022: Navigating Autism, Behavior Strategies, and Promoting Healthy Eating for Kids and Youth, with Mendi Baron, LCSW
Speaker 1
[00.00.00]
Hey, hey, welcome back to Real Food Mental Health. My name is Cody Cox. Today's episode is, uh, it
has a more of a conventional spin on it because I'm interviewing Mendy Barron. He is a licensed clinical
social worker, and I like to put some conventional things in my show once in a while, because I do think
it's important to, um, keep those in mind as we compare to more holistic or functional approaches to
mental health. Um, and sometimes these conventional approaches actually have some, some really good
value to them. And so Mendi will speak to that in today's episode, a little bit more about him. He is the
founder and CEO of several treatment centers, including Moriah Behavioral Health, Ignite Teen
Treatment, Elemental Treatment, Eden Center for Eating Disorders, Hope Street, and Bright Way
Behavioral Health. Clinically trained, Mendi has extended extensive experience as a therapist in both
individual and group counseling programs. He's a well known expert spokesperson in the field of mental
health and addiction, and he's even appeared on The Doctor Phil's show and is a frequent guest expert on
local Las Vegas news programs and also Knpr. Today's episode is going to be a little bit more
conventional because it is a licensed therapist, but if you would like to get started on a more holistic
journey to better mental health and honestly better physical health, then you might be interested in
starting one of my nutrition programs. Particularly if you want to save some money, you can start with
my small group nutrition program called restart. It is offered online and the nice thing about nutrition is I
can offer this to pretty much most people in most states and countries. So head over to Beaver Creek
wellness.com/restart to read more about it and to choose a start date. Welcome to the Real Food Mental
Health podcast, where we explore the powerful connection between mental and physical health. My
name is Cody Cox, a holistic nutritional psychotherapist, and I'm here to guide you on a journey to true
wellness mind, body and spirit. If you're tired of quick fixes and want real solutions that address the root
cause, you're in the right place. Let's get started on your path to lasting wellness. Welcome back to Real
Food Mental Health with Kody Cox. Today I have Mendy Barron Mendy. Why don't you take a minute
to introduce yourself.
Speaker 2
[00.02.44]
Absolutely. Well thanks for having me. Um so I am a LCSW. I'm a psychotherapist. I specialize
primarily in working with children, teens, young adults and their families. Um, kind of a developing age,
if you will. Um, I have a private practice, and I also operate a larger company that services teams.
Speaker 1
[00.03.04]
Okay. And you've got different companies in different states, right? So it's the if I remember, right, it's a
residential facility in Las Vegas.
Speaker 2
[00.03.12]
Correct. We have residential facilities in Las Vegas. Yep.
Speaker 1
[00.03.15]
And then you've got in Maryland a private practice and.
Speaker 2[00.03.20]
Correct, uh, private practice primarily,
Speaker 1
[00.03.22]
so. Oh, okay. Okay. Gotcha. Now you're let's talk a little bit about your residential facility. So is that just
for teens, young adults? Is there a special particular focus for
Speaker 2
[00.03.38]
that. Yeah. So we, we, we specialize in working with teens. Um, teens are a particularly challenging
population, right? Teenagers know everything. Um, but at the same time, it's a very rewarding sort of
process because you can really see the change that you make with younger people. You can shift them
and see the shift. Um, and so we primarily focus on mental health, um, some addiction. And as a
secondary concern, we can deal with some disordered eating, um, processes. Um, and we do work with
the nutritional team alongside our staff. So it's, uh, sort of a combo we try to address as much as we can.
Speaker 1
[00.04.14]
And is there a particular reason you chose Las Vegas to establish that practice?
Speaker 2
[00.04.20]
Oh, that's a longer story, but, um, I, I, uh, I had built and operated quite a few facilities for other people,
um, in California, where I lived. And Las Vegas looked to be an untapped location. Um, and it really is
they they have very, very few resources as it pertains to this. So I said, okay, it's a new frontier, 30, 31
minute flight from LA. So let's give this a shot.
Speaker 1
[00.04.44]
And yeah, I've actually made that flight before a few times. I was practicing in southern Utah. I'm now in
northern Utah, but in southern Utah we have a lot of wilderness therapy programs. And so essentially it's
residential, but it's outside, right? And it seems like there's there's always like a particular reason why a
residential facility is in its current location. So southern Utah just is it's just kind of the wilderness
therapy area as far as like lots of national forest, national parks, they don't really go into the national
parks for treatment, but a lot of, um, ideal landscapes for, for being outside in a therapeutic setting.
Speaker 2
[00.05.28]
There's a secondary reason for that also.
Speaker 1
[00.05.30]
Yeah. Tell me about that.
Speaker 2
[00.05.32]Um, so in Utah, due to some religious exceptions, you're allowed to run therapeutic boarding schools that
are locked. You can't lock a teenager into any location anywhere in the country except for Utah or your
hospital. And because of that, those programs operate there and they work in partnership with the
wilderness programs. So it makes sense. They go to a wilderness program, and then from there they
transition to one of the therapeutic boarding schools. Um, so that's also sort of a common behind the
scenes feature.
Speaker 1
[00.05.59]
Ah, see, I did not know that I grew up in Utah. I have been I mean, I went to school in Arizona, but I've
been practicing in Utah since I became a therapist, and I just figured it was kind of the same in most
states, but I just thought it was more of the the outdoor landscape, which is why they, they chose Utah
for. Yeah, most of the wilderness therapy programs. Um, how does your program differ from wilderness
therapy? Is there a particular angle that you're taking with it as far as like therapeutic modalities or
anything like that?
