Please note: this transcript is not 100% accurate.
Dr. Nina Mafrici 0:00
What we’re seeing now more than ever, and sort of the field of, of psychology is we’re seeing a lot of those longer term effects from COVID. So we’re seeing things like there’s almost a cynicism to people, people are a little tough around the edge hits.
Dr. Meenal Agarwal 0:21
This is Dr. Meenal, and welcome to Uncover Your Eyes, where we uncover reality. As a mom and eye doctor, I want to know it all. Today, let’s be real. People are angrier, there is a definite change or shift in people’s behaviors. They are more frustrated, they have a heightened sense of entitlement. In my last 16 years of practicing, I definitely feel like it’s at its peak right now. Sometimes going to work is stressful, knowing that patients are going to be angry or upset with me. But I also see the flip side. I also know that when I go to my health care providers, that sometimes they’re angry or with me or more frustrated with my problems. So what’s going on? Has this gotten worse just because of COVID? Why this shift in patient behavior or people’s behaviors? I have an expert guest with us today. Dr. Nina Mafrici. Dr. Nina Mafrici is a clinical psychologist and co-founder of Toronto Psychology & Wellness Group, where she supports individuals with various mental health challenges. She also serves as a clinical consultant for various schools and organizations. So please welcome Dr. Nina Mafrici. Thank you, Dr. Mafrici, for being with us today. We’re really excited to have you.
Dr. Nina Mafrici 1:53
Thank you so much for having me and call me Nina. Okay,
Dr. Meenal Agarwal 1:57
call you Nina, for sure. Um, so tell me like the healthcare field, I’m gonna say is struggling for sure. There’s that change in patient demands patient behaviors? I know, it’s a broad question. But why? Yeah,
Dr. Nina Mafrici 2:13
I mean, I think it’s a loaded question. So I think there’s, there’s a lot of reasons why there’s increasing demands on health care providers in the profession in general, like, we certainly saw, a lot of shifts happen in around COVID. And I think, you know, it wasn’t that COVID Suddenly, you know, changed our healthcare system or the landscape, I think COVID showcased a lot of the holes in the system and the existing system. And with that came, one is way more demands and pressures on health care providers. So, you know, I work with a lot of health care practitioners who I treat, and many of them in COVID, we’re being asked to sort of leave a department that they’re been accustomed to, for many years, and to go in and help out in things like the ICU or doing, you know, installing ventilators and things like that. So it was, it was a really taxing time for I think a lot of health care providers, and demonstrated just how strapped we are as a system. And I think because of that it also changed how people viewed healthcare, and the demands that they have of our healthcare system. I mean, it’s good that we demand a lot, I think of our government. And I think people are unfortunately, you know, putting a lot or projecting a lot of their anger and frustration out on healthcare practitioners, as opposed to the government and, and, you know, trying to lobby for, you know, actual changes, systemic changes that are going to help our health care providers and are going to help our, our health care system in general.
Dr. Meenal Agarwal 3:59
So tell me, like me, as a provider, I’m seeing patients daily, and, you know, like you said, their anger or their frustration is, is directed towards me, even when we are trying our best, right. I mean, we are Speight you know, we’re booking eye exams less, you know, more further apart so that we can spend that time and take that time to talk to, you know, our patients, their parents, to where has that sort of shift in appreciation go on, or, you know, or that, how have patients become so entitled, or their parents like, how, why that shift? You know, it used to be that they appreciate us and now it completely shifted?
