Mental Health
By Marsh Naidoo
Rose Reif is a Licensed Clinical Mental Health Counselor, a Certified Rehabilitation Counselor, and a Qualified Developmental Disability and Mental Health Professional. Her private practice, Reif Counseling Services, focuses on providing support to adults with congenital or acquired disabilities and the people who love and care for them.
What is Rose’s Background?
Rose was a case manager working with adults with disabilities for many years. She ran an independent living program and really loved that work. Over the years, she started to see that there was not a lot of mental health support for adults with disabilities. This prompted Rose to go grad school and obtain a Master of Science degree in Rehabilitation Counseling and Psychology from UNC’s School of Medicine. About six months into her practice she started to receive a lot of calls from parents of younger kids with disabilities. The feedback she got from parents, usually after they read her blog or heard her speak was that Rose "got it" in a way that other therapists rarely understood. Her practice grew organically and now eight years later her caseload is a 50/50 split between serving adults with disabilities and those who love them.
During a recent podcast interview with Rose we talked about quarantine strategies for this period of social distancing. Rose points out an important consideration, that social distancing does not equate to emotional distancing. These are some of her thoughts from the podcast.
What are Rose's Coronavirus Strategies?
Strategy: Lower the Bar.
We are all guilty of looking at social media, looking at the color-coded school schedules, seeing people who have taken this time to do some wild woodworking projects or repaint their house, and feeling like we should be doing more, feeling like we're not doing enough, or feeling like we're not doing it right.
There is no right way to do a global pandemic. If you are meeting your child's emotional needs, if you're taking care of your family at a very basic level, food and shelter, you've done it! You have done the day. You have done all that you need to do.
So whenever you can, reduce the expectations you have of yourself and reduce the expectations you have of your child. I have talked to a lot of people who are saying: "But I'm an introvert, I love staying home and this should be easy for me. Why does this feel so hard?" Because we don't have a choice. Acknowledging that our choice has been taken away and that we feel very powerless right now is huge. Whatever you have to do to get through the day is fine. There are certainly other specifics that we can talk about like limiting your exposure to the news to those times when you really feel up for whatever it is you might come across.
On the flip side of that is to really focus on what things are within your control. For example: It's a beautiful day and I want to go for a walk with my family however it starts raining. I can still control if we get exercise. I can turn on a dance video and have a party in the house and move our bodies. So I can't control the weather, I can't control what kind of exercise we get or if it'll be outside or inside but I can control that we do it.
Looking at your day in that way will help you regain your sense of power and control. I think that's what we're all craving right now in this uncertain time.
Rose's Quarantine Strategy Takeaways:
Reduce the Expectations.
Acknowledge that our choice has been taken away and that we feel very powerless.
Focus on the things that are within your control.
How do you explain a pandemic to a child?
There are a ton of great resources out there. You can google how to talk to kids about this and then get more into the specifics. For example, kids with anxiety may need to hear things in a certain way versus kids who have some intellectual disability who may need to have things presented very visually.
I know for my own kids who are seven and nine years old, I showed them a clip from the TV show Scrubs. It showed that when hands touched how germs transferred and how it spread when people are close together. It talked about what would happen if everybody separated and how that would limit the transmission. Understanding that, even though it feels very boring, we are helping a lot of people by staying home.
And then I talked to my own kids about we can choose to be frustrated by this time or we can choose to find the good. It's okay to talk about the things that frustrate us but we also want to balance that by talking about things that we're enjoying. We're not enjoying that we can't go out to eat as much but we are enjoying cooking together as a family.
Why are special needs parents equipped to tolerate the stress of Coronavirus.
When this first started and when we were given the stay at home direction, I remember so many of my clients saying this really hasn't been that tough and I was surprised because they were saying that they have already kind of done this. They already heard news that felt really overwhelming and they weren't sure what they would do with it. They have already had to isolate themselves from others socially a bit because of their child's medical needs. So for a lot of the parents I work with certain aspects of this just didn't feel difficult, which is why I wrote the blog postWhy are special needs parents equipped to tolerate the stress of Coronavirus.
