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Finding Your Way Through Therapy
Join Steve Bisson, LMHC as he unravels the complexities of therapy and counseling. Engage in straightforward dialogues, enriched with insights from special guests sharing a like-minded perspective. Each episode presents valuable, easy-to-digest information designed to help you perceive therapy, and those who partake in it, in a grounding, relatable manner.
Finding Your Way Through Therapy
E.171 A Career Redefined by First Responder Encounters
What happens when a child and family specialist immerses themselves in the fast-paced world of first responders? Join us to explore the captivating professional journey that began in 1999, where our host's initial role as a crisis team triage coordinator led to unexpected yet profound career transformations. Through late-night calls and high-stakes emergency situations involving police officers, dispatchers, and firefighters, you'll gain insight into how these intense interactions redirected a career toward a dedicated focus on first responder mental health support.
From the challenges faced on the first day dealing with crises in 2005 to the intricacies of implementing a mental health evaluation system for parolees, we delve into the complexities of balancing public safety and public health. Hear firsthand accounts of working with the Region Nine team and the Jail Diversion Program, riding along with police officers, and managing mental health-related calls. Our host's transition to Vermont underscores the vital role of supportive communities and effective mental health programs, shedding light on the tough decisions required in the co-response model.
The journey continues through an extensive career supporting federal probation, the National Guard, first responders, and veterans across diverse environments. You’ll hear about involvement in Critical Incident Stress Management (CISM) training, crisis intervention, and efforts in opiate overdose prevention. As we move towards the latest chapter, the focus shifts to educating first responders about their mental well-being and exploring post-traumatic growth. Stay tuned for the highly anticipated Episode 172, featuring the return of the Mental Men—Bob, Dennis, Pat, Andy, Chris, and our host—for a discussion brimming with insights and personal reflections. Don't miss this episode that promises to be both educational and profoundly engaging!
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Hi and welcome to Finding your Way Through Therapy. A proud member of the PsychCraft Network, the goal of this podcast is to demystify therapy, what can happen in therapy and the wide array of conversations you can have in and about therapy Through personal experiences. Guests will talk about therapy, their experiences with it and how psychology and therapy are present in many places in their lives, with lots of authenticity and a touch of humor. Here is your host, steve Bisson.
Speaker 2:J'apprécie tellement cette introduction. I really appreciate this introduction. Hi and welcome to Episode 171 of Finding your Way Through Therapy. If you haven't listened to episode 170, please go back and listen to it. Sarah Waite, who was the accidental paramedic she also worked dispatch for several years shared a lot of stories about that, her new endeavors and things like that. So I hope you go back and listen to it. But episode 171 will be about me.
Speaker 2:Yeah, I'm not always good to talk about me. I do have some solo episodes, but you know a lot of things have come up lately. Where, how is? Why did I start working with first responders? You know, I'm going to start off by just saying that the first thing is I'm actually a child and family specialist. So when I went for my master's degree in counseling psychology, you can have some sub specialties. One of them is cognitive behavioral therapy, which I'm very happy I've done. But the other one was children and family, because this is being recorded. Some people know exactly my feeling, but I didn't really enjoy working in the environment with children and it had nothing to do with the children. You want to know the inside behind that. Please write me a DM or write me a message. Just click on the button in the show notes and I'll share with you. So that's actually my specialty. But I've worked with first responders really since probably when I first moved here in 1999. And I will continue sharing a little bit of my journey with first responders after this brief message from freeai.
