Transcript

Derek Smith:

Hello, and welcome to Baylor Connections, a conversation series with the people shaping our future. Each week, we go in depth with Baylor leaders, professors, and more, discussing important topics in higher education, research, and student life. I'm Derek Smith and our guests today is Dr. Holly Oxhandler. Holly Oxhandler serves as Associate Dean for research and faculty development, and assistant professor in Baylor's Diana R Garland school of Social Work. A recognized expert on the intersection of mental health and religion, her research focuses on ethical and effective integration of clients' religion and spirituality with evidence-based practice processes in mental health and behavioral health treatment. She developed an assessment scale to gauge mental health care provider's attitudes towards, and ability to, integrate client's religion and spirituality in treatment. Dr. Oxhandler also serves as the cohost of CXMH, a podcast about Christianity and mental health. And we're glad to have her on our radio program and podcast today. Dr. Oxhandler, thanks so much for joining us on Baylor Connections.

Holly Oxhandler:

Hey Derek, thank you so much for having me. I am so honored to be here with you today.

Derek Smith:

Well, it's great to have you, and an important topic here as certainly we are more aware of certain mental health needs during COVID-19 in a lot of cases. And especially now, as we are almost four months in and there's still so much uncertainty, it remains as important a topic every bit as much as it did at the beginning of this. When I know you had a lot of requests from people asking for tips about approaching your own mental health during something like this. So I want to, I'm curious as a podcast host, as a mental health expert, what have the last few months been like for you, and what are some of the topics that have been most pressing, or that you've been hearing the most from people?

Holly Oxhandler:

Yeah, that's a really great question, Derek. Well, it's definitely been an interesting season, to say the least. For each of us, just as human beings, navigating such an intense level of uncertainty, change, stress and more, in ways that none of us have ever had to navigate before, let alone collectively across the world. The podcast that you just mentioned, it's paused right now for the summer, which is something that we do each year. But in mid-March, we pivoted a number of the conversations to focus on supporting our listeners with COVID-specific issues, which we heard were really helpful for them. But also, honestly, for us too. As a mental health expert, I've been humbled by a number of opportunities recently to share my research around this intersection of faith and mental health, which are critically relevant right now for many of us. We're seeing these rates of anxiety and depression skyrocket in light of navigating such uncertainty, change, trauma and more. And at same time, we're learning that many are leaning on their faith more than ever. It's interesting, I even noticed that when President Livingstone first emailed the Baylor community about COVID in early March, there were two resources that were elevated within her email, which included the counseling center and our university chaplain. And the research really has shown that we can't ignore these areas of our lives in general, but especially not right now in the crises that we are navigating.To answer your question about topics that are most pressing right now, they've really been more around the reality of the prevalence of those struggling with anxiety and depression and other mental health concerns, which many have not realized that they either had, or that they could be predisposed to until being exposed to these extreme levels of stress that many of us are facing. So conversations on the prevalence, how to cope with mental health struggles, how to support kids and parents who are unsure about the fall, as well as how to care for those whose homes aren't safe. There's really a lot of topics that are connected to what we're facing right now.

Derek Smith:

We're going to dive into some of those topics here in just a moment. But setting the stage for those conversations a little bit, I gave a rundown of your research focus here at Baylor, but I'd like for people to get a more detailed view of that. When you talk about studying the intersection of mental health and religion in spirituality, how should we envision that as you do?

Holly Oxhandler:

Yeah, that's a really, really great question. Mental health care providers are trained to practice what's called the sense of cultural humility, meaning that as therapists, as social workers, a psychologists, as counselors, we need to be sensitive to and curious about all areas of client's lives that make them unique, that honors their diversity and that recognizes their culture is an important part of who they are, and how they engage and see the world. And one aspect of that sense of culture is one's religion or spirituality. When we think about the intersection of mental health and faith, I want you to think about a client, a mental health client, whose faith is really an important part of their life. Maybe it guides the way that they see and think about the world. And that client, let's say, is struggling with depression. They may be wondering, where is God in this painful season? Or they may be leaning on verses within their sacred texts to find comfort, or they may even find that some kind of spiritual practice like prayer or meditation helps them to return to the present moment. So religion and spirituality can certainly be something that's a source of support for those who are struggling with mental health concerns, or truthfully, it can be a source of pain. And the mental care provider then must be willing to hold space for that area of clients' lives, alongside the other areas. Especially when we see in research that clients often want to talk about this area of their lives, and that considering it in mental health care can actually positively impact treatment outcomes.

Derek Smith:

What led you into this area of focus, and where did you see some of those needs most prevalent that led you there?