Dr. Nina Mafrici 4:40
Yeah, I think it’s twofold. I think on one hand, I think there’s been a lot of pent up frustration from the time of COVID. So we had a lot of individuals who, for instance, whether they themselves experienced healthcare issues during COVID or lost loved ones had law ones, you know, struggling to navigate the system during COVID. You know, I myself had had an elderly parent trying to navigate treatments during COVID. Very, very challenging. And I think a lot of people carried many of those frustrations from that time. And now when things are more open, and they’re able to book with providers, it’s getting dumped on them. Right. Yeah. So I think there’s that aspect. I also think that COVID And I don’t mean to harp on COVID, but COVID was a really significant global event that changed emotionally. Yeah, right. Absolutely. I think it puts a lot in perspective for people. But it really what we’re seeing now more than ever, and sort of the field of, of psychology, is we’re seeing a lot of those longer term effects from COVID. So we’re seeing things like there’s almost a cynicism to people, people are a little tough around the edge hits rough. Like, yeah, yeah, you know, they’re, they feel yes, there’s a sense of entitlement. I think, for a lot of people, I think that people have gone gone a little bit, gotten a little bit harder in how they interact with the outside world. And some of that’s been due to the fact that for so long, they didn’t have to interact with as many people. And so people lost things like social graces and respect and respectful communication. And then, you know, it was also that that entitlement that stemmed from, you know, a privilege of people who are able to afford things like private services where, you know, I knew people that went to the States during COVID. And there, they accept and paid for private health care, they come back here, and they think it’s preposterous that we don’t have something where they can immediately see a provider. So, you know, within the public sphere, they want to support the public system, that’s where our taxes are going. And yet, they’re taking out the frustration these people. Right,
Dr. Meenal Agarwal 6:59
right, right. Yeah, I know, for us as optometrist, like, we had a lot of changes with our HIPAA regulations and things like that. So we’re getting a lot of that, you know, frustration, well, why am I not covered by Oh, hip? Or why is this happening? So, you know, I have never seen so many health care providers with anxiety or opening up about anxiety, and I myself, you know, suffer from anxiety, and I never have before. So these are, these are changes, I feel even anxious, sometimes going to work, you know, knowing that I’m going to be dealing with this daily. So, you know, what are your recommendations or thoughts on health care providers that are going through these anxious periods at work? or strategies or coping mechanisms to help? Yeah,
Dr. Nina Mafrici 7:42
great question. So, you know, I think there’s, there’s a piece of it, that’s preventative in nature that we can talk about. And then there’s also you know, what to do, sort of in the moment, I think, you know, I talked with a lot of my clients about vulnerability factors, like universal vulnerability factor. So for each and every one of us, it doesn’t matter if you struggle with anxiety, or don’t, or if you struggle with depression, or don’t, when we’re, when we haven’t slept well, when we’re not eating regularly, when we’re not moving our body when we’re consuming, you know, substances that aren’t great for us, or when we’re not taking our prescribed medications as directed, or when we’re feeling physically unwell, all of those are universal vulnerability factors that will impact our propensity to feel a certain emotion or be triggered by something in a much greater degree. So, you know, I think for all of us, it’s, you know, when you’ve had a bad night’s sleep, you’re much more triggered the next day. Yeah. You know, the term hangry when you haven’t eaten? And yeah, that’s for sure. For all of us, that’s gonna happen. So those are sort of some of the the basic kind of, you know, daily, daily sort of checklist for you to manage, in terms of our prevention standpoint is, you know, how am I doing on all of these things and self care is, is looped into that as well. So what are the things that really fill up your energy bucket, when work can be draining of that bucket? So you want Ryan be able to, to manage those things? And then I also think when it comes to patient interaction, there’s even some prevention that can go into that, which is, you know, how are we communicating to patients about the state of our healthcare system about the services that we provide, when people have a chance to be prepared for those expectations? It can help them in terms of navigating it a little bit easier in the moment. So things like sending out a mailing or email blasts to patients in your roster