Q&A with Nurse Practitioner Lisa Everhart

Q&A with Nurse Practitioner Lisa Everhart

Lisa is a dual certified psychiatric and women’s health nurse practitioner with a master’s degree in nursing from Vanderbilt University and a Doctor of Nursing Practice degree from University of Tennessee Health Science Center. She has experience treating a range of acute and chronic psychiatric conditions and has specialized interest in women’s mental health across the lifespan including treatment of mental health conditions common to adolescence, prenatal/postpartum periods, pregnancy/child/partner loss or separation, sexual dysfunction, infertility, menopause, and life transitions.

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Spravato (esketamine) for treatment-resistant depression

If you struggle with treatment resistant depression, there's a different choice to turn to!

What is Esketamine?

Esketamine is made from a drug called ketamine, an anesthetic that has also been used for many years to treat depression. It is FDA approved, and is covered under some insurance plans for qualifying individuals. We are currently accepting BCBS plans! Esketamine has the potential to distort your perception during the first two hours after treatment, so it must be administered in the clinic setting. Clients must be observed for two hours after treatment, and cannot drive for 24 hours after treatment.

 Who can take Esketamine?

Esketamine is FDA approved for people with treatment-resistant depression. That means you have tried at least two other antidepressants (for at least six weeks each) and have not experienced remission or at least a 50% improvement in mood.

How does Esketamine work?

Conventional antidepressants increase levels of naturally occurring chemicals such as serotonin, norepinephrine and dopamine. These chemicals are messengers that relay communication between brain cells. Having greater quantities of these neurotransmitters allows for better communication between brain cells and positively affects mood.

Esketamine works in a similar fashion, but unlike other antidepressants it increases levels of glutamate, the most abundant chemical messenger in the brain. The result? A greater impact on more brain cells at one time, and often immediate long term relief from depression.

What are the benefits?

Esketamine immediately impacts brain cells, often offering immediate relief from depressive symptoms within hours.

Up to 33% of people with depression don’t respond to multiple kinds of conventional antidepressants. Esketamine reduces depression symptoms in a majority of these people in clinical trials.

It has been shown to decrease suicidal thoughts.

Esketamine treatment is a short term treatment with long term effects, as it helps the brain form new connections. Treatment plans begin with two treatments per week for one month.

How do you get started with Esketamine treatments?

Step 1: Fill out an application by clicking here or the button below.

Step 2: Attend your initial evaluation with one of our trained medical professionals.

Step 3: Once you have received authorization from your pharmacy, the medical professional and the insurance company, our intake team will reach out to schedule your first treatment!

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Alex Williams

Alex has been an Office Manager at Forward Counseling for three years now. She is a native Memphian and has lived in Washington D.C. and New Orleans. She has a B.A. in Philosophy and Sociology and is pursuing a Masters degree in Social Work. She is excited to dedicate her time to helping the brain health of vulnerable populations in Memphis.

The stigma behind women's mental healthcare: what you can do

womenmentalhealthcare female health stigma

Not so fun fact: In Ancient Greece, it was believed that if a woman’s womb wasn't continuously impregnated, the uterus (which in Greek is “hystera”) would wander the body and cause mental health problems. Eventually the term "hysteria" was used as a catch-all diagnosis to discredit the struggles of women... Yes, seriously!

It wasn't until 1980 when “hysteria” was finally removed from the diagnostic manual. After centuries of misdiagnosis and mistreatment, the topic of women’s mental health has slowly but surely lessened in stigma as research has caught up with reality.

The good fight isn’t over, though. Unfortunately women's struggles are often discredited or overlooked as a symptom of their sex. The disadvantage in women's mental health cannot only be seen in the professional world, but also in their personal lives. Disgruntled exes everywhere can still be heard summing up their failed relationships with "she's crazy." *cue the eye rolls*

In the wake of this new movement to improve women's mental healthcare, it is important that we stand up and raise our voices in support of our community. Oppression, societal expectations, pervasive body image ideals in media, postpartum depression, hormonal imbalance - these are just a handful of debilitating issues that have monumental impacts on a woman's quality of life.

