The Price of Pandemic- Calling All Therapists (on Facetime)

Today we're taking this opportunity to discuss mental health and the importance it plays in the current state of affairs.

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The point of this podcast and platform is to push the idea that talking about money doesn’t have to be just the obvious topics. Topics can be broad, and this episode is an example of that. Today we’re talking about mental health, and the importance it plays in the current state of affairs. The importance of mental health professionals couldn’t be more prevalent. They are there for all of us during these trying times - from providing simple meditation to calm our nerves to treating the nurses and physicians on the frontlines.

Episode 3: Calling All Therapists (On Facetime)- In today’s episode I am joined by Dr. Angela Aznavorian, a clinical psychologist who also happens to be my wife and partner, to discuss the following:

  • How the business traditional brick and mortar therapy works
  • The history of Telehealth, and the use of it now during social isolation
  • How Telehealth & technology gives us all access to mental healthcare
  • What the future of therapy might look like, and the importance of self-care

We will be doing deeper dives into this subject later, so I hope you enjoy this glimpse into this topic. If you found it beneficial, please share it!

For Today’s episode, we’re showing our support for the NYC COVID Care Network. If you or your family member is an essential worker, you can receive free support from a volunteer mental, emotional or spiritual care professional. Go to nyccovidcare.org for more information, and to sign up as a volunteer.

Thank you!

Mesh

Episode Transcript

(Pre Roll)


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(Coin Drop)


MESH NARR: Hey everyone, Mesh here from Talk Money. Welcome back to The Price of a Pandemic, our series where we discuss the economy, business, markets & investing, and how they’re being affected by the coronavirus. Given this is a show about money, I’m a believer in looking at how financial and social changes can affect industries across the board. We know that essential workers are still out there on the front lines, whether they’re in hospitals treating patients, in grocery stores keeping households stocked, or in restaurants keeping small businesses afloat. In today’s episode, we’re discussing the people who help us get through times like this - when anxieties are high, safe spaces are compromised, and resources feel limited. In times like these, mental health is essential. And mental health professionals are out there providing care for those of us that need it - from meditation on our phones to therapy for physicians on the front lines. With technology, this kind of help has become more accessible than ever.

My guest today is a psychologist who has worked in both private practice and public care - and she also happens to be my wife. Please welcome Dr. Angela Aznavorian. 

Angela: [00:00:11] My name is Angela Aznavorian and I'm a clinical psychologist here in New York City. // [00:00:26] Outside of my private practice, I also work as a [00:00:30] staff therapist at the state university of New York, downstate medical center here in Brooklyn, SUNY.

Mesh: [00:00:37] And // [00:00:41] how is it that we know each other?

Angela: [00:00:44] Funny story, husband // (FROM TAKE 2 FILE: [00:00:20] We met about eight years ago when you stumbled into a restaurant bar and wouldn't leave me alone until I gave you my phone number and now we're married.

Mesh:  [00:00:30] I think that's a pretty accurate description. // [00:01:05] So, Angela, tell us, how long have you been a therapist?

//

Angela: [00:01:09] I have been a therapist for going on about 10 years now. I graduated in 2011 with my doctorate in Chicago.

Mesh: [00:01:33] And so from start to finish, how long did it take you to get your PhD?

Angela: [00:01:38] So my program itself was a five to seven year program. I finished in five and I did my masters and my doctorate and during that time.

Mesh: [00:01:45] That's amazing. You're one smart cookie // can you walk us through how a // [00:02:03] private // practice works? // You pay rent, you charge hourly, you pay for insurance. I think it'd just be helpful to understand how the business itself works.

Angela: [00:02:13] Sure. // For private practice itself // we have an office space, so whether that means you rented the entire space yourself, or maybe you have just an office space within a larger suite of other offices so that clients can come in and meet with you. We // charge by the [00:02:30] hour or the timeframe in which you're meeting with the client. [00:02:33] We do have our outside time that we take to do our paperwork, whether that means, you know, our notes for the client's sessions. If I'm doing a custody evaluation, if we're doing neuropsychological testing, all of that is note taking or report writing time that we do. // in terms of insurance, if a clinician takes insurance, then there's // [00:02:52] submission time with insurance companies. Some people, you know, hire an administrator to do some of that work for them. Or [00:03:00] now there's // a lot of online tools that you can use to do online submission yourself. So that's also time though to take into account.