that basically says, you know, this is what we’re sort of facing right now. You know, we’re doing the best to try and meet the needs of our patient population in a quick and efficient manner. We ask also, you know, for patients as we know navigate this time, you know, usually that helps to lower a bit of the defenses kind of going in. Right. And that’s true for any form of communication between people. So I think those are, those are things that we can work on at the outset. And then it’s the sort of day to day like, how do you kind of manage day to day? And how do you deal with, you know, people that are coming in that are not always respectful or that are, you know, communicating a sense of entitlement. And it’s not only patients, it’s can be staff that you have at your practice, and, you know, how wearing a multitude of different hats at once. And so, boundaries is really important. So yeah, yeah, no, and I always tell people, it when it comes to boundaries, what kind
Dr. Meenal Agarwal 10:42
of boundaries mean? Like, I would like to build a wall around me at work sometimes and be like, just no one talked to me. Right? So yeah, what kind of boundaries like so? What I’m saying, Oh, totally,
Dr. Nina Mafrici 10:55
totally. So boundaries are, that’s a great example. Everyone always wants to build a wall. But boundaries are actually, okay. Boundaries are a little bit more like a window or a door. Right? Okay. You can open, you can close, you know, boundaries can be flexible, they don’t need to be so some boundaries are quite firm. And that’s when you really know, you know, I feel strongly about this, like I, you know, I’m not going to let for instance, somebody come in and try and abuse me physically. Right, right. That’s like a hard line. So what are what are sort of some of those hard lines? So when you think about boundaries, you want to think about, you know, what am I absolutely willing to tolerate? Right? What am I absolutely not willing to tolerate? And then something in the middle, which is I need to figure that out, right? Those are the harder ones. And boundaries can be emotional boundaries, they can be physical boundaries, so space, how close somebody is to you, right? They can be boundaries on time and energy. So what times in the working day, am I opening myself up to communicate with patients or staff or other things like that each relationship, every single relationship we have, whether it’s an intimate relationship with someone in our family, or whether it’s, you know, the person at the store checkout counter, we have boundaries with every single relationship that we have. And so it’s sometimes helpful to think about those closer relationships you have, and like, what are those kinds of boundaries that I have in those relationships to make function effectively those relationships, translate some of that into my practice? And so, you know, is it the way patients speak to me, you know, what, what, how do I communicate in a way that, you know, provides reciprocation of that respect, or if somebody does communicate in a verbally aggressive way, can I free plan sort of something that I can state that allows that boundary to be very clear to that person, which is, you know, I’m going to have to, you know, pause the appointment, or we’re going to have to meet another day, if you know, if this is how you continue speaking, that type of thing. So they can take lots of different forms, right, and they’re highly individual. So you might have very different boundaries than the next person who’s working in the same position as you.
Dr. Meenal Agarwal 13:15
So tell me like sometimes, like, I’ll have patients that will, you know, I’m their eye doctor. But they will either they’re not getting the help outside from their, their health care providers. They’ll talk to me about other problems, right? You know, whether it’s their depression or their or whatnot. And obviously, we want to lead them in the right direction and seek help where you know, they should be, but they want to talk about it with us. And, you know, as healthcare providers, we don’t want to pass people off. But it comes across as rude. Or they get frustrated with us that oh, that doctor doesn’t care, right. But that’s not our expertise. So how do we set boundaries with those patients? Right? Like, you can’t just say, Listen, I don’t want to talk about this, or I can’t talk about this, because I’m not an expert in the area, because sometimes they’ll come back at us and say, Well, I know but the other person is not listening to me. So we need you to like how do we set those boundaries but still come across? Like, yeah, we do care. It’s not that we don’t we just don’t know how to give advice or in don’t want to lead. Give them the wrong advice,
Dr. Nina Mafrici 14:16
I guess would be the one. Yeah. Yeah. That’s such a great example. It’s like the foot in the door technique. Right. Like, when they get in you with like, I’m just going to
check my carotid.
