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On the Windhorse Model & Medications: A Conversation with Courtney Joachim

At Windhorse, we believe collaboration is the cornerstone of counseling. The work we do with our clients and patients does not exist in a vacuum. Rather, the team at Windhorse strongly believes that collaboration between counselors, psychiatrists, school counselors, primary care physicians, nutritionists, and other experts provides more comprehensive care and treatment. Each of our clients is vastly different and needs varying support systems. Healing takes a village and it's our work to assemble and work alongside your team of villagers!

We're lucky enough to have an incredible network of experts and collaborators at Windhorse that make doing this work both effective and wildly gratifying. Over the next few months, we're excited to share in-depth conversations with our go-to collaborators to dig into the work they do and how joining forces with a client's counselor can better provide care and treatment.

To kick us off, Alannah connected with Courtney Joachim, Windhorse's in-house Certified Psychiatric Mental Health Nurse Practitioner to chat about how Courtney found herself in the mental health field, if medications are always the right fit for patients, and so much more. Stay tuned for Part 2 of this conversation!

ALANNAH: Courtney, why don’t you explain how you found yourself in this field?

COURTNEY:  I share with patients that I really believe in seasons of life, and they're not all sunflowers and everything is wonderful. Sometimes we end up in the dead of winter and we don't quite know what to do or what supports we need, or we don't have people around us.

I describe what I do Windhorse like this: we're here to give you your mittens and your winter hat. We're here to help you and get you into summer. I share with my patients that I've been in the dead of winter before too, and I didn't love everybody that was sitting in the seat across from me, which is why I decided to go into this line of work.

My job is to ask people where they are in this moment and not immediately give a diagnosis or intervention. I give my patients options and together we decide what feels best depending on their goals.

I think it's also important to know that I didn't just decide I was going to become a psych nurse practitioner. I actually worked as a nurse for a long time before I went into psychiatry. I realized that helping people with just their immediate medical conditions did not bring me joy.

Instead of simply treating the medical condition, I wanted to ask "How do we get you to be able to live your best life possible? How do you want to be taking care of yourself?" And for me, that comes way before asking “How's your blood pressure doing?”

And really, the goal of this work is to be able to have one-on-one relationships that feel meaningful with patients. Patients are constantly evolving and, need different things at different times. The goal is for them to know they have someone they can trust to be on their side throughout the journey.

ALANNAH: Do you believe that meds are for everybody?

COURTNEY: My spiel on meds is that they don't have to be forever, but they might be helpful right now. This is why Alannah and I work together and why I believe in the power of combining therapy with medications.

Sometimes we learn things in therapy and they feel too far away and too hard, right?

I've had some patients who have said, "my therapist just keeps telling me to go for a walk." They're like, I literally can't even think about getting out of bed and putting shoes on. So I explain that's the part where medications might help us get to that point where these things become more accessible.

With meds, we can start to engage in the next level of therapy, doing the skill work. And then at some point, it might be that this is your new baseline. Things feel a little bit better and then maybe we're in a place where you don't want to be on meds anymore and you feel like you have the skills to support yourself. Then, we can address coming off of medications.

But there are also some people for whom taking meds is really not their goal, and they instead want to learn about the impact of nutrition, movement, and sleep hygiene. And there's a lot of research around all of those skills as well. Exploring this is work that we often do together.

I think it's important to meet people where they are and first understand what their thoughts are on taking meds and if they want to use medications to be able to engage with holistic modalities or if that’s where they want to start first. I think both paths are really viable and important and I'm not here to tell people what to do. I'm here to help them do what they feel is best for them.

ALANNAH: And would you say that's an all-encompassing list of the services that you offer clients?

COURTNEY: I would say I can offer psychiatric medications with a side of counseling!

I want to be a resource, and for people to feel like they can ask questions and interrupt me. I always say our meetings are really casual and, if you don't understand something, speak up. I'm here for you.

Patients will ask, “How do I even know if meds are going to work or if meds are even going to be helpful?” And I say, “Well, remember when I was nerding out in our first visit, taking these crazy notes about like everything you were saying?” I'm going to be tracking your sleep, your mood, your anxiety, your appetite, how you feel about your social life. What does home feel like? Do you like your job? Then I can read these notes back to you to show your progress. I do that with patients sometimes, and they often have no idea the progress they made so far.


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