[00:00:00] Speaker A: Welcome to the Art of the Referral.
[00:00:02] Speaker B: Podcast where we explore the nuances of mental health referrals to better serve our patients and our communities. I'm your host Anna O'Brien, a practicing licensed professional counselor and co founder of Be well Private Practice Communities and theravera Care Connection Technologies. I am passionate about creating a stronger professional community that works together to reduce provider burnout, increase continuity of care and ultimately improve the lives of people living with mental health challenges. Each week we dive into a different specialty or supportive tool bringing you expert interviews, practical advice and inspiring stories to help you master the art and ethics of referrals. Join us as we navigate the complexities of patient care, enhance our professional skills and build a more connected health conscious community. Let's get started.
[00:01:04] Speaker A: Hi and welcome to the podcast. We are here today with Dr. Kibby McMahon. She's the co founder and CEO of Coolamind, an AI powered platform that supports people coping with loved ones mental illness. She is also the co host of A Little Help for Our Friends with which is a podcast that gives science based tips for family and friends of people living with mental illness. Thanks so much for being here Kibbe.
[00:01:32] Speaker C: Thanks for having me.
[00:01:33] Speaker A: So Dr. Kibbe, how did you get into this topic? What kind of made you passionate about this area?
[00:01:39] Speaker C: Yeah, I think it's both personal professional paths. All kind of like all roads lead to Rome kind of thing. I always kind of come back to this point. I grew up with a mother who had a lot of difficult issues. She immigrated from Hong Kong and had a really tough divorce. So she struggled with alcoholism and depression, a lot of emotion dysregulation. And so I grew up in kind of being like a source of support or caregiver or person like antagonist.
And so that's what got me into psychology. And I did a lot of psychological research and yoga teaching and all that fun stuff. And I ended up at Duke university for my PhD program and I was specializing in dialectical behavior therapy, which is a therapy for very severely ill people with self harm, substance use, emotion dysregulation in general. And what we noticed was our patients were getting care with us, but their family members were also struggling a lot. They would be calling us, asking what do I do? My daughter keeps texting me saying she's going to hurt herself. I can't even focus on work, you know, like what? How can I support her? Also I'm going nuts. So we had this program at Duke for the loved ones of people with motion dysregulation. It was like an in person class. And we taught the science of what emotions and mental health are and gave a lot of skills like how to validate your loved one, how to communicate, how to set boundaries or limits. And it was just such a rewarding experience. It's just really cool to see when you can actually work on the patient's environment and make that support supportive. Right. So they're not just coming into therapy, you know, learning skills and getting relief and going home and then having the same problems. It's like you're actually changing their lives in like different ways.
So that that program, my experience with that inspired us launching the podcast in Covid, which was crazy, but we launched the podcast A little help for our friends, for the same group, loved ones of people with mental illness or emotions regulation. And that became popular and it just, it just kind of felt like there's a lot of hunger out there for support for the people around the quote, quote, identified patient. Right. So it's. The more I do this work, the more I realize that mental illness is not an individual thing, but it's a community wide thing. It affects the family. Right. So, yeah. So, long story short, I ended up founding Cooler Mind in the past year that's supposed to help the family members and friends of people with mental illness really apply skills in the moment. So something that we heard from people listening to the podcast or people in the program was that they're like, okay, great. It's so helpful to know what emotions are, how they work, how to validate them, and my loved one, how to set boundaries. But when I'm in the moment talking to my loved one and they're like, in huge distress, I don't know what to do. All my skills go out the window. So Coolamind was meant to really add that extra support, like give people skills and support in that moment, like on.
[00:04:58] Speaker A: Demand, whenever they need it. I mean, I love that. From my own clinical practice, I've definitely experienced what it's like to try to be working with someone and notice that there's a lot of interpersonal conflict at home. And it's challenging because in most situations, people's reactions are really coming from a place of wanting to support and help their loved ones. But you know, when we are really worried or concerned about the safety and health of someone, it sends us into fight or flight mode. And sometimes what we intend to do as support ends up actually exacerbating or causing more friction. And I, you know, I know a lot of people are just like, just tell me what to do. And it sounds like what your program is doing is really helping do one part psychoeducation of understanding what's happening, and then two, kind of giving some really specific ideas about situational scripts or things that you might do to support people in certain situations. And you were saying you kind of applying some cbt, Is that correct?