I can’t get in with my GP, right. A lot post COVID too, right. Yeah. Yeah. shopping around it trying to open up to I mean, pharmacist thought it a lot, right. Yeah. Yeah. So like, a magical addition. It was like, diagnose me. Can’t you prescribe this? I saw people getting verbally aggressive with pharmacists. Like they’ve just recently gotten some prescription rights to you know, like before that they ever had that. Yeah, I think that’s a really hard one. And I think a lot of people are also feeling really lonely. and feeling really hopeless. Yes. And so when they get a healthcare provider, just to kind individual, and I think it speaks volumes to who you are, as a person, if somebody feels comfortable enough to sort of open up in that regard, it puts you in an in an uncomfortable position, though at times, right, like you want to help, but at the same time, you probably have other people you need to see. One, it’s also not your area of expertise. And, and to, you know, it’s, it’s not the service that you’re providing to them, right, that they’re that they’re coming in for. So you don’t want to mislead them either. So I think a great way to, to really approach situations like this, and we talk about this as psychologists a lot with any form of communication, when somebody is coming to you with something that is, you know, might be more emotional in depth. And, you know, they’re asking something of you that you might not be able to provide for them, is start with a validating statement. So keep it really simple. And just, you know, you want to validate, you want to convey that you hear that this person is going through something, or that they really want a listening ear. So sometimes even if you don’t understand what they’re going through, you can just say, you know, sounds like you’ve got a lot of really important things to talk about. And, you know, I I’m really invested in wanting to make sure that you find the right person to connect to about this. So, you know, on your way, oh, I’m going to, I’m going to actually write down some names, or I’m going to direct you to some places that that can offer you some support. So that might be sort of a quick and dirty way of kind of getting done, then there’s, you know, when somebody’s like, sometimes people are like sobbing to you, and they’re, you know, they will open things up, right. And it’s really hard to pack that in, you know, we have to do it as a psychologist in therapy sessions, where it’s like, you know, you got the next person coming in, okay, somebody breaks down and talks about their trauma in the last 10 minutes of a session, ultimately, we do have to wrap up, and we can still do so in a respectful way. But saying things like, oh, this sounds super, super important. And, you know, I’m mindful of the time, I’m mindful that you need to get connected to somebody that can really support you with this. So I’d rather actually, you know, if you can come out with me, we’ll make sure you get, you know, a list of some resources. And I think it’s always helpful now for providers to have a list of various resources. So if it’s a mental health thing, there’s, you know, the Canadian Psychological Association, the College of psychologists of Ontario, know, those are lots of places that they can go to look up providers, if it’s for other medical needs is referring them to the College of Physicians and Surgeons or other places where redirecting them to their family physician, other ways that they can get access to supports that they can walk away with. But I also think it’s important to remember that when we model appropriate boundaries, that’s really, really important for other people who might have in who might have a little bit too loose of their boundaries. Right. Right, and how to actually demonstrate to them that okay, you know, you’re right, this isn’t the person that I should be opening up to about, you know, my depression right now and so on. But, yeah, I also I understand that right now, people are kind of gravitating towards anyone in any where that they can be listened to, right.
Dr. Meenal Agarwal 18:18
That’s yeah, yeah, definitely. So I find, that’s great. No, thank you. So I find a lot of times, like, I mean, I have three kids going home, and taking it all in going home and feeling things about yourself, right, I like I should have helped that person or I could have helped that person more, or just hearing their stories of their depression or whatnot. You take it home, you take a lot of that home. And for me, I find it’s very hard to separate work and my life, right. You know, and not even that, like sometimes patients have gotten to a point where they’re emailing us off the hook that why are these things not done in the last two hours, you know, and you’re at home with our family, or you’re emailing us on a Sunday? You know, hello, I’m looking for this. You know, I mean, it’s also on us that we’ve set those expectations that we used to do things that fast. But now obviously, our focus is our well being when we come home and our our children and our families. So how do we restructure that and their thought process to have that work life balance and also be seen as good health care providers? Yeah,
Dr. Nina Mafrici 19:27