So, what now? Talk about it. Extend a message of support to a woman in your life. Throw a tomato (real, metaphorical or emoji version) next time you hear someone calling a woman crazy. Change demands action, but even the smallest of conversations can create a larger impact.

Women’s mental health is a topic that is important not only to us at Forward, but especially to Lisa Everhart, our psychiatric nurse practitioner who specializes in women’s health and has a passion for standing up for women. Lisa is committed to getting to know her clients and tailoring her practice to their individual needs.

It’s your turn to take the next step in seeking out the answers that so many women before us were refused. And we might just know someone (ahem- Lisa!) who could help you embark on this journey. And don't forget to let other women know there is support available! Together, we can make a huge difference in the de-stigmatization of mental health.

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Alex Williams

Alex has been an Office Manager at Forward Counseling for three years now. She is a native Memphian and has lived in Washington D.C. and New Orleans. She has a B.A. in Philosophy and Sociology and is pursuing a Masters degree in Social Work. She is excited to dedicate her time to helping the brain health of vulnerable populations in Memphis.

If Mama’s not happy then nobody’s happy: Preparing for pregnancy with a mental health diagnosis

by Lisa Everhart, DNP, APRN, PMHNP

Hey, babies happen! Having a mental illness doesn’t mean pregnancy should not or will not happen for you. And having a pregnancy doesn’t mean sacrificing your mental wellbeing for baby’s wellbeing. Untreated mental illness increases risk for multiple maternal and newborn problems, so your mental wellness matters now more than ever (Hardy & Reichenbacker, 2019).

What can you do to promote smooth sailing through pregnancy, delivery, and beyond? Consider the

checklist below:

  • Start taking a daily folic acid supplement now.

    This is the single most important step you can take to prepare for a healthy pregnancy. Folic acid is essential for closure of the neural tube that will develop into the brain and spinal cord and eventually the baby’s entire nervous system. It is complete before most women know they are pregnant. The recommended pre-pregnancy folic acid dose of 400 micrograms (mcg) a day can be taken as a single supplement or as part of a multivitamin. Already pregnant? Bump your dose to 600 to 800 micrograms (mcg) a day. Any prenatal vitamin will cover this dose. Your OB/GYN, fertility, or mental health provider may recommend a higher dose in certain cases, but if you are unsure, start with the typically recommended dose.

  • Plan if you can.

With any existing health condition, a planned pregnancy allows time to optimize health and manage risk for pregnancy complications. There are a range of contraceptive options that are effective, and reversible when the timing is right. If you are not planning a pregnancy in the near future, start your folic acid supplement anyway and see your primary care or OB/GYN provider to discuss contraception.

  • Check in with your mental health provider.

Mental health symptoms tend to wax and wane with hormonal, physical, and life role shifts during pregnancy and postpartum periods. Fertility treatments will affect symptoms too. You and your mental health provider will want to review your medications to ensure they are optimized and safe to continue with pregnancy and breastfeeding. For the at-home health researcher, there are reliable summaries of fertility/pregnancy/breastfeeding risks for specific medications and conditions at https://mothertobaby.org/fact-sheets/

  • Check in with your primary health provider or OB/GYN.

    Untreated conditions like high blood pressure, diabetes, and autoimmune disorders can lead to serious complications for moms and babies. Your primary care or OB/GYN provider can offer screening, interventions, and non-psychiatric medication adjustments to promote your best state of health for pregnancy and birth.

  • Discuss substance use habits with your providers.

    Whether prescribed, over the counter, natural, legalized, or otherwise, all substances carry a level of risk for unwanted effects. An open discussion about all substance use will help us create your safest plan for pregnancy. Your providers will collaborate with you to determine your readiness for help with cutting back or quitting potentially harmful substances and prepare for specific interventions if complications arise.

  • Check in with your therapist.