Holly Oxhandler:

Oh, I love this. I love this question. So I've actually always been fascinated by mental health. And when I was a little girl, around 10 or 11, I really was hoping to become a therapist one day. I just loved this idea of holding safe space for people. And so my undergrad focus was in psychology. And between undergrad and grad school, I worked as a research assistant on a couple of projects with older adults with anxiety and depression. And in one project, I saw older adults had provided what's called Cognitive Behavioral Treatment to them. So we talked about their thoughts and their behaviors, and how those related to their clinical circumstances. And then what I found was that these older adults often said that faith is really important to them, but I had no clue on how to talk about that with them. And then in the other project, what we did was conduct some interviews with older adults on this topic, and we found that they prefer to talk about their faith, and for the therapist to be the one to bring it up. Shortly after working on those projects, I was in a lecture with a mentor of mine who explained that most Americans believe in a God or higher power, but few mental health care providers felt the same way. And that very few programs train therapists to talk about this area of people's lives. So it was like a lightning bolt for me in that moment. And I was about two months away from starting my master's social work program, so I was curious about what was happening in social work. I quickly realized that little was being done in social work, I fell in love with this topic, applied to the PhD program at University of Houston, let go of my plans to become a therapist, and just devoted my life's work to better understand mental health care provider's ethical and effective integration of client's faith in mental health care treatment.

Derek Smith:

That's great. As we were talking to Dr. Holly Oxhandler, associate Dean for research and faculty development and assistant professor in Baylor's Diana R Garland School of Social Work. Whereas you have done that research, continued that research that you started there in your postgraduate work, and now at Baylor, what are some of the areas that have been maybe the most rich, or some of that low hanging fruit that's been exciting to see? Some positive changes.

Holly Oxhandler:

That's a good question. Well, what I've seen is, in terms of these biggest areas that we need to be thinking about and focusing on with regard to this topic, my heart is really focused on two areas. The first is on equipping mental health care providers on this topic. I think that is the greatest need that we have right now that we see. We have therapists who are graduating from their programs, and this topic is often avoided in the classroom. So that ends up being avoided in the therapy session. And because it's a taboo topic, a lot of clients aren't sure if it's something they can bring up. So it really needs to be on the therapist to at least say, "Hey, if this is important to you, it's okay to talk about it as it relates to your mental health." To at least open the door. Of course, we're not pushing an agenda, a faith agenda in any way onto our clients, that would be unethical. But what we do see in the data is that just opening the door and saying, "Hey, you can talk about it," is enough. We also are seeing in the data that the therapist's internal motivation to live out their faith is actually the top predictor of whether or not they consider their client's faith in mental health treatment. So we really need to be talking about this in grad school, so that therapists have the tools and skills they need to talk about it in practice. That's some of the work that I'm doing right now. In addition, the other piece that I'm looking at, that I think is a very close second, would be looking at what clients want. There hasn't been a lot of research on client preferences related to this topic. Just recently, my research team and I finished a national survey of nearly a thousand current mental health clients to understand, how relevant do they see their faith as being to their mental health? What are their attitudes towards this topic, and how confident do they expect their therapist to be?

Derek Smith:

We're excited to see the results of more of these studies, and the implementation of these. As we talk about that intersection of faith and mental health, I want to pivot a little bit and talk about this current moment. As we think about the COVID-19 public health crisis, the ebbs, the spikes, the uncertainty, the link, obviously the landscape has changed quite a bit in the last four months. From your standpoint now, are there any ways in which the mental health landscape, the way people are dealing with this, looks different now than it did in March?

Holly Oxhandler:

Yeah, for sure. I do think it is looking a little bit different, quite a bit different. While some of us have been able to adjust and adapt to this new constant of change, I'd say that most of us haven't, because that's so against our human nature. Change is hard, and releasing that illusion of control is really difficult for us. And as we continue to learn about the virus and the implications of it, I think we are in this constant state of releasing this illusion of control and having our new constant be change. Plus, we're continually seeing new ways that we need to be pivoting and shifting from how we used to do things, that that continual practice of shifting causes added layers of stress. The reality is that what we're experiencing is traumatic, and there are ways in which the stressors we're navigating are absolutely exceeding our ability to cope with them. We talk about something that's called big-T Trauma or little-t trauma. Big-T Trauma would be a much larger traumatic event, whereas little-t trauma would be some of those smaller traumatic events that, again, exceed our ability to cope with them. And this season could include either or both. For example, a job loss, or health concerns, or safety concerns with domestic violence, or losing a loved one to COVID. These could all be big-T traumatic events, but there's also those little-t traumas that I mentioned, that include changes to schedules and rhythms, and trying to juggle childcare and work, carrying anxiety nonstop. Missing opportunities to connect with loved ones in ways that we used to, that used to be normal. I think those are some other ways that we're seeing that landscape around mental health changing, because we're seeing that this isn't just a short window of experiencing this. This is going to ... We're in this for a long, a long time.

