What does a Licensed Professional Counselor do?

Kevan believes that any professional does not allow people to humiliate themselves in therapy, but rather, strives to obtain the most self-efficacy with the least intervention possible. These programs are varied, including testing, coaching, on-site observations, and specific skills such as art, speech, and computer instruction.

Transcript

0:01

bindwaves intro music

Carrie: 0:11

hi, I'm Carrie, a stroke survivor, and a bind member.

Olivia: 0:15

Hi, and I'm Olivia, a stroke survivor, and member of bind as well. And today we are going to learn a little bit more about Kevan and the importance of counseling during the, uh, during recovery. So welcome back, Kevan.

Kevan: 0:29

I'm. I'm glad to be here.

Olivia: 0:30

Thank you so much. So tell me a little bit about, um, where you work, um, and what you do.

Kevan: 0:36

Um, right now, I'm working in Frisco at Baylor Scott and white Institute rehabilitation in their day neuro program.

Olivia: 0:44

Great question to lead. To, to kind of follow up with, because I have very, very little experience with Day-neuro. Um, what is Day-neuro?

Kevan: 0:53

So Denero is a post acute rehabilitation setting. Um, individuals who are done with their, um, acute care hospitalization, they've been through all that. Uh, part they've been through their, um, inpatient rehabilitation perhaps. Um, and have been safe to return home, but may not be ready to return to their lifestyle yet. Um, often come to Dane, neuro Denero is, um, a day hospitalization. Uh, in a sense we don't have nursing, but we have all the therapies. So it's physical therapy, occupational therapy, speech pathology. Counseling therapeutic recreation. We have a medical director. We have case management and people come generally, um, from like nine in the morning and they leave at three in the afternoon. And in between they do all the kinds of therapies that I just described. Um, With a focus on. Returning to all those lifestyle skills. And one of the big differences is that with tends to be a more dynamic. Type of therapy. So. Um, you get all the basic PT focus and the OT focus, but then we start working together and taking that and doing things with it. Because the brain learns better by doing things. Yeah. So, um, lots, a lot more collaborative. It's a lot more engaging. And it, it can be, um, very personalized. Um, so yeah.

Olivia: 2:26

Well, thank you for, yeah. Thank you for answering that long awaited question. No problem.

Carrie: 2:32

And I would just add in, um, because I know when I was in day-neuro. And then place and you've mentioned it here. So what is the. How does the counseling aspect fit in? What is the benefit to a newly acquired brain injury? For counseling.

Kevan: 2:47

You know, I tell my brand new clients when they come in and their families that, um, psychology kind of breaks down into two major pieces in day-neuro. One part is neuro-psychology, which is predominantly an assessment and a descriptive field. To, um, you know, it's a PhD. Psychologist. Who. If you can imagine an MRI kind of looks physically at your brain. Um, and tells you what's in good condition. What's not in great condition and how they're doing. When your neuro-psychologist does testing and they can talk about how all those regions of the brain. Are doing and how they're communicating with each other. Where there are strengths and weaknesses, and that helps us a lot. And then there's counseling and counseling. Really is there to help with. Um, the, the, the person who's sustained the injury, but also for their families, um, to help with adjustment and just dealing with. All the things that might come along with the recovery process, all of the uncertainties that difficult times. Um, the confusion. And I do straight. Counseling. I do some testing. Um, I do a lot of education. So a lot of times it's not like telling me about your mother. But it was like, let me tell you about your brain. And, um, and then I worked with the rest of the team and we do functional things to help people get back into their lifestyle.

Carrie: 4:15

I'm going to focus on one thing you said. I'm not trying to hog the show, but, um, cause I kinda do remember this. But talking about that, the counseling, the EDU. For the name brain injury patients is not just for the brain injury, but for the caregivers. Yes. And we try to focus on a lot of that. Do you want the caregiver to hear that people don't seem to always get that brain injury? Didn't just affect the person that had it. It affects the entire family. That's right. And the whole dynamic and the family changes, and you're not going to friend Karl. He said he was like, no one takes a class on high school and what to do after a brain injury, you know, and his wife had to re figure everything out. And my parents had to. Bring home a 38 year old child. So I'm glad that you mentioned that, that this council, this counseling is not just for the brain injured, but for the whole family.