    We all have skeletons in our closets and pregnancy, birth, and parenting have sneaky habits of inviting them out. Studies show that Adverse Childhood Experiences (ACEs) increase risks for physical, mental, and substance use disorders in adults that can impact pregnancy outcomes (Felitti et. al., 2019). There are interventions that can help you address past trauma and bolster your resilience against the potential effects of ACEs. If you are interested in learning your ACEs score, take the quiz here! To learn more about steps you can take to support healing from a traumatic past check out “Healing from a Dysfunctional Childhood.”

Your therapist is the best person to help you sort through the good, bad, and ugly parts of your past and navigate the bumps on the road to becoming a parent. Our intake staff at Forward can help connect you with one of our excellent therapists who may be a match for your needs. Missed the planning stage? It happens to the best of us! Your primary care, OB/GYN, and mental health providers are here to help with that too. If you check in with an “I’m pregnant, now what?” appointment we are happy to work with you to optimize pregnancy/postpartum wellness from any starting point.

References

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M. Edwards, V., ... Marks, J. S. (2019).

Reprint of: Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 56 (6), 774-786. DOI: 10.1016/s0749-3797(98)00017-8 Hardy, L. T., & Reichenbacker, O. L. (2019). A practical guide to the use of psychotropic medications during pregnancy and lactation. Archives of psychiatric nursing 33 (3), 254–266. https://doi.org/10.1016/j.apnu.2019.04.001


The woman who fought against a corrupt judge (and won!)

The woman who fought against a corrupt judge (and won!)

Although she knew it seemed like a difficult feat to challenge a member of authority in an unfair institution, Angelik had an important realization: she could form a strategy to raise awareness for her family’s unfair treatment in the court system. Angelik’s work helped uncover other individuals who had experienced unfair and irrational treatment from the same judge. She wasn't the only one. This led to the judge’s investigation and ultimate removal from a position of power. After her own success fighting injustice, Angelik realized she could be a voice and guide for others.

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The 5 Best Books for Boundaries in Relationships

The 5 Best Books for Boundaries in Relationships

Looking to have healthier relationships that last and don’t leave you feeling used and misunderstood? Experts say the key to maintaining the healthiest relationships (including within your job, your friendships, your romantic relationships, and even your family) is being a ruthless, unapologetic boundary setter. Simply put, setting boundaries promotes respectful relationships. According to coach Angelik Sims, “Boundary setting is the most important way to teach people how you expect to be treated.” I get it- this is easier said than done. Many of us (ahem- me) have people-pleasing tendencies that make getting into the habit of setting and sticking to clear boundaries feel uncomfortable and awkward.

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Life Coach Q&A: What is Mindfulness? With Expert Dean Graves

Life Coach Q&A: What is Mindfulness? With Expert Dean Graves

Dean Graves shares information about the importance of mindfulness. Dean has taught clients all over the world how to heal from trauma, how to get rid of unwanted conditions, and how to develop professionally and get rid of conflict in the workplace.

Q: Why should someone see a counselor or life coach?

A: A counselor and/or life coach can provide significant perspective to specific or general “unwanted conditions” that a person may be experiencing. Everyone has unwanted conditions that they experience in everyday life. The degree to which an unwanted condition limits a person’s enjoyment of life varies from person to person and by the nature of the condition and can vary in intensity from a minor recurring irritation to a foundational existential angst about the human condition itself.

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Life Coach Q&A: Reaching Success with Business and Life Coach Angelik Sims

Life Coach Q&A: Reaching Success with Business and Life Coach Angelik Sims

How do you find a great therapist? You may have made the decision to seek counseling, which is a great first step, but are not sure how to find the right person without having to first “try out” multiple providers. We have compiled a list of commonly asked questions, and are sharing the answers from Licensed Professional Counselor Elizabeth Welwood.

