Meet Our Team: Jeanette Alonso

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jeanette-alonso

Clementine Family Therapist Jeanette Alonso has been an integral part of the Clementine treatment team since the doors opened in 2014. Jeanette provides families and adolescents the support and care needed to heal through her family therapy sessions. Learn more about Jeanette and her work at Clementine by reading this week’s “Meet Our Team”…

 

What is your name and what are your credentials?  

My name is Jeanette Alonso. I am a Licensed Mental Health Counselor.  I am a Family Therapist at Clementine Pinecrest and have been since it opened its doors in October 2014.

Please give us a brief description of your background.

I attended the University of Miami where I received a Bachelor of Arts in Psychology with a minor in Human and Social Development and then went on to complete my Master’s in Mental Health Counseling at UMiami as well.

Prior to OPC & Clementine, I worked exclusively with Post-Traumatic Stress Disorder and sexual trauma conducting individual, family, and group therapy where I developed an expertise in Trauma-Focused Cognitive Behavioral Therapy as well as other evidenced based practices aimed at children, adolescents, and adults.  I also received certifications in Play Therapy and Infant Mental Health. In 2010, I began working at the Oliver-Pyatt Centers and worked within all programs: residential, intensive-outpatient and transitional living where I developed a specialty in the diagnosis and treatment of eating disorders. I then moved into a family therapist role when Clementine opened in 2014 where I get to work closely with families and adolescents in critical need of support at a higher level of care.

What does a typical day look like for you at Clementine?

Typically my day begins by meeting with team members to discuss the most updated clinical information on each of my cases. I then hold family sessions indoors or outdoors (weather permitting). Sessions are either done in person or via computer with parents.

In your own words, please describe the philosophy of Clementine.  

Each client and their treatment is highly individualized and specifically addresses the needs of the client. No one client is treated the same and treatment follow up and goals are all developed from a multidisciplinary approach that captures every overall aspect necessary to treat the ED. The family oriented, loving, and warm environment is the backbone of all the work and dedication that goes into treating the ED.

How does your team work together? How do your roles overlap and differ?

“Teamwork is the dreamwork”. The close team approach is essential and at Clementine the team is always in close contact via email, phone, personal meetings, and shared office space that constantly lends itself to continuous process and discussion on how to best manage each client and family’s individual needs. As a family therapist, my role at times may overlap in similarity to the primary therapist role.  My specific role, however, involves more one on one contact and support to the parents as well as sessions that involve both client and parents that aims at solely focusing on the family system and the role of the ED.

What is your favorite thing about Clementine?  

My favorite aspect of Clementine has been the people I have worked with, the passion and dedication to saving lives, and the outcome stories of so many brave and beautiful women and girls that have gone on to live lives free of EDs.

What are three facts about you that people do not know?

I am terrified of lizards, I used to sing in the church choir and can actually sing, and my driver’s license says my height is 4’11” but I’m actually and inch shorter!

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our website, subscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine location with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.

The Heart of Clementine Nursing

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vanessa-hernandezClementine Adolescent Treatment Program Nurse Vanessa Hernandez, RN shares the important role nurses play in supporting the adolescents on their journey to being fully recovered. She explains the strong rapport built with the adolescents and the nurses’ willingness to be by their side every step of the way.

The very core of Clementine Nursing is muddling through the intricacies of their life, their recovery, and their medical care right along with them. It’s countless hours of teaching. You have to maximize that learning brain and boy, are they open to learning! “What is going on with my body and why?”

Ahem, well..

Clementine Nursing is owning up to the inevitable awkwardness of the conversations, medical visits, complaints, and procedures–and letting them know, it will all be okay.

“Listen, we’ll get through it together.”

It’s slowly, but surely; detangling the responsibility of their medical care from their parents, onto yourself, and eventually; onto themselves.

Clementine Nursing is setting high standards for my girls, because they are the smartest, most willing ladies in all of Miami.