Speaker 2
[00.06.34]
Sure. I mean, um, so therapeutic boarding, uh, therapeutic. Sorry. Wilderness programs, um, are
primarily designed as a high intensity intervention for a short period of time. Um, they're also primarily
indicated for kids who have really intense behavioral struggles. Right. So going out into the wilderness
gives you a chance to kind of work through some of that stuff. Um, they do not they don't meet the
clinical qualifications for residential program. It's not 24/7 staffed by clinicians and doctors and nurses.
It's primarily a therapist and then some wilderness experts. Um, and now some of them have a
psychiatrist who will either travel with them or meet them at base camp. Um, but they, they're designed
really to kind of let kids get some stuff out of their system versus really implement, um, truly
scientifically backed therapeutic interventions. Um, and because of that, that's the reason they can't build
insurance and other things. They just unfortunately don't qualify like that. Um, so our program is a true
residential program, meaning from there or sometimes in replacement of that, they'll come to actual
homes. These are licensed homes. These are accredited homes, um, staffed 24 over seven nurses,
psychiatrists, uh, therapists, uh, physical coaches, nutrition. So it's a really robust, around the clock
licensed psychiatric residential treatment center. And so it's it differs in almost, almost every way, um,
from a wilderness program. But, but. Those programs certainly do have their benefits. And the other
piece is we take insurance and um, because those programs and also the boarding schools aren't
considered, um, licensed therapeutic locations, they can't build insurance for that. So we've become a
little bit more affordable than some of those programs, like a wilderness program. You'll pay 25 K for
three weeks. Um, boarding schools, you pay 15 K a month, but we take insurance. If you have a Blue
Shield policy, 500 bucks a month for your policy, and the rest is on us. Um, so it becomes
Speaker 1
[00.08.27]
affordable, way cheaper.
Speaker 2
[00.08.29]
Yeah. But when we talk about mental health, you know, as a therapist, right. It's not like, oh, you broke
your leg. We're going to fix it in four weeks and you're on your way. Right? Mental health is something
that in different, varying degrees, you're going to deal with for the rest of your life. You know? And even
like diabetes, things can be in check. But you got to be mindful, right? And so parents assume I'm going
to spend 25 K. And in those three weeks it's all going to be fixed. Um, you know, or in this half a year it'sall going to be fixed. But the reality is you need to be able to handle it financially much longer than that.
And that's why insurance is a really critical piece of that, because most families can't afford the cash, uh,
pay version of long term mental health treatment. That would be in the hundreds of thousands of dollars.
Speaker 1
[00.09.08]
Yeah. And that's a I know that's a huge barrier for a lot of people. I mean, there are a lot of people who
don't even have insurance despite qualifying for Medicaid or whatever. And that's just that's another
hurdle to jump over. But, uh, people really need this care and they're not accessing it for whatever reason.
I keep hearing that, um, there's a huge shortage of therapists, at least in my state. Are you hearing that
where you are to like there's a there's a shortage of therapists. And I keep thinking, well, I don't have a
full schedule. And I know a lot of therapists who don't have full schedules. I don't think it's a shortage of
therapists. I think it's a shortage of affordability.
Speaker 2
[00.09.45]
I would tend to agree with you, um, for a couple of reasons. In Las Vegas, we have trouble with getting
therapists. Not because there aren't enough, because when I say again, a lot of therapists get into it with
this picture of like the couch and the nice office and writing on your pad and, and sort of like that, you
know, in treatment type show stuff. Um, and so they don't imagine themselves working and billing
Medicaid and, you know, getting the insurance rates that, that they may get that are far below what they
imagined. Um, and right now in Las Vegas, for example, there are a lot of private practices scooping up
all the licensed clinicians. And they're getting pretty, pretty decently. So it is actually hard to find
therapists. Again, not because there aren't therapists, but because they don't want to do the hard work.
They want the simple work. Um, dealing with teens in a residential setting is not the easiest.
Documenting for insurance is not not the easiest. Yeah. And and when you do typical obviously you can
cut me off whenever you want. But when you do, when you're a private practice therapist, a lot of them
it's just talk, right. You sit and talk and then we use some tissues and we talk again. And then we arrange
to talk again next week. But they can't actually speak to what they're doing in the session. What actual
interventions are you implementing? What is actually going on in the session? What changes are you
hoping to gain? What's the homework and what practical things are you doing right? If you're playing
soccer, you like, I kicked the ball. I passed to him, I passed to him. We had the strategy. We got to the
goal. We got one goal, right? They don't do that. It's just like I spoke. We talked a lot. But when you
build insurance, you can't do that because they want to know what they're paying for. And so for a
private practice therapist, it's a lot harder to work in our kind of setting. Um, and a lot of people just don't
want to do it that that's sort of one big piece of it. The second piece is, um, you know, qualified therapists
versus therapists. You know, as we talked about earlier, there could be a lot of therapists, um, not all
qualified. I'm not speaking to your situation. Um, and then the third thing is just purely business skills,
right? They don't teach you, like. Like you mentioned. They don't teach you too much about nutrition.
They also don't teach you how to build a business. Um, and most therapists don't have any idea how to
build a business, how to market themselves, how to connect with resources so that people send them
referrals, how to navigate online, none of these things. And so they sort of again, they open this office,
they rent a nice space, they decorate it. They're all psyched. They put the little shingle on the door and
like, nobody shows up. So you really do have to, especially nowadays with all the competition and the
internet, which is where everyone searches for everything. You really have to learn a little bit about
marketing and how to run your business effectively.
