Breaking Barriers in Mental Health: Dr. Barbara J. Brown’s Mission for Accessible Care | Healthcare Series

[00:00:00] Anthony Codispoti: Welcome to another edition of the Inspired Stories podcast, where leaders share their experiences so we can learn from their successes and be inspired by how they’ve overcome adversity. My name is Anthony Codispoti, and today’s guest is Dr. Barbara J. Brown. Barbara is a licensed clinical community psychologist who has been practicing for over three decades and is the founder, CEO of Capitol Hill Consortium for counseling and consultation.

[00:00:29] Anthony Codispoti: Otherwise known as CCCC. This large private group mental health practice in the greater Washington DC region is celebrating its 15th year and employs over 80 staff that have served thousands of children, adolescents, and adults. Through the years, Dr. Brown has received both local and national recognition for her company’s contributions to the community.

[00:00:53] Anthony Codispoti: CCCC, which can be found at ccc cc Mental health.com was founded in 2009 as a mental health group, private practice dedicated to providing high quality, accessible and culturally responsive psychotherapy, psychological assessment and testing for children, adolescents, and adults. They also provide training for pre and post-doctoral psychologists, including an American Psychological Association accredited internship.

[00:01:23] Anthony Codispoti: A new clinical and community professional development program for early career social work counseling and marriage and family counselors launched in fall 2023 with the ambition of becoming a national model for clinical and community focused mental health practice. Now, before we get into all that good stuff, today’s episode is brought to you by my company Add Back Benefits Agency, where we offer very specific and unique employee benefits that are both great for your team and fiscally optimized for your bottom line.

[00:01:52] Anthony Codispoti: One recent client was able to add over $900 per employee per year in extra cash flow by implementing one of our innovative programs. Results vary for each company and some organizations may not be eligible to find out if your company qualifies. Contact us today at add back benefits agency.com. Now back to our guest today, the founder of Quad C, Dr.

[00:02:14] Anthony Codispoti: Barbara Brown. I appreciate make making the time to share your story today.

[00:02:18] Dr. Barbara J. Brown: Thank you. Thank you for having me today.

[00:02:21] Anthony Codispoti: So, Barbara, tell us what first drew you to the field of behavioral health?

[00:02:26] Dr. Barbara J. Brown: Oh, that was, uh, fortunate in, in my, uh, high school, I was, um, provided an opportunity to take psychology and my um.

[00:02:39] Dr. Barbara J. Brown: Professor was both a minister and taught a psychology. And so I really was introduced to it, um, through a spiritual component, but also a way of healing, uh, people. So learned about, uh, Jung and dream psychology and primal screen therapy. And I was hooked in terms of just, you know, being fascinated by studying human behavior.

[00:03:02] Dr. Barbara J. Brown: So

[00:03:03] Anthony Codispoti: and so from there, what inspired you to first start your own practice?

[00:03:07] Dr. Barbara J. Brown: So, I had never planned to start my own practice. I really, um, when I went to Boston University for my grad school in, um, clinical and community psychology, I intended to just, you know, serve the community. So I, I started running, um, well.

[00:03:25] Dr. Barbara J. Brown: Being a psychologist as well as, um, being an administrator for various programs that were based in the community, uh, hospital, um, outpatient, uh, treatment programs, um, government, uh, government, uh, clinic as well. And so. The reason And universities, I’m sorry, I worked at universities, so I had a lot of different kinds of experiences, but it wa was really the fact that, um, there were glass ceilings there for a black woman as well as, um, just the bureaucracy, the level of bureaucracy that led me to start my own practice.

[00:04:10] Anthony Codispoti: And how has that evolved over the years? I mean, you started probably just, was it a, a one woman show? Did you Yeah,

[00:04:17] Dr. Barbara J. Brown: I started a solo practice. I had a mentor who was very, uh, good, Dr. Joyce Berry, who was excellent and really taught me the business of private practice that they don’t tell you about in school.

[00:04:30] Dr. Barbara J. Brown: And so, um, I built my private practice successfully and then I decided to, uh, join with some partners. And we had a psychiatry component, a psychoeducational component in psychology, and we, uh, started a group practice family assistance in coping with trauma and stress that lasted 11 years. And my partners, um, grew weary of, uh, of having a private practice and, and the struggles of it.

[00:04:59] Dr. Barbara J. Brown: And so they departed. Still good friends, uh, and colleagues, but I decided to then shift to, um, Capitol Hill Consortium for counseling and consultation because we had a small number of, uh, we had about eight clinicians working for us then, and really I wanted to make sure that it became. Um, a group practice that everyone could basically join and own their portion of, could show their expertise.

[00:05:32] Dr. Barbara J. Brown: So that’s why the term consortium of really coming together of like-minded people, we developed our, our mission statement and um, really started attracting, you know, people who were like-minded. In, in the area of working to provide. Services regardless of ability to pay. And so we took public and private insurances and just really had a wide swath of people, you know, age.

[00:06:03] Dr. Barbara J. Brown: I always joke and say age three to 83. Um, and, you know, providing all sorts of services in terms of psychotherapy for individuals, um, groups, families, couples, um, and then the psychological testing. Spans the, the variety of, uh, psychoeducational testing, personality assessment, neuropsych assessment, uh, cognitive assessment and intelligence testing.

[00:06:33] Dr. Barbara J. Brown: So we have all of that.

[00:06:35] Anthony Codispoti: And so how do most people find their way to you? Are they finding you online or per, or, you know, they have to come through like a primary care physician for a referral.

[00:06:45] Dr. Barbara J. Brown: Um, things have evolved over the years. Because we, we’ve just become very well known by all sorts of practices.

[00:06:55] Dr. Barbara J. Brown: Um, so we get a lot of our patients, uh, our clients from our current clients. They refer their family and friends. Um, we get a lot from insurance companies. We get a lot from doctors, uh, phy physical doctors in the area, uh, hospital settings. You know, we, we are pretty well known at this point.

[00:07:15] Anthony Codispoti: What are some of the most common conditions that are presenting themselves?

[00:07:21] Dr. Barbara J. Brown: So the garden variety, anxiety and depression and, you know, stress management. But I think we also, um, are well known for our trauma work. Uh, and that can range from, um, emotional neglect to physical and sexual abuse. And, um, we do have, uh, some veterans also who come back and need, uh, help for post-traumatic stress disorder.

