Episode 120 Beyond Talk Therapy | Innovative Approaches & How To Start Using Integrative Modalities : Interview with Dr. Roseann Capanna-Hodge

Chris McDonald: Have you been curious about using more integrative approaches but are unsure how to start? I know many therapists are hesitant to use integrative modalities due to fears around the scope of practice. We'll address these fears head on and explore how incorporating them can greatly improve client outcomes.

Join us as we explore the evidence-based practices that are shaping the future of mental health treatment. Whether you're a mental health professional, or someone seeking to improve your own mental wellbeing, this podcast is for you. So sit back, relax, and let's dive in. This is Holistic Counseling, the podcast for mental health therapists who want to deepen their knowledge of holistic modalities and build their practice with confidence.

I'm your host, Chris McDonald, licensed therapist. I am so glad you're here for the journey.

Dr. Roseann Capanna-Hodge: Welcome

Chris McDonald: to today's episode of the Holistic Counseling Podcast. I am so excited to bring you today's episode on integrative approaches. You'll gain so much from this and be able to start integrating some of these strategies from this episode. Today's guest is Dr. Roseanne Cap Hodge, a mental health trailblazer, media personality, and founder of Dr.

Roseanne, l l c. And she is changing the way we view and treat children's mental health. She is a former guest and came back on episode 45, effective Treatment for O C D with E R P, which if you haven't listened yet, I highly recommend. Welcome back to the Holistic Counseling Podcast, Dr. Roseanne.

Dr. Roseann Capanna-Hodge: I am so excited for us to have this conversation about all things integrative mental health.

Chris McDonald: Me too. And can we start with you sharing more about. Why you expanded your practice beyond traditional talk

Dr. Roseann Capanna-Hodge: therapy? Yeah, so you know, this is my 31st year in mental health. Wow. That's amazing. I dunno how that happens, Chris, like, but it's pretty amazing how time passes. But you know, I have always been a holistically oriented individual.

I am the daughter of Italian immigrants and my upbringing, We always knew that food was medicine and what everybody thinks about Italian food. Unless you've been to Italy, You know that the way American Italians eat is not the way that Italians and Italy eat. They eat a lot of very healthy, intentionally nutritious food and a lot of vegetables.

So that was my upbringing. You know, had a garden and. You know, my mother was way more likely to give me a bowl of not just soup, but like soup with garlic and onions and things that were designed to boost your immune system when I was sick than take me to the doctor. Okay? Of course, my doctor was an Italian speaking doctor, Dr.

Safari, and so. But what happened was, and when I went into mental health in the nineties, early nineties at that, is that I started working in psychiatric hospitals. So when you work with the most challenging clients, the clients that are have the trauma, they are on all the. Psych meds. They're so reactive in every aspect of how their brain interacts with the world.

How their body interacts with the world, their behavior just reflects this activation. You quickly realize you've gotta do a lot more things other than psych meds. And talk therapy. And in fact, what I learned was that these kids didn't respond to talk therapy. They responded to, of course, things like play therapy, but also I really took kids outside.

I got them connected to nature. I, I did a lot of things outside of the box right out of the get-go because. I am one of those PLE people that believe that every single human can get better, and I do not accept when my client, my family that I'm working with, they're trying and we've exhausted all of our avenues.

And that's exactly what happened to me. Chris is like, from the first cases that I had, it was like, well, they're treatment resistant. What does that word mean? That word means that. What we are doing in a traditional sense, whether you wanna call it allopathic, that's what a lot of times we refer to the medical model, that when we follow that medical model and we've hit that wall, what else can we do?

And so, you know, my story is I went and looked in microfiche in the nineties, and so I remember that. Remember that for you young people, it's down in the basement and you pull up on, you know, essentially almost like this thing with th with all the journals on it, um, in newspapers, and you look up journal articles, right?

And I was like, wait, why are we not talking about, you know, nutrition and neurofeedback, and biofeedback and different types of therapy, not just. Talk therapy, but really even very condition specific therapies like E R P and cognitive behavioral therapy when it's used with a high degree of training.

Because a lot of times we're trained in a generalist manner and we don't go deep. So it really became this point for me as these desperate, desperate mothers were coming to me. Chris, I mean, please, Roseanne, you are the end of the line. What are we gonna do? Well, I went to research and that is how I got into holistic methodologies because there are so many ways to change the brain, and thankfully 30 years later I have moved from kind of screening out who I could talk to about this with as families, like I.

Oh, you mentioned the word homeopathy. Do you know about homeopathy? Can we talk about it? Oh, you mentioned changing your diet. What do you know about it now? It's coming forward. This is, my work is encompasses all of these brain-based scientifically backed methodologies, and I love, love, love that therapists are talking about, you know, mindfulness-based stress reduction.

Yoga, meditation, as I talked about, nutrition supplements. It's all out on the table because the science is pointing us there. And we have a national crisis of mental health, not just for children but for adults. And we've gotta send the message that it's lifestyle, lifestyle, lifestyle, daily, consistent actions, whatever that is, that is going to move the dial A pill.

Ink could affix it.

Chris McDonald: And traditional talk therapy alone isn't gonna fix it. No. Yeah. I know you mentioned the wall. It is a wall, isn't it? Once we, the wall just are engaged and, and I've had people come to me, they've had traditional talk therapy for like 10 years. Mm-hmm. I'm like, they haven't, the dial hasn't moved.

I know you mentioned the dial. It's like, they're just like, I don't know what else to do. And I'm like, we need to look at holistic.

Dr. Roseann Capanna-Hodge: Solutions. Yeah. You know, I recently, and please now, whenever I talk about cases, I protect their identity. But I recently had somebody who I'd been working with for quite a bit, and it was a person who experienced developmental trauma abuse.