Speaker 1
[00.12.17]
You have to stand out among all the other marketing noise. And I'm noticing that. And where I live, we
have hundreds of therapists, and it's not a huge community. It's like maybe 100,000 people. I'm in auniversity town, lots of college students, but we have hundreds of therapists because it's a university
town. And this particular university has three different therapy programs. So marriage and family
therapy, social work and clinical psychology.
Speaker 2
[00.12.42]
Got it. So they're pumping
Speaker 1
[00.12.43]
out their own. And so yeah. So we've got new therapists every single semester. And that's making it
really difficult. But kind of to backtrack a little bit back to the discussion on residential treatment. I was
thinking residential actually has an edge on outpatient therapy because the therapist is more involved in
the patient's treatment where like in outpatient therapy, typically it's like one hour once per week. But in
a residential setting, it kind of depends on on the, the business, but usually it's a much smaller caseload
for the therapist. And that therapist is able to check in with that patient or that client pretty frequently.
And my am I right? Is that kind of how
Speaker 2
[00.13.30]
yours runs? Yes, I like how you reframe clients. I do the same thing patients. For people who need a fix.
They come to a doctor to get fixed. Clients or people who come and you help them help themselves.
Right? We're not here to fix people. We're here to help them work through their their own challenges.
But you are correct. The disadvantage of being a private practice therapist who sees someone once a
week or once every two weeks is you have no influence on the external environment once they leave
your office, that's the extent of your influence. That's also the extent of your data, right? All you have is
self-reporting. I did this this week. It was better for me. It was worse for me. But you have no way of
knowing in a residential setting. They're there 24 seven. So besides the therapists being able to check in
daily, you have staff and observations. Um, so for example, um, we have a client. I'm not using any
names, obviously, a young woman who came to us with a bipolar with manic features diagnosis, which is
pretty intense, right? That means like she's she and with psychotic features. Meaning that's pretty intense,
right? Like psychosis is a serious thing. Bipolar. Serious thing. Um, the client did not believe that this
was a good diagnosis. They felt that their parents had told the hospital that they were struggling in the
hospital just through a diagnosis at them. So this client refused to take medication. Um. Fast forward
within a week, the parents like, we must take medication. He's going to get terrible. It's going to be
terrible. It's going to be terrible. It's been eight weeks, and he's fine. There's no symptoms. Um, and we
know this because we've observed him her 24 over seven, and we can see all the elements that we need to
see. And so I actually had a call today with this child's advocate and with their parents. And I said, you
know, you guys are pushing for medication, but there's no moral basis for that at this point. The diagnosis
is maybe a rule out, but it doesn't stand, at least according to observations right now. If anything, if it did
exist, it's in remission. Um, so again, the ability to see that and not depend on self-reporting from a parent
or a kid or and the ability to control the environment, right, is a big deal.
Speaker 1
[00.15.28]
Yeah. And I, I can't tell you how many times I've had people come back because I do specialize in
nutritional psychotherapy. I've had a lot of people come back and they're like, oh, I didn't really do any of
the homework because I wasn't able to follow up with them between sessions. And yeah, like I could
send like a text message or something and some therapists do, but then that's time out of my day that I'm
not getting paid for. So in a residential setting, there's definitely a benefit to that, right? So the therapist is
still getting paid to follow up and to make sure that that these clients are being taken care of.Speaker 2
[00.16.03]
Correct. And if they're not paid for it, you still have the floor staff. Yeah,
Speaker 1
[00.16.06]
that's true. The support staff. So typically you sounds like you mostly work with with teenagers, young
adults. And I think you said families too, right?
Speaker 2
[00.16.14]
Yes, families and kids. In my private practice I actually deal with a lot of school age kids.
Speaker 1
[00.16.19]
What led you to focusing on on these younger populations?
Speaker 2
[00.16.24]
Uh, I think, you know the idea. I haven't written off adults. Okay. But with kids and teens, when you
make a change, you get the satisfaction of seeing that change, right? A little change has a much different
trajectory for a kid than for an adult. Um, at the same time, kids are super pain and teenagers know
everything. And, um, it's a very hard population to work with, but but it gives you a little bit more
reward, which is, again, as a therapist, you probably know you don't always get to see the results of what
you do. Um, and so being able to see that is very positive and reinforcing. Mhm.
Speaker 1
[00.16.57]
Yeah. And in, in my experience I have worked with kids. It didn't really click with me. I think it just it
takes the right therapist. Sure. And for some reason it wasn't clicking with me to to to work with kids but
then also having to communicate with the parents. That's just again, it's just extra work outside of the
session that you're not really getting paid for. Um, but then everybody's not really on the same page. And
so it can be it can be easier for a lot of therapists to only work with adults because you are only dealing
with one person. Yeah. But then you're right. I mean, it is hard work to work with kids, but I think that
actually has the greatest impact. And that's why I initially wanted to do that, because I was like, that is
going to make a huge difference for that person. If I can help them early on in life, rather than waiting
until they already have a lot of complex trauma, that's that's yet to be resolved.
Speaker 2
[00.17.52]
Yeah. well, the good thing about what you're describing is that you're sticking to where your
competencies are, meaning you know, where your strengths are. And a lot of people want to be, you
know, a jack of all trades, master of not and treat everything. And, um, sometimes I go by these
restaurants and it's like we serve Chinese pizza, chicken kebab, fish burgers, you know, Thai food. It's
like, okay, well, you got to pick one or maybe two and kind of roll with that because you want to be
really good and competent at what you do. And there are different populations and different challenges.