[00:07:52] Anthony Codispoti: And what are you finding are some of the more effective types of treatment for whether it’s PTSD or other types of trauma neglect, uh, physical abuse.

[00:08:04] Dr. Barbara J. Brown: So we, uh, I, I personally have a psychoanalytic, uh, psychodynamic background and so I blend that with cultural features and. You know, we’re an integrative setting, so we have cognitive behavioral therapy, we have the, the range.

[00:08:21] Dr. Barbara J. Brown: So, but for trauma in particular, what we do, I think that’s different from other agencies is, um, we do evidence-based work, but we will go into the root. We really try to get to the root of the, the core issue. Um, and that takes time. And so I. I tend, I didn’t have a phase specific kind of treatment. I’ll do an initial assessment and find out basically, um, you know, uh, not only what happened, but also a lot about.

[00:08:59] Dr. Barbara J. Brown: Any patterns that are recurring in the person’s life that are indicative of attachment issues that may have happened that often happen because of the trauma with other people. I assess for ego strength to see how, how well people can tolerate going in and dealing with the trauma directly, and usually I find that people need.

[00:09:22] Dr. Barbara J. Brown: Better coping skills. And so, um, before we go deep, and so we have a dialectical behavioral treatment that we also do to help with coping skills and um, so that’s often mixed with the supportive psychotherapy. Getting to know the client, client, building a trusting relationship, helping them with coping skills, and then we can go further into the trauma in terms of the impact that it had on the in individual.

[00:09:54] Dr. Barbara J. Brown: You don’t always need to, um, discuss all of the trauma, but it is important to discuss the effects of the trauma and especially on the person’s sense of self and from that and helping people understand that. Uh, this is something that happened to them. It is not them. Um, it helps them get that distance so they can see that and go through the, the grieving in some way of, of the self that was lost because of the trauma, and then starting to rebuild a sense of self in a different way.

[00:10:31] Dr. Barbara J. Brown: Apart from the trauma, the trauma happened. But at the end of therapy, you want people to be able to put it on whatever shelf they want, um, that they have control of it. It doesn’t have control over them. And from that, they’re free to then start building their life in a new way.

[00:10:51] Anthony Codispoti: A couple of things. I wanna, um, go into a little bit deeper there.

[00:10:54] Anthony Codispoti: What does it look like when you assess for, um, ego strength? Is it sort of a, a series of multiple choice questions you’re taking people through? Is it sort of more of like a. Gut feel that you get from being in somebody’s presence?

[00:11:08] Dr. Barbara J. Brown: Um, well again, having a psychoanalytic background, I’m always looking for defenses that people use.

[00:11:14] Dr. Barbara J. Brown: And so I find that when we get closer to discussing what happened, people will do all sorts of things, um, to defend themselves from from it. Some people, uh, will use denial. Um, initially, and sometimes you don’t hear about the trauma until months after, um, a person starts treatment, um, because they’ve blocked, they’ve tried to block it out.

[00:11:41] Dr. Barbara J. Brown: Other people use humor. It, it’s like they’re telling you a story. Um, and, uh, you know, they’ll use humor as if it’s, uh, as a deflection of some of the true feelings. Um, other people have more serious. You know, defenses. Um, and I’ve worked with people with dissociative personality disorders, um, and all sorts of coping mechanisms.

[00:12:09] Anthony Codispoti: So I’ve heard stories before and I’m kind of curious to know how common this is, that somebody experiences rather significant trauma and then completely blocks out that it had happened until something triggers later in life that brings. This sort of back to the surface, is this more like TV and movie kind of scripts or is this like a real thing that happens somewhat commonly?

[00:12:36] Dr. Barbara J. Brown: It’s a common reaction because, you know, people are trying to survive and again, taking them to thriving is a different story. So they will, I see it a, a lot in, um, rape victims. That, you know, it will just be shut down. Um, and Willie won’t come out until much, much later and it will be triggered by, you know, a date or, uh, a person or, you know, any association could, could happen.

[00:13:12] Dr. Barbara J. Brown: Just

[00:13:12] Anthony Codispoti: something that who knows how in the brain. It sort of sparked a connection that. Right. Causes them to sort of re-remember this.

[00:13:20] Dr. Barbara J. Brown: Right. But then they often try to suppress it again. Mm-hmm. Yeah. You know, the goal of any defense is repression. We don’t, uh, that that doesn’t happen. It’s somewhere, it’s somewhere, it’s coming out in some way, uh, front way or sideways.

[00:13:35] Dr. Barbara J. Brown: And, and often again, it’s affecting people’s relationships with one another.

[00:13:41] Anthony Codispoti: Hmm. You made the point that they don’t always have to face all the trauma. What do you mean by that?

[00:13:50] Dr. Barbara J. Brown: I mean that we don’t have to get into all the details of the trauma. We need to know who was the perpetrator, um, and come to terms with who the perpetrator was.

[00:14:05] Dr. Barbara J. Brown: The closer the perpetrator, the more complicated. Uh, the relationships are so, you know, stranger anxiety, uh, is easier or stranger perpetration is in a lot of ways easier to deal with than someone you, you know, and you’re connected with. Mm-hmm. Especially in the family.

[00:14:29] Anthony Codispoti: Yeah. And you said sort of, you know, as you’re kind of taking them through this process, uh, at some point you get to the point where it’s time to work on rebuilding the sense of self.

[00:14:41] Anthony Codispoti: Mm-hmm. What does that process kind of look like?

[00:14:45] Dr. Barbara J. Brown: So first it starts with a lot of compassion for the self in terms of, um, and there are many techniques, um, to kind of separate. You know, the, what is commonly called the inner child, you know, the younger self that was hurt from the self that is starting to, um, be able to be a caregiver of that part of you.

[00:15:13] Dr. Barbara J. Brown: And so viewing that person, uh, that self, uh, with compassion, uh, as opposed to. What often has happened is they’ve condemned like it’s somehow the, the victim’s fault, you know, somehow their fault. And so, um, after you shift that to something that was done to you, then um, rebuilding first again. Um,

[00:15:44] Dr. Barbara J. Brown: it’s really helping that self come along and be reparented. Um, by yourself. Um, so they’re, they’re no longer a, um, they’re not viewed negatively. Um, they’re helped. They, you have to take them wherever they were hurt and then help them come back to the present and reshape relationships. Um, so lots of trust building first in your own self.