You know, not unlike many of the people that we work with, and there's Big Ts and little ties. This was a big T, and she had been doing talk therapy, not even trauma informed therapy, and I said to her, how long you been going? She said to the same therapist since 1998 and I, wow. And I was like, well, I'm gonna give you props for being consistent.

And you know, she's like, I know what to do. I know what to say, but I can't stop my body from activating. And I was like, well, let me talk to you about why. And we, I really helped her to understand what happens in the nervous system when you have trauma and the activation is leading things for you. And fast forward, we were able to change everything with neurofeedback changes in diet.

And she had said to me, it was one of those things where, you know, you really get pretty clump as I always say, that you know those moments you'll always remember cuz this is why we do what we do. And she said that. I didn't even know it was possible for me to not feel the trauma, to not feel so anxious in my daily life.

You know, she was able to graduate and move on and you know, she did some trauma work, just so you know. We wanted her to do more concentrated trauma work. And I think that same therapist learned E M D R for her. Yes. And, and that was great. And you know, there is that point, and this person didn't give up on herself.

God bless her, really, truly. And you know, the work the therapist was doing was important. It's just she couldn't access it with such an activated nervous system. And I think that's really important in the a conversation. My tagline is, calm brain, happy family, because I want everybody to know you've gotta calm the brain before you get to this talk therapy.

And. We're now realizing there's a variety of ways to do that, potentially. Medication is an option. I'm gonna tell you that I, I work with children primarily, and my belief is that that should never be the first option. That there are other evidence-based options because it's a developing brain. But there are a variety of ways to calm the brain, and, and that's what this conversation is about.

So therapists can feel good about what they recommend, they can understand. What their ethical and legal l, you know, limitations are. I think that's so important cuz Right Chris, we get this conversation question all the time. Yeah. So I know you

Chris McDonald: mentioned the nervous system and that psychoeducation piece.

So can you talk about that and why is that important to use that in therapy with clients?

Dr. Roseann Capanna-Hodge: You know, our clients of every age when they struggle, they have so much shame and blame and it is, the shame is the greatest. Stopper of any type of success. And I look at, you know, dealing with your anxiety and your depression or your family, getting through that and feeling good in your body is a success.

But we have so much, so many bad feelings about it. And part of it is I'm always in shock. So I am often the laughs. Stop when people come to me and they've typically seen five or more, I would say five is almost light providers. Um, and I tell the story that my world record is I had somebody who came to me and I was their 55th provider.

They were desperate. Yeah. Oh my goodness. They were in desperate search of the problem of what the problem was, which, you know, I was able to figure out in 10 minutes and it was called Lyme Disease and I got them to a medical provider, but, She knew in her situation it was so obvious there was a sun onset of a problem and, and nobody just took a medical piece.

Right. And, and when I say 55 providers, it was medical doctors, it was a lot of mental health providers. It was a lot of things. So people come to us and they don't understand what's going on. So yes. I am able to use this amazing tool called the Q E G Brain Map and just really simplistically, but you don't need it, but I'm gonna explain what it is.

It's a way to, to measure brainwave activity, to get a visual representation of exactly in the brain where, what is working, what is overworking, and what is underworking in the actual structures. And then it shows you brain communication and both. Are equally important in how a person functions in every aspect of life.

So I'm able to look at that data and say, oh, well, okay, well your frontal lobes aren't working in this particular region related to, you know, sensory processing or whatever it is, and give people really in-depth understanding. Even without that, when somebody has a d d or they have O C D or they have, you know, depression or anxiety, some of the most common clinical conditions.

For you to understand and then explain it to them in a way that's like, Hey, this is what the a d D brain is an a d D brain. It's not that they can't pay attention. An A d D brain actually can hyper focus on preferred areas of interest. It's just that they can't protect, pay attention when they're not.

Interested and the frontal lobes are in part of that. So you can get a feel, you can get something that you can explain to people and you can be the master of that. And to explain it that, you know, yes, this is your brain. It's not outta control, but there's ways to hack into that. Let me tell you of all the things that I do besides actual treatment, this is the most powerful thing that I do with the people that I work with because they have no understanding of what's going on.

They feel terrible about themselves, as we talked about, and knowledge really is power. The problem is we're giving people a lot of wrong knowledge. Like, oh yeah, you have a d d and you can't focus and you need to take a pill. Okay, forget about that. Even if that's the route you go, what are they gonna do about it?

You don't just take a pill and all of a sudden know what to do. You gotta teach them about their brain so they can understand and hack into those resources. Really, really important. And I think every single person, you know, every single therapist, you got a graduate degree, you don't need to be a neuroscientist.

You need to understand from a brain perspective what's happening in those few clinical conditions that you specialize in. Yeah. Cause I'm thinking

Chris McDonald: like P T S D I, you know, I treat a lot of trauma and, and I, when I go through the nervous system and provide that psychoeducation, there is just this look of

Dr. Roseann Capanna-Hodge: relief.

Relief. Yes. Just like

Chris McDonald: that. Yeah. It's almost like a con. They're like, really? Yeah. So I'm not just crazy.

Dr. Roseann Capanna-Hodge: No. They never understand why they're so, Activated and hijacked. Yes. You know, so, so many times people feel like I can never get control of that, so I'm just gonna give up. Yeah, right. And that's where like depression sets in and those other clinical conditions.

In my practice, depression is often a secondary result of another problem because you just sort of give up. You know, you go into that freeze mode and you shut down. But the understanding about the basic autonomic, you know, stress response, how our body, you know, goes from parasympathetic to a sympathetic dominant.

What happens, fight, flight, or freeze, and then what is that specific part of that clinical condition, I feel like is one of the best things that any therapist can do for their client. Agreed.