Speaker 2:Getfreeai yes, you've heard me talk about it previously in other episodes, but I'm going to talk about it again because GetFreeai is just a great service. Imagine being able to pay attention to your clients all the time, instead of writing notes and making sure that the note's going to sound good and how are you going to write that note, and things like that. Getfreeai liberates you from making sure that you're writing what the client is saying, because it is keeping track of what you're saying and will create, after the end of every session, a progress note. But it goes above and beyond that. Not only does it create a progress note, it also gives you suggestions for goals, gives you even a mental status if you've asked questions around that as well as being able to write a letter for your client to know what you talked about. So that's the great, great thing. It saves me time, it saves me a lot of aggravation and it just speeds up the progress note process so well, and for $99 a month. I know that that's nothing. That's worth my time, that's worth my money. You know. The best part of it of it too is that if you want to go and put in the code steve50 when you get the service at the checkout code is steve50 you get $50 off your first month and if you get a whole year, you save a whole 10% for the whole year. So again, steve50 at checkout, for getfreeai'll give you $50 off for the first month and, like I said, get a full year, get 10% off, get free from writing notes, get free from always scribbling while you're talking to a client and just paying attention to your client. So they went out, you went out, everybody wins and I think that this is the greatest thing. And if you're up to a point where you got to change the treatment plan, well, the goals are generated for you. So getfreeai, code Steve50 to save $50 on your first month and welcome back.
Speaker 2:I'm going to start talking about my experience with first responders. Sometimes I go to some trainings and they ask me these questions and I always feel like I'm gonna miss something or I'm gonna go way too long, because I've worked with first responders probably since 1999. In 1999 I started out a crisis team. I was the triage coordinator because I only had a bachelor's and I answered phones mostly on the overnight or late night as second shift, or mids as we sometimes call them. I worked full-time overnight for only about six months, but I was on call for a lot of those times and I was in the office regularly. And when you're talking to someone over the phone who might be suicidal, homicidal, having problems in general, maybe you're also going to have to contact the police. In regards to what they call in Massachusetts a Section 12, taking away a person's right for having those thoughts Not those thoughts, but wanting to necessarily have them in place, so to speak, right, so we're not trusting that the person will be safe and there are 12 A's. I can go on and on about Section 12s, but hey, I'm not here for a CIT training, I'm just letting you know what it is.
Speaker 2:So, working for the crisis team, even part-time and then full-time for a short while, I learned how to work with the police department regularly and it was very interesting and I certainly enjoyed it. You know they didn't quite know me. But I started recognizing some of the police officers, some of the dispatch, when I called there and, as well as the firefighters, started recognizing some of the police officers, some of the dispatch, when I called there and as well as the firefighters Working in a group home, also encountered in that town where I worked, a lot of the first responders, some of them who saw me do some restraints on the street because of situations they kind of like looked at me like oh yeah, that's what's happening. So I got to have some good interactions there, so much so that throughout my career and I worked at this agency for about 15 years, give or take I was gone for about a year but I worked all that time at the crisis team. Eventually I stopped being triaged because I had a master's, so I started doing some direct calls.
Speaker 2:I worked part-time to full-time there and at one point I was going in every Saturday, depending on the day, it would be five to five, five to three, seven to seven, a slew of things and you know, went to the emergency rooms and certainly there was a detail there with a police officer. So I got the call, talked to them there when they would bring in a patient, I would definitely be able to talk to them and see what's going on and why. Sometimes I'd have a heads up because it was our section 12 that they used at the time. Sometimes have a heads up because it was our section 12 that they used at the time. Sometimes I didn't. It was just someone coming in and say, oh yeah, they're going for a mental health evaluation. So if I was at a chance to speak to the firefighters, see how cooperative or not they were, the EMTs, paramedics or the police, I would always do that. So you got to work and see what they liked and what they didn't like.
Speaker 2:And I talk about my first responders also in the ER, working with the nurses there, with the doctors. I have learned how to communicate effectively with them too, because their job is hard too. And no, I'm not saying that because my girlfriend works in an ER as a. She definitely has been working in the ER for several years and now is in charge of a couple of them, but as a nurse. But I think that what I really found is that the nurses also understood what was going on and sometimes they didn't and they had questions. Why is a person doing this? Why is a person doing that. So I ended up working with a lot of those guys explaining things and you know I had some I joke around drag out fights with doctors and nurses and I'm kidding because we didn't. We disagreed sometimes but it was really good because I had a bunch of great nurses, a great bunch of doctors. When we disagreed, I'd say 99% of the time, we were able to work it out and not involve usually the psychiatrist or my supervisor. I eventually was someone who didn't need to go to a supervisor for consultation. I was there for so long but I still consulted with them because that was helpful and really enjoy that work and still miss the crisis team sometimes. I don't know if I miss the unpredictability, but I do miss some of that unpredictability.