Rose Reif
Rose Reif
Rose's website www.reifpsychservices.com offers an amazing blog resource titled The Mental Wellness and Disability Blog. She also has a facebook group, pinterest presence and (Shhh!) I can't wait to collaborate with her in the near future. This blog is just a segment of the podcast transcript, so hit the red button above or head over to the Raising Kellan Podcast on Apple or Spotify for the in depth convo...
Transcript
Marsh Naidoo (00:16):
Welcome to this episode of Raising Kellan Podcast, to motivate, inspire, and educate parents, raising kids with special needs. I am your host, Marsh Naidoo, and this is a crazy time. Indeed. It is Wednesday, April the 22nd, and most of us have been on a lockdown or a self-imposed quarantine due to the Coronavirus for about a month now as a family. We were in St. Louis when news of this pandemic unfolded. We were at St. Louis Children's Hospital for a therapy intensive from about the 16 to the 20th of March. As the week progressed within the hospital itself, things were in constant flux. You can hear more about our journey during this week by going ahead and listening to our short mini-episodes that we did each day from day one to day five, and you can find that between episodes 13 and 14 on the Raising Kellan podcast, it's been about a month now, guys and schools are closed, Parents at home trying to juggle, doing remote work, learning the take that's needed to do remote work, trying to keep up with the kids, trying to keep up with the finances, and basically just trying to survive living in these close quarters.
(01:55):
And with non-essential travel, being discouraged is really a catalyst for freed nerves. And what we've decided to do is actually reach out to three experts and their fields to provide our listeners with some strategies to help them. During this unprecedented time, we are gonna be hosting a mini track. Guys, this many tracks is gonna consist of three episodes of how to navigate the Coronavirus at home. Episode 17 is going to be a talk with Rose Reif, a licensed clinical mental health counselor from Carry North Carolina. This episode is actually going to be taped later this morning, and we'll air this coming Friday, April 24th. Episode 18 is a talk with Madison from Litz Yoga Perth. That's right, that's Perth Australia. Madison is an OT slash yoga teacher, and she has moved her practice online to teach relaxation and mindfulness to those kids with special needs.
(03:20):
So I am super excited to be chatting with Madison. That episode will air on May, the first, May day. Episode 19 is a talk with Misha David Doe. He's actually an educator based in Nashville, Tennessee that has founded a new Leaf preschool. This preschool is based on the regular methodology. I hope I'm saying that right. Misha and Misha's gonna talk about the restorative power of being outdoors as well as the signs behind it. So three jam-packed episodes full of tips and tricks for us to sink our teeth into, and those will all be airing within the next three weeks. Today we are going to kickstart our quarantine strategy series by talking with Rose Reef of Reef Counseling Services. Rose is from the research triangle area. Welcome to the show, Rose.
Rose Reif (04:50):
Hi. Thank you so much for having me. I'm so glad to be here,
Marsh Naidoo (04:54):
Rose. I love geography and yes, I could have Googled it, but I love hearing from a local where is the research triangle. Tell us about where you are located at.
Rose Reif (05:06):
Sure. So I am in central North Carolina and the research triangle refers to an area that's Raleigh Durham and Chapel Hill, North Carolina. And I am in a small town right inside of that, it's called C, so C A R Y, and that's where my practice is.
Marsh Naidoo (05:26):
All right. Well, Rose Guys is a licensed clinical mental health counselor. Her private practice focuses on a very niche market in that she provides support to adults either with congenital or acquired disabilities. So when we are talking about congenital or developmental disabilities, we touch on things such as cerebral palsy, autism, or down syndrome, <affirmative>. And when we talk about acquired disabilities here, I guess rose, are you talking more about patients with spinal cord injuries or
Rose Reif (06:10):
Spinal cord injuries? Traumatic brain injury. I work with a lot of people who are recovering from stroke and have language disorders like aphasia. So just across the spectrum of things, ways that people can be different.
Marsh Naidoo (06:26):
So what kind of caught my eye was that you also counseled caregivers of those with Disabil. So yes, I mean that would be myself as a parent creating a child with cerebral palsy, but also spouses <affirmative>. Tell me a little bit about that Rose.