Kevan: 4:57

Yeah. Adjustment is, is a much bigger idea than just, I feel sad because I can't do what I could do. It's much, much bigger than that.

Olivia: 5:06

So, how do you respond when a patient. That doesn't think that they need like counseling. Um, Well, like, w w what do you think is the, how do you, how do you kind of approach that?

Kevan: 5:20

Well, I get that quite a bit. Um, You know, most of the time I try to talk with them about what it is. They do want to work on. And I do have a number of. Clients that I work with that would say they don't really have any mood related problems at all. And they're doing pretty well. I mean, I think there. Pretty much right. But they do have other things that they want to work on. And so. I usually let them know that my focus is to help them. To resume being independent. I'm a cognitive therapist. So I'll come alongside, you know, say speech therapy is working on some fundamental skills. I'll try to find activities that we can do that will utilize those skills. And so they can get reinforcement, but not just do the same. Paper and pencil routines that they might do independently or at home it's much more dynamic. I might even be able to bring in another therapist or another. Client for some of those, if we want to do a more dynamic activity. But we just try to work with what they've got and what isn't important to them. And when the mood stuff comes around. We've already got rapport built because counseling is. As long as it's a, it's a relational therapy. And. You know, the whole, they say that the, you know, the supportive relationship and environment is what allows the person. To take the steps they need to take, to take care of themselves. And so that's, you know, I gotta be a little creative and sort of building that rapport and we do what we can from there. And sometimes. Sometimes, you know, people have the choice not to participate. And we figured that out too.

Olivia: 7:10

Can I ask one, one extra question. Um, What can you give me some examples of like, things that you've done depending on like, what, you know, I guess whether it's a cause. Yeah, all kinds of. I know about rummy cube. I do know that, but,

Kevan: 7:25

well, an occupational therapist and I for eight years ran a cooking group. Oh. So what does a counselor doing in a cooking group? Yeah. And this has maybe kind of an insight into day neuro as well. So for the, for the patient, the client. They're making lunch. And we made, I mean, we made good food and we made it from scratch. We made sushi, we made homemade pasta. We may, you know, everything you can imagine. I mean, it was like amazing group. So obviously occupational therapy is working on. You know, kitchen safety, hand dexterity, occupational therapy, things. What's a counselor doing there. Well, I'm watching that person's ability to read and follow directions. Their self-awareness their ability to relate to the other people in the group. Um, their ability to make changes as unexpected things happen, how efficiently that happens. Um, and then their flexibility in doing that in a. Sort of a natural way or is it really challenging for them? And so for the client, they're just doing something. They enjoy it. Wasn't voluntary group. And they're having a good time doing that for the therapist. We're doing something really meaningfully. Um, goal oriented. And then we can sit down and talk with the person afterwards and say, here's what we noticed. And here's where we see really great strengths. And here's some things we want to work on. Wow. So, and I tell people in you. You know, in our environment all the time, it's like, we're not testing you all the time. But we. Everything we measure everything. And so Dana was very dynamic that way.

Olivia: 9:00

Yeah. Credible and that, and that was eight, eight years. You left

Kevan: 9:03

that particular group until COVID. Yeah.

Olivia: 9:05

I see. Okay. Okay. Thank you.

Carrie: 9:07

Yeah, I know. And a lot of things. Um, I guess that brings me to another car. So like, You've made this report or you're talking to someone and, you know, we have our ups and downs. Unfortunately, sometimes we just have a plateau. And we get really frustrated with where we are. Well, I'm not making any more recovery. I. Um, am I going down? I'm frustrated with my progress. How do you help that person?