And I, for instance, couldn't work with the elderly because that's not my population, but a lot of people
specialize in that or chronic conditions or, um, people who are, you know, near death, so to speak, inhospice. These are really tough populations or prison, um, or who knows? But there's a lot of different
populations and therefore a lot of different types of therapists that might fit that. And since
Speaker 1
[00.18.42]
this is a little bit more of my wheelhouse, let's go ahead and allude to you. I know how you mentioned
nutrition being of importance in your residential center. How do you approach nutrition for mental health?
Speaker 2
[00.18.54]
So, um, as you already mentioned when we spoke before. Before the beginning is that, you know,
schools don't train you on this as it pertains to psychotherapy. Um, for a variety of reasons. And one of
the biggest reasons is because a lot of times, people fear the liability of, again, stepping outside their
competency, even though when it comes to nutrition, it really should be part of your competency. Right?
You have to understand all the facets of what someone's dealing with to make an appropriate diagnosis.
Um, and more often than not, you can miss out on a diagnosis by not knowing the whole picture. Right?
Is this kid acting out because X or is it because of Y? Right. Are these headaches coming because of
anxiety or because of nutrition issue? Right. Is the lack of functioning due to, you know, them having a
severe depression? Or is their ability to fight depression hampered by the fact that they're not going to
sleep till three in the morning? Right. There's a lot of elements that play into it. And so when we run a
treatment center, we have to be that broadly aware. Um, and so when people come in as part of our
assessment, like you said, bio psychosocial, um, we, we bring those elements in, um, and we look at that
and we seek to eliminate possible options. And when nutrition becomes an issue of note, we address it.
That's obviously besides the fact that we run a very tight, nutritious, nutritious program. Right? We're not
feeding them franks and blanks. And like we have everything designed by nutritionists. The health is
important. What they eat is important. How they eat it is important with whom they eat. It is important,
right? Especially with people who have budding eating disorders. You know who you're eating with. Is
everything right? Um, besides just the food? Um, so we do take that quite seriously.
Speaker 1
[00.20.33]
Yeah. And from my standpoint, how you eat it and who you're eating it with does make a huge
difference. I totally agree with you, because you have to be in a parasympathetic state for your body to
properly digest food. And so I was actually taught that the the digestive system starts with the brain.
Hopefully you're being mindful with your food. Hopefully you're feeling somewhat calm and hopefully
you have a sense of community. So that would be the the who you're eating with right. And you're not
eating with enemies. Because if you are, you're not you're not in a parasympathetic state. And for those
who aren't familiar, parasympathetic essentially means that calm,
Speaker 2
[00.21.14]
peaceful digestion about people who eat emotionally, right. That's not coming from the right place.
People who are anxious and feel nauseous and can't eat the brain definitely contributes a huge amount to
to all of it.
Speaker 1
[00.21.25]
So if you have clients who are say they're not eating the right way, how would you address that? Like if
they're in a more sympathetic dominance, the fight or flight?Speaker 2
[00.21.35]
That's a good question. Um, it partially depends on the client, right. You can't force feed anybody. Um,
obviously we're not talking about extreme eating disorders, where that's a very different situation, but,
um, where they may need two feeding, but, um, you can't force it. Force feed kids, but you can work to
do a couple things. Number one, um, to support their eating with some measure of reward, which is not
ideal. Eating for reward is not ideal. But in some situations you take the cards you're dealt. Um,
secondarily, through exploration. Right? Okay. Maybe you don't like this food. Why? Right. What foods
might you like? Um, you know, trying food experiences, right? I even do this in my private practice. I
have a I have a kid six, and he, like, eats two things and only those two things when I got started. And
even though my focus is on behavior in school and parenting, this is a big piece. And so we do food
tasting and texture and going through it and trying new things and identifying things at work. And then
building on that. I just said that this week we made a we both built forts out of the foods he hates and the
food he likes, and we made exchanges. I said, okay, I'm going to take one of them that you love, that you
hate. I'm going to trade for one that you like. Let's give it a shot. Turns out he likes cream cheese. He
thought he didn't write like little, little things like that. Um, but in a in a residential setting, you have the
ability to do that because you have more staff, you have the ability to modify the the menu because you
have a chef, right? You have the ability to offer incentives because you have around the clock program.
Um, and so you really have to work with what you're dealt with. And like you mentioned, people come to
our places in crisis, right? This isn't an outpatient setting. Um, and so they are inherently not in that state.
They need to be. Um, and so part of it is also getting them back to that state through the therapeutic
process. Um, and sometimes through a medication regimen, you know, if severe anxiety is preventing
you from eating because of a lot of reasons, not not the least, which could just be like, I'm nauseous and I
don't feel hungry. Um, the right medication regiment to help you with some of those nuances, at least
initially. It doesn't mean you have to do it for for life. Or at least to take you down. Take the take the fire
down a notch so you can clear the smoke. Then medication can also
Speaker 1
[00.23.45]
help. Yeah, medication was never really meant to be a lifelong thing, even though it seems to be framed
that way, especially psychiatric medication. And I know the research shows that it's way more effective if
you're getting therapy while you're taking that medication. The medication is meant to kind of give you a
boost. So that you can learn the skills and process the trauma while you're getting that boost. If you want
to support this podcast, go to kofi.com/codex. That's kofi.com/cody Cox. So how about like your clients
do they get a lot of time outside or like what does that look like as far as like time outside fresh air or
sunshine exercise.
Speaker 2
[00.24.31]
Good question. I mean, the reason I like the residential setting and more specifically we have small
residential homes or these are actual homes and actual neighborhoods. When you're sitting down to eat,
you're sitting at a table with other people. And the benefits of that is we like the opportunity that we get
to model real life, to model what it's going to be like in the home setting, to model how things should be.