They can recite every skill in their DBT workbook and their medications. They can willingly sit out from yoga and sip a cup of Gatorade because they’re feeling dizzy in that moment, and self-care comes first. They can sit through receiving their Dexascan results and understand exactly what Dr. Jahraus is telling them.

They can do all this, because their nurses took the extra minute to teach and because they know they must honor their bodies by giving it what it needs.

The heart of Clementine Nursing lies in the art of building their own sense of security in their bodies, their knowledge, and their processes. It’s building enough rapport with them that they can come to you with any complaint–and they definitely will!!

It’s building enough rapport within themselves that they can access the underlying factors of their physical ailments.

“What emotions am I feeling right now that might be driving this stomach pain I’m experiencing?”

“What is the reason I am requesting this Miralax, because I feel guilty over ordering dessert, or because I truly need it?”

We poke and prod. We ask insightful questions. We have embarrassing sessions.

We use therapeutic insight and weave it into nursing knowledge to see them holistically.

To us, they are not their weight, vitals, or medications.

Their bodies haven’t failed them. Their eating disorders have.

They are powerful young ladies, claiming their voices, their health, and their lives.

The heart of Clementine Nursing allows us to see this since their first day.

And the true reward, is when they begin to see it for themselves.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our website, subscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine location with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.

The Moment of Discovery

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Nancy Mensch Turett is the founder of WholeView, a consultancy to empower leaders to generate health across their personal, professional, and public life-spheres through holistic thinking and action. She will be contributing a series of blogs sharing her personal story of supporting her daughter on her journey to being fully recovered.  In part one of her series, she tells of the “Moment of Discovery”.

When colleagues invited me to offer my perspectives about eating disorders (ED) publicly, my immediate reaction was sure, this makes sense. I’m a professional communicator. I help other leaders find their holistic voice and share their insights broadly to generate health and well-being. I should follow my own advice. And it’s certainly true that ED demands a WholeView — it develops from a perfect storm of factors, manifests in several forms, and can be cured only through a holistic approach to treatment.

Before I jump in, given that there were many dark and difficult times, you should know that there’s a happy ending: my daughter is well. Thriving. As is the whole family. More on all that in future postings. Also, importantly, with her crisis behind us, my daughter is in favor of my sharing experiences and insights that might be helpful to other families. Her only caveat: that I use just my nickname for her, “Rosie.”

OK, so I resolved to share my story. But how to tell it? Where to begin? Like every family’s, our ED odyssey is long and winding. In some ways, it started at the start of Rosie’s life. It definitely continued through most of high school.

There’s so much to share. So my story will be told in chapters, with a different installment each month until I’ve filled in the chapters from beginning and end. Today, however, I start in the middle, at the Moment of Discovery, for the many other moms and dads out there who are sitting there right now, disbelieving, shell-shocked, and terrified. That fateful time when you suddenly realize that your lovely, loving, and “healthy” child is in fact terribly ill.

Discovery for me happened on a sparkling, below-freezing day in January 2010. I’d been looking forward to a “girl’s day out” – a special time when Rosie and I say bye to all the “boys” (3 brothers, one dad) to follow our own agenda, i.e., Shop. Lunch. Shop. Chick Flick or maybe Mani Pedi. Deliciously mother/daughter.

It couldn’t have been more than 11 AM when the day started to sour. In the car with Rosie, I was enjoying the bright snow and munching on a protein bar. When I offered Rosie a bite she turned to me from the passenger seat of the car and screamed NO. And a minute later she told me to stop chewing – that it sounded disgusting. Telling myself Rosie was just behaving the way 12 year olds are supposed to behave, I tried not to be alarmed.

But the first stop of the day was a wreck. We had planned to design stationery together. Parking the car and brightly cautioning Rosie to watch out for the ice, I got no lighthearted “ok mom” or even a “you don’t have to tell me that any more.” Rosie turned away and walked to the door of the shop. Once inside, Rosie refused to speak with the salesperson offering options for custom cards and simply glared at me. Feigning cheer, I excused us and promised to come back another time soon.