Rose Reif (06:45):
Sure. As you say, it's a very unique niche. There are not too many other counselors that have that specialization, and I'll be honest, it's not one that I intended to have either. My background is I was a case manager working with adults with disabilities for many years. I ran an independent living program and I really loved that work. But over the years, I did that for about a decade and I started to see that there was just not a lot of mental health support for adults with disabilities, whether that was developmental disabilities, or brain injury, just around our community. There wasn't anyone who said, Those are my people, that's who I wanna support. And finally, I said, You know what? We need to have somebody in this area who can meet the mental health needs of this community, and so I'm going to become that person.
(07:40):
So I went to grad school and started my practice straight outta grad school which was almost eight years ago at this point. And maybe six months or so into practice, I started to get a lot of calls from parents of younger kids with disabilities saying, Look, I know I'm not really who you advertise as working with, but I've just read your blog or I heard you speak somewhere and I just feel like you get it in a way that other therapists I've tried to talk to haven't really understood what our life looks like and what my future, why it's so different for me than for everybody else. And so would you see me too? And so it grew really organically to now eight years later, my practice is about 50- 50 split between adults with disabilities and the people who love them.
Marsh Naidoo (08:28):
I think that's a perfect segue talking about your blog, which is called the Mental Wellness and Disability Blog on Rose's website called reef psych services.com. This blog is a virtual gold mine. Let me give you guys an example of some of the articles that I've read through. In June of last year, Rose wrote about the caregiver self-care advice that no one will tell you. Yes indeed no one does tell you, but this article is just loaded with information. The second article, which I think is really poignant was Is it wrong to feel grief when your child is diagnosed with a disability? And the most recent blog, which I really thought was relevant and appreciated, resonated with me was Four Reasons Why Special Needs Parents are better equipped than anyone else to handle Coronavirus Stress, <laugh>. So that particular article, I'm gonna leave for a little bit later on to dig into is there any personal experience, maybe a family member that had a disability that kind of prompted you to become an advocate for the disability community?
Rose Reif (09:54):
It's a great question, and I know for so many people that a part of their journey is they love someone in their family who has a disability. For me, it's actually not my first exposure to really understanding what disability was. My father was in the military and we were stationed in Germany we moved to Berlin when I was eight or nine years old. And it was there that I learned about the history of people with disabilities being persecuted during World War ii. And I mean, this was in the, gosh, the mid to late eighties the wall had just come down. And so my parents, I had special education classrooms, were in a whole other part of the school at the time. I had never really seen people with disabilities. I had to ask my parents what that meant and they had to pull out encyclopedias and show me pictures for me to understand what it was that I was learning about.
(10:56):
But even at that young age, something just really struck me that it was wrong that people should be denied rights and liberties just because they happen to be born a certain way because their genetics were in a certain formation. And it just stayed with me. And I knew even then without ever really having connected with an actual person with a disability, that it was a group that I cared about and wanted to support. And so as I grew and went through high school and college, that was always my goal was to work with people with disabilities. And that I started to get to know some and realized these are amazing people and people who I love to work with. So it's, I know different from most people's trajectory, but that's mine.
Marsh Naidoo (11:43):
Can you tell me just as an educational piece, what is the difference between anxiety and depression? Are they two separate entities or do they kind of work together?
Rose Reif (11:58):
That's a great question because the answer is both. <laugh> anxiety is when we talk about that it's a degree of worry that's excessive to the situation and the risk at hand. It's worrying that sometimes you can't even put a name to and describe what it is that you're afraid will happen. It can be just a general fear of almost anything or most people are familiar with a specific phobia of say dogs or snakes, that kind of thing. So that's anxiety. But anxiety's best friend is depression. Depression is being kind of a general sense of hopelessness and sadness that you maybe can't explain. There aren't things that are going on that make you feel bad but you just don't seem to have the energy and enjoy things in the way that you used to. So as you can imagine, if you're feeling down and you don't know why, that might make you start to worry and think things like, What's wrong with me and why am I different from everybody else?