Mesh: [00:03:07] So it's fair to say that a lot goes into one session with one person // Besides just the 45 or 60 minutes that you're with that person?

Angela: [00:03:19] Absolutely. I think it depends on the client. I think it depends on the presenting concerns. I think it depends on the evaluation or it depends on what exactly you're [00:03:30] doing with that.

//

Mesh: [00:04:37] So Angela, now that we're dealing with the coronavirus, // what has changed for you as a therapist?

Angela: [00:04:51] I think a lot has changed, especially because I had never done tele-health before. // I've kind of always been a little bit, uh, outside looking in, in that department. [00:05:00] So for me, I've had to kind of relearn a whole new system // which, you know, we get taught about // but to actually be immersed within it and have to jump in almost in a crisis time to practice within. It has been a // bit of a shift for me.

Mesh: [00:05:17] And when you say tele-health, you mean [00:05:20] talking to people virtually?

Angela: [00:05:23] Yeah, so telemedicine // Technology  Assisted Counseling is how it used to be [00:05:30] termed. And now telemedicine is kind of the, the more grander context because that also means your general physician, for example, or other types of practitioners. It's not just // psychologists.

Mesh: [00:05:40] And when you say that it's taken some time for you to getting used to, it's because you are used to doing sessions in person.

Angela: [00:05:49] Yeah. I'm kind of more of that brick and mortar office type therapist versus having the online atmosphere. // Even for my own private practice, it wasn't something that I had offered. [00:06:05] I didn't necessarily have to with my clientele. But now // that we are // personally self quarantining // I've been forced to take on this new role as a telemedicine practitioner.

Mesh: [00:06:29] And that [00:06:30] means that your, your sessions are now either through zoom or FaceTime, is that correct?

Angela: [00:06:35] Correct.

// 

Mesh: [00:06:50] // When you're doing sessions now with your clients, what are people mostly spending the time talking about?

Angela: [00:07:06] So I just want to be clear // the clients I can give you examples from are going to be // the medical students I work with because right now I have not been seeing any private practice clients just to focus my time, particularly on the medical students who are on the front lines. 

Mesh: [00:08:35] So clearly they're going through something pretty traumatic right now. Can you help paint a picture of what it is?

Angela: [00:07:35] During a crisis like COVID 19, it's common for everyone to experience, you know, levels of distress, anxiety, particularly as a result of social isolation // [00:07:44] But for physicians and other frontline professionals…// [00:08:38] I mean, // healthcare professionals are particularly vulnerable to mental health effects. // As they try to balance the duty of caring for their patients. The overwhelming work and information overload that they're getting on a daily basis. [00:08:57] The insufficient personal protective [00:09:00] equipment // that is necessary to perform their jobs and medical devices needed to care for patients. All of these stressors coupled with the concerns of their own wellbeing // [add in “and”] the wellbeing of their family and their friends. So mental health right now for them, is of extreme importance.[00:09:18]And where, where do they find the time to take care of themselves? Like they typically could on a day to day? // You know, during a time of such pandemic.

Mesh: [00:09:27] And just like everyone else, everybody has [00:09:30] anxiety. I mean, these folks are dealing with not only death and not only severe sickness. They're dealing with being away from their family and also putting themselves at risk. [00:09:41] So // they're having a ton of stress that // you along with other therapists are helping treat.

Angela: [00:09:48] Correct. Absolutely.

Mesh: [00:09:51] And so // before you started doing tele-health with your students, you weren't exactly 100% on board with telehealth. Why is [00:10:00] that?

Angela: [00:10:04] You know, telehealth or telemedicine in itself can open the doors for treatment in so many ways. // But // to me // it just doesn't give me the same feel. For therapy. I believe there's a lot to be said about a face to face relationship. [00:10:23] The structure of a physical time and place at a session provides a client the ability to see and hear all their [00:10:30] verbal and nonverbal // communications. The ability to, or I should say the inability to always control. You know, if you're doing telemedicine, the environment, whether that be phone calls coming in. [00:10:43] If you have a dog at home that's barking, a bad wifi connection. 

CONTINUE WITH TAKE 2 FROM HERE

Mesh: [00:01:10] // Has it made it easier for people without regular access to mental health to get access now?