Chris McDonald: Now I see that and, and it's a, a normal reaction to abnormal circumstances as what I've learned in practice with clients and yeah, because it, I think once they have that understanding too, and it's treatable, we can treat trauma, we can come to healing.

I've seen it. Yeah. For

Dr. Roseann Capanna-Hodge: them understand that. It's amazing, right. You know, we, we always are painting this picture that every single thing has to completely derail you for the rest of your life. You know? That's right. I'm like, honey, this is just good marketing by pharma that wants you to stay on the pill.

But like, and not to say that these things don't experience, but I mean, I have the privilege of helping people walk out of their clinical conditions every day. You know, and it's. Just truly amazing and all of us, do we have people that move that whatever that issue is into the appropriate compartment in their brain or rectify what's going on?

I think the thing that draws me the most to being integrative is that we know that the mind and body and spirit are not separated. And so when we put only. Certain things in a bucket, like, oh, well this is the only treatment. Right? Integrative means we are integrating the best of what works. That is treatment.

Oh, say that again. Yeah. Integrative means we are integrating the best of what works, right? Yes. And we are using science. So when we start with the brain, And we start with education. I mean, it's just so empowering. And then what I do is layer in what are the brain techniques that are most likely to work with that clinical condition And yeah.

Okay. So I've done a lot of research. Yeah, I got a book, but people, we got Google. You don't have to go to the microfiche and you can really understand, I mean, you know, I tell the story. So I do a lot of one of the specialty areas that I really, truly embrace and people fly in all over the world. To come to me for is infection induced mental health problems.

So I work with people with pans and P does, which is you have a, it's a misdirected autoimmune response where the body toxin or an infection trigger. Causes the body to attack itself and produce all this inflammation and then neurocognitive and neuropsychiatric issues result. And a lot of today is, you know, and today of the day of filming, this is international Lyme Disease Day.

And so a lot of my peeps have of all ages have Lyme disease. But there are many reasons why and because of the work that I have done with that population, it really is an embodiment. Of, you know what happens when the physical problems drive mental health problems and really shines a light on how terrible and how archaic our systems are because there have a physical problem that gets misidentified and then they all end up on the door of psychologists and therapists and mental health workers, and they don't know or have enough training.

They only know when they get ex. Exposure to it. But you know, when we talk about, you know, mental health and you know what's actually working, we have to always go back to how do we teach people about the brain? And for me, how I even really started to really change my psychotherapeutic work was because I was getting so many people with infectious disease and I started getting a ton of people with O C D and what was my O C D.

Training. My O C D therapy training was C B T, and it was the same for anxiety as it was for O C T and that wasn't helping me. No. In fact, I was hurting my people and I led me to E R P, which is exposure, response and prevention. And. What a dramatic difference. I used to always say that when somebody came on my door with O C D, which again became increasing with pans and pan does, oh my gosh, I'd rather have a heroin addict.

I've better success with a heroin addict because I knew what to do. And by changing this, and we have to change one, we have to change. If we're working with certain patients and those are the patients we accept, we have to look. At what actually works for them. And that's how I found E R P was through scientific study.

Wasn't that hard. And I honestly was never trained in E R P, like it was so limited and so few people do it. But going to the science, looking at what's there, and even let's, let's look at O C D, right, because that's a specialty area of mine. What happens? What happens in their brain? What are the main sources?

So in my population, At least 80% of them had infectious disease. So I then had to say, okay, well you gotta study infectious disease. What works there? Now I'm not saying be a medical provider, but I had to make sure that I had a list of medical providers I had to, their nervous systems are so hijacked. Uh, with O C D I had to make sure that I really understood mindfulness-based practices, where to integrate, uh, things like breathing, yoga, meditation in the treatment process for them, because it's not the same for somebody with O C D than it is for, I wanna say, simple anxiety, but anxiety.

So really understanding when what to use and when. Was really important as an integrative provider, I know you mentioned all these different

Chris McDonald: modalities. Does it work better? I know you said layering too, and I've talked about that in this podcast, that usually it's not just one thing. No. That it's usually multi-tiered, isn't it?

As far as approaches, especially complex issues when there's

Dr. Roseann Capanna-Hodge: health issues. Yeah. You know, And I don't even get non-com complex issues anymore, Chris. Yes, I know.

Chris McDonald: Where are these people?

Dr. Roseann Capanna-Hodge: Where are they? You know, they, they're often complex because they get delayed treatment and by the time they get to the mental health provider, it, it's come from a small issue to a crisis.

Many people don't seek mental healthcare until crisis, and I think this pandemic shined a light on that. More than any other time because the ER visits for mental health was astronomical. But you know, we, we layering, so, okay. We are an impatient society. We are in our culture and our American culture, and I really do treat people all over the world.

And I'm first generation American, so it's given me quite an insight. Into what people are like in certain regions of the United States. You know, what are different value systems? I happen to live in greater New York area. I'm gonna call it ground zero for intensity and impatience. And it's been great cuz I have to educate people, but there is no magic fix.

So sometimes they come to a therapist and they're like, I'm gonna come to you every other week and I'm gonna do this and I'm gonna do that. And you're like, hold on. You're not gonna change your six years of anxiety coming every other week, right? It's about establishing boundaries. It's about educating them and what needs to happen.

But ultimately, when it comes to integrative work, and really for me, the brain, cuz everything starts with the brain, for me, the brain. Needs multiple ways that it's reinforced. Okay. Not just in behavior, but also how are we supporting regulating the nervous system? You can't work in the same way. The nervous system that is literally at max capacity cycling through fight, flight, or freeze.