(13:07):
And so where we see depression, we tend to see anxiety. And the reverse is also true. So they're not the same in that there are different chemical factors going on and there are different mechanisms of activation, all of that they present in different ways. People who are depressed may try to sleep too much and may feel lethargic and fatigued, whereas people who are anxious may have an overabundance of energy and be doing and they can't sleep and their thoughts are racing. So they look different, but they do tend to go together if that makes sense.
Marsh Naidoo (13:48):
No, it absolutely rose. That kind of segues into the question, why is it in your opinion that parents or individuals with disabilities might be more prone to anxiety and depression?
Rose Reif (14:05):
So for people with disabilities, we know that that's a risk factor that if someone has a developmental disability if someone acquires a disability, they are more at risk of those mental health conditions. The reason is they're different and they know it <laugh> there are some other neurobiological factors, such as brain wiring being different. But for example, I work with a lot of autistic adults who know the challenges they face. They can explain why things are difficult for them, but that doesn't make it any easier for them to feel better about going into social settings, trying to get a job, and trying to have a meaningful relationship with their parents. I think it has to do with, I mean there's fatigue, certainly, there's physical fatigue. It's more demanding to raise a child with disabilities, but it's the emotional fatigue. It's the compassion fatigue of watching your child be different, watching your child try to just be themselves and be a kid in a world that doesn't really understand or appreciate them. And over time, you know, start to ask that big question of what's gonna happen when I can't care for them anymore? What is the future gonna look like? What is my future gonna look like? Do I have a role and a purpose outside of raising this child? And it all can make a person just feel really withdrawn and isolated and that nobody understands. And unfortunately, that feeling is at the root of a lot of anxiety and depression.
Marsh Naidoo (15:46):
I think that's why your article on whether is it wrong to feel grief when your child is diagnosed with a disability is so poignant because in that article you describe acknowledging your child's disability and
(16:03):
Just acknowledging it grieving so that you can actually then move on to enjoy your child to develop that bond and provide that support that your child needs and giving that parent that permission to grieve and say that those were not expectations or that's not how I pictured things to be. Okay. So yes, as I said, that article was poignant. So guys, check that out. That was Rose's article in August of that last chair on the mental wellness and disability blog. Rose, I know we can talk about the subject forever, so I wanna go on to the coronavirus and what kind of strategies or advice can you offer to parents like me
Rose Reif (17:01):
Lower the bar? I've been saying it to my clients for the past five or six weeks, and I just feel like I can't say it enough. We're all, I think guilty of looking at social media, looking at all of the color-coded school schedules out there, seeing people who've taken this time and done some wild woodworking project or repainted their house or whatever, and feeling like we should be doing more, feeling like we're not doing enough, we're not doing it. There is no right way to do a global pandemic <laugh>. Amen. If you're <laugh> meeting your child's emotional needs, if you are taking care of your family at a very basic level, food shelter, you've done it, you've done the day, you've done all that you needed to do.
(17:58):
So wherever you can, just reduce the expectations you have of yourself, reduce the expectations you have of your child. I talk to a lot of people who are saying, But I'm an introvert. I love staying home. This should be easy for me. Why does this feel so hard? Because we don't have a choice. Acknowledging that our choice has been taken away and that we feel very powerless right now is huge. So let things slide. Too much screen time. There's no such thing right now. It's all fine, <laugh>, whatever you have to do to get through the day is fine. So I think that certainly there are other specifics we can talk about limiting your exposure to the news to those times when you really feel up for whatever it is you might come across.
(18:48):
But I think to lower your expectations of yourself. And the flip side of that is to really focus on what are the things that are within your control. We can't control what the weather is like. I'm here in, like I said, Central North Carolina, it's a beautiful day. I can go for a walk with my family later today but if it were raining, I can still control it. If we get exercise, we can turn on a dance video and have a party in the house and move our bodies. So I can't control what kind of exercise we get if it'll be outside or inside, but I can control that we do it. Yes, I can't control so many things. I can't control the newsprints, but I can control when I choose to read them. And just looking at our day in that way to find and regain our sense of power and control, because I think that's what we're all craving right now in this uncertain time.