Kevan: 9:32

It's a really beautiful question. Cause I do think that probably the two. Big, um, maybe landmark hurdles that are pretty reliable. One is frustration. Frustration is probably the first thing that I see. That people get really honest about, uh, more than sadness really. And as I'm tired of being sick, I'm sick of being sick. I'm tired of this. I'm tired of being in school. You know, And all of that. And then the next thing is insight development. Um, insight development is super hard. And when people become aware that, oh, wow. So this road ahead is a lot longer road than I thought it was going to be. Or. Maybe this thing's getting better, but I can't seem to break through this other thing. And maybe that's something I'm going to have to live with. Well, then you start seeing the other feelings come forward and people again, start getting real honest. About, um, the hurt that comes along with the recognition that my plan for my life has definitely changed. But it's also the. The bridge to acceptance and frankly, independence. It's really hard for a person to maximize their potential. When they're staying focused. You know, sort of in the past. And that's really challenging. So yeah.

Carrie: 10:59

Okay, thanks. I'm going to take a little break here. What quick again? And remind our listeners to go ahead and click that like button, click that share button, click that notify button, just click the buttons. Just stay watching. Don't click the button that turns it off. So, okay. Um, I do think that that's good. I like that you said it because frustration is and. It may have even been you that I still tell patients when I go and talk to them today, new patients. That when you, after you have life altering brain injury, you go through the five stages of grief. That you go through when you lose. Loved one. Well, you have lost. Very special, loved one. So, I mean, cause I know I was hit on frustration for a long time.

Kevan: 11:39

Yes. Yeah. Frustration is, is that feeling that says something's wrong and I want it to change, but I can't do anything about it. And it's a half truth because obviously you, even today in, in your world of. You know, doing podcasts and working and, you know, maximizing the life that you're living. Realize that, you know, I still can keep doing things I can still advance in and make it better. And so while I can't undo, what was. What occurred at that point in time? I do have control of control over a lot of things. And that control is maybe the. The safety. You relief valve. You know, from frustration people, they do get can do something right.

Olivia: 12:31

That's a really hard. It's a hard, it's a, it's a hard road. And in that sense, It's been. Yeah. I mean, I think for everyone in their, in their own, you know, recoveries and their journeys, Particularly with grief. Um, That frustration. It's it's a big chunk. So, um, thank you for doing what you do and helping guide people. Um, towards, you know, towards acceptance ultimately. Right? So. Um, well, so, um, Kevan, do you have any good resources? Um, for brain injury survivors and caregivers, um, that, you know, you can, you can basically share. Um, to learn and heal during recovery.

Kevan: 13:12

Um, there are, you know, there's tons of great, you know, um, self-help types of books and it's really individualized. I mean, I could go down the list of, you know, You know, here's, you know, here's how to, you know, Be more optimistic or do they send things, but I think we're the ones that I actually really enjoy sharing the most are other people's. Great success stories. So things that I kind of like to turn to. Um, if, if, if a person can find them as Jill Bolty Taylor's book, my stroke of insight. Um, Jill

Olivia: 13:46

Fun story. Actually, I actually, um, cause I couldn't read right for, um, well I I'm still struggling, but I, I can read, but I, you know, I'm still struggling. So. Um, I actually, um, where I was living before. I happened upon one of the, the, um, free. Li libraries. That I had in my area. And that was, that was in there. So it was just really nice to actually get, you know, to actually like physically have it. I'm like read through it. That's a great, great book.

Kevan: 14:16

Great. Encouraging story. And an interesting thing about Joe Bolty Taylor's story is that really her recovery happened before. A lot of what is, you know, neuro rehabilitation even existed. It was, yeah. It was in the nineties. This. You know, There were a couple of things around, but. Yeah. She, she and her mom basically did the, did the work. Yeah, because she was a nurse. Was she a neuro anatomist? Neuro

Olivia: 14:40

Out of Harvard. Yeah, she was she's incredible. Yeah.