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Therapist Q&A: Questions for a Therapist with Elizabeth Welwood, LPC

Therapist Q&A: Questions for a Therapist with Elizabeth Welwood, LPC

How do you find a great therapist? You may have made the decision to seek counseling, which is a great first step, but are not sure how to find the right person without having to first “try out” multiple providers. We have compiled a list of commonly asked questions, and are sharing the answers from Licensed Professional Counselor Elizabeth Welwood.

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The 5 Best Books Trauma Therapists Recommend

The 5 Best Books Trauma Therapists Recommend

A great way to heal from traumatic experiences outside of the therapy room is to educate yourself and learn from leading researchers and clinicians who are dedicated to providing the best information about the psychological effects of trauma and the methods that have helped others heal. You are not alone! Check out these great reads to get started in your journey towards beating PTSD and complex trauma.

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A better you: the benefits to seeing a life coach

Lauren Baker Life Coach Professional Success Coach Guide

Life Coach

EVERY goal is within reach with a bit of help from a trained guide like Purpose and Life Coach Lauren Baker, pictured above!

The pressures in our society today seem to engrain within us that finding passions and reaching success is the most important part of life. People are expected to work hard and become successful without any help, and feelings of deep shame arise when one feels lost in the journey to success. In reality, it is extremely difficult and maybe even unattainable to figure out one’s purpose in life and know what the steps are to reach goals without any help at all. Whether it be career goals, relationship goals, or even just an ambiguous goal of wanting to feel better about life, it can feel daunting to know where to look to begin moving forward.

Finding help is especially difficult for people who are not dealing with a mental health issue which requires a therapist or counselor. The good news is there is a whole realm of coaches who work with clients with these exact goals in mind. Life Coaches have the training and knowledge needed to guide clients through the recognition of goals and aspirations in life, and how to best go about attaining those. Read more to learn how a Life Coach is the catalyst for reaching success, with information from Purpose and Life Coach Lauren Baker, M.Ed, LMSW.

Lauren likes to consider Life Coaches the “personal trainers” for life goals. They teach clients how to improve ways of thinking and provide techniques for living a more purposeful life to people who do not feel like they have mental health issues. Most people who see Life Coaches have a specific issue they are struggling with- like wanting to change careers, resolving conflict in the work space, hoping to break a pattern in relationships, or looking to analyze weak areas in thinking/lifestyle choices.

Life Coaching is typically more short-term than therapy, with clients experiencing progress within an average of 6 sessions. The sessions are short and easy to fit in, typically lasting only 45 minutes. They provide clients a space to visualize, recognize life goals and identify the limiting beliefs and actions keeping one from reaching them. After choosing those goals, Lauren helps provide the education needed to make those next steps. The Coaching process continues outside of the session- with homework, outside reading, and exercises to continue reaping the benefits of the session in between (and for the rest of the client’s life).

Seeing a Life Coach at least once in life is the most helpful thing many people may do for professional and personal success. The Coach not only helps clients work through current issues, but also provides knowledge about how to apply what is taught outside of the coaching sessions, too- meaning when other problems arise in months and years after meeting with the life coach- the client has the knowledge needed to best address that problem.

Whether it be finding the courage to ask for a promotion, figure out a career path, or a general feeling like there is an internal struggle keeping one from reaching their best self, a Life Coach is the guide who can lead the way to full success, self-actualization, and identification of limiting beliefs that cause repeated negative patterns,

To book a session with one of our awesome Life or Success Coaches like Lauren Baker, click the button below or fill out a contact form on our site at forwardcounseling.com/contact

What is Prepare/Enrich Couples Counseling?

What is Prepare/Enrich Couples Counseling?

Relationships may start to feel complicated, painful, and hard to manage. It’s hard to talk to your partner about your feelings, expectations, and past experiences. You may even feel like something is wrong, but not even know WHY you feel the way you do about your relationship. DeKimberly is trained in Prepare/Enrich premarital and couples counseling, which can be just the thing needed to help your relationship flourish.