You cannot work with that same individual as you can with somebody who sometimes gets to a parasympathetic state. The ability to have insight is. Totally different from a complete neurological perspective. For somebody whose autonomic nervous system is regulated or capable of regulating, we have to walk it down.

And what are the ways that that I do that. I do it with nutrition, I do it with supplements. I do it with brain training, neurofeedback and P E M F. Primarily then I layer in good cognitive behavioral therapy and other things along the way and, and you know, obviously it's not easy, but I always tell everybody who's like, oh gosh, I don't wanna do all these things.

You have to shift because you're just. Taking so much effort down a road that's never gonna get you anywhere. In fact, it's often worse. And psychoeducation really becomes a place where I can get commitment. But once I get 'em into the process, the therapeutic process, they feel it. When you get yourself out of that activated state, wow, you feel a lot better.

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Because I know you mentioned about determining individually when and where to use the holistic modalities, and I know a lot of listeners may not have all those wonderful tools that you have. Yeah. So what would you say to a therapist that might be considering in using some integrative, well holistic modalities, but just like, how do I do this?

Like even, uh, for mindfulness, for an example? Well,

Dr. Roseann Capanna-Hodge: first of all, I'm gonna say bravo. If you are now realizing what you were traditionally trained for, doesn't. Fully support everybody and you are wanting to know more about science backed integrative therapies and you know, there's twofolds, like where do you actually start to learn?

And what I should say, and I don't know what point, Chris, you wanna have the. Discussion about what are your training boundaries? Yes. You know, what are your state boundaries? We can go into that. Yeah, let's do that and then let's talk about where to start. So people always ask me like, what, oh, Roseanne, what certifications do you have?

What are this, what are that? And all of that. Let's dive into that. First of all, I want you to know you are within your ethical and practicing boundaries to have holistic integrative therapies. Okay? What each state allows is unique what each license in each state. Allows is unique. So in my state, I am allowed to do a lot under my license as long as I am trained.

And training for me, because I'm truly like a learning nerd, I believe training should be deep. If you're doing a lot of superficial training, how are you gonna really help your people? You know, and I've trained a lot of therapists, like I was a college professor in a graduate program, but I've also had a large practice of therapists at, at different points in training people.

And people are very resistant. Therapists are very resistant to training at a deep level. And let me just specify what that means. Like, you know, I wanna do C B T and I would say, well, You're gonna get certified in C B T and they're like, well, I don't really have to. And I'm like, the difference between a certified C B T therapist and somebody who's taking a course means you've actually had not just a superficial understanding, but you are really getting practice.

You're, you're using those techniques that are, are gonna help move the dial. And it kind of is a shortcut to experience, but nothing, nothing negates experience, but experience when you're actually doing, you know, like I think about the first two years I did neurofeedback and I was calling my mentor every week because all my cases were complex.

And she was like, wow, you have really complex cases. And I was like, I warned you Mary Jo, and then you move to a point. But to have that lifeline is there. So one. You wanna check your state laws, you wanna make sure you know what, what is provided under it. And, and two, go for training certification if possible.

And training is great because you might be like, like I, I got trained in E M D R and when I really did the research between e m, like for my population, people, please don't take offense. Like the E MDR versus E F T are, my population did much better with EF F T than they did with e MDR and my population.

It just was a better fit for us. But I did the training and I did a lot of different trainings, and then I was like, wow, this is way more in alignment with me. So don't do anything that's not in alignment with you and. Your clinical population or

Chris McDonald: just cuz you hear that everybody's doing E M D R, just Oh my gosh.

Dr. Roseann Capanna-Hodge: To be in alignment. Absolutely. So, you know, and I'm all about nicheing down too. Like get your one or two clinical areas, get your technique, be the badass master of that like, Go to all the trainings and do all that and really just become an expert and your clients are just so much better for it. I think, you know, every client that winds up coming to me always is like, wow, like you really know your stuff.

And I was like, well, it's been three decades. I mean, I hope I do, but I'm so niche into certain areas. And that's just what I do when I, and I'm able to explain things. In a way that they feel so heard and hopeful. So that's really important to understand what your legal liabilities are and limitations are.

I mean, some states don't allow you to talk about nutrition and things like that. So I have two integrative certifications that I got much later because there was no certifications available, and it sort of legally protects me, and I continually do continuing education credits, obviously to maintain.

These certifications I have to do continuing education credits. So where do you start? So one, number one, what's in alignment with you? Okay. Two, the number one way that I like to start in terms of integrative and bringing that in is typically breath work. So, Breath work is the is free, and it's the quickest way that you can bring your autonomic nervous system down from a sympathetic dominant to a parasympathetic dominance, that relaxed date.

So when you practice it in a session with your clients, they feel it. Now you might get, some clients are so activated they don't wanna participate, and there's different workarounds for that. I have a lot of different tools, but it is the best place to start. Do you feel that way, Chris? I I

Chris McDonald: was just gonna say, yeah, I agree.

Yeah, that's how

Dr. Roseann Capanna-Hodge: I started. Yeah, that's how you start. And I think once you see that breath work, you're like, holy cow. Like. That's a big deal. Now breath work has to happen outside of the session, so you need to have, you know, a breath work, I don't wanna say homework sheet, but a practice sheet for your clients.

You need to have what it is. You need to have them do it every day. I tell everybody, go do it three times a day minimum. You need to get the nervous system practicing, and this is where the psychoeducation comes in. It's gotta practice being in a parasympathetic state. It's not gonna stay there. Like one nice session of breath work.

Yeah. Okay. Like it's like the massage that you go to once every year, you know, like, no. Right. So, so I think breath work is the best place to start. And then when it comes with the other things, like what is your population like? What do they want? So I have, uh, my specialties are pans and pandas, infectious disease, you know, o c D, and then more of the extreme cases of, you know, a d d, uh, anxiety, mood disorders, kind of in there is some autism too.