[00:16:17] Dr. Barbara J. Brown: Trusting yourself and then gradually, uh, trusting others. A lot of the clients that I work with go from individual therapy with me, and then they go into group therapy.

[00:16:30] Anthony Codispoti: Okay. That’s sort of like a, like a graduation process, right? Yeah. So are you still, um, practicing quite a bit? I mean, actually actually over 80 clinicians, like, it seems like you’ve got a lot of, actually,

[00:16:42] Dr. Barbara J. Brown: I have replaced myself.

[00:16:44] Dr. Barbara J. Brown: You know, when I said that, I said, oh, I’m not doing this, you know, so much anymore. I do supervise people, but um, no, I’m not in the day to day I had to step away actually right after the pandemic or during the pandemic in some ways to start taking care of the business that, that, uh. One of the questions that you have for me is, uh, about difficulties in the pandemic really, really, really changed the business.

[00:17:11] Dr. Barbara J. Brown: So

[00:17:12] Anthony Codispoti: let’s hear more about that then I.

[00:17:14] Dr. Barbara J. Brown: Sure. So, you know, the first thing was just like we were a hundred percent in person. Mm-hmm. And in the space of a weekend, you know, we had been talking about telehealth, but we had not planned anything, um, any timeframe. But when, I think it was March 18th came, we, you know, basically said, we’ve gotta.

[00:17:37] Dr. Barbara J. Brown: We’ve gotta do something else. So we went from a hundred percent in person to a hundred percent remote in a weekend and without even, you know, losing any clients, clinicians, you know, set, just setting it all up to, to, uh, succeed. And that’s with about a thousand clients a week.

[00:17:57] Anthony Codispoti: Wow.

[00:17:58] Dr. Barbara J. Brown: Yeah. It was really just at the flip of a

[00:18:00] Anthony Codispoti: switch, you had to do it.

[00:18:01] Anthony Codispoti: And so was there, we had to do it. Was there a platform that you guys could go to? Were you just using Zoom or like how did you make it up? No, we hadn’t

[00:18:09] Dr. Barbara J. Brown: even, we hadn’t even started with that. We, we cho we had been looking at platforms and so we chose a platform. I think we were with Valent at that point.

[00:18:18] Dr. Barbara J. Brown: Um, but we had to do, uh, we were not integrated. We had Zoom separate. Um, we had, you know, billing separate. We had all of that. Now we’ve integrated all of that. But, um, at the time it was just like, what can we, what can we do quickly and HIPAA compliant in, in HIPAA compliant way in getting all the clients to sign this new telehealth form.

[00:18:41] Anthony Codispoti: Yeah, so. Now a lot of businesses that I talked to as they went through the pandemic, there were times where they’re like, I don’t know if my business is gonna survive. I’m gonna guess that wasn’t the case. No, we grew for you, you were overloaded, right?

[00:18:54] Dr. Barbara J. Brown: Yeah. We grew, we, we grew I think three or four times larger.

[00:18:58] Dr. Barbara J. Brown: I mean, it was just amazing. And I kept hiring clinicians and, um, we were all remote and for that two year period. So it really, and how were you

[00:19:09] Anthony Codispoti: finding clinicians?

[00:19:11] Dr. Barbara J. Brown: Um, they were finding us. I mean, we always advertise, um, but people resonate with the mission and, you know, to, to be able to give back to everybody and to really, um, make mental health accessible.

[00:19:27] Dr. Barbara J. Brown: And as you can imagine, a lot of people were really hurting during the pandemic. Especially, we did a lot of, um, work with frontline people too. Mm-hmm. The physicians, um, especially they were, they were having such a hard time, it was such a scary time for them.

[00:19:43] Anthony Codispoti: Yeah. I’m kind of curious, you know, as somebody who had a front row seat to sort of mental health picture pre covid during Covid, and now that, you know, we’ve kind of come out of that, what, what sort of, how, how would you sort of describe the trajectory, the curve?

[00:20:01] Anthony Codispoti: If you were to kind of describe it in, in a big picture term,

[00:20:06] Dr. Barbara J. Brown: um, I think it really depended on your ability to adapt to different, uh, circumstances. And some people adapted pretty well and took advantage of it, and some people adapted very poorly, uh, or they didn’t adapt. And, um, you know, the mental health crisis.

[00:20:26] Dr. Barbara J. Brown: As you know, got so much worse with young people. A lot of anxiety, just, uh, anxiety on its deepest level, it’s, it’s not having control. Mm-hmm. And none of us really had control over that period of time, and so you just had to, as I said, adapt or be anxious a lot. Mm, depressed, isolated people who were in relationships during that period of time that were positive, you know, got a lot out of that time together.

[00:21:04] Dr. Barbara J. Brown: People who, um, were having difficulties or ran into difficulties, you know, there were a lot of breakups during that period of time. Yeah, we don’t know. I don’t know the extent of domestic violence that was occurring. Uh, without any outlets, you know, people, if kids were not going to school, people weren’t going to work.

[00:21:27] Dr. Barbara J. Brown: What were the outlets? So I, I would imagine a lot of negative things happen as well

[00:21:34] Anthony Codispoti: that we don’t

[00:21:34] Dr. Barbara J. Brown: even know about

[00:21:35] Anthony Codispoti: Now that we’re on the other side. Yeah, for the most part. What are you seeing? Is there a recovery? Are people still struggling? What

[00:21:46] Dr. Barbara J. Brown: I think people are recovering. I know that a lot of mental health, uh, programs started as a result.

[00:21:53] Dr. Barbara J. Brown: A lot of funding started coming into mental health as a result. Um, we are in the school system. Uh, now that was one of the grants that we, we, uh, got after the pandemic to help the kids. Um, and, and kids, kids need, need help. But I, and the suicide rate, I had never seen kids that young, I mean, very young, be very serious about suicide.

[00:22:20] Dr. Barbara J. Brown: You know, they just, the loss of hope, the loss of, um, you know, uh, wherewithal to keep going. So. How young are we talking? Depression. I saw kids as young as six and before the pandemic, um, there were some kids who were talking about it, but they weren’t serious. These kids were serious. Wow. Yeah. So, um, the need for family support is also great.