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Healing from a Dysfunctional Childhood

Healing from a Dysfunctional Childhood

Trauma can also be generational in nature, meaning that it is passed down from one family member to the next as part of a given family’s cultural schema. Simply being aware of maladaptive interpersonal patterns of communication within your family won’t undo generations of dysfunction. Knowledge is power, but healing requires hard work. Here are some tips for coping with the newly discovered dysfunction.

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Starting Therapy: Should I use Insurance or pay out of Pocket?

Starting Therapy: Should I use Insurance or pay out of Pocket?

For people who worry about confidentiality, have high deductibles, or don’t have a mental health diagnosis, choosing to pay out of pocket with a therapist has benefits. Understanding which is best is a frustrating barrier. Insurance doesn’t need to be the factor holding you back from getting the absolute best treatment for your situation. There are many highly skilled therapists and life coaches at Forward Counseling who are excited to partner with you in your journey to reaching your highest self possible.

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The Benefits of Play Therapy for Children

Calvin’s Play Therapy Room at our location in Jackson, Tennessee

Parents aim to raise children to make the best choices in life, while also giving them the room to grow and make mistakes without judgement. Sounds easy? You’re not alone if your answer is a resounding “NO!” Regulating emotions and behaviors can be especially difficult with children who are not old enough to understand their emotions.

Finding the middle ground between discipline, guidance, and acceptance can be one of the most difficult yet important things you do for your children. Play therapist Calvin Clark is trained to help children realize they are equipped with the ability, knowledge, and confidence in their internal locus of control to be able to independently make the best decisions possible in life, and ultimately become an amazing adult who makes the world a better place.

Play therapy is a therapeutic approach that utilizes games and play to provide a safe space for clients to express feelings and explore behaviors, thoughts, and experiences (Landreth, 11). Typically before age 12, children are not yet equipped with the words and skills to fully express themselves in a typical talk therapy environment, like an adult can. Play therapy utilizes the language children already know; play.

Clients are encouraged to spend the sessions doing whatever they may wish to do at that moment; some kids like to play a board game, with a sand tray, wooden blocks, a doll house, or a punching bag. Purposeful play allows creativity and imagination to be the door through which children can walk through and reflect on their experiences and emotions.

In the playroom, the first session is with the parent/guardians to discuss the family history and create an individualized plan for treatment. Calvin is open to providing suggestions to help equip parents who may be working on developing their personal parenting styles, as well. Calvin explains how he creates a safe space in the playroom which allows even the most apprehensive of children to process emotion, gain confidence, and realize their true power.

Calvin opens the floor to whatever the child wants to do at that moment and encourages risks, exploration, and discussion of behaviors. He utilizes recognition of behavior patterns and the way a child may interact with him while they play. For example, take a child asking questions they may seemingly know the answer to- in the playroom, that may be as simple as a child verifying with Calvin if a toy they have is green.

“Children often question what they already know to be true, to verify if their perception is reality.” Calvin will often reflect the question back to the child to validate that they are equipped with the correct answers. By equipping children with the ability to stop questioning themselves and looking to the outside world for validation, the growth of a healthy individual is fostered. Calvin has the belief that children already have everything they need internally to process and move through difficult experiences. His role as a provider is as observer, affirmer, reflector, and creator of the safe space through which one can use their creative, playful minds to best grow.

Play therapy is a useful tool for helping children recognize positive and negative actions and behaviors. Negative behavior is not the sign of a bad child but the sign of a child dealing with emotions, thoughts, feelings, and adverse experiences which need to be explored. With Calvin, the therapy session is not punitive in nature. Negative seeming behaviors will not be shamed, but explored, in order to analyze the symptoms and encourage the healing of the underlying cause of those actions.

Children may try to test limits, and Calvin explains a great way to set the limit is by using Landreth’s “ACT” method: acknowledging the intention of the action, communicating the limit, and targeting an acceptable alternative. Every child has the ability within them to recognize positivity and replace behaviors.