Having jettisoned the first part of the day’s plan, I suggested we move on to lunch. Silence. OK, let’s listen to music rather than chat en route to the deli.

Our easy tradition was to order a couple of items together to split. This time, no such thing. Not only didn’t Rosie want to share, she couldn’t even decide what she wanted. Conscious of the line of customers waiting behind us, after just a bit more cajoling, I put in an order. Something easy, like a turkey sandwich and a bag of those salt and vinegar chips Rosie favors. At the table, she couldn’t manage to take a bite. Actually, she couldn’t manage to stay seated. Pacing around the little restaurant, Rosie was clearly uncomfortable with the simple concept of eating lunch. I felt sick but smiled and ate and didn’t make a big deal of it when Rosie consumed nothing but a few chips and a can of Diet Coke. But still tried to file it away in my brain as just one of those tween things… no big deal.

Next up was to be the highlight of the day: Shopping for a special-occasion dress for Rosie. Given how much she loves dressing up, I anticipated our both having a great time while Rosie tried on a variety of frothy numbers. This was our first time clothes shopping together since before Thanksgiving, and Rosie, at 12 and a half, was clearly getting taller and I figured, developing a woman’s shape. Having mentioned her desire to lose her “baby fat” over the summer, and just having gotten her first bra, I hadn’t thought it odd that I hadn’t seen her undressed for a few months. Rosie was just private about her body as I was too on the cusp of adolescence. Totally normal.

With a few items she and the salesperson selected, Rosie went into the dressing room to try on the first dress. What transpired next was surreal: A young girl came out in a form-fitting dress. With Rosie’s face but a stranger’s body. Thin. Very thin.

As I’m telling myself this is not good, others in the store, staff and customers alike, ooh’ed and ahh’ed at Rosie’s appearance, saying things like “you look amazing” and “you should be a model.” No she didn’t and no she shouldn’t.

I slipped outside to call my husband. I did my best not to break down right there on the sidewalk when telling him that something was very, very wrong. Our Rosie – our healthy, smiling, never-complaining, lovely child was not well. How could she — seemingly overnight – morph into a too-thin, very-tense, and apparently humorless pre-teen? What did we do wrong? What should we do now?

And then I got a grip. I told myself that my daughter is sick. That I don’t know how or why it happened but it was important that her mom and dad keep as calm and steady as possible. I cannot say we always achieved this goal, but keeping in mind that our behavior would affect her sense of things helped a lot.

Driving home in the car together, it was already dark at 5:00 so there was nothing to look at but the lights on the highway ahead of us. I didn’t know what to say. Rosie filled the space easily. While she didn’t mention the new dress, or the shoes, or the special event it was all for, she spoke with elation about now “being” a “2” or maybe even a “0” (a size I hadn’t known existed). Any spark of hope I had that she wasn’t sick was extinguished.

I was frightened about what would lay ahead for Rosie. But resolved that we would get her well, ASAP.

That evening, we called an eating disorders specialist and the next day, my husband and I were sitting in her office. The doctor asked many questions, and as we answered each with a “yes” I began to weep with fear and worry. At that meeting on that Sunday, we learned four important things:

  1. Our daughter was suffering from anorexia nervosa.
  2. With specialized care including parental commitment to participating fully, this potentially fatal disease was curable.
  3. That time was of the essence. We needed to do all possible to keep the disease from taking deeper hold in her brain. No more dismissing her withdrawn mood, weird eating habits, and baggy clothes as nothing more than ordinary tween stuff.
  4. That ASAP is the right thought for accepting the diagnosis and getting going on treatment, but not a realistic mindset for time to full recovery. We had a long haul ahead of us and life for our entire family would never be the same.

The sooner we accepted the enormity of this, the better for Rosie. It felt like the nadir of our lives. How could it not? But in retrospect, I see that it was the beginning of our facing the truth and getting Rosie the help she needed for a real chance at a full life.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our website, subscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine locations with one of our clinical leaders please reach out to a Clementine Admissions Specialist at 855.900.2221.