[00:22:52] Dr. Barbara J. Brown: I always think that I, I have always thought, uh, since I was a sociology and psychology major at Wellesley, that um, the family has got such a burden on it to carry forth all these things for, for the human condition. And it’s too much. We don’t have enough support, I don’t think, in the United States, but, um, when families became isolated like that, and it was a matter of who had resources and who didn’t.

[00:23:20] Dr. Barbara J. Brown: It just got much worse. Yeah. And if the family, if the adults can’t support the children, the children can’t support themselves. It’s, it’s really, they try, but it takes a toll. Always takes a toll. ’cause they, they’re not allowed to be kids.

[00:23:38] Anthony Codispoti: You know, there was a lot of debate going through covid about, you know, should we isolate, should we not isolate?

[00:23:43] Anthony Codispoti: Should we mask, should we social distance, should we come back together? Um, and you know, early on I was a big proponent of. Man, let’s lock down, let’s mask, let’s separate, let’s do as much as we can to prevent death. Having now come through and hearing stories like yours as well as many others, um, I think the big part that I discounted was the mental and emotional suffering that would come from.

[00:24:08] Anthony Codispoti: Being isolated like that, you know, for me it was just, Hey, if we can just stay apart long enough, we’ll get some vaccines. You know, like, we’ll, we’ll make it through this. Um, you know, because once somebody, once somebody passes away, you know, there’s no undoing that there’s no bringing them back. Right. But the, the part that I so heavily discounted was this component of human suffering that went with being, you know, physically disconnected from each other.

[00:24:34] Dr. Barbara J. Brown: And I think we all did. I, I, you know, it was just how do you, how do you stay safe during this very scary period? And with people dying at such high rates, it’s like, I’d rather stay home.

[00:24:48] Anthony Codispoti: Right. So how has your mission evolved sort of through Covid and, and post covid?

[00:24:55] Dr. Barbara J. Brown: I think we’re just really trying to find resources.

[00:24:59] Dr. Barbara J. Brown: You know, more and more resources to bring to people, um, and insurance. Again, taking insurance isn’t always the easiest, uh, path. You know, a lot of businesses, uh. Psychologists, therapists in general went into self-pay practices because of some of the issues with insurances. Um, managed care, I always say I, I started the field and I had my first private practice, uh, in the eighties before managed care existed.

[00:25:33] Dr. Barbara J. Brown: And so just seeing, seeing it now and how it’s evolving and how much control. Um, people who are not, uh, the therapists or are not the providers have over our practice is just not the best sort

[00:25:56] Anthony Codispoti: of. Right. People who aren’t trained and aren’t seeing the patients or making decisions on what level of care they should have access to.

[00:26:04] Dr. Barbara J. Brown: Uh, yes. Yeah,

[00:26:05] Anthony Codispoti: yeah, yeah. It’s a challenging situation for sure. Are, are there, I mean, you talk about being able to accept, you know, people across different abilities to pay. Are there, um, you know, do you take donations? Is there like a nonprofit component to this so you can serve people who.

[00:26:23] Dr. Barbara J. Brown: Well, so most people can get, um, Medicaid or, um, if they can’t get that, they can get, um, the public, you know, the commercial insurances through their, their work and through the, um.

[00:26:39] Dr. Barbara J. Brown: The healthcare, like we use d DC Health Link, you know, the Affordable Care Act allows that. So, uh, we mainly go through that. There is a low fee component If people can’t pay, um, we can have a sliding scale. I. I tend to come from the point of view that people should, um, in order to be accountable for the value of the, the work.

[00:27:04] Dr. Barbara J. Brown: Um, if they can’t, if they’re not paying, if Medicaid, then you need to show up to your, your meetings. Um, but if you can pay, then even a small amount is important for people to, to value it.

[00:27:19] Anthony Codispoti: Great. You’ve grown. To what, 80 clinicians now? Over 80 clinicians?

[00:27:25] Dr. Barbara J. Brown: Yeah. We have, we have 80, 80 clinicians and including our, our trainees.

[00:27:30] Dr. Barbara J. Brown: So,

[00:27:31] Anthony Codispoti: and we just touched on already how your role has sort of changed. You’re not, um, practicing like you used to. Do you miss that? Is has that been a difficult transition for you?

[00:27:43] Dr. Barbara J. Brown: I think that it was, I mean, after. Doing it as long as I’ve done it. Um, I think that it was okay to transition. I still have lots of, lots of, uh, experience to rely on, but I, I keep in touch with it through the, the training.

[00:27:59] Dr. Barbara J. Brown: I, I am now the director of training in addition to being the CEO. Um, and so I meet regularly with all of the, uh. Trainees and students that we have, and we, um, I love it because I’m, that’s like my new passion is to help the, the next generation take over. So,

[00:28:22] Anthony Codispoti: so we touched on telehealth a little bit, and you went from a hundred percent in person to, you know, a hundred percent remote.

[00:28:29] Anthony Codispoti: Um, now I’m gonna guess. What was that? Now you’re hybrid. Now hybrid, right? Yeah. So, um, what percentage is in person versus remote, and do you, what are sort of the differences that you see between being able to deliver the care remotely versus in person?

[00:28:47] Dr. Barbara J. Brown: So, uh, we’re about 25% in person now. I would say 75% remote.

[00:28:54] Dr. Barbara J. Brown: And that’s, um, in large part because the clinicians prefer it, but also the clients have adapted to it and really, really like it. We found that our no-show rate went way down with telehealth. Um, and people could make it on time and stay the whole time going back to work. Even there’s more flexibility from their jobs and being able to do, um, in, do both in-person as well as, um, remote work, you know, during their, their lunch breaks.

[00:29:27] Dr. Barbara J. Brown: So. It’s really helped. I think we were all therapists, were surprised that we were the more resistant ones to starting telehealth and, but once we started it, we love it. Um, you can do a lot more, um. A lot more than you think in terms of reading nonverbals, reading, you know, being in interaction just like we are today.

[00:29:56] Dr. Barbara J. Brown: You know, you can tell how someone’s feeling, you can tell all of that. Um, I do think it’s more difficult with children. It’s hard to, there are some play more and more play therapy, um, techniques that you can do online that are, are, are, um, digital. Um, but allow some of the same thing that you can get in person where it’s more interactive.

[00:30:22] Dr. Barbara J. Brown: But I still, you know, that and psychological testing again, uh. The field has adapted to the need and so there are testing things that you can do that are, have manipulatives that you can use online as well. But by and large, we still like prefer the play therapy in person and the testing in person. I.