Um, because this is a real life model with support and with role models. And so among those things,
obviously exercise is critical exercise, sleep, food, three critical elements that have nothing to do with
medication and have every impact on the mental health state. And so we have each house has a pool. We
have a little gym setting to each house. They go off site to boxing. We do hiking. Um, we take that very
seriously as part of what they do. Um, and again, for health, for fitness, for mood regulation, for
endorphins, for for everything really, even how to work with other people, camaraderie and teamwork
and so on. So yeah, it's it's a big piece. Yeah.
Speaker 1
[00.25.29]So it sounds like you're addressing a lot of things at once, which I think is, is really the best because it's
like I was saying before, we tend to focus more on the psychosocial part of the bio psychosocial, which is
only part of the puzzle. And so as you you encourage your clients to, to mingle with each other, they're
developing a sense of community, a sense of belonging, maybe a sense of purpose. So I mean, there are
some spiritual components in there as well. But but then more lifestyle things going outside, uh, cooking
meals together or enjoying meals together. So like just just different things. And I hope listeners are as
they listen to this or thinking, well, I'm not going to go to residential treatment, but. These are things that
I need to be doing
Speaker 2
[00.26.18]
too. That to me is is actually a big piece that I work with parents in the outside setting. How many
parents have this setup when they go to dinner? Right. You go to dinner, you cook the food and it sits
there, and then kid number one rolls in. A half hour later, kid number two is in their room playing. They
take the food back to their room. Kid number three is going to eat at midnight whenever they get hungry.
When they're done gaming. Dad is on the phone. Mom's here, mom's there. Right? There isn't a formal
eating process. And because of that, things fall through the cracks. What your kid is eating, what they're
not eating, what they may be struggling with. And so I always tell parents, one of the key elements to
building structure within your home is besides bedtimes and other things, we can discuss meal times at
least one meal a day. You should all sit at the table so that you can all eat together. You can see what
they're eating, you can make sure everyone's getting what they need. And obviously the benefits from a
psychological perspective is you're spending time together. You're talking, you're going through your
day, you're going through what happens. And ironically, it's more of a challenge for the parents do that
than the kids. Like, dad, mom, you're going to have to put down your phone. I hate to say this, but, you
know, put all your phones in a bucket and put the bucket in another room and give yourself 20 minutes.
Doesn't have to be an hour long party. 20 minutes, you know, don't you? Don't do much more. If it's too
much, it's too much. But at least 20 minutes you can't carve out. You can carve out 20 minutes to go to
the bathroom. Um, so that that is a huge piece like you mentioned. This is a perfect example. Yeah. And
that can be hard for some families. Maybe they don't have, um, a sense of trust between their
relationships. And so, uh, for some kids, it might feel like forced family fun. Right. And so what would
you recommend for a family like that? Like where, I mean, maybe the child wouldn't really want to do
that. Maybe. Maybe it is a teenager who's a little bit defiant and they need a little bit more of a.
Speaker 1
[00.28.08]
A little bit more support in developing a stronger relationship before they can eat dinner with their family.
Speaker 2
[00.28.13]
So that's that that's. Well, let's start with that's an excellent question. Also, a little bit of a complicated
question. Um, so if you're talking about eating disorders, you would be correct. Right. Who you eat with
like we talked about and how you eat and what you eat is important. And a lot of times if they don't feel a
family has that understanding and many of their siblings do not have that understanding, and the family
does not know how to adequately respond to their concerns or what's really triggering them, what their
actual thoughts are in their head as they're eating or not eating. So there it is, more complicated. And
there you do have to get professional help and people involved to help navigate that. And you have to
become very educated. But your general college rebellious teen or just call it teen, um, you know, you
know, hanging out with their with their parents is not the most exciting thing in the world. But at the
same time, if you told your teen, hey, um, sorry, my headset just fell out. Um, if you told your teenager,
like, hey, um, I'll give you a ride to the movies, it's going to take us 20 minutes to get there. They'll figure
out pretty quickly how to sit with you in a van. Um, so it doesn't mean that you have to have long
conversations or kumbaya, sing songs, hold hands, or even talk too much. But to be present is just to be
present and to teach him to be present and be mindful with your food and and just exists around otherpeople. And as a parents, you know, these are certain things you should be pushing. And again, if you
have to reward it, okay. Reward it. Not a 1 to 1 correlation. Not like here's a meal, here's a dollar. But
you know, overall if you participate we'll work on X or we'll get Y or we'll get Z. Um, that's usually my
best recommendation. I don't recommend forcing or kicking down doors or things like that. But you can
do certain things like, okay, just understand that after 7:00, the kitchen's closed, you're not going to come
in and graze. There's not going to be extra food just sitting around for you. If you don't eat now, then,
then that's it. We're not going to be like making second, third and fourth meals. And that's to some extent
helps.
Speaker 1
[00.30.11]
I follow pretty closely autism and it's linked to nutrition and more like ancestral principles to nutrition.
Um, and they say that if you have an autistic child, maybe they're very, very picky with food, but. All
you have to do is keep putting the food in front of them. They have to be exposed. It's something like a
minimum of 15 times before they'll finally start to accept it. They're not going to starve to death even if
they don't eat for several meals, they're not going to starve to death, and eventually they'll start eating.
And so maybe that's all it takes. You just have to be consistent with these these family meal times. And I
totally agree with you. At least one meal a day. We're so busy we can't make it three meals a day for most
of us, but one meal a day, usually that's dinnertime for most of us. Just have that. Maybe it's a standing
appointment 6:00 every evening we're going to have our family dinner, and we're not going to go and and
offer alternatives to the people who are picky. We're not going to offer another meal to the people who
aren't able to be home. It's just this is dinnertime. And that's.