absolutely. Well, again, I think it comes back to those expectations. So, you know, if you’re finding you’re getting those emails on weekends, and evenings, that’s a sign that, you know, an email Vacation Responder needs to go up. And, you know, a lot more people are doing this whereby, you know, after the working hours, once they’re going home with family, if their policy is that they’re not going to get back to you until the next day. Have that Vacation Responder on that says you know, thank you for your email. I truly care about sort of what you have to say, basically, you put in your own kind of words, if this is an emergency, you know, go to the emergency room. Otherwise, I look forward to getting back to you at the next business day, or, you know, there’s lots of creative ways that you can write this. But that also might be something that patients are given when they come into for CEU is, you know, what is the expectations around email communication? I know a lot of physicians struggle with this. You know, we have physicians in our practice that come from a hospital setting where their emails never released, right to any patient. And so, navigating, okay, how does that work in a private setting, it’s sort of like this expectation. Now for VR, I should be able to, if I’m paying for your service, I should be able to access you at any point in time. But that’s not the case. Right? As as non Oh, hip providers as well, you know, we have boundaries and expectations that we have to talk through with our patients. And oftentimes, it’s saying things like, you know, I know you were frustrated when I didn’t get back to you, you know, over the weekend, and it sounds like you were having a really hard time. And, you know, these are the times when I am actually able to respond to emails to check emails, and outside of these hours, unless it’s an emergency, in which case, I would direct you to the appropriate services, we come back and we discuss them in session, right? It takes some behavioral shaping on the part of the provider to really establish that. And I mean, as I’ll always say, I’m a DBT, therapist, dialectical behavior therapy, we use a lot of behavior, behaviorist principles. When you crack in one moment, the floodgates open and people will continue to to email you. So if you respond to that email on that off chance, I like Oh, absolutely. By god, yeah. 9pm on a Friday and expect you to respond, give them a call. Yeah. So start laying those expectations. And sometimes it has to come from, I know that in the past, I’ve been able to email, my schedule has changed. And as a result of that, this is what I can offer in terms of it. And this is when you can expect to hear back from me when you send me an email. So even in the working days, right? When you’re seeing patients back to back, they can’t expect you to be checking email all the time in between, that doesn’t give us time to be able to decompress between patients to be able to have a bite to eat, right, all of these things that we need to help sustain us. Right, right. And the other thing I’ll say about that is this whole piece of bringing home work with you. And I had it I had a prof once tell me that if you’re in the health care profession, you know, if you’re not bringing a little bit of your clients or patients home with you, you’re probably not in the right profession, the Senate that the idea is that there’s we care, like we Yeah, to the profession, because we care. And so I only say that not to say you should be taking stuff home, but rather give yourself permission and accept that a little bit of your patients, let’s say the one that opened up to you, and you know, was really looking for added support kind of weighs on you a little bit, give yourself permission to understand that a little bit of that is going to come home. But you also put a boundary around it. So you say I can think about this for you know, 15 minutes on my car ride home or on the commute back home, or, you know, prior to me getting into the door at night, I’ve often recommended especially for healthcare professional professionals, once you’ve made your commute back home, do like a walk around the block and just allow yourself to transition from work life to home. And whether that’s unpacking thinking about what it is that you’ve been bothered by in the day and remind yourself nothing needs to be solved tonight, I can come back to the office tomorrow, right? And I can talk with my colleagues or I can reach out to somebody, but I’m going to put this aside for now. And I’m I’m preparing to go back into my house.
Dr. Meenal Agarwal 24:10
So you know sometimes, I mean, I love those points, because a lot of them I don’t do so we know we’re going to start implementing that. But where do we reach a point like for healthcare providers, I have worked with many, you know, colleagues who are in a state where, you know, whether it’s home life combined with, you know, work life, little triggers from patients, whether it’s them getting angry at them for you know, charging this fee or whatnot, have have triggered you know, depression, anxiety. I mean, I think I you know, I’ve seen their doctor have an anxiety attack, you know, they’re stressed out, right? Like, what is that point where you keep trying, you want to set those boundaries, but what’s up point where they seek help, like, how do we know as healthcare providers, we need help and I think younger siblings don’t want to seek help, because we feel we’re we’re amazing right now we feel like how could it be us? No, it’s our patients that have it. So how do we know when to seek that help? And that, you know, what, enough is enough? I need help. Yeah,
Dr. Nina Mafrici 25:15