And so I have very complex cases, so my people want from me, they want nutrition support. They want supplements and of course they want the brain-based therapies. That's the main reason why people come to me, cuz we use equipment that we're able to mail out and we work remotely with people. And it's coaching, it's neurofeedback, it's not, you know, I'm not doing psychotherapy across state lines, just so everybody knows.

It's actually a coaching program that incorporates all those things in it. So I knew what my people want and it's so funny, like every time I think, oh, they want this. No. They tell me what they want and I ask them, I have like a Facebook group. You don't need to have that. You can, you can. You can explore it.

So what's in alignment with you? What does your clients want and do? I think every single person on the world can benefit from talking about sleep hygiene. Yes. Right? Like if you have adult clients, they're not getting proper sleep. Right? Start, start there. Start there. And diet. Am I prescribing a specific diet?

Well, now I am because it's my own diet. It's got its own name. We're not gonna reveal that right now. But what I prescribe isn't is an anti-inflammatory diet. There are multiple types of anti-inflammatory diet every single day. On my Google alerts, I swear at least three times a week, I get some type of research showing the benefits of an anti-inflammatory diet, which also includes a Mediterranean diet.

So general education and the way I talk about diet. Yeah, I'm gluten free and dairy free, and sugar free and all that stuff. That is not what you have to have. An anti-inflammatory diet is really about having low inflammation foods, so it's about increasing those foods and everybody can make a 20 or 30% change.

And when you do that, wow, you can feel different. That can be something you can talk about. Cuz I tell you what Chris, when I look at the threads, either in my state or in the national, people get very hung up about talking about diet. Well, we're not nutritionist and we're not all that. Absolutely. I'm not telling you to do that if you are very interested in diet like I am.

So that was really my first entry into all of this. The holistic stuff really was diet. So I did a lot of training. I've done an extensive amount of learning and and education on this and will continue, but the research is very clear. You can make general rec recommendations. You can recommend a book.

That talks about diet. There's no harm in that. We all make recommendations. And guess what? For those therapists that are out there that are just recommending psychiatric meds, you're not a licensed medical provider. So somehow we feel better about that and it has terrible side effects, but yet we're not telling people to have more fat and protein.

Who's gonna get harmed from that? Nobody. But science shows us. So clearly that it's super effective. I mean, two big studies came out this year. One was about mindfulness-based stress reduction techniques and how it was as effective a psychiatric medication for anxiety and depression, and similar studies related to nutrition.

Why are we not doing a summary and giving that to our client? My clients are like, nobody's telling me these things. And I have really educated and clearly wealthy people cuz they're flying in, flying on airplanes, um, to come and see me. So we have to be that purveyor. We have to educate people and there's no harm in that.

There's nothing about it. You can have lots of literature. You could have research study summaries, well, however you feel most comfortable, but taking an investment in helping it or going to that next level and getting your training, that's what integrative care looks like. Yeah, that's a lot you just said.

Yeah, and I hope people like it's an aha moment for them of their own power as a therapist, but I still believe breath work and I think nutrition and even those mindfulness, Based stress reduction techniques. Like what about meditation? What about getting certified in yoga? Right. We were just talking about that.

You know, what if doing a training in yoga to understand how it can help, it doesn't mean that you're necessarily gonna be doing yoga, but I've done a lot of yoga techniques. Do you know how many people, Chris, when they're struggle with brain fog and things like that? You know, I always tell 'em to do legs up the wall.

Yes,

Chris McDonald: I

Dr. Roseann Capanna-Hodge: love that. So I don't have to be yoga instructor to do that, but I've been, I've learned how that gets blood back into the brain and how, you know, how powerful it can be with alertness. So instead of feeling like, you know, I think the power of integrative care is that we're able to give the best clinical options.

To our clients and they get so excited and so empowered. And, you know, listen, we all have the clients that are low motivation and it might be harder. And for them it's sticking to one thing until that dial sort of moves. And then we layer and we layer. I definitely get a lot of jump in the deep end.

People who are like, Dr. Rowe, I wanna do it all. And I'm like, wait a second, let's, let's be strategic. And I do. A lot of intensive work, particularly for my people with O C D where they, where they work with me for two weeks and this is what we do for two weeks, not just psychotherapy. We literally are like, okay, what are you eating when you're here?

You're not allowed to eat, you know, da da da. And you know, we really show them. What it feels like when you feel better, and then people are way more motivated to do the cognitive behavioral work.

Chris McDonald: Yeah, I'm thinking about what you said with, um, even sharing research studies. So it's almost like giving them those options and they, they make the decision.

That's it.

Dr. Roseann Capanna-Hodge: That's it. And even, like I said, if you're not going to like, okay, well I don't feel like I wanna do biofeedback or whatever it is, um, some peop people contact me all the time about neurofeedback and I always say that contact the. You know, you can go to b cia.org for more understanding of training.

I don't mentor anybody. There's not enough hours in my day to do that. Um, at some point when I exit out of all this, I'll probably do an integrative practitioner mastermind, but I'm nowhere close to that. You can follow me on social if I decide to do it. There's a lot to do. There's a lot, right? And you and I are deepening every day because I think.

When I first started, you know, I, I talk a lot about this boy that I work with. It's not his real name, but he's a man now. Alec is not his real name. And he came to me and he was the case that, you know, people gave up on and his mom found me. And even I at that time was like, well, I think I need meds. And, you know, he.

Had cardiac problems as a result. Long story, his mom found neurofeedback. I was like, go and do it. I wrote a paper on it in grad school and there's no local provider, so she, she slept like an hour and 10 minutes each way and I happened to see him and he truly to this day had the worst case of a D h ADHD I've ever seen in my life.