Speaker 2
[00.31.19]
Yeah, and you're 100% right. And one of the things in dealing with kids is behavioral interventions. If
you make adjustments to everything, more adjustments will be requested. Um, if you allow certain
things, more things will happen. And that doesn't mean you have to turn into a drill sergeant. You don't
say you must eat now. It's like it's a natural consequence if you don't eat. The restaurant closes right from
6 to 620. The restaurants open, um, and then the restaurant closes. It's not a punishment, but I'm a mom.
I'm a dad. I can't keep cleaning the kitchen. I can't keep cooking food. And that does start to get them to
go, okay, here's here's the time I eat. For example, um, as a therapist, you're familiar with doorknob
therapy, right? Someone comes to a session. They talk about very little during the session. At the very
last minute, as they're walking out, they're like, oh, remind me next time to tell you about this time I was
attacked. Um, and the whole purpose of keeping a session limited to 45 minutes to an hour. So let them
know this is the time. If you're going to talk and you want to open up, it's in this space. It's not going to
be afterwards. It's not going to be via text for six hours. This is your space. And by conditioning that it
becomes their space. Um, and that is that is a principle that applies across the board when it comes to
spectrum. You are correct. They are very picky and not just because of the food itself, but the taste, the
texture. These are these are things that that are. That become very problematic. Right? It's it's the, uh, that
that whole piece of it. Um, and that's an example, some of the things I mentioned I do with kids, like you
have to just keep keep going at it. Right. You got to keep trying, keep trying, keep trying. Um, and
slowly navigate it and come up with clever ways to get them to try things right, like I did with the trade
off he got. He got the candy he wanted. He got to try the cream cheese. Right now. He like cream cheese
because you discovered it, but you don't want to touch it before, um, you know, you learn what they don't
like about something, right? Squishy tomatoes versus firm tomatoes. There's a big difference. And I'm
not even on the spectrum. Um, so you kind of have to learn little elements like that.
Speaker 1
[00.33.16]
And even if your child does not have autism, maybe it's, uh, just a picky child. It's the same principles. I
mean, and I'm dealing with this with my own children where, like, I've got one who just doesn't eat a
whole lot of what we give her, but the more we offer it to her over time, she eventually starts eating it. Ihave noticed that, and sometimes it takes a few months or a few years, but eventually they try it. And so
if you're a parent and you're having a really hard time getting your your children to eat together as a
family or just eat healthy food, just be consistent. Keep trying, but do it gently. We're not forcing.
Speaker 2
[00.34.04]
All right? Correct. Parenting is about being consistent. That is a number one thing that parents do not do
well, whether it's rules and implementing them, whether it's, you know, telling your kids, do as I say, not
as I do, and being inconsistent by your own behaviors, whether it's inconsistent, see about follow up,
whether you promise things and don't come through on them, whether you don't. Consistency is the key
to everything. How you do things, if it's done consistently, will result in positive change or whatever
change you're looking for. Hopefully not a negative change.
Speaker 1
[00.34.32]
I think there is some value in having a routine every day. Your your morning, your routine, your bedtime
routine, having a set schedule. I do think in some ways it's also limiting on the opposite end of the
spectrum. But but we need to have some kind of routine that that makes us feel like. Like we know
what's happening. We know what we're supposed to be doing. And I think ultimately it ends up being
more productive. But then you need you do need to have that flexibility where sometimes your routine
doesn't quite work out. Like maybe, maybe you have an appointment in the evening and it gets in the way
of your family dinnertime. And so everybody just kind of has to fend for themselves that day. That's
okay. But just jump right back on that routine as soon as you can be as consistent as possible. And it's not
going to be perfect, but as consistent as
Speaker 2
[00.35.25]
possible. And as long as it's a change from the norm, right. Obviously in life things change. But if this is
if you're doing it right, then that change is recognized as not the norm.
Speaker 1
[00.35.36]
Yeah. In your residential center, how how long is the typical client there?