[00:06:03] Speaker C: Yeah, cognitive behavioral therapies, especially ones that are what's called like contemporary or third wave CBT's that incorporate mindfulness or acceptance. So we found that that's really helpful to teach loved ones to really accept their loved one as they are. Right. Not just lean on. They gotta change. They gotta change. But how can I accept what I can accept and do what's in my control?
So, yeah, I mean, just like giving. Giving those skills in the moment. Cause you're right, like in the moment. I mean, this is the case with all emotional issues. It's like you might know the right thing to do, but then when you're in that moment and it's like fight or flight mode, you know, all your. All your skills go out the window.
[00:06:46] Speaker A: So it's really difficult, I mean, even right as a trained clinician, because it's. It's family members right there. It's people that we love. And so it targets something that like, really pierces through the heart and it makes it challenging to separate out. And we have very personal reactions to family members. So I can totally see the benefit of this. And I'm curious, how have you found it to be most effective, like, in terms of how you set the platform up and ways in which you kind of offer that support?
[00:07:13] Speaker C: Yeah, I mean, we're experimenting now. We're so new that we are. That my approach is, hey, I'm just. This has always been my approach figure, like just talking to this group, talking to family members, thinking about my own experience or my friends experience and thinking like, what do people need? What do they want? That's how the podcast came out. They're like, we want more information. We want to talk about other topics. So I was like, okay, the easiest ways podcast. And for this platform, I paired up with an AI researcher from Duke, so we can make digital tools that really respond. One of the things that's so hard in CBT and therapy in general is learning these really great, effective CBT skills, like how to think differently and do things differently. But then to have to personalize it to your own situation is tough. Right? Like a good therapist can help you do that. Or if you. Sometimes it clicks and it works, but sometimes people go Like, I don't know how to restructure my thoughts. Like, I get the idea, it's pretty simple. But how do I do that when I'm super pissed at my loved one for drinking again? Right. So it's really hard to make that leap and to make that adaptation from the science of psychology to like, what am I supposed to do now with my loved one? And AI helps us do that, Helps us, you know, take those standard materials and make it applicable to you as an individual.
[00:08:41] Speaker A: That's really neat. So very situational. And taking into account the unique situation that's happening and what are, what are some of the kind of, you know, using that term, mental illness, what are some of the things that you see people needing the most support around? Like you mentioned the drinking. That totally makes sense. Right? Because that's a cycle that can be really challenging for folks. What are other types of situations besides just, you know, run of the mill depression?
[00:09:07] Speaker C: Yeah. I think that the people who tend to engage with us the most and need the most help are mostly women. Mostly women of the sandwich generation actually kind of fall into. It's people like me who are women in their 30s or 40s who are taking care of kids, taking care of their family members, have parents that might have mental illness themselves, and they're kind of like juggling everyone's needs, right? And it's when the needs are too high, when the needs of someone is just like great for them to handle. So often is, you know, someone with a kid who has substance use or other, kind of like a troubled teen kind of look, right. It's like they. Kids who are like falling apart, who can't handle daily challenges, or parents who are more self involved than they, I don't know, should be, quote, quote, that's a judgment. But just like older parents who have their own mental health issues who tend to try to communicate a lot with a potential client, like needing emotional soothing or get really angry, like high conflict parent relationships, those are the types that tend to seek support. Because I think women moms of sandwich generation are really motivated to learn how to support people better as well as they have this also, like, I know this very well as like a mom too. You have this idea that you're supposed to take care of yourself too and that you're like, I have 10 million things and demands on me. What am I, like what am I gonna get my nails done? Like, I don't know how to do that. So they tend to seek support through some. Something like us.
[00:10:47] Speaker A: So yeah, no, that Makes sense. I mean it's, it's challenging, right, when you get that call from a loved one where there's this kind of clashing of feelings of one wanting to kind of this instinct to drop everything and show up and be there and coach them through that. And then also in the sandwich generation, like very divided, lots of responsibilities between work and children if you have them. And then that kind of resentment can build or feeling like your hands are tied and there's no way to win. And we often like kind of swing into high emotions in those situations. Right. Of either kind of extremes. So it sounds like what you're talking about is really kind of looking at like, how do I make my support the most effective that it can be and take into account my own boundaries and my own needs so that I can continue to show up consistently as opposed to kind of throwing myself into trying to support burning out and then kind of sending mixed signals to my loved one.