[00:30:45] Anthony Codispoti: I am gonna guess, especially in a heavily congested area, like the DC area where you guys are, that, um, you know, not having to drive across town or, um, you know, fight traffic is, is probably a big reason that both clinicians as well as patients are taking to this and a big reason why the no-show rate has dropped.

[00:31:04] Dr. Barbara J. Brown: Yes. And you know, the pay payment for parking and all of that. Mm-hmm. That ha that goes along with the commute. So it, it is much easier.

[00:31:14] Anthony Codispoti: So are you able to employ clinicians who live in different parts of the country then? Does that give you sort of more flexibility in hiring?

[00:31:21] Dr. Barbara J. Brown: It does. Um, but we try to do that very carefully.

[00:31:24] Dr. Barbara J. Brown: It’s, um, because, you know, again, the. One thing about having, being in a remote world is trying to connect, and we do find that when we do have in-person, you know, get togethers there, there’s a different feel to it than just seeing each other on Zoom. So, um, we prefer to have people that we know, but. Having said that, we’ve had clinicians who have been with us and then have moved, um, to other locations, and we feel very comfortable with employing them because we know them.

[00:31:57] Dr. Barbara J. Brown: And if someone has been recommended to us by one of our clinicians, then that that helps. Um, but otherwise it’s really screening and just really having at least three interviews and really making sure there’s a good connection and that our values are the same and our practices are, you know, just again, excellent and ethical and, and, uh, life changing.

[00:32:21] Anthony Codispoti: How do you, Barbara, how do you. Ensure that across such a big workforce that is geographically spread out. I mean, even for, you know, most of the folks I get are still kind of in the same physical region, but you’re not in person together, all of you all the time. I would imagine that presents some challenges.

[00:32:40] Dr. Barbara J. Brown: Yeah, it, it certainly does, especially in terms of feeling people feeling really connected. But we do have, uh, several things in place. Again, we have supervision for people who are not yet fully licensed. So, um, licensed graduate workers, or again, our predoctoral or postdoctoral, um, trainees. But then we also have peer consultation.

[00:33:06] Dr. Barbara J. Brown: And peer groups that, that are, are, I would love everyone to be in them, but not everyone has has the time. But we know we can con contact each other as needed for consultation and especially on issues where there’s liability. You wanna have a second opinion? Um, we also have a, a unique thing called challenging case, um, presentations.

[00:33:32] Dr. Barbara J. Brown: And so twice a month people can come. Anyone can come and present a case that they’re having a challenge with and we’ll, we’ll discuss it as a group.

[00:33:40] Anthony Codispoti: Hmm. Your team has been described as experienced, multicultural, multidisciplinary. Why is the diversity component, uh, so important in providing. Effective mental health services.

[00:33:58] Dr. Barbara J. Brown: I think we wanna be representative of our society for a few reasons. I al I also think it’s, we’re good role models for other practices in terms of really looking at diversity as a strength. Um, but also we have a lot of variety in terms of, of who people can relate to. And so because I started the company, we have a lot of people coming and asking for a black female therapist.

[00:34:31] Dr. Barbara J. Brown: Um, we, some of our male therapists don’t get it filled at the same rate as the female therapists, because even men, and this has been throughout my career, often men when they’re coming in this vulnerability, oh, they want to see women as opposed to men. But we value our men in our practice as very much, and, um, even though there are fewer of them than there used to be when I started, um, women were the, the minority instead of the majority when I started, um, in practice.

[00:35:05] Dr. Barbara J. Brown: But now it’s the reverse.

[00:35:07] Anthony Codispoti: I mean, you, yeah. You talked about in the beginning of the interview, sort of the glass ceiling that you were running into. Mm-hmm. I’m gonna guess some combination of, you know, being African American, some combination of being a woman. Um, have you seen both of those sort of glass ceilings kind of.

[00:35:23] Anthony Codispoti: Disintegrated or do you think there’s still very much that? No, I didn’t know to. Pollyanna not, we’re not there yet. Huh? Okay.

[00:35:31] Dr. Barbara J. Brown: No. I will tell a story of we had, I. Because our practice had, uh, been very successful in keeping people out of the hospital who had a lot of complex trauma. We were asked to, we were on the preferred list for, uh, as providers, one of two in DC at that, at that point.

[00:35:55] Dr. Barbara J. Brown: Anyway, we were asked to join a group and, um. It is, I think it was myself and maybe one other female. And of this large group and everyone else were, were males, um, white males. And when I, I was asked to come back to, um, GW to help out. They were having some issues there. And so I came, I went back there and, and I had someone else, um, take over the practice for a little bit, even though I was still with the practice.

[00:36:26] Dr. Barbara J. Brown: Um, but I was just doing a side. Uh, thing in helping gw anyway, um, I sent him to the, uh, same meeting I had been going to for a year, and he was a white male, and he got invited out to this, you know, old boy network to enhance the practice that I had never been invited to. And I was like,

[00:36:51] Anthony Codispoti: nobody ever brought it up even.

[00:36:53] Dr. Barbara J. Brown: Nope. And I said, huh. This is something.

[00:36:58] Anthony Codispoti: Yeah.

[00:37:00] Dr. Barbara J. Brown: So no, it exists. Okay. And I’m in, I’m in a, I’m in a lot of, um, female business, um, groups. I. As a result. Yeah. Um, ones that are just strictly for, for, um, black women like the Bow Collective, um, black owners and Women Collective. Um, but I’m in the women president’s organization, um, women elevating women, just a lot of things where you get validation, you get, um, colleagues who.

[00:37:32] Dr. Barbara J. Brown: Who wanna help you. So,

[00:37:35] Anthony Codispoti: and these groups that you’re a part of, is this, um, more business development or is this, um, more of, um, sort of engaging with the community? I mean, community empowerment seems to be central to your mission, right?

[00:37:50] Dr. Barbara J. Brown: Yes. Um, so a lot of it, some of the groups are both and, um. In terms of business development is, is their primary goal.

[00:38:01] Dr. Barbara J. Brown: But I’m like with the, one of my newest ones is women, uh, the women’s, uh, business collaborative. And I’m in a special group, you know, the Women of Purpose, and so we really wanna make a social impact. So it’s, it’s both and. Uh, the Bo Collective we’re working on, um, black women empowerment in our society and really building that in a financial structure that we don’t have enough of.