Speaker 2
[00.35.42]
Good question. On average, um, the advantage of our kind of setting is it's driven by acuity, which means
as long as they're struggling to some extent, they will qualify for continued care through the insurance
company. Um, on average, that ends up being around 90 to 120 days. Um, the residential setting is not
designed as a fix. All, you know, I believe in the belief is in the clinical world that you want a kid to be in
the least restrictive level of care possible. So you're in residential when you cannot function efficiently
outside of residential. But once you can, you may still struggle with a lot of things. But once you can
function in outside environment, then you would transition to a PFP or IOP day programs, things like
that, and that's optimal. Um, so on average about 90 to 120 to get them stabilized to the point that that
they can try their skills in the outside world. And
Speaker 1
[00.36.31]
how how severe should a person be before someone would consider going to residential treatment?Speaker 2
[00.36.38]
You're asking a whole bunch of great questions. Um, it's very nuanced. Um, so it depends on what you're
dealing with. So, for example, um. A kid may be able to maintain from a therapeutic standpoint. They
can deal with their depression with an outside therapist or anxiety, but they're engaging in super high risk
behaviors, right? Driving the car without permission, flipping the car, sneaking out the window, having
sex with strangers, talking to random people on the internet. So if they can't be maintained safely and
effectively in the outside environment, that might be a qualifying criteria. Um, if they're home but they're
depressed and they're anxious, and a regular therapist can't handle enough because they're becoming
suicidal or self-harming, that might be a qualification. Um, if they're explosive at home and things get
violent and the police have to be involved and they're not in school, that could be a qualification. So it's a
mixture, especially with kids more so than adults, of how strong is the mental health component, how
strong are the other components. And the biggest question is can this child function effectively in an
environment outside of a residential setting? And if the answer to that question is that they cannot right
now, then residential makes sense. And the minute the answer is they can then residential stops making
Speaker 1
[00.37.49]
sense. Yeah. And I see that a lot where I've got a lot of university students as clients. And some of them,
I would say are pretty nonfunctional. And I would say maybe residential would be good for them, maybe
that they're not usually suicidal. And so that's where it's like kind of a blurry line where it's difficult to
clinically make that judgment. I think most therapists would agree, though, that if they are, if they have a
high degree of suicidality and and they are not functioning in life, that would be a good referral to
residential treatment. But then there are these other cases too, where maybe it's just a high degree of
defiance or social deviance. I guess that's more of a socio sociological term, but, um, they're just not
getting along in the community, I guess is a nicer way of putting that. Um, maybe those would be good
candidates for residential as well. And I know you mentioned substance abuse. You do a little bit of of
substance abuse work. So what degree of substance abuse would warrant residential
Speaker 2
[00.38.58]
treatment? Um, so I'm going to answer your first question or statement. Um, in terms of behavioral,
you're right about the ability to function within the community. Um, the the thing about teens versus
adults is, at least from an insurance perspective, they do the adults as having free choice. And from the
legal system, they view these adults having free choice even if they're extremely suffering. They imply
that this is the choice that they may. They are choosing to be this way. With kids under 18, they can't say
that these kids are minors. These kids are under their parents support. And because they can't say that,
and because you can hold the teenager against their will in a treatment center versus an adult who can
just walk out. The behavioral type clients tend to end up being teens, and the behavioral adults end up,
unfortunately, in a hospital or in jail or other things like that. Because, again, they view the impetus for
the issue differently. Right? And the same thing with addiction. They say, look, a kid being an addict is
because he's a kid. We need to get him help if something happens is terrible, but an adult is choosing to
use these drugs, right? They don't recognize them as the same thing. Um, and so when we deal with.
Substance use, especially as it pertains to teenagers. We also view things from a different lens, and it
helps get rid of that whole idea that it's completely free choice to be an addict. Addiction is, in a large
part genetic, which people don't recognize. An addiction qualifies as a mental health disorder, which a lot
of people don't recognize. Um, you know, viewing it as a moral choice is antiquated at best. Um, but with
teenagers who don't have ten years of alcohol, five years of heroin, 20 years of, you know, marijuana,
whatever it might be, they're using, um, you really are dealing with an underlying mental health condition
when you peel it back. And usually they're self-medicating to cover other things up. And so even though
we treat addiction, we treat it from a mental health lens, which makes it just a little bit different.Speaker 1
[00.40.49]
I know a lot of wilderness therapy programs. Well, I mean, it's I guess it's it's a natural part of wilderness
therapy to take away electronics. Is that something that you do, too, as part of the residential treatment?
Like you remove electronics from the teens life or, I mean, they might have some access to like email,
home or whatever. Like what? What do you think is best for that?
Speaker 2
[00.41.14]
Um, so you are correct. Uh, cold turkey is the way to go with teenagers because oftentimes they connect
with the same friends. They call for help. Um, kids will come in and hide drugs or other paraphernalia in
the bushes. Um, their negative influences can reach out to them. Obviously, social media access all that is
not a good thing. It's kind of a culture shock. When they show up, they have to hand in their wallet, their
phone, their condoms like they assume it's going to be a party, you know, a rehab party. Mhm. Um, and
it's not that um, so we do disconnect them from everything. You have email for school, right. You use a
computer for school. But um, it is critical to separate them from all of that because again when you're
looking at an issue, you have to look at the issue completely objectively and and clear of all other issues.
And having social media and all these other things can actually contribute to their mood changes and all
the other things we're trying to address. So we really want to separate it nice and clean. Okay, now we're
looking at a kid. Now what are we doing right now? What our interventions. What is the diagnosis
without it being muddled by all the other factors that exists in their home environment?
Speaker 1
[00.42.16]
Mhm. Yeah. And that can be really difficult. And I'm not sure if there are any official withdrawal
symptoms from electronics. So I mean we were talking about substances a minute ago and that made my
mind transition to just general addiction. Um, obviously we're also if this is a problem for them, we're
helping them abstain from sex addictions or what other addictions are there, sugar addictions, um, or
particular process addictions. And do you know if there are like do people deal with withdrawals from
things like
Speaker 2
[00.42.53]
that? Good question. This is all relatively new. There are definitely some studies as to the impacts. I can
tell you from teenagers, the most obvious withdrawal is they become obnoxious and they become bored,
and they don't know how to fill their time, and they become anxious and they become a lot of parents use
technology as a thing just to keep their kids entertained, right? I put it in front of the screen and not drive
me crazy. Um, so so to some extent you see withdrawal in their behaviors. It's not the same withdrawal
as like the physical withdrawal of like, heroin or something. Um, and you're not necessarily feeling for it
like you might for other process addictions. Um, but certainly for teens, it's a, it's a big piece. And even
adults, you know, adults who are basically adolescents of an older age who maybe never learned to be
social and lived around a computer. And they're gamers, and that's their whole identity. And so removing
them from that, you know, can have a really big effect mentally, which then could look like withdrawal
symptoms. But it's also like, who am I now without my technology and what am I and where am I going?