[00:11:47] Speaker C: Yeah, it's just, it's just a fact now with our society that some people, some caretakers or people who are responsible for others, the burden is just too high. It's just too high to have a full time job and take care of a struggling kid and a spouse with addiction issues. Like, it's just like it's too much for one person to handle on their own. And suddenly people have to be in this position of being like an expert. Right. Like, especially if your loved one has gone through something very severe like they've had a drug overdose or alcohol overdose and they go into a facility or get a detox or they might have bipolar, disord or they harm themselves. Like when there's like a serious mental illness, the loved one goes into a hospital, learns all about what they have, like, learns all of, you know, like it's all the diagnoses and the words and the terms and treatment options. And then they come home and the parent or loved one, like just, you know, they don't know what's happening. They have their saddle with this huge job of being like essentially like a untrained provider at home, but they have zero training.
So it's scary, it's overwhelming. And it just makes sense to turn to professional support to be like, what do I do? And also I'm tired and I have my own resentment and own feelings and where do those go?
[00:13:14] Speaker A: Yeah, you know, that brings up a good, good point that I was, you know, I think there's so much meat to explore here and around. When you're working with someone who you know Has a. A family member. Right. Oftentimes depression runs in the family. So we may. These family members might already be in therapy support, doing their own work, and then this happens, you know, maybe a crisis situation or whatnot. And I know as a therapist, it can be really challenging because I feel torn and I feel like there's not enough minutes in the session to help support that person in processing their own experience and really honoring what they need in that moment while also trying to provide them with some tools on how to support their loved one. Right. Because ultimately their loved one isn't your client when you're an individual therapy. Right. So you don't want to go down that route or road. But it ends up if, you know, it feels like a big piece of the puzzle of like helping that person develop some skills to set themselves up for success in that relationship. Does interplay with their own mental health and their own concept of. Of self and the relationship. So, you know, in this podcast, as we talk about referrals, it's interesting because what you're talking about in some ways is, is more along the lines of coaching, right. It's not so much like therapy and session. And I can see different situations. One where perhaps someone doesn't struggle with mental health and, you know, they're just exasperated and need some tools. But then another situation where maybe offering it as kind of a between sessions support to kind of tackle those. Those skills. Right. So that in session you can really support this person and the little loved one of someone with like, just really like entering their own world and not making it about their family member, which often it feels like, right. When we're having someone in the household who struggles with mental health, it can start to feel like everything revolves around that person.
[00:15:13] Speaker C: Is there a question?
[00:15:15] Speaker A: No, it's okay. Just like validating like that really does make a lot of sense. Yeah.
[00:15:21] Speaker C: Yeah. I, it. I cool a mind. I'm calling it a coaching program. It's psycho education skill training. But it is more education. Of course. I have my own practice. I have a small practice, and I absolutely love therapy. But I do see that there is a need for something other than therapy in this context. I think that if you have a family, a loved one with who's really struggling and then you are struggling to help them, often people go, like, I would go to therapy for that normally, right. Like to get support around that and try to, you know, be like, what do I do?
But not the. You might not always need therapy, right? You might not always need a weekly, you know, 60 minute session that's often very expensive or needs a health insurance like a lot of people do. A lot of people with loved ones have like anxiety about their relationship with their loved one or depression or burnout or even trauma symptoms. Especially if it's like someone with like self harm or substance use, like seeing their loved one hurt themselves is very traumatizing. So they might be coping with their own trauma symptoms. However, if it's like I just need to know what's going on and need some skills how to deal with this, then therapy might not be the best place for that. Right. Like a therapist isn't necessarily going to be in the moment when you're talking to someone reminding you of your like what boundaries you want to set.
So I definitely think that you know, love people with, people with loved ones definitely need their own therapy. But there's also other ways to get mental health support.
[00:17:05] Speaker A: Yeah, that's, I was thinking about that too in terms of like when you are supporting someone and you know this specifically happens a lot of times with teens. Right. When I was working with teens, the parents would kind of want to know like how do I support. Right. And often you feel torn because you're the teens therapist and you don't want to you know, over share. But this sounds like a nice tool to support them and having like an actionable step of learning and doing things on their own to, to like support them. Can you share a little more about like how it works? Like let's say someone wants to join KulaMind or sign up. Like what can they expect from the experience?
[00:17:44] Speaker C: Yeah, I, I wanted both one on one coaching support and community support. That's something that seems to be very important for family members. I'll call them family members, like potential clients family members. So when family members would, would join Cool of mine, it's like a monthly membership. So it's, the idea is it's not just like build per session, it's kind of like you're in and you get support, like unlimited support.
