I recently had the opportunity to attend the annual Hawaii Doc Talks conference to immerse myself in the most up to date research and science in primary care integrative health. This Hawaii Doc Talks conference was conceived of in 2014 to address the need for continuing education requirements to be met by physicians in Hawai’i. In an attempt to disrupt the prevailing PowerPoint paradigm, the conference is modeled after TED Talks – 25-minute presentations meant to engage and inspire, beyond simply educating. One of the big perks and draws of this conference, held annually in January, is that this conference attracts some of the best doctors from around the country who want to present and/ or get their continuing education credits in beautiful, warm Hawaii during the winter.
This conference feels like a multi-sensory playground for me, there is a tremendous amount to learn and do with experts in my field. Last year, I was selected to present twice at this conference therefore this year felt more relaxing as I was there solely to learn and reunite with colleagues. Some topics included a discussion on how mental health is imperative to physical health and how they are married and inspiring to one another. This presentation boosted the understanding of current evidence-based care to explore the future of mental health diagnostics and treatment.
Chronic neurological conditions were also the main topic of this conference with extensive presentations on the latest in research pertaining to dementia, Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis, and general cognitive decline. The protocols and research for these neurological conditions coincide with what we know pertaining to attention deficit disorder. How brain inflammation and particular practices set up a cascade of events to increase the risk for these neurologic diseases as well as impede positive treatment outcomes.
One of the many take-home points which I would like to share with you is dementia (and ADHD) risks of oral diphenhydramine (Benadryl) use. Chronic use of this class of medications and other anticholinergic sleep aids leads to increased progression and risk of diseases associated with cognitive decline. Diphenhydramine is critical in allergy medicine but if this medication is prescribed chronically for anxiety and/or sleep this research needs to be heeded.
Coupland CAC, Moore M, Hippisley-Cox J. Association of Anticholinergic Drug Exposure With Increased Occurrence of Dementia—Reply. JAMA Intern Med. 2019;179(12):1730–1731. DOI:10.1001/jamainternmed.2019.4908
Stella F, Radanovic M, Balthazar ML, Canineu PR, de Souza LC, Forlenza OV. Neuropsychiatric symptoms in the prodromal stages of dementia. Curr Opin Psychiatry. 2014;27(3):230-235.
An important aspect of the PQ model is staff development and the opportunity to learn and grow alongside our students.
Staff members recently participated in a company-wide training focused on Horticultural Therapy and Rites of Passage. It was a great opportunity for the team to come together on our new farm property and have time to connect while learning new skills and strategies to work with our students.
One of the main goals was to emphasize the importance of how to incorporate these various lessons and projects into the daily routine with students. PQ Field Therapist Sarah Blechman, MSSW, who helped organize and facilitate the training comments, “The whole day was so engaging! It was abundantly clear the facilitators were authentically passionate about the rich union and incredible effects of the interplay between horticulture, rites of passage and how to facilitate the two using the neurosequential model. My favorite part was when our program guides, managers and therapists all worked together to create our first garden bed in our ethnobotanical garden. Working on such a large project together felt like the whole community was working on a gift for our new farm.”
Many thanks to Nick Vejvoda, Adolescent Field Manager, who made this video!
The Pacific Quest team is made up of incredibly talented individuals who are passionate about working with our students and providing a safe and structured environment for them to learn and grow. This month we want to highlight our Young Adult Program Manager, Anthony Florig.
Anthony worked at Pacific Quest from 2012-2016, starting as a direct-care Program Guide, and working through several positions including Young Adult Program Supervisor, Program Coordinator, and Purchasing Manager. Anthony left Pacific Quest in 2016 to pursue an MBA in his hometown of Youngstown, Ohio. In 2018, he returned to the company as the Off-Site Facility Manager to work on setting up new locations and managing the Rites of Passage phase of the Young Adult Program.
Anthony’s tenure with the Pacific Quest program combined with his business experience and education allows him to bring a unique and level perspective to the management team. Jody St. Joseph, Program Director, comments, “Anthony’s passion for horticulture therapy and his keen eye for risk management truly enhance our stellar team. We are thrilled to have him in this leadership role!”
Mahalo Anthony for all your hard work and dedication!
Pacific Quest Young Adult students recently visited OK Farms in Hilo, where they assisted in transplanting Mamaki and coffee plants. The historic OK Farms is over 1,000 acres and is home to amazing waterfalls and exotic fruit varieties.
After lending a helping hand on the farm, students enjoyed lunch by a scenic waterfall and then returned to Reeds Bay to enjoy some time playing in the ocean! The group launched kayaks and SUPs from the ice ponds and paddled around Hilo Bay, taking in the beautiful scenery!
Pacific Quest’s Clinical Director, Dr. Lorraine Freedle was recently invited to speak for the Taiwanese Society of Wilderness in Taipei. Dr. Chun-lin Cheng, a Psychiatrist, Jungian Analyst and officer of the Taiwanese Society of Wilderness (SOW) learned that Dr. Freedle was visiting Taiwan to teach sandplay therapy workshops and thought it would be an ideal opportunity to collaborate.