//

Angela: [00:01:29] Yeah. So [00:01:30] telehealth has many benefits, and it always has. I think we started to see it being used in the 1950s but over the last, I want to say five to 10 years, it's grown exponentially. You know, in psychology, in my field specifically, it's improved access to care for individuals living in remote locations, for example, in underserved areas. [00:01:48] // There's a lot of clients that, let's say, can't leave their home due to illness, whether that's a medical issue or a mental health issue. It's used in emergency situations like we're seeing with COVID in this pandemic time, [00:02:00] or even people that don't have mobility to get to, you know, a brick and mortar office, that type of thing. // But if we want to go, you know, and look at COVID, for example right now, tele-health has been amazing for people to get access to care. // It's interesting to see how the system is being flexible on its general regulations. // [00:02:24] For example, just recently the department of health and human services // made an // announcement that is allowing [00:02:30] video chat apps like // FaceTime, Facebook Messenger, Google Hangouts, all of these ones that typically aren't HIPAA compliant // being [if there’s a “to be” we can replace with, please do] used for different medical consultations, given the extreme need // for people to get access to care. // [00:02:48] So, with that flexibility, it'll be interesting to see how all of these practitioners are using telehealth and how maybe some of these // guidelines that we've had to really follow // might change.

//

Mesh: [00:03:20]  I love the idea that, you know, regulation would be more open to giving people more access and using technology for // people who don't have access to brick and mortars [00:03:30] or maybe don't have access physically to mental health professionals. // So it's exciting to know that // the best folks out there that could provide care, can reach out to really anybody. [00:03:50] And given the time that we're in right now, any tips and practices for people out there to reduce anxiety? What kind of self care do you find most effective that you can [00:04:00] practice // at home?

//

Angela: [00:05:00] You know, // it's common for everyone to experience increased levels of distress, and I think everyone's emotions will be experienced differently. Different levels of anxiety, different levels of possibly sadness, maybe some sleep issues, particularly because we're all socially isolated and we're really worrying about what's going to happen with this pandemic, whether it's // to ourselves [insert an “or”] our loved ones. // Taking care of ourselves is super [00:05:30] important right now. And I can't stress self-care that enough. // [00:06:10] I know it's an overused word. But // reaching out to // your current therapist, if you actually have one, and seeing what your options are for telehealth, // that type of communication ability. // [00:06:30] There's apps that everyone can download that are really helpful,  // Headspace for example, or Calm or these mindfulness and guided meditation apps. Just to kind of help reduce some anxiety, help us get to sleep a little bit easier. // [00:06:50] Getting enough rest is super important. Finding respite time during your work schedule is really important. // We're working from home now, so we're taking our work [00:07:00] environment and our work stress, and we're kind of putting it in our safe [00:07:02] space. // Engaging in physical activity, I know that's really hard, especially when we're // supposed to be socially isolating in our homes, but just [00:07:19] stay moving, keep our body engaged. // And most importantly too, I think is taking breaks from // social media // and the news, as much as we want to keep [00:07:30] informed, there's also, I think limits to that, that we should each try to take into account // and // just stay in contact as much as we can with // family and friends. // Just to kind of stay connected with our loved ones, I think is super, super important.

Mesh: [00:07:55] Angela, thank you so much. Really appreciate your time and we'll see you [00:08:00] in five seconds. //

Angela: Thank you.

MESH NARR: You know you’re in new territory when “isolation” is the healthiest thing you can do. So while we wait for things to change and for life to feel safe again, we have to take care of ourselves - physically and mentally. A crisis like this reminds us of the importance of mental health professionals, as well as the technology that let us access them. And we’ll see what new business models emerge from all of this, so that everyone has affordable access to mental healthcare, from professionals who are well-trained and fairly compensated. In the meantime, we can take advantage of meditation platforms, many of which appear to be offering their services for free during these trying times. See you next week, and be safe.

I want to thank my guest Angela Aznavorian for her time. This episode was edited and produced by Olivia Briley & engineered by Maia Tarrell. Sign up at thetalkmoney.com for further deep dives and to hear other episodes. We appreciate you sharing this with your friends, and subscribing to us on Apple, Spotify or wherever you choose to listen. Until next time.


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