He could pay attention for. Seconds for seconds and, and know that I worked, as you heard me, I worked in residential treatment centers. This kid still had the worst case of A D H J. So he wind up completely reversing his issues. He would've later been diagnosed with autism and. It was unbelievable to me what happened to him when his brain regulated and how it alerted, and I just jumped right into it.

I was like, I gotta be doing this neurofeedback. He might be one of my most extreme cases, but I got so many variations of it and he inspired me to go deeper. Now that is a huge commitment. The learning curve for that is absolutely two years. Maybe you wanna do that. That's okay. But knowing what you wanna do, you might not know and you kind of have to explore a little bit about it.

And I think these kind of things, a huge podcast listener. I listen to probably at least one podcast a day. I actually have quite a bit of a drive, so it's a great opportunity for me. But I. I just like to listen to things so I can be doing one thing and listen. So starting with podcasts, then selecting trainings and doing that and reading books.

But I think you just gotta jump in and pick something. And again, breath work moving through, looking at your wins. Even before I did neurofeedback and biofeedback, when I had people who couldn't do breath work, I used to do temperature training. I don't know if you've ever done it, Chris. No, what's that? So you can Google on, you can go to Amazon and you could do temperature dots.

Google that word. And so it is these little dots that change color when your body heats up. This is a form of biofeedback. So I would have a dot and I would put it on somebody's hand. They're super inexpensive by the way, so, and you put it in somebody's hand. And this is so fascinating. You tell the person, I want you to heat up your body.

You're going to concentrate on your hand and you're going to heat up your body. And I literally have never had any adult or child not be able to do this. And what's the benefit? When you heat up your body, you go into an. Alpha brain state and an alpha brain state is a feel good brain state. Alpha comes out with, you know, things like dancing or hugs or sex or smoking pot like it.

It comes out in these ways that can be healthy or unhealthy, but this is a healthy way. And so when I would have a really anxious person, I would do temperature training to get them into an alpha state. Really easy. I would start out my psychotherapy sessions. First with that, and I think that's one of the best things if you're starting out in integrative work, find a way to help them regulate their nervous system in the first five to 10 minutes of a session if you really want them to maximize their session.

Breath work, temperature training, other forms of biofeedback, heart math, which are very easy and inexpensive to add to your practice. It is a game changer in maximizing the growth of your clients.

Chris McDonald: Agreed. And I, and I just wanna circle back to you, when you mentioned consistent practice, that's what I teach a lot with clients and I start from the first session to say, Hey, you can't just come here and learn these holistic modalities and expect everything's gonna change.

So this has to become part of your lifestyle and practicing at home and being able to do what I call preventative work. And it's. Also learning about that these practices, doing them for the sake of these practices and to reframe the way they think about, cause a lot of people will say, I don't have time, or I have a busy schedule, there's too much going on.

But what is a way that I can give this to myself and take time for myself and

Dr. Roseann Capanna-Hodge: everyone who isn't busy? Chris, I know. You know what I mean? Yeah. Even though I work with kids, I still have retirees that come to me and they're always the coolest people, cuz. They're invested in themselves and they're the busiest people.

Cause they're like, I'm going here. I'm doing this. It's reframing that and making an investment in yourself. Exactly like you said. And you know, if we aren't teaching people that, because we have to dispel the mist, because also when we, you know, especially people have a lot of expectations when they work with me, right?

Like, they've seen me on something or whatever. Or you know, they're desperate. So many of us work with desperate people and then they're like, This is the thing. No, I tell everybody you are the thing and you are the magic, and it's the consistency and that consistency is not a message in our culture. We are a culture, right?

Yeah. Yeah. The media gra gratification, like, okay, yeah, here's what it is. I'm so disappointed that med didn't fix it. It was like, okay. Well, are you still doing X, Y, and Z? Yeah. Okay, well, how is the med gonna fix it if you're still doing X, Y, and Z? There's such a disconnect, and I think that's why there is, you know, people are generally stressed, but they're moving away from healthy components in their lifestyle and that's what makes me feel so good about bringing all of these things back because even though people are like, oh, they don't work as quick, I.

Completely disagree. I feel that when I really get people to actually practice at home, they feel a difference much more readily and are able to move through the higher level cognitive work and getting rid of, you know, the negative self-talk and oh, the things that really hold people back is their belief systems about.

Healing this isn't gonna work, or I'm a bad person, or I'm dumb, or all those terrible things that even the youngest of children say to themselves. That, to me is a much more harder piece. And this becomes, this helps to carry the load and, and also change the brain, right? We know that in as little as 40 days of 10 minutes or more of meditation, the brain actually changes.

So

Chris McDonald: true. And I think, I think once clients see the benefits too, and hopefully therapists are doing these practices as well. Cause I feel like you can't teach these if you aren't embodying them yourself. So true. That's Chris. That's the other piece of it,

Dr. Roseann Capanna-Hodge: right? We can't pretend that, you know, oh yeah, this is what you have to do, but I'm, you know, not gonna do it myself.

And they ask a lot of questions like, how do you integrate this? And I have my own podcast, it's gonna be okay for parents. And I share all the time, my kids' stuff and you know what we're doing. And, and some of them are like just real life moments because they, they need to know that we are utilizing these same things too.

And can

Chris McDonald: we go back to supplements? I know you mentioned that briefly. So I have listeners have asked about can we recommend supplements if we know some have worked for us or we've heard some good things. So what are, what are your thoughts on that as far as scope of practice and

Dr. Roseann Capanna-Hodge: competence? Yeah, so obviously I do spend a lot of time talking about supplements.