I mean, the health care professional domain, or that population in and of itself is like, the hardest to tap into, to recruit, to come and seek the support. Because in their mind, it’s like, well, I know this, I should be doing this, I should be doing I know what I need to do. I’m just not managing my time. There’s no excuse upon excuse for an excuse. Therapists are the worst in this regard, right? Like, the number of therapists I’ve seen, who are severely depressed and have not reached out to anyone because it’s like, well, I should know. Or I’m ashamed because I’m struggling with something that I’m supporting people with, right? Yeah. So first and foremost, gotta cut through that shame that what I call unjustified shame, you haven’t done anything to break your moral code, you’re just feeling badly about something. And, and really, it’s a human condition that affects every single one of us. So it’s never too early to seek help. I mean, I as apologists will see people with Yes, severe depression, bipolar disorder, borderline personality disorder, also see people who had a difficult Easter long weekend with family and it triggered some feelings for them. And there’s no, there’s no line in the sand that says, Now you deserve help, everyone should be able to get and hopefully one day, they will be able to get access to some form of universal mental health care. But when it is really imperative is, of course, like, when it’s starting to impact other areas of your life. So you are starting to feel that you may be not able to cope as well with your work. Maybe it’s rubbing off on family life in a way that is is is different than anything you’ve experienced before, you know, your kids are no longer bringing you the same joy, right, you’re short tempered, you have little patience, you’re not sleeping well, those sorts of things, when there’s a characteristic change is really a sign that there’s more than just kind of low grade mood going on. Right? It’s probably something that’s a little that needs a little bit more support, in the form of counseling and therapeutic strategies to sort of help you through. It’s so treatable, right? Depression, anxiety, we have wonderful evidence based treatments for for these, you know, disorders now. And even if you don’t fit in within that category, there’s still so many ways that we can support individuals, and that you can actually start to feel better. And oftentimes, it’s like your patients just being able to sit with somebody and unload, right.
Dr. Meenal Agarwal 27:51
Yeah, without being judge. That’s the biggest danger. Without I think, I think, correct me if I’m wrong is stigma or being judged, is probably the biggest barrier to seeking
Dr. Nina Mafrici 28:03
help. Absolutely, absolutely. It still is, despite all the efforts that we’ve made. You know, Let’s Talk Day, right? All of that mean, if you’re on social media, the number of apps that you get around, you know, reaching out about mental health, I mean, COVID, that that turned turn the conversation to mental health, right, everyone was struggling in some way in somehow. And yet, we still face an enormous barrier due to stigma, oftentimes rooted in how people were raised. There immediate sort of social circle. So if you don’t know as many people who have also sought help, or you know, go see a therapist, things like that, it can feel a lot more daunting to do that yourself. Right? And yet, the stats are high, you know, alarmingly high. How many people do seek support many in silence? And that’s something right. withdrawn. But yeah, it’s, it’s unfortunately, still still a big barrier that we’re fighting. So
Dr. Meenal Agarwal 29:07
tell me, like, where would someone who obviously has not gone through this and wants to seek help, but doesn’t want to just Google it? Like, where can they go to seek help, right? Like, they’re not going to go to another healthcare provider, in their network that could be their friend, they want to go to someone else and, but they also want to feel secure about that person. And know there’s, I don’t want to call it reviews, but know that that person is a good, you know, person to talk to and a good therapist. So how do they find this person? Yeah.
Dr. Nina Mafrici 29:37
So there’s lots of great ways to go about finding support that are that you can do confidentially in your own home, right? That aren’t just googling so you know, Psychology Today is a big platform, which actually houses a number of not only psychologists but social workers psychotherapist. All with varying degrees of training and expertise, and basically sort of almost list their CV, up on on these pages where you can then reach out and contact them and find out a little bit more about sort of the services that they offer. So that’s sort of one domain. And you can really, you can narrow it down your search by sort of geographical location. So you can look in particular areas of the city of the country, I mean, it’s all over North America. So you can really fine tune if you want to see somebody in person versus virtual, the Ontario Psychological Association, the College of psychologists of Ontario does have a member search where you can look up based on sort of psychological issues that you’re struggling with, I always say to people, you know, make sure that whoever you’re reaching out to offers you an opportunity to connect, to have a session without sort of any type of requirements. That’s fine. That’s, yeah, that’s actually against our ethical code.
Dr. Meenal Agarwal 31:01
Oh, really? Yeah. Okay, that’s good to know,
Dr. Nina Mafrici 31:04
the fee and say, Okay, you signed up for a membership, that’s not what we do. Okay, we are a big part of our practice at Toronto psychology wellness group is really finding an effect. Because we do know that still one of the number one factors of therapeutic change has to do with the therapeutic fit between the therapist and the client. So I need somebody that you feel you can work with, who has the area of expertise that you’re looking for, but also in today’s day and age, whether you want to meet that person in person versus virtual, because there’s a lot more virtual services offered. Now, it’s really important that if you find somebody you have a session, you didn’t really click that you’re able to and that you feel the ability to to explore other options.