Speaker 2:When I got my master's I finished my master's in 2003 in December. I was working for the crisis team a little bit still with a. It was a housing situation where people in the community with a mental health or substance abuse issue or both. So I had that job as a supervisor at the time. So that was my full-time job and I worked at the crisis team. But I also eventually got offered a job going to the county jail in Worcester, massachusetts, and where I'd be mental health and I. That's where I learned that my name is mental health, it is not Steve.
Speaker 2:So they kept like, hey, mental health, and that was both the inmates and the correctional officers. And during that time at Worcester County I really learned a whole lot about that. Because you know, one of the things that first responders you know people in the community don't understand, and sometimes other first responders don't understand, is that, yeah, you arrest someone, you put them in jail or what have you. Well, people who work in the county jails and the Department of Correction, they have to deal with those guys 24-7. They're sure they have a shift for eight hours, but that's where they go right, and even the longest shift ever. As a police officer you kind of deal with more than one person when in jail. You deal with them on a regular basis and some of them have very severe mental health issues. Some of them don't and are very good at faking it. So that plays a factor and you learn to interact with the correctional officers.
Speaker 2:I can share a couple of stories If you want to again write to me. I don't want to share too many, but when there was a suicide watch, someone was suicidal. I'd have to go evaluate that. People came in. We did a suicide evaluation so to make sure they aren't suicidal when they're coming in and everywhere in between. If there was a crisis somewhere, we were called. So if someone had attempted to assault officers, we had to make sure to do a mental status exam, make sure they're okay. And it was both hurry up and wait, because if there was movement or they were locked in for lunch or something else, yeah, you can evaluate them, you can talk to them, but when there was stuff to do then you had a lot. So it was a very fast pace as well as a slow pace in writing your notes and making sure you make sure that you write the note properly so that it covers you.
Speaker 2:Again, a few stories that I don't want to share on a podcast because it's recorded and people might recognize themselves. But I've had a few stories from there and I only worked there for about a year. Due to a conflict with someone in charge who ended up being fired. I decided to leave in my own will, but they got fired. So I'm going to leave it at that. If you want to know the rest of the story. You know where to reach me.
Speaker 2:And after that, because I didn't know what to do, I went back to the crisis team, because that's always my safety valve until I can. They told me they came over and they said, hey, steve um, do you want to work with? We have a great program we're going to start it's. You'll be a substance abuse coordinator at a parole office and and I'm like, yeah, no fucking way, I don't want to work with people in the first responder world anymore. I got burned. And again, if you want to know that story, I'll share it with you privately. But I said F no, and fuck, no, right, I can say it here. It's my podcast. And they convinced me. And basically, what really was fun is that I got to work with a team who treated me.
Speaker 2:Unfortunately, they had a crisis when I started there in 2005. Right, the first day I was there, there was a crisis going on and again, if you want to know the story, I can share it with you. I'll save it from you. But basically they had no mental health evaluation. They had this sheet from the Department of Public Health. It really was useless. They didn't really talk to the inmates in that way either, or the parolees, I should say. When they came out and there was, you know they had a plan for their housing but they necessarily didn't have a plan for their health insurance, where to go for treatment, where the meetings were, how to get to resources in their community, especially for those who may have been going to a group home or treatment program because of X, y, z reasons. So I started a evaluation that to this day I think a lot of the elements are still used and it was a vast improvement on the Department of Public Health's.
Speaker 2:I don't even know what to call it checkboxes, because literally it was checkboxes to having to talk to someone and you know I got to play good cop, sometimes I got to play bad cop and that's where I really learned that balance between public safety and public health. You know, some people still struggled with me at times, with parole and the jail too. They always say, you know, to public health people they always want to save them, they want to hug them and all that. Anyone who knows me slightly knows I'm not that guy. And that's where parole I was able to fall into myself because people were so nice to me and they really let me develop my own thing.