And first I really get to know what they need, like do an assessment and really understand, you know, is this appropriate for them, is this a good fit and also what are their goals? What, what does getting better look like? What do they want from their relationship with their loved one and then I figure out what kind of skills they need or what kind of education they need. And then on the platform on cooler mind, I basically assign different, I call them practices because the idea is we're all practicing, right. There's no like assignments or Whatever, it's just practicing. So they might get information on what their loved one has and how it affects them based on the research.
And then I will just assign different practices. Like, you're gonna learn meditation this week because you need to get in touch with your feelings more, because you kind of ignore your feelings until the point of burnout. So let's learn how to just be mindful of how you feel, and then let's talk about how to communicate with your loved one. Or let's make a safety plan so that you know when your loved one is in a crisis, you know exactly what to do. You don't have to think on the spot. Right. So I kind of make this custom program of CBT skills and resources for each person, each family member. And then their membership also gets them access to our exclusive community. So there's any platform where they could, you know, chat with other people in the same situation. Brainstorm. And I also do like, group Q&As and webinars. So we get kind of like a full, full support system.
[00:19:43] Speaker A: So when you use the term AI, what do you mean? Like, how. What does that actually look like? Or how does that support. What are the AI components and how does it support your tool?
[00:19:52] Speaker C: Yeah, I know that AI and mental health is a really hot topic right now. It's also very scary for a lot of people. I am not in the. Of the people who think that AI is going to replace therapists. I think, I mean, this is just from the people we serve and we talk to is like people want to talk to a person who, you know, so let's just go with that. Like, the people feel secure and they want to learn with a person, and that's great. So I. We use artificial intelligence for the. For the purpose of teaching new information and skills. So it's a tool, like, I think humans and a relationship to a expert who's there to pay attention to your needs and find the resources that make sense for you. I'm going to keep that as a person me for now. But we're using AI to teach the skills in the same way that I always teach them. For example, we're using large language models, open source large language models, meaning we take a model that can process information and spit out English language and can be prompted with English commands. To take teach, for example, Deer man, the skill from dialectical behavior therapy. I teach the same way every time and I say the same things. So if it's the same thing over and over, I'm just going to automate it with something that can mimic the, you know, talking like a person or you know, mimic like delivering some information to the client. Like here's the first step of dear man, why don't you give it a shot and then to respond in interactive way. So I'm not using it to like replace people, but just as a teaching tool.
[00:21:34] Speaker A: That's really neat. It makes me think about how like we don't blink an eye of like using AI to pull up a recipe for, you know, how to make a fettuccine Alfredo.
[00:21:43] Speaker C: Right.
[00:21:43] Speaker A: And so why, why would we blink an eye? In fact this actually might be a more powerful tool of getting a really consistently powerful description of how to use a recipe. Like Deer Man. Right. Like it's very prescriptive and research based. So having like that kind of consistent quality control that AI can really support. And it, it sounds like this tool is really built for that and not for the part of like taking over the therapy relationship or anything like that. You know, this is, this is more skill building. So. Perfect.
[00:22:16] Speaker C: Yeah. I mean I, I think that the mental health crisis, a big part of it is that there's too few of us therapists out there who have this like expert knowledge. So if AI could kind of learn a little bit about, you know, what knowledge and what thinking processes do we have and use it to help people, I think that's one way that we can make mental health support a lot more accessible than it is now.
[00:22:37] Speaker A: Yeah. It actually allows us, I think too to, to make care more personalized because I know certainly there's in sessions it just doesn't feel like you have enough time like you want to spend time like making them feel seen and heard and really validating their experience. And then oftentimes I'll find at the end I'm like trying to jam in some skills, skill building and it's like ah, there's not enough time to do everything.
[00:22:59] Speaker C: Yeah.
[00:22:59] Speaker A: And are you going to remember this during the week? Because I wouldn't. Right. Like having something that you can actually like reference and, and you know, interact with in a more kind of. Yeah. Like a Google search. But it's really, you get to really control the information as opposed to like sending them down the rabbit hole of Google.
[00:23:16] Speaker C: Yeah.
[00:23:19] Speaker A: Cool.
[00:23:20] Speaker C: Yeah.
