzzle, um, and then the therapy is the other piece of the puzzle, um, but like stephanie said, that some sometimes the patients are not able to really find therapists. They're not able to meet the financial restraints and they only are able to go ahead and pick one. So I think for the psychiatric nurse practitioners, and this is what we tell our students. It's an area of opportunity that you're able to connect and there are some students that gravitate towards that area because they have a background in teaching, they have a background in psychology. But I do see that misconception with patients and not knowing their role and I think that in nursing, you know, we at times create more confusion with the different tracks, the different roles and so forth. So I try to educate the patients and, in that same vein, see that as an opportunity to talk about like what really brought them to seek treatment and at times, like I've mentioned, just being able to voice some of those concerns with this one patient that I met who had anxiety and depression, had gone through a number of um uh transitions, life um changes, uh that that really uh brought together um a lot of strain um in in her life.
Speaker 3:Um, she wasn't necessarily in crisis, but there was that like overly um anxious. There was that like overly anxious, like panicky, like feelings and sensations. When I met with her and just being able to sit with her for that hour for the intake to kind of unravel some of those, those patterns, some of those processes, and I remember having a conversation with her about some of those, some of those common coping skills that might have worked back in the day, back in the day of her at this point in time, from financial to, like you know, the personal and like so forth, and there was a bit of an aha moment for her because she, that was her comfort zone. So the comfort zone was like this is how I took care of things in the past and that's what I see with patients that, like you know, are in their recovery journey. They tend to just got to go to that comfort and with therapy, the talk, therapy, and like the sessions that I have with like patients, they are able to at times identify that that was how I dealt with things then and now I need to be able to learn new ways. That might be uncomfortable, they're outside my comfort zone, but I'm going to be able to probably augment those coping skills and not necessarily rely so heavily on those that didn't work for me in the past, rely so heavily on those that didn't work for me in the past. So I've had those aha moments with patients which I've enjoyed, which in the emergency room.
Speaker 3:Obviously, like you know, it's like you said, treat them and street them. With my current role, I'm able to actually like carve out some time and really hear the patient. And, yes, there's that medication piece and we had suggested different medication regimens to kind of help with her feelings of like panic and so forth. But just being able to meet with her throughout the last like six or seven months, um you know, monitor the medication and the efficacy of the medication, but then also just have those like touch points of like how are we with those coping skills, um, you know, uh getting her connected in the community, like getting her, um, uh, the support that she needs, not just for like housing, like work and and so forth. Um, we like work and so forth. We work through a lot. So I think that is one story that kind of like stands out as an example of how therapy I think is a powerful tool.
Speaker 5:Thank you both for sharing. The metaphor of a bridge came to mind as you're talking. You know, helping patients navigate previous coping skills and seeing how that's not working and sort of building that bridge to new ways of navigating their life and their challenges. Thank you, yeah.
Speaker 2:Yeah, I like that, melissa. You know I was also thinking that it's. You know there's, this is a process, right? You know, one of my first you know mentors in my career, she would talk about that. Actually, her mentor which I still would like to do had above her door and it was in Latin, so kind of no one knew what actually said, but but it was always trust the process, because I think that is a challenge.
Speaker 2:Whatever kind of role we're, you know, using, as you know, as PMHMPs, you know, whether we're focused on medication management or we're doing therapy or we're doing some combination between the two, it is, you know, you know it's hopefully it's reassuring for people to hear. You know, especially new practitioners, there is going to be a lot of times where you're going to feel like you're not doing very much and you're really kind of feeling as lost sometimes as the patient. And so, you know, I think that's always a call out to make sure that we're, you know, leaning on our professional networks and, like we talked about earlier, you know, when we meet we met at a conference, you know and kind of connect with people. It's surprising, but I mean, every conference that I've gone to, you know, I've always found somebody who has very similar experiences or struggles that I have as well. So it's just got to kind of go up and do the hard thing of introducing yourself and meeting some people. So, yeah, yeah, so it's, you know.
Speaker 2:The next question. You know kind of get a little bit more globally. So we kind of asked you more kind of personally, kind of your experience with therapy and things. But now we're going to kind of I'm going to kind of ask you you know, what do you see as nursing, kind of being a leader? Obviously, you know psychotherapy is done by multiple professions psychotherapists, you know psychologists, social workers, other professions out there too. But you know what is nursing. How do you guys see nursing, being a leader in doing psychotherapy? Or yeah, just leave it there.