I also have my own supplement line, neurotistic coming out, which for me is another company. So just so you know, it's another company. There's a whole legal way kind of around it, but I'm trained in supplements. I. So I have a certification that, uh, where I was trained in how to use supplements. So I am covered within my state laws about supplements.

However, you always have to disclaimers. So anytime you're recommending a supplement, my supplements have a disclaimer. We'll talk about two ways to do this. So one is directly recommending things at work, right? So I have lots of informational blogs on my website about supplements for adhd. Anxiety, wellness, O C D, very specific, but again, have disclaimers.

So there's the general way to do it. Like here's some information you can point your clients. You could build a resource library for them. Same thing you could say, you know, here's a book on, you know, this or whatever it is that you are comfortable with. Phase two is now I've gotten a certification that legally protects me and I recommend in writing specific, Supplements.

Now, I only recommend evidence-based research stuff that's just across the board. But what are supplements that are brain basics for mental health? That is what I focus on. So magnesium, you know, vitamin D. I do recommend a lot of methylated folate due to genetic mutations and a few other sort of basic, basic ones that are generally really safe.

Again, always have a disclaimer. Always tell them to check, and a lot of my people will go to a functional practitioner who will check their nutrient levels in their blood and verify that's there or not. You have to work what's there. I do believe. Every single human being should be on magnesium and vitamin D.

I think that you're pretty darn safe as long as you know magnesium is not fat soluble. And the worst that's gonna happen to you with magnesium is you're gonna have loose bowels. So that's okay. And there's different kinds of magnesium. Um, so understanding the different kinds, understanding what helps the brain.

I have all the stuff on my website if anybody wants to get education. Plus you could just Google and you can look at research studies. And then vitamin D is different. Vitamin D is fat soluble. So when anything is fat soluble, it means that it can build within the system, which can be bad. So you know, just if you're, they're gonna come back to you and they're gonna wanna know dosages.

If you're recommending a specific thing and you're putting it in writing adults with clinical issues, you probably wanna do 5,000 IUs kids. I wouldn't go over 2000 and you can kind of just say, here's the maximum you should. Or you can say, here's what I recommend. Go get your lab work and have your doctor tell you.

But most doctors recommend too little of a level for it to change a clinical problem. And please know that many people have low nutrient levels with these clinical conditions, particularly stress activat, you know, anxiety and things like that. And also particularly with depression, because their body is in such overdrive that they're using nutrients.

That they should be able to get from food number one. But number two, most people with mental health issues have genetic mutations, which interfere with how the body utilizes these nutrients. So they're gonna need to be supplemented. You're not gonna be able to eat as healthy as possible to get this. So it has a lot to do with the stress activation and the nervous system and what happens to the resources in the body.

So, Recommending supplements. Two ways general or getting some training to legally protect you. Putting it in writing, but always having a disclaimer. But I don't think, you know, unless you're really diving deep into it, you're better off just doing general stuff. Here's a research summary, here's a blog of somebody else, or whatever it is.

But I think it's helpful to have, they're asking questions I, number one, questions any patients ask me about, or not even patients, like on all my social media follow, it's always supplements. Yeah. Yeah, I know a lot

Chris McDonald: of interest in that and cuz it can be very helpful. And I wonder, is it okay for us to, to refer to like more of the doctors that are trained in that too?

Cause I know there's,

Dr. Roseann Capanna-Hodge: oh, most definitely. Functional medicine and that kind of thing. Yeah. I mean I have great, I think everybody who's moving into integrative needs to find. Two or three practitioners in their area who they love to refer to, who you can have a synergistic partnership with. Plus, I just, I love it.

I love care that's coordinated and my patients really appreciate that. I'll get on the phone, or I like to email people in this world, you know, having a conversation because we can't stop disconnecting the brain. And you know the body, right? We, we can't, we, we, mental health issues, you know, the, these are all related and it's shockingly positive how awesome some of these interventions can be.

You know, I was, um, recently on a podcast talking about just anatol. And Anatol is, is uh, basically an amino acid. It falls under the B vitamins and then it's really a lot of clinical research for mental health and. Things you wouldn't thought of, like eating disorders, panic disorder. And I use it a lot for O C D.

It's one of the top O C D ones. We can give this research to people. And what I tell people with, for example, just with Anatol, and this is consistent with the research, is that about one third of my people notice a significant improvement very quick. I mean within a couple weeks, but one third notice, some kind of change.

And about one third notice nothing. And you know, when I say to my. People, you have about two thirds chance. There's almost zero negative side effect from it. What do you think? Do you wanna do? You wanna try it? And they're like, yes. I mean, especially with like O C D, which anybody who's ever worked with somebody with O C D I think can tell you that if you're not trained in E R P, you feel like, oh my God, like that was a hard case.

Right? Like incredibly, incredibly hard because it's such an irrational, it's based in irrational fear. So when you're trying to talk to them, you get caught up in their irrational fears. And if you don't know how to corral it and move it and challenge it, you, you're like, I think I just, I. Made that worse, you know, so, so the case of an acetol, you know, it's really empowering for people to know, and I let my clients make, make choices.

But working with functional practitioners is amazing and, and that's the way to say, I don't wanna do any of that, but I want somebody else to educate them. That's a great way to be an integrative practitioner. You're on an integrative team. You know, never to say to your client like, well, that's terrible.

I don't think that's a good idea. You know, I mean, I'm always in shock sometimes what another practitioner will tell a client who's considering something integrative. They could say, I don't know about it, but if you feel good about it, give

Chris McDonald: it a try. And I think that. As a holistic therapist too, because I've developed a lot of resources for clients too to refer in the community.