Speaker 2:Got to work with a fabulous team on region nine and again, if you want some stories from there, I can share them. But we help people stay in the community. We got people treatment and sometimes, unfortunately, because of situations, we had to lock them back up in jail. But yeah, I really learned how to work with a complex system because parole officers in Massachusetts have special powers, they're special state police, but we also had to work with the local police. We had to have conversations with different things and I was involved with that, which really led me to an opportunity to work with what was developed by Dr Sarah Abbott called the Jail Diversion Program They'll call the co-response model and framing him and basically we ride along with the police, go to calls if they're mental health related not necessarily all the calls, just the mental health related ones and then we were able to help them either. Put like it was what I call pre-arrest model, so basically, if they needed support to say, no, this person needs mental health support, how are we going to get it to them, and this, and that we'd be able to do that, and sometimes it would be something that was out of our hands because the public safety had the prime right. So I learned to live on an island and anyone who knows me knows that I've talked about this.
Speaker 2:If you you want to work in this field with first responders, particularly law enforcement, you got to learn how to live in an island because sometimes you're going to piss off the public health people and sometimes you're going to piss off the public safety people had to do that a couple of times. People who are a danger to the community. They, you know, I had to. You know, put public safety before public health and it brought some conflicts with some people and I still stand behind those decisions and I was right. I don't remember being wrong and of course, maybe it's my own brain, but ultimately we need to find a way to. You know, sometimes public safety primes, sometimes public health primes and if you're a therapist who wants to work in this field, understand you're going to piss off one side or the other sometimes and you got to be okay with that because I pissed off my bosses at my non-profit organization and sometimes I pissed off some of the officers, sergeants and other people at the police department.
Speaker 2:But this opportunity was really good because I got to ride along, got to get know the guys, and some of these guys literally would say, hey, come with me. And one of them was super nice and you know, shout out to John I'm going to'm going to say his last name who was always there for me, always took me for rides. But other people took me for rides as sergeants who did that, and sometimes we went to calls, you know, on Route 9. And Route 9 is a fairly big artery in Framingham and you know dangerous and stuff like that. I was never in danger, for the record, the police made sure I wasn't. And obviously I was never in danger. For the record, the police made sure I wasn't. And obviously I was. The same way, if I felt uncomfortable, the police would be like, yeah, don't come. So it was really helpful to have this supportive environment. There was there a 5%. I always you've heard me on this podcast and anyone who knows me knows I talk about the 5% there are 5% of our assholes and really didn't want me there and call me to hug a thug program and this is a joke or what have you. Yeah, yet today the co-response model is available in so many towns and cities across Massachusetts as well as for me. I'm continuing that great tradition and I have a friend who still works there, who's amazing and they do fantastic work and the jail diversion program slash co-response model has really saved some lives.
Speaker 2:But at the end of the day, you know, at one point in time I had to change something in my life and what happened was I moved to Vermont so I wasn't working for that company anymore. When I moved to Vermont again, it was for a non a hospital, and you know there's a lot of stories I can share about that too, especially with my quote, urban clients. And if you ever want that story I can share it with you privately. And the reason why I'm giving you a lot of this stuff very vaguely I think that there's so many great stories but I don't want to get lost in the story and not tell you everything Ended up doing substance abuse there too, and that's two different licensures in Vermont so I ended up getting both.
Speaker 2:So I was going to help one of the therapists who already went to the county courthouse, and I also helped other people in the community. I ended up working with federal probation a few times worked with we had the national guard there in particular. Sometimes they would send me those individuals because of my vast experience and never forget my veterans. I never forget my current active duty people who are in the Navy Air Force, marines, coast Guard, and I forgot one Marines Army, navy Air Force. If I forgot someone you'd yell at me, but at the end of the day, in the National Guard and I ended up working with a lot of them too, and those are first responders too, because when you're going to a disaster zone, you are a first responder. You go to a war I think there is some first response that goes there too. So I think I got to know a little bit about that.