[00:38:29] Dr. Barbara J. Brown: So,

[00:38:31] Anthony Codispoti: Barbara, I’m curious, are there any, um, new types of, uh, therapies or approaches to therapy that you’re excited to either continue to follow or maybe, you know, use yourself?

[00:38:43] Dr. Barbara J. Brown: Yes. I think, um. The frontier that is really, and it’s toddler phase is really, uh, neuropsychological you, you know, just really brain behavior, uh, really understanding the brain much better.

[00:39:00] Dr. Barbara J. Brown: And, um, some of the techniques that are newer, like tapping or EMDR are, have a neuropsych basis to them. Uh, neurobio feedback, you know, really trying to help the brain do something different. We, we used to think, you know, very backward, like the, you know, the brain didn’t have plasticity, it didn’t have a way of, of resilience, et cetera.

[00:39:28] Dr. Barbara J. Brown: And now we know that’s not true. We, you, the brain keeps evolving and that, um, nothing has to be set in stone even though it can be hardwired. There’s still ways, there are approaches, uh, that are now being called like bottom, bottom up approaches to, to pass the verbal. The verbal is head down. Uh, the bottom up approaches are not verbal, but they are effective.

[00:39:56] Anthony Codispoti: So, uh, explain what tapping in EMDR.

[00:39:59] Dr. Barbara J. Brown: So EMDR is, um. Uses the bilateral parts of the brain to help shift people while they’re talking about some difficult areas, or they’re trying to reinforce positive, uh, coping skills. And so bilateral means that you’re using, you know, you have the person follow your fingers or, um, you know, there’s other, you can use your, you can use tapping or you can use, but you’re using both sides of your brain to kind of help.

[00:40:30] Dr. Barbara J. Brown: Um. Uh.

[00:40:36] Dr. Barbara J. Brown: Breakup the previously, uh, set patterns and

[00:40:42] Anthony Codispoti: shift, is it sort of like forming new pathways in the brain?

[00:40:46] Dr. Barbara J. Brown: Yes. That’s the, that’s the idea is like when it, they’re, the pathways are always there, but when you keep doing the same thing over and over, it just, it’s, that’s what you automatically go to. So to shift it, you want to, um, create new pathways.

[00:41:03] Anthony Codispoti: I’ve seen, uh, some wearable devices that, um, I don’t know, neck or head area that will deliver like, uh, small, like electrical stimulation. Is that kind of in this same field or is that kind of ho

[00:41:17] Dr. Barbara J. Brown: I think I, I don’t know which one that’s called ’cause there are a bunch of them coming out. But, um, yes, they’re trying to, to get to different parts of the brain.

[00:41:25] Dr. Barbara J. Brown: Yeah.

[00:41:25] Anthony Codispoti: Same, same kind of idea. Yeah. Yeah. Um, Barbara, you’ve been involved in mental health advocacy through different published works and speaking engagements. What are some of the messages that you’re most excited to share?

[00:41:41] Dr. Barbara J. Brown: I, I always like the normalization. Issue. It’s like we all have issues. Um, we believe that the healthiest people have been in therapy have done therapy either by themselves ’cause there are these wonderful self-help books or with someone through more guided facilitation.

[00:42:05] Dr. Barbara J. Brown: And that, uh, the joke is that people are in therapy. Uh. You know, because of other people, you know, that they’re in, in touch with. Um, but again, the, the relationship to self is also critical. So I always wanna make sure that people know that it’s okay, the whole thing, it is okay not to be okay. Before that existed, it was just really trying to normalize whatever you’re going through.

[00:42:32] Dr. Barbara J. Brown: Um, we can work through and it’s important to work through that self-awareness that you have. Is important, um, as well as, you know, being surrounded by a supportive community. Are there

[00:42:46] Anthony Codispoti: any types of treatments, um, maybe new or experimental that you’re kind of, you’ve got an eye on, you’re like, yeah, that, uh, that’s probably something people should stay away from?

[00:42:57] Dr. Barbara J. Brown: No, I, I think because we’re, you know, some things are tried and true and we know they, they work. Other things we are experimenting with and we’re testing, we’re seeing what the outcomes are. But you have to, you have to experiment because if you don’t, you’re gonna stay the same. And so, um, I, I told, I said, I mentioned primal screen therapy that I was introduced to in, in, uh.

[00:43:28] Dr. Barbara J. Brown: High school? No, I don’t use that technique. What is it? Basically just releasing. Okay. It’s basically a cathartic release. I think there’s, uh, lots of ways other than that to, to do that. Um, but it’s, um, you know, I, I, I think we have to experiment to keep, keep going. You know, and see what works. We just have to have good handles on it.

[00:43:54] Dr. Barbara J. Brown: That’s why they have, uh, internal review boards for any kind of experimentation for research, um, so that we make sure that it’s ethical and that it doesn’t hurt people more than it’s helping.

[00:44:07] Anthony Codispoti: Why did you, uh, get away from Primal screen therapy?

[00:44:11] Dr. Barbara J. Brown: Um. I, I don’t think it was, I, I heard it wasn’t very effective.

[00:44:17] Dr. Barbara J. Brown: And, and it’s too loud. I, it hurt my ears, so, so,

[00:44:22] Anthony Codispoti: fair enough. Yeah. Uh, plus if we’re doing telehealth now and I’m in my office taking, taking my, uh, telehealth visit. Yeah. I don’t wanna upset my, my coworkers.

[00:44:33] Dr. Barbara J. Brown: Right, right. Yeah.

[00:44:35] Anthony Codispoti: Um, where do you see the future of the practice going? Quad C, the consortium? What’s, what’s in store?

[00:44:41] Anthony Codispoti: I.

[00:44:41] Dr. Barbara J. Brown: I see us expanding. Um, I do am looking, I’m looking at diversification in terms of, uh, payer types. Um, as we’ve gotten more contracts and insurance in some ways, um, is getting more bureaucratic in terms of their oversight. Um. I just wanna have more options. So, you know, we have, uh, self-pay components in terms of doing psychoeducational workshops and, uh, we’re have a series of webinars that we’re planning in terms of the training component, um, contracts in the schools, contracts with the military.