Dr. Cheng is the Medical Director of the Psychiatric Unit of the Far Eastern Hospital in Taipei. Dr. Freedle had the privilege of touring the hospital and seeing first hand the incredible gardens of their Horticultural Therapy program, where patients have the opportunity to spend time in the garden in the large courtyard.
The main goal of the SOW is to connect people with nature for preservation. Dr. Freedle’s lecture, entitled, “Nature-assisted Therapy and Brain Development” emphasized how to use a growth-focused approach, environmental design, and nature-based activities to target brain development and assist young people to connect more meaningfully to themselves, others and the natural world.
The audience was made up of Horticultural Therapists, mental health professionals, and conservationists. Dr. Lorraine took them on a “virtual visit” to Pacific Quest, where they learned about our program and how students acquire coping skills to manage stress. Dr. Freedle notes, “We had a great response! People were very excited to learn more about Pacific Quest and nature-assisted therapy. The group had a lot of questions and were very interested in our new property and how we utilize our gardens therapeutically.”
The SOW motto is ‘Wilderness is where life begins’ and it was evident the efforts being made to connect people with nature and the importance of utilizing nature in the healing process. Dr. Freedle continues, “It was an amazing experience to be an international ambassador and to collaborate with a group that shares our values in connecting kids to the environment. All of our lives depend on protecting and sustaining our environment, and fostering that connection locally and globally.”
John Souza, DMFT, and Mike Sullivan, LMHC recently presented at the Young Adult Transition Association (YATA) conference in Coeur d’Alene Idaho, speaking to the “Myth of Independence” within emerging adulthood and the need for relationship. After dispelling the common perception that young adults (and the rest of humankind really) are independent entities, and highlighting some of the shame and sense of failure that many emerging adults feel when they remain in-dependence with others, Dr. Souza focused on teaching attunement skills and empathy tools within a corrective relational experience. Dr. Souza and Mr. Sullivan identified strategies that Pacific Quest employs to create such experiences for emerging adults and their families.
The presentation was among many thought-provoking breakout sessions at the YATA conference, all focused on the challenges posing todays emerging adults, ages 18-29. Keynoting the event, Dr. Jeffery Arnett, set a positive tone for the conference. Despite the significant obstacles many emerging adults face today, Dr. Arnett’s research suggests a very high level of optimism. This was very welcome news, albeit, contrary to what many in the audience experience on a regular basis. Most conference attendees focus their careers on providing emerging adults with therapeutic services, helping them navigate the multitude of problems they are experiencing in their lives. The YATA conference continues to stimulate powerful conversations regarding the changing landscape for emerging adults.
“Transformative and life-saving are just two of the many positive adjectives that describe our family’s experience with PQ. If your child is in need, and you are fortunate enough to be able send your child, just do it. Theresa and Camille, just two of the many gifted and caring PQ therapists, support not just the child, but the family as well. Weekly calls help parents understand what their kid is experiencing, and the difficulties in the family dynamic that led them to PQ. PQ therapists then educate the family on how to change the dynamic – how to talk to, and listen to, your child. Moreover, the experienced individuals working daily with the kids are top notch – patient, kind and empathetic. The PQ parent on-site parent program is top notch. The individual and group sessions provide deep insight and understanding of your child’s behavior and causes of that behavior. It’s an incredibly difficult journey, but at PQ you are not alone. I cannot say this enough times – if you are in need of a program, look no further, just send your child to PQ.”
Last week Pacific Quest staff members participated in a company-wide training focused on Horticultural Therapy and Rites of Passage. It was a great opportunity for the team to come together on our new farm property and have time to connect while learning new skills and strategies to work with our students.
The training began with an introduction to the Four Shields and the Neurosequential Model of Therapeutics that’s utilized at Pacific Quest and an integral part of our program. After the intro, the team divided up and spent the morning at various “stations” that focused on different learning objectives. Staff members had the option of picking which workshop they wanted to participate in. Some of the options included: Meditation & Mandala workshop, Cordage and Ti lei making, medicine walk and planting skills, soil & compost, and hard project skills & “imagineering”.
One of the main goals was to emphasize the importance of how to incorporate these various lessons and projects into the daily routine with students. PQ Field Therapist Sarah Blechman, who helped organize and facilitate the training comments, “The whole day was so engaging! It was abundantly clear the facilitators were authentically passionate about the rich union and incredible effects of the interplay between horticulture, rites of passage and how to facilitate the two using the neurosequential model. My favorite part was when our program guides, managers and therapists all worked together to create our first garden bed in our ethnobotanical garden. Working on such a large project together felt like the whole community was working on a gift for our new farm.”
Last week I was contacted by PQ to check in with my family; it has been about six months since my son finished the program. They asked if I had news or photos to share. I didn’t have any photos. I only saw him for a couple hours when I picked him up at the airport and drove him to the place where he would likely spend the next nine to twelve months of his life in a transition program. We had lunch and got him moved in to begin the next stage in his journey, and then I got back in my car for a very long, lonely drive back home. It hits me hard every now and then, confronting that I’ve only seen my son for a few hours over the last nine months, such as when someone asks for a recent photo…and I don’t have one.