I'm so anxious this is going to be miserable, right? These are all, you know, a form of withdrawal, but not
quite the withdrawal that you think of. So
Speaker 1
[00.44.02]
kind of an identity crisis or emotional instability, at least on the temporary, until they can stabilize and
become mindful with the present and, and learn that life is okay without these things. Correct. I wish asadults we could get away from these things too, sometimes, and many of us do. Like we go hiking or
camping on the weekends. But then at the same time, we've got our Monday through Friday jobs. And
we've got all these demands, a lot of responsibilities, especially if we're parents or or highly educated
professionals. So what would you recommend for the average adult who's having a hard time getting
away from those things,
Speaker 2
[00.44.46]
as you sort of highlighted, not like people considered therapy. The, the um, what's the word? Uh, the, the,
the, um, benefit of the wealthy, so to speak, or something that, you know, if you can afford the time to
see a therapist, pay for a therapist and take a time out of your day, that's a luxury. And it is true. Not a lot
of people have that luxury. People have to work 9 to 5 or 9 to 9 or, you know, who have to work to
survive. You don't really have the time or luxury of putting that down and going for a hike or or doing
any of the things we've talked about, even though they're important. Um, so there's kind of a twofold
process to that. One is learning to do that while you're moving. Right? So maybe if when you work 9 to
9, you're always on your phone, put it down for ten minutes and read a book, right? Um, you know, there
are ways you can do it within the context of your day. Um, if you do have the luxury or ability to
disconnect, then do that. I myself, I'm sort of in the middle. I have the ability to do that, but I work. I'm a
CEO of a company and I'm getting calls and text 24 over seven, um, to, you know, to my wife's chagrin,
so to speak. But but, um, I actually downloaded an app where, um, you basically have to do a certain
amount of push ups or sit ups or pull ups to open your apps. Um, which was pretty fascinating. Um, but
at some point it became so annoying, given the volume of things I needed to do, that I just disconnected
it. So I'm a bad example of what someone should do. But I definitely know that, um, I would love to be
that way if I could.
Speaker 1
[00.46.22]
And I mentioned this on a recent episode, but my strategy is to have people switch their phones to
grayscale because at least if it's grayscale, you can still mostly do everything on your phone. It doesn't
lock you out, but you get way less of a dopamine hit that way. It's much, much more boring to the brain.
And so typically when I have clients do that, as long as they keep it on grayscale, they report great
success with it. But then occasionally, of course, I get that person who comes back and they're like, oh, it
was just annoying. So I turned it back on color. Um, the other strategy, and I think I mentioned this on
another episode before too, is if you've got an iPhone, there's the screen time settings or I'm not sure what
Android has, I'm sure they have something similar. But often when people turn on like the the screen
time limits, maybe it's you set your your phone to limiting you to like two hours a day of screen time. I'm
just throwing out around random number here. No, no. And that that notification pops up and says you've
hit your limit for today. Most people will just manually override it and keep doing what they're doing.
But I always say it still has value because it still making you think twice about your screen time, where if
you have that turned off, you're just going to go crazy with it. It's going to be so many more hours. You're
not even going to be thinking it's too much. Well, Mindy, we are coming up on the end of our episode. If
there is one thing that you think people could do to change the way they approach health and wellness,
what do you think it should be?
Speaker 2
[00.48.05]
Um. Education. Education. Education. Education. Education. We assume we know everything. We get
our information from all the wrong places, taking a little bit of time to educate yourself, whether as a
parent educating yourself about the struggles your teen goes through, that or about parenting as an adult,
learning about depression and how that works. Um, learning about how medications interact, learning
about strategies to do different things right. People shoot from the hip when the reality is, are
professionals out there? There are books out there. There are well-established principles out there.
There's research out there. Um, and so I recommend the number one thing you can do to help yourself oranybody else is to get educated. And with today's access to everything, it's really not that hard to get
educated. Um, it's actually quite fascinating. I saw an article today that ChatGPT functioning as a
therapist and answering people's questions has been rated higher than an actual therapist, which is kind of
shocking. But, you know, you can you can get yourself educated utilizing almost any tactic out there.
And it'll even do the research for you. Right? Give me some strategies for dealing with depression. What
are some of the things people think about when they're, you know, trying to get a meal together?
Technology has come a long way, so getting yourself educated to ask the right questions, getting
strategies is is the key really to everything. And consistency
Speaker 1
[00.49.22]
obviously. Yes, I love the education. Um, I know historically, at least before the internet, people would
rely on authority figures for education and I mean maybe books, but typically they were written by
authority figures too, right? Nowadays we've got the internet, we have access to so much more
information. And I mean, I'm not saying it's all good information. I would even say most of it is not the
best information, but I would encourage people to just consume this information with an open mind.
Think critically about it. Don't just trust everything you hear or everything you read because you
mentioned using ChatGPT. And I was like, I know a lot of people who are using that and they're relying
on it right now. But as long as we can keep a critical mind, we can keep our sanity at the same time and
and glean the benefits from it. Uh, one last thing. If people wanted to work with you, how can they find
Speaker 2
[00.50.21]
you? Mendy. Baron. Mhm. Andy Baron
Speaker 1
[00.50.26]
okay. All right. Thanks so much for being here Mindy. It was great talking to
Speaker 2
[00.50.30]
you. Likewise. Thank you for your time.
Speaker 1
[00.50.32]
If you enjoyed this episode make sure you leave a review. That really helps me out and also subscribe to
the show wherever you listen to your podcasts. Real Food Mental Health is intended for informational
and entertainment purposes only. The information presented on this podcast is not intended to replace
any medical advice, diagnosis or treatment. While I am a health care provider, I am not your provider.
Always seek the advice of an appropriate health care practitioner with any personal questions you may
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