[00:45:23] Dr. Barbara J. Brown: I mean, we’re open, um, to, to different kinds of funding. I really, as I said, my passion. Um, at this point is really the next generation and developing an army of therapists that are really well trained in clinical and really have the outlook of wanting to help people in the community, not, not, uh, not just self pay, but just really being open and, and, um, finding more and more effective and faster ways to treat people.

[00:45:57] Anthony Codispoti: So is is the size of. The consortium, uh, unusual, I mean, are most, uh, mental health practices on the smaller side? Are, are you a bit of an outlier here?

[00:46:09] Dr. Barbara J. Brown: Um, we are one of the larger practices for sure in the, in the area and that growth as. It’s wonderful, but it has created challenges in terms of keeping people, you know, connected and, um, but we, we do a pretty good job making sure our standard of care is good.

[00:46:29] Dr. Barbara J. Brown: We do a lot of outcome pieces with clients to make sure that they’re doing okay. They let us know if they’re not doing okay and then we help and, and, uh, they know that if, uh. Therapist is not the right fit for them that they can change. Um, but they like the flexibility that they, like the choice, that choices that we have in, in the people.

[00:46:52] Dr. Barbara J. Brown: And because we were one of the first, um, group private practices in the area, again, we’re well known. Um, we’ve been around for 15 years, tried and true. And so we, we see ourselves continuing. Um, I do see that. You know, there are a lot of national practices at this point that, um, are growing and certainly have knocked on my door many times to see if we are interested in selling.

[00:47:23] Dr. Barbara J. Brown: Um, you know, I, I think that, you know, it’s not something that I’m looking for because I’m looking for us to grow, but again, I, I, I have not found yet someone with the same. Value system as, as we have, um, that’s looking to, to, you know, expand that service. So I think people say that they are committed, but then people will only take certain insurances, et cetera.

[00:47:52] Dr. Barbara J. Brown: So, um,

[00:47:54] Anthony Codispoti: that was gonna be my follow up question is where are the disconnects? Is it primarily in the forms of payment, the insurance that they’ll accept?

[00:48:01] Dr. Barbara J. Brown: Yes.

[00:48:02] Anthony Codispoti: Like they don’t wanna take Medicaid. I’m assuming

[00:48:04] Dr. Barbara J. Brown: many of them don’t take Medicaid. Um, but some do. Some do, but not the, not the large, uh, national ones.

[00:48:13] Dr. Barbara J. Brown: And there’s, you, you, we have to be careful with the bureaucracy in Medicaid, um, because you don’t wanna turn off people who really wanna help people. Yeah. Um, by over, you know. Bureau bureau. The bureaucracy of it.

[00:48:31] Anthony Codispoti: Yeah. Right. Is there thoughts in your mind of expanding geographically from your base now?

[00:48:38] Dr. Barbara J. Brown: Yeah. Um, again, we’re in the DMV in, in Virginia, Maryland, and DC but um, as I said, some of our providers who we know who are still licensed here, um, have moved. And so there’s the possibility of opening up places there. As well.

[00:48:59] Anthony Codispoti: Barbara, you’ve got a lot of experience in clinical community psychology. Um, I’m kind of curious, uh, from your perspective, have you developed any unique theories or perspectives on.

[00:49:14] Anthony Codispoti: People, business, life in general, you know, being able to have helped so many people and now supervising so many people that are helping an even broader range of people. Are there sort of patterns or things that you’ve kind of identified?

[00:49:29] Dr. Barbara J. Brown: I don’t think this is new. Um, but it, it always amazes me how micro and macro.

[00:49:38] Dr. Barbara J. Brown: You know, really are the same thing. Whether you’re studying an individual, studying a, you know, a community, studying, a culture, studying, you know, globally, it’s, it’s human nature does not change. I. Human nature doesn’t change. Uh, that’s the science of psychology. And so when we’re looking at the, the aggression and the war, and I, I’m always thinking about who the, the leaders are and what they’re thinking and why they’re acting the way they are.

[00:50:13] Dr. Barbara J. Brown: And you can see it, um, in a family. You can see it, uh, in a warring, a person who’s warring with themselves. So it, it’s. That always amazes me that it’s the same, the

[00:50:26] Anthony Codispoti: micro and the macro is the same. Yeah. Whether it’s world leaders who are fighting over a piece of turf or it’s an internal family dynamic that there’s friction going on over something.

[00:50:37] Dr. Barbara J. Brown: Yeah. And so I find that fascinating and, um, I wanna write more and more about that. If I get, get a chance, I need the time.

[00:50:48] Anthony Codispoti: Um. What’s something you wish you could teach a younger version of yourself, doctor?

[00:50:54] Dr. Barbara J. Brown: Um, to go to business school or to, or to go into the Goldman Sachs or, or one of these things at a much earlier age because, uh, a lot of, I mean, I was, I didn’t go to school to become a business woman.

[00:51:08] Dr. Barbara J. Brown: I went to school to become a psychologist, and so I’ve learned by a lot making a lot of mistakes. Um, and going into some of the business, um, development groups has really helped. But I, an, an earlier version, I would’ve gone to business school in addition to this. To the PhD.

[00:51:29] Anthony Codispoti: You mentioned, uh, one mentor in the beginning of our conversation.

[00:51:32] Anthony Codispoti: Is there anybody else or maybe any books, uh, or other podcasts that have been particularly helpful in your, uh, personal professional development?

[00:51:42] Dr. Barbara J. Brown: I. Yeah, when I think of the influences besides, besides my father, my father, you know, and my, my family or, you know, physicians, uh, you know, like my sister’s the fourth generation physician in the family.

[00:51:57] Dr. Barbara J. Brown: So a lot of healing, a lot of community, uh, work. And then I had social justice people in the family who were really, um, really good at, in. Really focused on civil rights opportunities. And so those were very early influences. But David Satcher, I will say this, when he was, um, the, the, uh, surgeon general, um, and I, I was, was it in Carter?

[00:52:25] Dr. Barbara J. Brown: I think it was when Carter was around. I can’t, I can’t remember exactly, but he influenced me in. You know, his saying, you know, there is no health without mental health. Mm-hmm. And I, and for a physician to say that in, on a national level was so significant in terms of validating the role of mental health and it wasn’t popular at that time.