Dr. Meenal Agarwal 31:49
So when we’re dealing and let’s just talk about this in particular, because this is what I see the most of is anxiety, and maybe even depression going into suicidal thoughts. I can see that a lot with colleagues to excuse my ignorance, but who are they like, which therapist are they reaching out to? Are they reaching out to a psychologist? are they reaching out to a psychotherapist? You know, who are they? Who are they reaching out to a social worker? Who would we be looking up?
Dr. Nina Mafrici 32:15
It’s so I know and I hear you It’s so confusing, because you have all these different therapists and a lot of people the general public don’t doesn’t often know the distinction. So basically, all of those that you mentioned, psychologists, social workers and psychotherapist can all have experience in doing therapeutic work with with clients within a specific sort of population, whether that’s anxiety, suicidal ideation, oftentimes you’re working with with clinicians that deal with both mood and anxiety disorders. Psychologist psychologists go through a doctoral program, they have the ability to diagnose a medical condition, that’s sort of what separates them from social workers and psychotherapist and they follow that evidence based practice. So they’re sort of looped in with the other health care professionals and being able to diagnose go through, you know, testing, psycho diagnostic assessments, although not always required. In each case, I don’t do that with every person that I need. Social workers typically go through a master’s degree, and then they have, you know, internship following where they’re doing therapy. Right. So, you know, previously a lot of people thought social workers, you know, worked in, in sort of social services and things like that. Now, we have many individuals that are working private practice and then psychotherapist, or now as a regulated College of psychotherapy. They also, typically, not always, they can come up from a bachelor’s degree and then do basically required hours under supervision to become a psychotherapist. But all of those, all of those colleges are those healthcare professionals are sort of overseen by their respective colleges. So the College of psychotherapists, psychologist social work in the College of psychologists, even OTs, some OTS have also gone undergone certain training to do therapy, some physicians as well have the ability to also do therapy. So when you’re looking at who you should see, a lot of it depends on sometimes it’s what your insurance covers too, right? So, a lot of the time, you know, looking into if you have private insurance, your insurance might cover a psychologist, oftentimes, that is sort of what it covers. Sometimes a psychotherapist sometimes it only covers a social worker and a psychologist. So if you’re using insurance or you plan to use some insurance, that’s important to factor, but then it’s really about, you know, what is their area of specialization, right? So, you know, making sure that that individual works with things like mood and anxiety disorders, right, which typically loops in suicidal thoughts, suicidal ideation, individuals that practice within a cognitive behavioral therapy, or a dialectical behavior therapy framework, so DBT Te or dialectical behavior therapy, very specifically was kind of created to help originally individuals with borderline personality disorder, but it’s now been proven as an evidence based treatment modality for depression and anxiety eating disorders, wide range of disorders. But why I mentioned it is because with DBT, it really beautifully works at helping to shift cognitions and behavior associated with things like suicidal ideation, self harming behavior. So for individuals who are struggling with that DBT is a really nice modality, we call it sort of CBT is older, cooler cousin, it sort of took the traditional approach of CBT. And, and sort of augmented it a bit. It incorporates skills like mindfulness, distress, tolerance, emotion regulation, interpersonal effectiveness, so it’s a really nice, almost like life skills. But when somebody is really struggling, it is proven to be really, really effective, and helping them to work through those more intense emotional responses. And
Dr. Meenal Agarwal 36:07
that’s something offered by all three provider, all three
Dr. Nina Mafrici 36:11
providers can do DBT, it’s important to note that, you know, not every psychologist has DBT training just like this does. So you want to make sure that when you’re looking up the therapist that you are, you know, interested in seeing that you see what their primary modality is. And typically, if you’re looking on something like Psychology Today, or if you find a therapist on a website, through one of the colleges, they will list the approaches that they they work within, right, so emotion focused therapy, cognitive behavioral therapy, dialectical behavior, therapy, psychodynamic therapy, so different sort of approaches. So you really want to keep your eye out for things like CBT and DBT.