Speaker 4:I think nursing has such a global approach and we are looking at, I think, the background of nursing, looking at the whole person is, you know, such a great starting place. I think the heart of nursing, you know, I don't know that we are taking a leadership role, but I think we can. I think nursing are the ones. If you look at, you know, underserved populations and you look at free clinics and all that, that, you know the people who are the providers in these types of underserved areas are typically nurse practitioners mostly. So I think we're the ones out there, you know, seeing this, doing this and where to go with it, I don't know. But I think the heart of what we do, I think we're ideally suited to, you know, move forward.
Speaker 3:There's so much that needs to be done, you know, even from a policy standpoint, in this arena us and I would say, you know, to kind of put a plug in Pat Lau, who this podcast is named after, right, you know she is the basis of um that, that that nurse patient relationship, right, where everything is kind of like built on um, nursing uh is identified as the most caring uh profession.
Speaker 3:Um, and I think it's because the nurses are at that bedside and are able to hear the patients and sometimes it's just that presence, like I said, now we have the capacity to be present virtually right from different parts of the world.
Speaker 3:But even just being on that screen or being next to that patient, like holding their hands, that is a therapeutic and powerful experience where people sometimes just need to have someone listen. And what I find is in my current practice, a lot of patients are in an island. They feel that they're alone, that nobody can get to that island and sometimes by connecting with you, you're given that bravery, you're given that opportunity to listen to their story and can kind of help unravel some of those concerns. And yes, there is a place for for medications. We know that there's advances and um, we know that uh, the, the, the realm of, like um pharmacology has completely like revolutionized, like the treatment uh approach for for select patients. But I think also at times as nurses we have to go back to the basics and and listening to the patients. Having that patient centered approach is kind of like the the basis of of what we do.
Speaker 2:Yeah, yeah, thank you, herbert, for mentioning PEPLA. Obviously, yeah, that's kind of the the model here, but but you know, I think I totally agree with what both of you say and I think that I love this idea. You know, just kind of remembering that nursing is a very holistic, you know, perspective, and so we can offer, you know, medications, we can offer therapy. You know we can kind of and again, I think from my perspective, you know, as psych, mental health nurses, I think we're skilled at kind of knowing where you know because I think that still comes to question you know what patients need just therapy, what patients just need medications and things like that too.
Speaker 2:But even like you're saying, umberto, like the idea of medications and they keep advancing, and you know meds save lives, I mean, you can't not argue that basically. But it's, you know meds only do so much if and they only work if a patient takes them Right. And so I still think there needs to be that therapeutic alliance that that patient trusts you and they, they kind of believe that. You know, I'm going to prescribe this medication where the pharmacist is going to give them, you know, an arm's length of side effects that could happen you know, and then sometimes you can say don't read that at all, or however you want to kind of approach that.
Speaker 2:But you know it is about that trust and about that. You know that person heard me and that's what I hear a lot more too, is you know, when you talk about different professions and people coming to you and, like you know, finally someone listened to me, someone I felt heard as we were talking earlier too. So, yeah, thank you for those perspectives. That's great. I think Melissa is going to kind of get us on our last question here.
Speaker 5:Yes, and I just had to. I love metaphors, so thanks for the island metaphor. That's so powerful, yeah. So the last question is what?
Speaker 4:do you each see as the future of psychotherapy for PMHMP? Okay, I think it's going to expand, but I think you know we are going to need to provide more education than that and you know, currently, as you, you know you do give education on psychotherapy, but we're trying to. Most places are really trying to make sure that they understand the different kinds of psychotherapy and have this global view and we focus on motivational interviewing and ours. But I think the need for additional growth and education in that area is going to be very great because I think it's going to be getting. It's going to become more and more common.
Speaker 4:You know, barriers are insurance payments that you're. You know whoever you're working for doesn't want you to do psychotherapy, often because they can't bill enough, which is very sad state of affairs. But I think it's going to become more and more because you cannot help but see the need when you're talking to individuals, even if you're seeing them for med managers, you cannot, and that's how you kind of fall into it. So, but I think, further education, you know, I would love to see we're seeing a little bit of it, being able to go to a conference and all right, let's do a two hour course on. You know CBT, you know, or you know? Just, I think nurse practitioners are going to seek more education because they're going to be like me and they're going to be like oh, wow, okay, now what? Let me read a book. You know?