[00:52:52] Dr. Barbara J. Brown: He also talked a lot about the, the, um. The lack of resources in the black community in terms of mental health. And so those two things were really influential on me. I, I, I am just a, such a fan of his and he has continued his work. Um, I think down at Morehouse, I think, um, my. Hussein Abhi Bohan, who was my first reader for my dissertation on, which was the first dissertation on, um, violence in black couples in the eighties, in the early eighties.

[00:53:35] Dr. Barbara J. Brown: Anyway, he was a huge influence on me. He taught me about the psychology of, of oppression. Basically he was, um. One of the foremost exert e experts on Franz Fanon. And so what is that? Franz Fanon, who was a psychiatrist in, I think in Algeria. And um, so he taught me the psychology of oppression. So really putting that.

[00:54:01] Dr. Barbara J. Brown: Together with these very westernized psychoanalytic concepts and the psychology of oppression, how do you work together to help people free, you know, the individual bonds, um, that they have, you know, how do you free them from those? So, um, it was, it, those were my biggest influences in my career.

[00:54:25] Anthony Codispoti: Uh, Dr.

[00:54:25] Anthony Codispoti: David Satcher. If Google is to be believed here, was the 16th surgeon General, uh, served under Clinton from 98 to Clinton. 2002? Clinton.

[00:54:33] Dr. Barbara J. Brown: Clinton, okay. Yeah.

[00:54:34] Anthony Codispoti: Yeah. Carter would’ve been, uh, quite a few years earlier. Yeah, I was

[00:54:38] Dr. Barbara J. Brown: gonna say before I started psychology, right? Yeah.

[00:54:41] Anthony Codispoti: I think I was in diapers back then.

[00:54:43] Anthony Codispoti: Mm-hmm. Um, Dr. Brown, is there maybe something fun or interesting that we haven’t covered about you? Something that maybe most people wouldn’t even know about you?

[00:54:55] Dr. Barbara J. Brown: Um, the first thing that came to mind was, uh, I’ve been in the same book club since, uh, I moved to DC basically since 89, and we, we get together every month and read and talk and gossip and, you know, all sorts of good things.

[00:55:11] Dr. Barbara J. Brown: But we’ve been together and that has been a very special, you know, bond, uh, that I’ve had with these. We call ourselves the seven sisters. So

[00:55:21] Anthony Codispoti: I like that.

[00:55:22] Dr. Barbara J. Brown: Yeah. But there are actually 10, 10 to 20 of us at any given time, but

[00:55:27] Anthony Codispoti: it’s grown beyond the original core. I get it. Um, one more question for you, uh, Dr.

[00:55:33] Anthony Codispoti: Brown, but before I ask it, I wanna do two things. Everyone listening today, I know that you love today’s content. Please hit the like, share, subscribe button on your favorite podcast app. I also wanna let people know the best way to get in touch with you or with the consortium. What would that be? Sure.

[00:55:47] Dr. Barbara J. Brown: So our, our main number is 2 0 2 5 4 4 5 4 4 0.

[00:55:54] Dr. Barbara J. Brown: And um, again, CCCC. It, um, mental health.com is our website, and you can reach us by email at support@cccmentalhealth.com or for business, uh, purposes, business@cccmentalhealth.com. Great. Um, and you know, we are reachable.

[00:56:21] Anthony Codispoti: Yeah, we’ll have all that stuff in the show notes if somebody missed it. But last question for you.

[00:56:26] Anthony Codispoti: Um, how do you see the mental healthcare, mental healthcare space evolving in the next couple of years? What do you think? Maybe some of the biggest changes that are coming.

[00:56:36] Dr. Barbara J. Brown: Technology. Okay. Technology is going to, it is already starting. It just, uh, helping us. Helping physicians, um, and and therapists do what we do faster.

[00:56:51] Dr. Barbara J. Brown: I think it will help us in our compliance with all of the bureaucracy that is coming, uh, the value-based care models. Um, it will help us so that we could stay focused on our clinical work and, and helping people. Um, there are gonna be. Virtual agents, there are gonna be lots of things coming, um, soon. And so I can’t predict at all, but I just know that AI is gonna change the game and help people scale, help people have access, uh, help people save time, be more efficient in our operations.

[00:57:27] Dr. Barbara J. Brown: So technology for sure.

[00:57:30] Anthony Codispoti: Do you see the AI bots as a threat to. What you and your colleagues are doing. Do you see it as just a way, I mean, if, if an AI bot could do some percentage of what you and your staff do, does that feel like a threat? Does, does that re risk replacing somebody?

[00:57:51] Dr. Barbara J. Brown: I don’t. Not. Not to me, because I do think you’re just, the human element will always be there.

[00:57:59] Dr. Barbara J. Brown: That it’s just helping us. Maybe expand our workforce in the ways that we need to because there aren’t enough therapists for all the needs that there are. And, um, so I, I don’t, I don’t see humans being separate from what we’re gonna do with the technology.

[00:58:18] Anthony Codispoti: Do you see like a human therapist using AI to support, um, the way that they’re delivering care?

[00:58:27] Anthony Codispoti: Or is it sort of a different level of care maybe? You know, they, somebody can’t afford a therapist or, you know, they can’t get into the schedule or something, and so they meet with the, the AI tool today. Right. Do, do you have sort of a, any concept of how this might unfold?

[00:58:43] Dr. Barbara J. Brown: Yeah, I do. I do. I do. And I have NDAs on some things.

[00:58:45] Dr. Barbara J. Brown: Okay.

[00:58:46] Anthony Codispoti: Fair enough. Maybe we’ll have you back in the, in a couple of years as some of this is unfolded and you could give us a little peek behind the scenes.

[00:58:55] Dr. Barbara J. Brown: Yes. But yeah, there, there are lots of things happening that I think are, that will enhance our abilities, um, in the field and it won’t detract from it.

[00:59:04] Anthony Codispoti: Okay. Well, that’s very exciting. Sometimes the mystery of it is more fun of knowing, uh, what, what it actually could be. Well, Dr. Barbara Brown, I wanna be the first one to thank you for sharing both your time and your story with us today. I’m really grateful.

[00:59:19] Dr. Barbara J. Brown: Oh, thank you. This was, this was a lot of fun. You were a great host.

[00:59:22] Dr. Barbara J. Brown: Thank you. I

[00:59:22] Anthony Codispoti: appreciate your kind words, folks. That’s a wrap on another episode of the Inspired Stories podcast. Thanks for learning with us today.