Dr. Meenal Agarwal 36:51
So tell me, cuz you’re awesome. Obviously, if someone came to your practice, and obviously does not know, you know, what kind of therapy they need, you know, they just know that I have these feelings, I can’t sleep at night, you know, my behaviors have changed. And they come to your practice and say they book a session with yourself or another provider there. And they’re like, No, listen, that’s not my expertise, then you guys would shift them amongst each
Dr. Nina Mafrici 37:16
other. Okay. Yeah. And what we do is prior to and most larger practices will function in this way is, prior to even getting set up with a therapist, we actually have clients or prospective clients fill out a pretty detailed form, which is sometimes followed up with a call from one of our intake care coordinators, who will clarify some things on the form. And the purpose of that form is to find out all of those things. What are you struggling with? What are you looking for? What are your preferences? Do you want to use insurance? What days Are you available all of those things? So we take that information, and we say, okay, this person is particularly well suited for these few people, here are some options, who might you’d like to pick from those options, so you can peruse their, their, their profiles, and then when you meet with them with every therapist, really, I think, you know, any person that anyone goes to, should really begin any session, and it’s a red flag if they don’t with things like consent and confidentiality. So what are the consent to what’s the consent to beginning treatment with them, that they can end treatment at any point in time that the first session is really kind of a get to know you session? Right, how do you feel? And if we think and part of our commitment is, if we don’t think that we can, you know, support that individual. So if somebody comes in to see me, and they might be having some episode of psychosis, which is not something that I work with in private practice, you know, I would make every effort to connect them to the appropriate service provider that could support them in that regard.
Dr. Meenal Agarwal 38:51
Excellent. That was a lot for me to take in. I’m sure our listeners and viewers. But you know, tell us, where can we find you? Where can our listeners and viewers find you? You know, you’re awesome, and a lot of people might be lost and, you know, want to connect with your practice. Being local as well. So where can we find you? Like social media as well as you know, practice wise? Yeah,
Dr. Nina Mafrici 39:18
yep. So we are, well, we’re conveniently located at Yun, and Lawrence. So we have two large office suites up on the fifth floor. We have a number of lovely clinicians, office managers, intake coordinators who will greet people. You can stop by in there, but you can also conveniently Find us on our website www.tpwg.ca. We’re also on Instagram. And we like to put out a lot of informative videos about our about our services that we offer who we are, we’re trying to connect more to people because we know that that’s that’s something that people want to see. They want to get to know who they’re therapist is and and what are sort of the modalities that they use? And how do they how do they speak and talk to people, we do work with a lot of health care providers. And it goes without saying that our services are strictly confidential. So we take the utmost care and making sure that, you know, there’s there’s some times people, you know, physicians coming from hospitals nearby and they, they’re concerned about maybe running into patients and things like that. So we make sure to, to ensure that their privacy is protected at at sort of all costs. But yeah, so you can check us out there you can also give us a call. And we’re always happy to connect with excellent
Dr. Meenal Agarwal 40:39
I am I am a Instagram follower of you guys, so I love your videos. But no, thank you. Thank you, Dr. Mafrici. This was phenomenal, a lot a lot of great advice for our listeners and viewers. And we hope that some of them will soak it all in and connect with your clinic and seek help if they if they need to. So thank you for your time.
Dr. Nina Mafrici 41:04
Thank you for having me. I’m I always love talking about this stuff. And it’s always helpful to hear more health care practitioners who are shedding light on an issue that all of us face right and that we all need support with from time to time. Yeah,
Dr. Meenal Agarwal 41:19
thank you.
Dr. Nina Mafrici 41:20
Thank you.
Dr. Meenal Agarwal 41:21
Thank you, listeners and viewers, for tuning in. If you want to catch more episodes of Uncover Your Eyes, make sure to follow or subscribe on your favorite podcast platform and on YouTube. To learn more about me, follow me on Instagram @Dr.MeenalAgarwal. Until next time, keep those eyes uncovered!