Listen to the full interview here
Welcome to Coffee with a Coastie. I had the pleasure of sitting down with Mindful Recovery Services founder, Alex Wilson. After being helped by counsellors to navigate her own difficult teenage years, Alex has gone on to forge a successful career in mental health, helping teenagers and young adults. Alex’s journey is one of inspiration, so I was excited to get the opportunity to chat with Alex.
How did you come to live on the Central Coast?
My husband’s originally from the Central Coast, and when we first met in Sydney working at Royal North Shore Hospital, he introduced me to Avoca. Then when we were planning to have kids, we wanted to move out of Sydney, for financial reasons and the environment here just seemed good for raising kids. So we moved here when our eldest was four weeks old and we’ve been here ever since.
Before working as a social worker at Royal North Shore Hospital what did you do and what influenced you to become a mental health social worker?
I went straight from school into a social work degree at Sydney Uni, then straight into hospital social work. Starting in critical care settings, like emergency departments then I fell into mental health after having had exposure to mental health working in emergency departments. It wasn’t my plan to specialize in mental health, but a job came up that sounded interesting, and I took it. It was in community mental health, and I found that I loved it.
It all happened in a roundabout way when I was a teenager, I was very difficult. I gave my parents hell and did not want to do what I was told; my teenage years were quite rough, I was getting kicked out of school and just not complying to anything. My parents ended up sending me to a boarding school in America for two and a half years, so that it got me out of the country. At the boarding school I was lucky enough to meet counsellors that I bonded with who helped me navigate that time of my life. That’s why I went into social work and then moved into mental health so that I could help teenagers and young adults in particular.
You specialise in Dialectical Behavioural Therapy (DBT), which was developed in the late 1980s to treat borderline personality disorder and chronic suicidal thoughts. Can you share a little about DBT?
Until the development of DBT there was really no treatment for borderline personality disorder. When DBT came along, finally we had something to treat this. Borderline personality disorder can be a funny diagnosis, because it’s a diagnosis of exclusion. People usually get diagnosed when doctors are like, it’s not anxiety, it’s not depression, it’s not bipolar, it’s not this, it’s not that, it must be borderline personality disorder. One of the most difficult things about Borderline Personality Disorder is it often involves chronic suicidal ideation. It is still one of the deadliest mental illnesses, having the second highest fatality rate behind anorexia nervosa.
The difference with DBT is that it’s aimed at people with risky behaviours, whereas other psychological therapies are not, and one of the problems we still have in our community is that we have this gap between “regular” psychology services which are for mild to moderate acuity issues. Then you’ve got nothing up until the hospital services, which are acute mental health services for people that need hospital admission. There’s a big gap in between, and that’s where DBT fits in. It was designed to work with risk, and the original research showed it to be a gold standard for treatment of borderline personality disorder and suicidality.
Now lots of studies also show it’s effective for drug and alcohol issues, eating disorders and when people are struggling to regulate their emotions.
Mindful Recovery Services focuses on providing mental health treatment and support for teens and young adults struggling with complex mental health issues. What was it that inspired you to go out on your own?
When I was working in the public mental health system, I worked within community mental health teams and inpatient psychiatric wards, where I was involved in starting a DBT program. This was my first exposure to DBT therapy, where I got to see first hand how effective it was for clients that hadn’t responded to other things before. When I decided to go out on my own it made sense for me to focus on DBT because I’d seen how effective it was. I really loved working with that client group who previously had really poor outcomes. Up until we had a DBT program, we just couldn’t offer them very much. I was passionate about DBT and wanted to move into private practice because to be honest, I got sick of all the red tape. I felt like there was so much that would take up our days that we barely got to see clients in between it all. So I wanted to move into private practice where the bulk of the work is just seeing people and not having all of the other bureaucratic stuff to deal with.
Lastly, if a parent is concerned about their child’s mental health but is unsure how to approach them about it, what would your advice be?
The first piece of advice I always give is choose your timing wisely. Don’t try and talk to them when they’re stressed out, just home from school, in the middle of an online game or in a text battle with their friends. Try and create activities where you know you can talk to them. This might be when you get them in the car and you have a captive audience, going with them to take the dog for a walk or taking them out to lunch or a shopping trip, timing is really important. When everybody’s calm, that’s when you’re going to have your greatest chance. Otherwise, you’ll just get a door slammed in your face.
Then ask questions, listen, and just shut up. Talk less, listen more. An example could be that you say, hey I’ve noticed you don’t seem like yourself recently or you seem upset and/or stressed out, do you want to share what’s going on. Then just shut up and listen. If they say they don’t want to talk about it, respect that and let them know if they do want to talk, you’re there for them. You could say, I don’t have the answers, but I’m happy to listen, that will often get them talking. What young people don’t want is advice. But if you listen first, they may be open to some advice if it’s delivered in the right way. But you have to listen first. You could tell them that you’ve noticed that they are having a hard time, and you’re just there to listen. Plant the seed and leave it alone. You can revisit it, and if eventually they start talking you’ve got to stick to listening.
Don’t jump into, well what you should do is ABC, just listen, validate, and ask them what they think might help. If they don’t know or don’t want to share, you can start to plant seeds and ask; do you want to maybe talk to a counsellor? I could ask around and see who might be good. Do you want me to research it for you? Do you want me to book the appointment?
You can do all these things to help without saying, you should do this. As soon as you tell a young person what they should do, they’re not going to do it. Listen more, talk less.
If you are concerned about suicidal stuff, ask flat out, just ask. And if they say they are having suicidal thoughts, the mental health access line is a good place to start. They’re a community team and if there’s any concern of imminent risk, they can get all the right services involved right away. If not, they can direct you to where to go. If you’re not sure, just ask. It’s not going to put the idea in their mind. That’s not how that works. Young people are aware that suicide is a thing. It’s not like we’re introducing them to the idea. Research says around 90% of people who are having suicidal thoughts will tell someone before they act on them.
If we ask the question, we are creating an environment where we’re saying, I want to know if you’re having these sorts of thoughts. This way we can intervene early so that it doesn’t get worse and worse overtime. If you get a response, you’re not going to freak out and you’re not going to ignore it, you’re going to do something in the middle, this tells the young person, oh, okay, this is something that I can talk about. And we want them to talk about it so that we can do something about it. It’s not going to give them the idea. They are very aware that this is something that happens. So, if we provide an environment where they can talk about it, they will. Then we obviously want to take the steps to do what we need to do, to keep them safe.
If anyone would like to find out more about Alex and the work she is doing to help teens and young adults, you can find her online at mindfulrecovery.com.au
Click here to hear the full conversation where I talk to Alex about:
• Building resilience in children
• Practical ways to deal with and work through anxiety
• Her love of Martial Arts for her own mental health
• Alex’s most vital DBT skill essential for change, the Distress Tolerance Curve
• Identifying and understanding your values
• Advice if living in a difficult environment
• The diver’s reflex and how to use it when experiencing panic disorder
• And so much more to help you and your child
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