Derek Smith:

People overlook the mental health aspect of this when they're kind of in the day to day? And if so, why is that, and what might the impact of that be?

Holly Oxhandler:

Yeah, that's a really good question. I think in moments of crisis, we absolutely focus on ensuring our safety and security as our primary go-to. So instinctively, our minds and bodies are wired to ensure we're safe. And so our mental health needs may not be at the forefront of what we're thinking of. I use this example often, that if we were to think about, we're walking on a hiking trail and we came across the bear, in that moment, I'm not going to be contemplating my level of depression in that moment, my whole body, neurologically, is going to switch on to ensure that I am able to get to safety. And then, once I reach safety, then my body and my emotions can move towards regulating and being able to calm down. But in a crisis like what we're in right now, where we're in this constant state of stress, and facing this constant state of stress, there are very few opportunities to physically and emotionally regulate to remind ourselves we're safe. So we really have to be doing what we can to tune in and to recognize when our bodies are elevating that sense of insecurity and fear. And ensure that we are tuning into whatever those mental health needs are that we may have within this season.

Derek Smith:

I want to ask you in a moment about tips, ways people can engage in some of that regulation and analysis of the way they're feeling so that they can care for themselves, both mental health wise and from a spiritual standpoint as well. But let's talk, since those overlap for so many of us, let's talk about that. What are some things we need to be thinking about in terms of our spiritual health and the way our faith informs how we are dealing with this right now?

Holly Oxhandler:

I do think that, in many ways, we do need to be paying attention to our mental health and ways to care for our mental health, as well as our spiritual health, and practices to consider that. Just looping back to the example that I mentioned before, our spiritual health, in the same way as I was mentioning that example of coming across a bear on the hiking trail, our spiritual health is not going to be at the forefront of our mind in that moment. And yet, what we do know is that when we are in crisis, our faith may be one of the first things that we turn to, but it's not quite the same as tending to our spiritual health. Some ways and practices that we might be tending to those needs, I'll start with the mental health side first, and then touch on a few things related to spiritual health. I want to first elevate that there is never a time in which our mental health needs aren't bad enough for us to go see a therapist. I really want to first emphasize that the most important thing to tend to our mental health needs would be to see a licensed therapist. If you aren't feeling quite normal or just aren't feeling like your normal self, just like we would see a dentist if we had a toothache, or we'd go see a medical doctor if we started to have symptoms of strep throat. I want our listeners to be hearing that you are worth taking care of, and there is absolutely no shame in seeing a mental health care provider. And if you are in crisis, I would ask that you reach out to a crisis line. There are a number of them that are out there, but one example would be the national suicide hotline, which, the number is +1 800-273-8255, or the national crisis text line, where you would text home, H-O-M-E, to 741741. Now, some everyday ways or practices that we might be tending to our mental health might include having a regular schedule each day, ensuring we're getting seven to eight hours of sleep each night, eating regularly, drinking plenty of water, even just meeting some of those basic needs first are really important. But I also like to recommend a grounding practice, for perhaps when our minds begin to race, or for us to have a moment to just pause and to identify one thing that we see, one thing that we can touch, one thing we can taste, that we can smell, and that we can hear, which will help us to return to the present moment. Certainly, deep breathing exercises can be helpful too, to bring us to that present moment, which ties right into some spiritual health practices, which that deep breathing piece can weave into. But I do want to start by saying that it's really important to focus on practices that are grounded within your faith tradition, whatever that may be, and to honor those practices. For those who do not have a faith tradition, there are some more spiritual practices that you may lean on that cut across a number of traditions, such as prayer, practicing gratitude, reading sacred texts, practicing yoga, or attending religious services, or meditation may help. But really, we not only see that engaging in these practices can help one's spiritual health, but also their mental health. But the really important thing is that these are practices. And just like I couldn't suddenly pick up a guitar and play like Dave Matthews without a lot of practice, it's really important to be engaging in these spiritual practices regularly. And so I want to encourage our listeners to find a spiritual practice that is most helpful for you, personally, and to engage in that regularly. And to feel free to talk about that with your mental health care provider, kind of looping back to the mental health piece.