Marsh Naidoo (19:43):
There was an exercise on your blog, Rose, where you kind of drew two circles, one circle contained within a bigger circle.
Rose Reif (19:54):
<affirmative>,
Marsh Naidoo (19:54):
I love that concept. Yeah, explain it to us, explain,
Rose Reif (19:59):
Etc. Sure. It's really what we're talking about just create a circle. Everything you can control goes in the circle and I think I have a blank version on the site if people wanna download it and actually write it out. But even just if you do this mentally, just okay, what can I control? I can control what I wear if I take a shower. When I take a shower, what we're going to eat for dinner? If I'm gonna look at our finances and try to work out a budget for the next few weeks, those are all things I can control. What's outside of my control? I can't control if my job has laid me off, but I can control what I choose to do if I choose to look for unemployment benefits or find other ways to make money in the interim.
(20:46):
Again, as I said, I can't control what the weather is, but I can control if I get exercise. So trying to focus on the idea of maybe it doesn't look how I expected it to look. Maybe it's not ideal, maybe it's not how I want it to be, but it still can be. And so just saying whatever's in the circle, that's the stuff I focus on. Whatever's outside of the circle, my energy and worry and focus on that does mean no good. It doesn't serve me at all, so I have to let that go.
Marsh Naidoo (21:16):
Talking about kids, how would you explain something like a pandemic to them? I mean, I'm struggling with this anywise with regards to that.
Rose Reif (21:30):
Sure. I know there are a ton of great resources out there if you Google how to talk to kids about this that get into more specifics. Kids with anxiety may need to hear things in a certain way, <laugh> versus kids who maybe have some intellectual disability and need to have things presented very visually. But I think all kids can benefit from just considering what's their age, what's information that they need to make sense of this what's gonna be their developmental understanding. And then showing them things that fit within that. I know for my own kids who are seven and nine years old I showed them a clip that was going around from the TV show scrubs that they showed when two hands touch and how that transfers germs and how things can move in a room where people are close together. And then talked about what would happen if everybody separated and everybody wore gloves and how that would limit the transmission. And understanding that even though it feels very boring, we're actually really helping a lot of people by staying home. And then I talk to my own kids a lot about we can choose to be frustrated by this time or we can choose to find the good and it's okay to talk about the things that frustrate us, but we also wanna balance that by talking about what are the parts that we're enjoying.
(22:56):
So we're not enjoying that. We can't go out to eat as much, but we are enjoying cooking together more as a family, those sorts of things.
Marsh Naidoo (23:03):
I love that. Rose <laugh>. Do. You talked about special needs parents being equipped to tolerate the stress of Coronavirus. Why is that Rose?
Rose Reif (23:16):
Sure. So I think when this first all started happening and when we were first given the stay-at-home direction, there was a week where I just remember so many of my clients, I would log on for our online sessions and say I was bracing myself of how hard has this been for them? And session after session, my clients were saying, This really hasn't been that tough <laugh>. And I was surprised because they were saying, We've already done this. We've already heard the news. That felt really overwhelming and we weren't sure what we would do with it. We've already had to isolate ourselves from others socially a bit because of our child's medical needs or behavior. So for a lot of the parents I work with, they were saying certain aspects of this just didn't feel difficult. And I really wanted to call them out for that in a positive way, which is why I wrote the blog post to say that, you know, have skills and resilience that you're unaware of if you're raising a child with disabilities, you know how to do things differently from the norm. How to take an unexpected situation and say, we're gonna make it work. We're gonna do what we have to do, we're gonna roll with it. We're gonna accept the ambiguity. We know that life can't be black and white. Let's quit focusing on what's normal and just do what we need, which is exactly the skills that all of us are having to dip into now in this pandemic. So that was really the inspiration for that post,
Marsh Naidoo (24:55):
For that article. You talk in that article as well about social distancing, not equating to emotional distancing. <affirmative>, walk us through that rose.