Speaker 2:And a rural environment, which was very difficult when you don't have transportation to go to AA or treatment, it changes the ballgame in the rural area. When you're in suburbia or urban environments which is mostly what I worked with throughout my career definitely changed things. But ultimately, you know, knowing a few sheriff department people, having some people who helped you from federal probation and the shout out to the local police I worked with in Morrisville who had helped me on a few occasions too. So give them those shout outs to them in Vermont, but I ended up being only there for a year. We were trying to sell our house in 2008,. Try to figure out what happened after the crash. We weren't able to sell, so we came back and went back to the jail and it was Worcester County, so it was the same thing. But I also, during that time, ended up working with two very important things. I got a CISM training, which is the critical incident stress management and debriefing process, and that was very, very important for me to know. That I still use to this day and I was working with first responders after a critical incident, sometimes a few days later, sometimes almost a day of a critical incident, sometimes a few days later, sometimes almost a day of and you know we were. You know, in the last 12, more than that, 14 years now we've refined the process not me but the CISM teams across the great country that we have, and I really appreciate the changes that have occurred. But I really enjoy the CISM stuff and, again, working with first responders, you get to know them, you get to know what makes them click and not.
Speaker 2:So went back a little bit to, like I said, worcester County Jail for a short while and then ended up. We did so well in Framingham when I was there the city of Worcester, massachusetts the parole office didn't have anyone who bid for the contract. So parole asked me to do it and asked my agency to do it. My agency was able to negotiate and I ended up there for another three years or so and I really enjoyed that work. I was doing a little bit of outpatient work at that point. I was also doing a lot of crisis work because I was having a second child needed to pay the bills. So I was doing a lot of overtime and I really enjoyed doing that work because again got the environment of parole in Worcester. Worcester is much more collaborative.
Speaker 2:We ended up working on the opiate overdose prevention team, which was when we first started thinking about putting Narcan in vehicles for the police department and the fire department. So if you are a first responder and remember those times, shout out and remember how hard it was and how it was resisting. They were resisting getting that in. So I was on that committee for several years and we ended up having it in. You know, worcester obviously talked about neighborhood towns too, but now nowadays who doesn't carry Narcan? So got Narcan trained, got to talk to police who were resistant, not so resistant and everywhere in between, which was really cool. And during that time, too, I ended up working while I was doing the parole stuff.
Speaker 2:I ended up in about 2013, working in the probation department Worcester Superior Probation Department with, in conjunction with the Department of Correction, and we did a collaboration again to do again re-entry type stuff and end up we would go to the jails. I'd get to see the DOC people and then we interview the, the inmate. We'd have to work collaboratively with everyone in order to get them back into community and make sure they had a safe environment and, of course, most of them had a mental health or substance abuse issue. So that's how they got referred to us and it was kind of cool to be able to do that for a long time and I really enjoy that work. And what I was thinking about, too, is this is one I forget all the time. I don't remember the years, but during my time I came back from Vermont.
Speaker 2:I had worked with the drug court in air. A good friend of mine, the late great Karen Raymond, miss you, karen. All right, I'd asked me to help with the drug court, but I did some schisms there too, and then I ended up working with the drug court there. And then Newton Massachusetts said hey, we want to start a drug court. So I ended up consulting and helping him open their drug court in Newton. They weren't quite on model when I met them and they got to the model really quickly.
Speaker 2:And while I was in Worcester doing all those great things, I ended up being contacted by a judge who said to me hey, we really need this drug court here. I think that's now called the recovery court for the record. I'm not trying to play down the name, I'm just telling you what they used to call it and what they call it now. And ended up getting Worcester almost going. And then we hit a snag and for about a year I was pushing, pushing. I was actually no longer working with my agency that I was at the time and we ended up opening to Worcester at the time drug court, now recovery court and was able to see a few graduates there too and really work with the team and show them how the 12-step model of the drug court slash recovery courts work. So really enjoy that. Karen miss you and you really helped me with that.