At the PQ family program I attended last Spring, we were given a bean seed to take home. Well, I could just look at that bean every now and again to reflect on the program experience and learning, or I could put it to work. And as it turns out, it put me to work. So I got a little pot, some soil, planted the seed, and placed in on a south-facing windowsill where it reveled in the lengthening spring days. Around Mother’s day, when we finally got consistently above 50 degrees at night (I’m from Seattle…it takes a while spring to actually take hold in my part of the world), I moved it out to the garden–thinking of the exercise we did where we learned about transplanting. I carefully tended to the roots, and gently repacked the soil, and made sure it was well watered over the next few days (actually I didn’t have to do much external intervention in that department–did I mention I live in Seattle?), all the while thinking about my son and his recent transplant experience. I wasn’t quite sure what I would find when I picked him up at the airport, twelve weeks after I sent him to you. I know he had a bumpy time at PQ, but the person who emerged was like the kid I had once a long time ago–open, reflective, curious, not so defensive, and even a little optimistic. He had found a place, a tribe, acceptance. As we drove from to the new place, where he would start another, even longer program, he talked about feeling ok about himself–something he hadn’t felt in a long, long time. I had this rush of relief and euphoria, thinking that he had turned a corner, and that he was going to be ok.
Well, transitions can be difficult. Very difficult.
Everything progressed well for a couple weeks. Little Bean started to bloom. But one day some deer came through and ransacked my whole garden–tomato plants, raspberry buds, carrot tops, beets, leaves and buds on fruit trees…and Little Bean was taken down almost to the ground. I thought it was toast. But we had a two warm weeks afterwards, and it started to leaf out again. And then came June…also known as Junuary in Seattle. It got cold and rainy. Bean barely grew at all. But it was still alive.
Towards the end of June, it was just starting to get warm again, and Bean started growing. But then one morning I came out and… AGAIN. Chomped by deer. Just as it was starting to produce. Our dog has one job…ONE JOB—keep the deer away! Apparently he is no longer taking his job seriously. I didn’t have a picture before the attack, but Little Bean was bushy, about 1.5 feet tall, had blooms, and actual beans.
I started to realize that Little Bean’s struggles were another parallel process. So on June 24th, I started taking pictures of the deer-struction.
Summer arrived on July 5th (as it usually does). I had started growing pole beans on the trellises. Little Bean, it turns out, is a bush bean. This was a major contributor to its struggles as it couldn’t grow up out of the way of the deer. But Little Bean kept trying…until another deer attack, July 18th.
They denuded the pole beans of all the leaves along the trellis, but couldn’t reach those at the top.
So, as we approached the end of growing season, I realized (duh) my laissez-faire strategy wasn’t working. The dog was no longer effective as a deer-terrent and they weren’t getting full on the many other tasty treats in the garden. I had to try something different–Little Bean couldn’t grow indoors, but the out-of-doors wasn’t quite working out either. Enter the cloche. I use these to get tomatoes going early in the season. It finally dawned on me that I could deploy them against the deer.
With this protective covering, Little Bean grew a bit more, survived two more pillages, and on August 30th I harvested two small beans.
But then came the slugs: September 24
I deployed slug traps, put the cloche on at night and during rainy days, but here we are at the end of September, and realistically, I’m not going to be able to count on Little Bean to produce enough food to get us through the winter.
But there are a couple new blooms. Little Bean is still trying. September 29th:
Some takeaways– I need to improve the deer proofing of my garden. Little Bean was not the only casualty. Harvest was way down across all product lines. Next year, I’m enclosing the garden. The cloche did the trick for a while, but I deployed it too late in the season. However, Little Bean started getting too big for the cloche, so that solution wouldn’t have worked indefinitely. Then came the slug invasion. So the cloche couldn’t protect from all predation. I also realized that I need to plant the right kind of bean for my conditions. Pole beans do much better, not only in terms of surviving the deer, but they just get far more light in my garden configuration. If Little Bean hadn’t carried the additional burden of symbolizing much more and serving as proxy for the care I wanted to be giving my child, I would have given up and chocked it up to a poor plant choice and bad luck with the deer. But it was what you guys gave me, just as the universe gave me my particular kid. I kept at it, and looked for new strategies to help it survive. Another solid lesson is that it’s good I’m not a farmer and people don’t have to rely on me for their food supply. The small success story of the garden this year is the pole beans, which survived the repeated pillages and are now in full production mode. Here’s what I harvested today, and there’s still lots coming, even though the middle of the plants keep getting eaten.
The growing season is coming to an end, but fortunately, we humans can keep at it even during the winter months. Thank you PQ for all that you have done for our family…we are still growing though it hasn’t been easy. Thank you especially to Mark White who really stuck with my Little Bean.