Derek Smith:

Visiting with Dr. Holly Oxhandler here on Baylor Connections. And Dr. Oxhandler, what about expanding the circle a little bit as we think of others? Maybe it's immediately the people in our household, our family or our extended family, or maybe it's coworkers, as you and I were talking off-air about adjusting to working remotely. What are some ways that we can be attuned to others, and in the midst of maybe some of our own struggles, support each other?

Holly Oxhandler:

I love this question. So as a mom, I have definitely navigated the careful attention to my kid's needs during this time, and have realized the importance, honestly, of being able to tend to my own needs in order to tend to others' needs. I want to start by saying that first, that we really need to be attuned to our needs first, so that we can be attuned to other's needs really well during this time. So helping our kids and partners by offering as much consistency as possible, creating a schedule, helping one another to pay attention to and choose activities that help them feel good, versus activities that perhaps results in them feeling less good. Those are really important, and I think those are a good way to, with our closest loved ones. Of course, communication is important right now, and modeling the importance of asking for what you need can empower those around you to ask for what they need, and to build trust too. With coworkers, I think communication and checking in as often as you feasibly can is important, and finding ways to adjust expectations and timelines, perhaps reduce some nonessential tasks, just so that we can ensure that we're doing what we really need to be doing and focusing on. And with strangers, or really anyone, I really think we need to elevate the idea of loving our neighbors as ourselves right now, and practicing empathy more than ever. To envision what it might be like in the other person's shoes, and finding ways to support them if we can, while keeping that collective good in our minds.

Derek Smith:

Dr. Oxhandler, if someone listening is thinking about talking to a professional, hearing some of this, or maybe they've been thinking about it and want to do that, do you have any thoughts or advice for them to maybe go into it, to help be ready to make the most of it?

Holly Oxhandler:

Yeah, I really, I think that's a great question and I really do encourage our listeners, if they are thinking about contacting a professional, to just make the phone call. Therapists sometimes can have long wait lists, and so getting on someone's wait list early on is really important. Remembering that you can always cancel if you need to, but at least making the call and scheduling the appointment is a great start. I think being prepared with a few things that you would want to talk about once you get to your session is good, but to remember that your therapist is trained to help navigate that session if you're not sure what to talk about or where to begin. That said, don't be afraid to bring up what's most important to you. So again, for example, if your faith is important, then let your therapist know that, even if he or she does not ask you about it. Communicate that. And remember that just like it can sometimes take a while to find the right dentist or medical doctor, it may take a little bit to find the right therapist, too. But to be patient, recognizing you are worth caring for, and that your mental health and your wellbeing are worth caring for as well. There's also a lot of mental health care providers, they're doing sessions online. And so being able to connect with someone online is feasible in this season right now, particularly related to COVID.

Derek Smith:

Dr. Oxhandler, as we head into the final couple of moments on the program, I mentioned your podcast, CXMH, people can find it at cxmhpodcast.com. Are there any recent topics or a podcast of interest that you might like to share people, if they've been intrigued by what they've been hearing, to take a look at?

Holly Oxhandler:

Yeah, that's a great question. I think as far as podcast episodes, we had a handful of folks come on around March, April around the March-April time, including some of our own faculty. Dr. Sarah Perry and Dr. Karen Melton came on to talk about family leisure, and working from home in this season. But we had some other really good ones that I would recommend as well. I would also recommend to, on my website, listeners, if they're interested, they can sign up for a newsletter that I have, that I send out each month from my website. That includes a number of resources, and podcasts, and content around this intersection of faith and mental health. Yeah, and just some general resources that they might be interested in. In addition, on my website under the resources tab, there's a lot of information for therapists who may be interested in integrating client's faith into mental health treatment. And then there's also some resources for individuals who may be interested in finding a therapist. They can find that under my resources tab as well.

Derek Smith:

I know people can Google, but where can they find your website?

Holly Oxhandler:

I'm sorry, it is hollyoxhandler.com.

Derek Smith:

Hollyoxhandler.com, easy enough to remember. Well, Dr. Holly Oxhandler, thanks so much for your time. Really, a lot of important topics we've covered. And I appreciate you sharing. If people would like to learn more, they can go to some of these resources that you mentioned, if something we talked about here really particularly intrigued them. Thank you so much.

Holly Oxhandler:

Thank you, Derek. I appreciate you.

Derek Smith:

Thank you very much you as well, Dr. Holly Oxhandler, Associate Dean for research and faculty development, and assistant professor at Baylor's Diana R Garland School of Social Work. This has been Baylor Connections, I'm Derek Smith. A reminder, you can hear this and other programs online, baylor.edu/connections.