Children behave in a way that gets their needs met, and they can often recognize when a behavior is no longer of benefit to them. When a behavior is in need of being changed, limits are set and an alternative behavior is introduced. By helping kids realize they have the power to make a different decision, and the power to make the BEST ones, life is improved. Calvin provides an example of utilizing the ACT method with a kid who is acting out by hitting. Utilizing the “ACT” method in session, Calvin would:

Acknowledge the feeling: “I can see that you’re really frustrated right now.”

Communicate the limit: “but I am not for hitting.”

Target an acceptable alternative: “If you want to hit something, you can choose to hit the bop bag or a stuffed animal.”

Whether it be at home or at school, we want to equip our children with the knowledge that they are capable of making choices and decisions that are in their best interest.

Choosing which type of therapy is best for you or your child can be daunting. Reach out to us at forwardcounseling.com/contact and our trained intake specialists will help you find the best fit for you and your children. Play therapy and typical talk therapy can both be useful in adolescents. Play therapy and the creation of a safe space to explore emotions, feelings and behaviors fosters the realization in children that they are powerful, amazing individuals with the creativity and self management to grow into a wonderful, happy, and fulfilled individual who helps make the world a better place for all.

Calvin Clark is available for sessions at our location in Jackson, Tennessee!

For more information, visit: https://cpt.unt.edu/what-is-play-therapy

For parenting resources, visit https://www.parentingpurposefully.com/

Sources:

The Art of the Relationship (3rd ed.), Landreth (2012) defined child-centered play therapy.

Center for Play Therapy. (n.d.). Retrieved from https://cpt.unt.edu/what-is-play-therapy


by Alex Williams, Office Manager at Forward Counseling

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Alex Williams

Alex has been an Office Manager at Forward Counseling for three years now. She is a native Memphian and has lived in Washington D.C. and New Orleans. She has a B.A. in Philosophy and Sociology and is pursuing a Masters degree in Social Work. She is excited to dedicate her time to helping the brain health of vulnerable populations in Memphis.

LENS Neurofeedback: The Key to Your Brain Health

LENS Neurofeedback: The Key to Your Brain Health

Neurofeedback can help reduce symptoms brought on by the stressors of daily life and bring you back to feeling like a kid. Neurofeedback allows you to take control over your brain patterns. In many situations, it is possible to cure your brain health without using prescription medication. What we aim to do is address the brain as a whole, the patterns it creates and the experiences the client is having in order to propel the client to feel fully optimized.

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Grief is All-Inclusive: Join our Grief Group this Holiday Season

Grief is All-Inclusive: Join our Grief Group this Holiday Season

An interesting thing about grief- because it’s taboo to talk about- is that we tend to feel like the only one. Therapist Sarah Rather, M.Ed., NCC wants you to know that grief doesn’t need to be a scary word- let’s embrace it! Joining a grief group can provide the skills needed to healthily work through and make grief more bearable, and is the safe space needed to remind you that your feelings and experiences are valid and important. You are not alone on this journey.

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What is EMDR?

What is EMDR?


Eye Movement Desensitization and Reprocessing (EMDR) uses techniques like snapping and tapping to create bilateral stimulation and rapid processing within the brain. Activating this process allows old memories, feeling and thoughts to be “digested” and replaced with a positive belief (Rininger, D). EMDR is evidence based and treatment ends when patients can visualize themselves in a future scenario where they were able to face the re-elaborated targets while feeling no emotional discomfort (Santarnecchi et al., 2019).

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The Benefits of Sand Tray Therapy

The Benefits of Sand Tray Therapy

One innovative form of therapy provided by Forward Counseling is known as sand tray therapy. By presenting a client with a small tray of sand and a wide variety of figurines, a therapist can sit back and observe what the client chooses to create. Though perhaps initially presumed as juvenile, there are actually many benefits to this type of therapy. 

Firstly, it provides a way to communicate when verbalizing becomes too difficult. Often clients find themselves not yet ready to discuss what might be going on, and in that case, sand trays provide a medium through which to communicate to the therapist what words aren’t ready to say yet.

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