[00:23:20] Speaker A: All right, great. I love that Dr. Kibby. And it's, it's. I mean, I know like AI sometimes gets a really bad rap, you know, with, within mental health, but this is kind of that perfect situation for using it. Right. Because it allows you, it sounds like it's allowing you to take evidence based care and personalize it and you know, use it in a subclinical way where you know, it's not, it's not therapy but it really does provide people with really personalized education and skill building in a way that like we, we rapidly need right now. I mean with everything going on in the world, you know, I sometimes joke like mental health's a boom business. You know, it's, it's definitely not going anywhere. And you know, also one of the things I was thinking about is like we are simultaneously often dealing with stressors. Right. Like with things going on with the environment. Right. Oftentimes our, we're watching our family member who's struggling with mental health cope with something where we are simultaneously experiencing it on our own and trying to cope. So I could see how sometimes like it kind of inadvertently like you're able to, you know, if you don't need therapy but you could use some support which I think all of us could at some point in our lives. Right. It allows you to build your own skills but also kind of set that boundary or allow your loved one to you know, have their own experiences and show up for them while maintaining like your own space for self care.
[00:24:49] Speaker C: Yeah.
[00:24:50] Speaker A: Yeah. Well, so if people want to learn more about what you're doing or engage and I know you said you're early on and that's how we met. Right. Is like women founders, clinician founders and it's, it's so important to get early feedback and community engagement. So if people are looking for a tool or if, if clinicians or referring providers want to let their, their either current clients or family members of clients know, what do you suggest? Where's a good place for them to start?
[00:25:19] Speaker C: Yeah. Go to our website, coolamind.com k u l a m I n d.com or you can email me directly. Kibby
[email protected] and then we're also on Instagram. Cool. Of mine. Yeah, just, just reach out to us. I encourage therapists who have, let's say so you have a patient who is struggling and you just, you just know that their loved one is trying to help but it's like making it worse. Maybe like there's a lot of fights, a lot of arguments or they're like really struggling to support your patient with their treatment. This is, you know, you could send them the information too or if, yeah. If you, if you have, if you come across someone who's like I'm really stressed out, trying to support my husband or my kid. What should I do then? Also send them to me.
[00:26:11] Speaker A: So that's great. And I love the community aspect too. That's so cool because it is isolating when you're dealing with something. So it's nice to be able to connect with other people who might be having a similar experience.
[00:26:22] Speaker C: That was, I think that was one of the most popular parts of our program at Duke was just having. Because it is isolating. Right. If you're an older mom who has like an adult, like a 20 something year old kid and the kid is, maybe has some like really, you know, substance use or severe issues where they're living at home, they're not, you know, you're financially supporting them and you, you feel like, oh God, he or she should be out in the world, should be independent. But I'm trying to help them out while they're, while they're going through a tough time. The parents could feel really ashamed sometimes or really just lonely or like, is this my fault? Or what can I do? So connecting to other people in similar circumstances and sharing ideas like, hey, this is what I tried with my kid, you know, it seemed to work. So just, you know, sometimes brainstorming is helpful and getting community around this experience, which unfortunately with social stigma can feel really, you know, shameful in a way.
[00:27:24] Speaker A: So. Yeah, absolutely. Yeah, totally. I mean, it can feel so isolating when you're hearing like your friends talk about how their kids, you know, got married or got a new promotion and your kids may be living at home or struggling still. And also sometimes it's uncomfortable to like open up about your family members mental health to other people because it can kind of feel like a boundary issue, you know, and so imagine that having other people who get it, it feels a lot safer and more validating.
[00:27:51] Speaker C: So, yeah, it's also so sad that if your loved one has different medical issues, right. Some other kind of disabilities, it's a little bit less stigmatizing to be like, my kid is struggling with, I don't know, seizures or something like that versus if you say like my kid is struggling from psychosis. Right. There's, there's unfortunately this stigma still of it's a, you know, someone can have, someone can like get over it or it's your fault or something like that. So, yeah, I find that it's especially lonely to have a loved one with mental illness because of unfortunately how society still sees mental health.
[00:28:29] Speaker A: Yeah, totally. Well, thanks so much for what you're doing, Dr. Kibby. It's a huge contribution to our field and just society in general. So thanks for taking your experiences and turning something really powerful out of them. So keep up the good work. I'll be. I'll be cheering you on.
[00:28:44] Speaker C: I appreciate it. Thank you so much.
[00:28:46] Speaker A: Yeah. All right, take care.
[00:28:49] Speaker C: Bye.
[00:28:50] Speaker B: Thank you for tuning in to the Art of the Referral Podcast. We hope you found today's episode insightful and valuable. Don't forget to subscribe and leave a review to help us reach reach more providers and clinicians like you. Follow us on social media and visit our website for additional resources and updates on upcoming episodes. Until next time, keep mastering the Art of Referrals and making a difference in patient care. Goodbye.