Speaker 2:So I work with them too and again, when you work at the drug court. You meet the court officers, you meet the judges and they're all type of first responders because they do have to deal with these things and it was really cool to be in that environment of collaboration. And sometimes I turned out to be the jerk, because they would make referrals that were not sensical and I'd have to say, no, they try to do certain things. I'm like that's not the model, and so on and so forth. So sometimes I wasn't the most popular person in the room but I had a lot of respect and if you know a little bit about the recovery courts, we work with the police, we work with fire. We work with the police, we work with fire, we work with probation, we work with the judge, we work with the DA, we work with the prosecution and the defendants and the public defendants, I should say. And it was really, really fun to get all those and then meet treaters in the community and make sure they get the heads up that this is happening. So it was really, really fun and I ended up doing that for a couple of years when I wasn't working for that agency anymore. So basically I worked about two years, not every day, obviously, but regularly and every Thursday for that drug court. So I'm very proud of that work. And again, working with all those levels of district attorney's office, you learn that this is a different part of first responders. In some ways, they kind of clean up afterwards, but you need to have some first responders experience. So that was really fun.
Speaker 2:And the individual stuff that I've done for therapy. I've been a therapist since 2004,. Essentially and because of my experience, I've done a whole lot of first responders and right now I didn't do my stats. Last time I checked my, my stat was 48, 49% of my clients were first responders and I wouldn't want it any other way because you know I do EMDR, eye movement, desensitization and reprocessing. And just giving you a heads up and a spoiler for those of you who are first responders, it's not the end. All that be all. You got to do other work. I've done cognitive behavioral therapy, reframing and all that. Building the relationships and making sure the relationships with their family continues was also a big part of it.
Speaker 2:I started a group in 2018 and went on till 2020 and something happened in 2020 that really made my group stop if you can figure out that one but it was really cool and I restarted the group this year and we're so well. It's going to go to two days a week and at different times and spaced enough so that the firefighters who are on one on one off will be able to attend, as well as the police officers who may not be able to do it because they're a second shift or first shift and vice versa. They'll be able to attend at least one of them. I've also became a cit training person in 2023 in the Middlesex County in Massachusetts and I've truly enjoyed that experience too, because you get to talk about mental health, substance abuse, psychopharmaceutical stuff, and we, you know, I get to do trauma once in a while.
Speaker 2:My good friend Katrina okay, katrina, sorry, catherine Branca, don't kill me, catherine she's been on the podcast before. She did a great one. I just use her slides and modify it a little bit, but she did a great one too. And then I also sometimes get to do the suicide prevention, which you know wasn't a first responder thing, but I was a suicide prevention specialist mid 2000s to about the beginning of 2000, that 2010 or so roughly and enjoy that work too. But I've also sent out surveys with different questions for first responders in particular and what they want and what they need and the support they need in regards to that and Catherine really helped me with that too to create at least a document that we've shared.
Speaker 2:And a lot of people have raved about it, and I'm currently working on a little goal of mine and I'm not going to share too much, but it has to do with first responders and education with mental health, and not educating around what we just talked about, but their own mental health. That mental health is not just trauma, because that's the other part that I find very frustrating. Sometimes people think, oh, first responders, just mental health. No, there's a lot more to it than that. So, hoping to do that and I'm also looking at post-traumatic growth One of my clients, who happens to be a first responder, talked about as well as just continuing to develop my skills.
Speaker 2:But I know this was very long and I appreciate you listening to me, but at the end of the day, I just wanted to show you that I really loved the work I've done with first responders and would love to continue, and if you have any questions or you want to know those stories, just drop me a line, buy me a coffee, I'll talk to you face to face, but I hope that you enjoyed my journey in the first responder world and why this is so important to me. Well, episode 172 will be with the mental men. So important to me. Well, episode 172 will be with the mental men Return of the Mental Men. You know those guys Bob, dennis, pat, andy and Chris myself, and I'm sure the interview will be great.
Speaker 1:So hope to see you then. Please like, subscribe and follow this podcast on your favorite platform. A glowing review is always helpful and, as a reminder, this podcast is for informational, educational and entertainment purposes only. If you're struggling with a mental health or substance abuse issue, please reach out to a professional counselor for consultation. If you are in a mental health crisis, call 988 for assistance. This number is available in the United States and Canada.