Speaker 2:Yeah, no, I agree, and if I could kind of just follow up with that, do you have or can you think of any examples? Like, I totally agree with you. This insurance thing is is an unfortunate pushback and I think there's a misconception out there. I personally believe there's a misconception that doing therapy is somehow financially disadvantaged. I think there's a way to kind of use double book. You know coding and things like that but is there any examples that you've had that somebody pushed back on you that saying you couldn't do you know what you thought was best and you kind of were able to kind of push back and have a little? Maybe we'll say a victory of some sort? Do you remember?
Speaker 4:Yeah, I, you know, I guess my, my biggest challenge is with the office manager. You know, they always think that they're in the thoughts and not all of them. I shouldn't put them in. But you know, in saying and scheduling me for short appointments and then bugging me if I went over, you know, and me having to say, look, this person needs more than what 15, 20 minutes, you know, well, we're not coding for that. I'm like, well, code for it, you know, because that's what I'm going to do. But then I was constantly doing workarounds, and the one I'm describing that I saw every week for an hour. I never got paid for that, you know. So I just, I guess I got paid more than I thought, but I know there's probably better workarounds than that. But yeah, I think you know, and then that's why I talk all the time we just need to do our own thing, because we want to do it the way we want to do it and feel like it should be done, you know, versus somehow working for somebody.
Speaker 2:I love it. I always say that you know, an advanced practice nurse has a little bit of ODD when that little opposition with the client where you just kind of push back on that system every once in a while, so thank you for sharing that.
Speaker 3:And I would just say from the academic side, right. So Stephanie and I have our lived experience and we're trying to share that with the new generation, those that are stepping up and really starting their journey and meeting the demands of the community, and those patients we try and expose. So part of our curriculum includes psychotherapy and she and I, as we were mapping the curriculum and creating the Psych NP track, kind of wrestled like how do we include this? No, we need to make sure that they know X, y and Z and yes, we would love to expand on the therapeutic portion but we're also limited to the amount of like credit hours and what we can offer in that short semester and in that short program.
Speaker 3:What we've tried to do is kind of thread some of those therapeutic modalities throughout so that they're not just exposed and it's like I'm going to remember this for the test and I'm not going to go ahead and apply it.
Speaker 3:We've been able to successfully, I think, introduce it, reinforce it and then also highlight it in some of the assignments that they do in clinical so that they're able to really appreciate the approach and see those patients that therapy does benefit, right, and you know, in my current practice. We work with specialists in EMDR and CBT and we're all familiar with like motivational interviewing and so forth. So there are success stories for patients and exposing students that are probably just comfortable with the meds and that's their comfort zone and saying like, like, take a step back, let's look at the patient as a whole and how can we support the patient and have a more global approach on their mental health. And we've been surprised that students do gravitate and through some of our on campus activities where we have like standardized patients that they have to kind of interview and use some of that therapeutic communication, therapeutic communication we've been surprised that students do feel comfortable and are actually able to role play some of those experiences that they've learned in clinical as well as in the classroom.
Speaker 2:Love it. Thank you, that's so great. I mean it's, it's. I think there's just these kind of common themes of you know. You know, if we're kind of going like Melissa with you know the the, the metaphors, I'm thinking like sticking. If we're kind of going like Melissa with you know the metaphors, I'm thinking like sticking your toe in, just kind of just feeling how the water is, you know it's like oh, that's okay.
Speaker 2:I can probably do that. And then you know, like you were saying too, you know get more education. You know look for programs that you know have that in their curriculum and then, once you get out, obviously you're going to start, you know, getting some more expertise and things as you mentioned, like Stephanie and kind of the work you've done as well. So so again, thank you so much. We're kind of pushing up on time. So appreciate this, as so much for Herberto and Stephanie from Mercer University to join us on this episode of Peplau's Goes. As always, if you've made it this far, that's great. Please like, subscribe, put comments. Contact for Herberto and Stephanie will be in the notes as well, but look forward to having another episode coming out soon and have a wonderful day and weekend. Take care Bye.
Speaker 1:Work hard until those thoughts are finally leaving so you can be you. They feel it before it's true. Work hard until those thoughts are finally leaving so you can be you. Guided discovery, identifying and challenging your beliefs, reframing your mind. Negative thoughts release. These cognitive distortions decrease until they cease. Guided discovery, identifying and challenging your beliefs. Reframing your mind, negative thoughts release. These cognitive distortions decrease until they cease.