Kevan: 14:44

But I also like, um, if you want to go on YouTube, um, Uh, if you look up Jason Crigler really, really enriching, amazing story. There is actually a video. Uh, that's out there called life support music. Um, this is the Jason Crigler story and that's the full story, but you can go on YouTube and see him talk about his remarkable recovery. Um, a gentleman who at seven months was still in a semi vegetative state after his injury. And had a absolutely beautiful. Ultimate recovery. And, you know, in his life. Um, I also like, uh, Kevin Pierce's story. Um, you can see the, maybe track down the crash reel, which was an HBO film. Um, and, um, Another really good one. And it's a little harder to find. Um, but, uh, the story of Bob Woodruff, who was an ABC news reporter who got injured in, um, Afghanistan, No, I'm sorry in Iraq. And, uh, they did a documentary to Iraq and back. But his book, um, with his wife, Lee is out there. Really again, beautiful story of a person who had a really remarkable injury. Had, you know, uh, an astonishing recovery. And I think looking at those people, who've been down the road, they talk about all these things. That they. Never saw the end of you. We never expected the end up. And then all of a sudden here they are telling their story and all this beautiful. Outcome. And, um, I want to kind of throw in one last little thing. If. You got the time. Yeah, of course. Okay. So people come to neuro rehab, they have goals. They want to walk again, talk again. They want to be able to move that body part efficiently. They want to be able to read. They want to be whole to see, they want to be able to do these specific things. And I want that too. I think it's really important. But as a counselor. Uh, there's a part of me that thinks if you come, you work for months. Towards getting that stuff back, you get back to your baseline. It's a little bit of a let down that I worked all this time to get back to par. However, I look at people in BIND. I look at people. You know that I've worked with another settings. Who have gained something. And it's a little bit harder to find something, a meaningful, something. That is deeper than that. Tangible recovery stuff. And they say. Yeah, but if I hadn't been through that, my life wouldn't be this. Better this way now. And I think that that. Change of self, that deep change of self. Is. A powerful thing. And I think, you know, when, when. You know, we don't know the outcomes of everything. It's a meaningful direction to go.

Carrie: 17:46

I agree, a hundred percent. Okay, one last little Councillor rehabilitation question. Um. When that person discharges from day-neuro. And they don't have you on an easy basis. Do you recommend that they find a counselor or just, I mean.

Kevan: 18:05

Sure. But yeah, especially if they have demonstrative needs and the cool thing is that out in the community nowadays, There are a handful of people in our community who actually understand. Um, You know, neurological injury recovery, and our counselors or psychologists. And that didn't exist back when I first started doing this. So that's really cool thing, but yeah, I think even just finding a good counselor for an individual. Sometimes even just for their family can be really helpful if they're really still struggling or if everything seemed really peachy while you were in the hospital or in day neuro. And you get back home and go, okay, wait a minute. There's a lot more happening here. So, yeah. Counseling is a good idea. Okay. Great.

Olivia: 18:49

Always a good idea. Kevan. Thank you so much. You're welcome so much. It was wonderful to have you, um, thank you for enlightening. Me particularly. Sure. Yeah. Uhm, about uh day neuro. So thank you so much. Um, and thank you. Yeah, I think all listeners. Thank you.

Carrie: 19:06

Thanks Kevan. And again, if you'd like to contact us, You can email us at bindwaves@thebind.org. Or follow us on Instagram at bindwaves. And also visit our website at thebind.org/bindwaves.

Olivia: 19:21

And don't forget to like, share subscribe on all of your favorite platforms. And also hit notify'em on the, on YouTube while listening to bindwaves.

Carrie: 19:33

And again, every Thursday you can find our, find us here. On your favorite stuff. Favorite dial. And I'm just getting on your favorite platform. I was trying to think of something cute to say it didn't work. That's all right. So until next time,

Olivia: 19:44

Until next time.