Rose Reif (25:07):
Sure. Again, this a concept that so many parents raising kids with disabilities I think are familiar with because maybe your child just can't sit through an hour-long church service, but it's still important to you to contribute to your faith community. So I work with a lot of parents who say we don't go to regular church services anymore, but I still do work at home in my downtime so that then I can contribute back to a mission at our religious house of worship. Or not being able to go to certain family events just because you don't know how your child is going to respond or that they wouldn't be able to tolerate the travel for various reasons. A lot of parents have already had to socially isolate themselves to meet their child's needs. And so they already know that when you do that, if you lose the emotional connection to other people, that's, like I said, the root of the anxiety and the depression.
(26:06):
It's feeling like I'm different, nobody understands me. So a lot of the clients I work with, a big part of our work together is figuring out, okay, if the reality is that my child and their disability won't let me stay engaged in the way that I'm used to, in the way that I plan to be, how can I maintain a connection to the people and the places and the activities that are important to me even if I can't go out as much. A lot of the parents I work with talk about tag teaming with their spouse you know, run the errands and I'll watch the child and then I'll take them to the medical appointments where you can get some work done. It's a lot of back and forth
Marsh Naidoo (26:43):
Though You are licensed in North Carolina and as a medical professional, are you kind of bound to the state of North Carolina, or do you practice elsewhere?
Rose Reif (26:55):
No, so unfortunately state licensing boards have not quite caught up to the technology that we have available to us. So because I'm a licensed clinical mental health counselor in North Carolina, I can only work with clients who are in North Carolina at the time that we meet. So I do offer online counseling. That's something I've actually always offered even before the pandemic, just because so many of the parents that I work with, it just works so well for them to not have to travel for one more appointment and be able to meet if their kiddos are sick. So I've always done online counseling now, just doing exclusively online counseling. But yes, can only work with people who are in North Carolina.
Marsh Naidoo (27:37):
Your blog, as I said, is an outstanding resource, but if for example, parents are feeling overwhelmed or mm-hmm <affirmative> having that sinking feeling, who can they reach out to? Is there any link up on your website?
Rose Reif (27:53):
Sure, so there's not a direct resources link because that's sort of constantly in flux. But if people email me and say, do somebody in Kenya or Kentucky or <laugh>, wherever, cause I get those emails a lot I always send people to a blog post that I have on my site called Finding a Counselor who will understand your child with special needs with the caveat that a counselor who is gonna understand a child with special needs is probably also gonna be able to work with parents. And so that blog post really came out of me getting those kinds of emails from people and wanting to offer resources. But obviously, I can't know people around the world so I just did a massive brain dump of all the different ways I could think of that somebody might be able to connect with a counselor who has a good understanding of disability. And certainly, I always put this out there, if people can think of another way to connect with a professional like that, please leave a comment on that post and share that idea with others. Cuz I know there are so many people who are hoping to find someone who can help them.
Marsh Naidoo (29:05):
So Rose, I just wanna go through again, how can parents or how can individuals with disabilities contact you?
Rose Reif (29:15):
Sure. So all of my information is on my website. They can get my email, and my phone there's a contact form on there as well. I'm also on Facebook Reef Counseling Services and there are some additional things behind it. I think it's a carry disability practice, something, you'll find it <laugh>. And then I'm on Pinterest as well, so if people want another way to connect, they can get me on there. But yeah, really my website is the best place to be in touch.
Marsh Naidoo (29:45):
And that website, again, guys, is reef psych services.com. Rose, I can't thank you enough. Thank you so much for taking the time to join us today and thank you for sharing your knowledge with those parents out there listening today.
Rose Reif (30:02):
Thank you so much for having me. It has been such a pleasure.
Marsh Naidoo (30:21):
As always, folks, if there are any topics that y'all would like to discuss, please let me know. Reach out to me at raisingkellan@gmail.com. Also, if any of these episodes are ready to touch nerves with you or you find them helpful, leave a review. Those reviews help rank us higher within Apple and Spotify. So reviews, help share those episodes with friends as well. The more folks we have listening the more content we can bring you and every little bit helps. So look forward to bringing you all those episodes. And as always guys, remember, get to the top of your mountain. This is Marsh Naidoo signing off.