A Fine Line: The Intersection of Mental Health and Medicine in the Treatment of Eating Disorders

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Joel JahrausLaurenOzboltClementineBlogClementine’s Chief Medical Officer Joel Jahraus, MD, FAED, CEDS and Medical Director Lauren Ozbolt, MD, CEDS oversee the psychiatric care and attending psychiatrists at all Clementine adolescent treatment program locations. In their writing, they share the many challenges with eating disorder treatment and the broader implications for adolescents and young adults. They stress how accurate diagnosis and treatment necessitate the interaction of a multidisciplinary team including mental health, medical and nutrition.  

“I have yet to see any problem, however complicated, which, when you looked at it the right way, didn’t become more complicated.” –Paul Anderson

To say eating disorders are multi-faceted illnesses would be a serious understatement, as any professional in the field would tell you. Not only do treatment teams have to find a balance between their different disciplines when addressing complicated medical and psychiatric issues, but they also face the added challenges of working with patients who are often unhappy about being in treatment, tend to have difficulty trusting treatment providers, may feel in denial of their condition or resistant to treatment, and on top of everything else may face legal or financial barriers to seeking proper treatment. All of these obstacles don’t even begin to cover the myriad of psychiatric and medical comorbidities that typically present in a patient with an eating disorder.

When unraveling an eating disorder medically, we are first encountered with the challenge of discerning whether or not symptoms such as dizziness, tremors, and heart palpitations are the result of malnutrition, dehydration, altered metabolism or from psychiatric manifestations such as anxiety.  Additionally, we also come across co-morbid medical conditions such as hypothyroidism, anemia, and atypical chest pain (just to name a few) that can in turn cause psychiatric symptoms. When psychotropic medications are introduced into the equation, it is important for the team to be vigilant as they themselves can have side effects that can manifest as medical or psychiatric complications. This constant presentation of symptoms that compete for both medical and psychiatric care calls for effective and cohesive clinical integration when treating clients with eating disorders. The underlying illness, whether psychiatric or medical may be challenging to diagnose and one should not immediately rule out the other when complications arise. People with mental health issues often get physically ill; they are not mutually exclusive.

It is clear that there are a multitude of considerations to make when first meeting a client and as promised, the problem is only more complicated when we hone in on any one aspect of the illness. When it comes to evaluation and treatment planning, once again, clinical integration is key. There are several general considerations that we recommend taking into account when first meeting a patient:

  1. Be suspicious- patients may make evaluation more difficult, either by being unwilling to give a full history, unable to give an accurate description of symptoms or too frightened to allow a full physical exam.
  2. Remember that patients with mental illness develop medical problems too.
  3. Be alert for presentations, which make medical illness more likely, but don’t stop considering a medical illness just because they don’t initially fit.
  4. Look for symptoms that make medical illness more likely.
  5. Do not assume a certain symptom “must” be of psychological origin.
  6. Be holistic- note the patient’s feelings and functioning within the current context as well as what happened in the past.

Above all, it is important to be aware of the limitations placed on a patient’s capacity for recovery when looking at a complex illness through a narrow lens. It is crucial that clinicians are acutely aware of the urgency of the patient’s needs, whether medical or psychiatric, and appropriately empathize with the individual to reassure them that you understand their concerns. They need to know that you will you will work to help them feel better whatever the cause.  Integration of the various disciplines involved in the care and treatment of eating disorders takes collaboration. With balance, careful consideration of contributing factors and regular communication, eating disorder providers can successfully help treat their patients in a holistic and effective way.

To learn more, join Dr. Jahraus and Dr. Ozbolt in Tarrytown, NY at the Westchester Marriott on September 15th. RSVP to Professional Relations Manager Jennifer Vargas (jennifervargas@montenido.com).

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our website, subscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine locations with one of our clinical leaders please reach out to a Clementine Admissions Specialist at 855.900.2221.