I think that that's another piece that you can offer is I think we can't be good at every part of this. No, that's, I think that just being realistic, cuz I. I know listeners get very excited with holistic approaches and wanna do everything and learn all the, all these bits and pieces, but not to overwhelm you.

I think if you do try to do too much, it's, it's, you're not gonna be good. No. If you take on too much,

Dr. Roseann Capanna-Hodge: and I think where a practitioner has to start and just, and that is so important because you're talking about, I've been doing this for 31 years, and right out of the gate I became holistic. So I've now gone through a lot of trainings.

Of course. Right. I'm getting my cus and beyond, but I also am this very sort of, I'm very nerdy. I dive right in, you know, to everything. You gotta pick one thing and really master it. But I think you have to start with the psychoeducation for yourself about how that clinical issue affects the brain. So you can be super.

Awesome at educating your client with it. And then you really have to pick like, what are the one or two things that I really wanna start with and really master that before you start layering and adding it in, because otherwise you're not gonna get the response from your client population either. But I do believe, I mean, I don't think there's a therapist out there that wouldn't say Breath work is awesome.

Is it a work a hundred percent of the time? No. So this is where you, because some of our clients refuse it, or I have clients with O C D around sensory processing and they can't do breath work. Like, so there's limitations, right? Some of my trauma people

Chris McDonald: refuse to breath. Yeah, I was gonna say that. Yeah, sometimes, yeah, sometimes that's a safety mechanism that they breathe a certain way.

And when you change that, that can be activating, which puts them into sympathetic, which is not what you're looking for. Which is not

Dr. Roseann Capanna-Hodge: what you're, you're right. So we have to meet everybody where they're at, and that's. Where having, you know, some resources. But you know, if you're somebody, let's say you're a practitioner who specializes in anxiety.

Well, there are some really beautiful resources that are holistic, that work amazing for anxiety. You know, maybe it's understanding again, magnesium. I mean, magnesium is your friend. It doesn't matter if you're overstimulated or understimulated. Everybody needs it. We are so activated and magnesium is the number one most n nutrient used nutrient in the body.

It is a co-factor, so it's a helper in over 300 chemical processes. We are burning through it in our busy stress lives, our busy minds. I just feel like it's a standard for, you know, everyone always says like, what are you giving your kids? You know, like it's magnesium. It's vitamin D. It's of course a good probiotic.

So, um, we didn't even get into probiotics and people always ask me about, you know, the gut brainin access and things. So, you know, educating yourself about the, the gut brain access, like what is happening in the body. I. Under stress conditions is incredibly, incredibly helpful. And it's such an education point for clients.

And then you really have to decide like, what are those things I'm gonna own? How am I gonna do this? And you can play around like, okay, breath work. You don't need a certification for that. Okay. But let's say you're like, I love breath work so much. Biofeedback and heart math might be your next step. And you can buy that.

You can do that. You can do a clinical training course and get certified pretty inexpensively. And

Chris McDonald: I think meditation is another area. Meditation to kind of go into meditation. Yeah, but you don't have to be certified. I think there's some ways to practice with that too and get used to it before you,

Dr. Roseann Capanna-Hodge: before you teach practice.

It can be huge though. Meditation, it can be so big. Like I always feel like. I've learned, I mean, I've been using meditation like right at the get go, and I use a lot of, um, progressive relaxation meditations where you're tensing the body and releasing, because I feel like that's the biggest bang for your buck.

But I also did a lot of guided visualizations where people are releasing things. And even when I did that, I remember being very in my twenties and doing that with people and then, Not understanding. There's certain people, you can't get them to release stuff cuz it actually was the sympathetic trigger and you know, so having some guidance and a container for that, whether that's education on your own or you're doing a class, I do think is really important.

But I think basic level meditation, whether they're listening to something on YouTube, Why wouldn't we recommend that? And if

Chris McDonald: you're not comfortable doing meditation with clients, I have some supervisees who just play one in session, a short one, or I'll recommend it for homework. So you don't have to, like I said, you don't have to be trained in every single thing.

So if something you're not comfortable, but could be beneficial, you know, just use those modalities. So those free things that are already out there, like the insight

Dr. Roseann Capanna-Hodge: timer. Oh my gosh. Insight timer was like a game changer, right? Mm-hmm. You know, and, and you know, hearing like, oh, should I do EMR over Z just said e f T, tapping.

Oh, you know, like you've gotta see what it's like and then decide like, Ooh, I don't like doing that. Don't do anything that. Feels uncomfortable to you. You know, I would have people that would start training when I used to do a lot of mentoring with neurofeedback, and I definitely think it's a game changer.

It's such a commitment. It's so hard and I've, I've done training with physicians and they told me it was harder learn neurofeedback than to get their degree. Wow. But that's because it's complex than, it's not a straightforward way to do it. Like, okay, here's surgery and this is what you do. That's what they told me, and I was like, okay, but you know, then I had people who were just, Like, I'm doing it and I wanna continue doing it, but I don't like it.

And I was like, well, why are you continuing it? Because your clients are gonna know. But also, what is it about it that you don't like? Is it fear of yourself? Like, what is it? And you know, be your, put your own therapist hat on. Yes. And look at your own stuff, but you know there's gonna be more than one thing that's in alignment with who you are.

I think you just have to decide when you start and, and look at the results. Decide, do I wanna go deeper and do I wanna layer on more? And how much do I wanna make this as part of our practice? I can't imagine doing therapy today with the level of stress, which is so amplified than when I started in 1992.

Like so amplified. I can't imagine doing. Traditional talk therapy and psycho men meds with no other options in between. Yeah,

Chris McDonald: exactly. Well, this has been a wonderful conversation. I so appreciate you coming back on the podcast, Dr. Roseanne.