Wendy Kendall
Hello, everyone, and welcome to episode 10 of the Inspiring Psychologist podcast where we're breaking the mould of private practice. And in this week's episode, we are going to be speaking with three inspiring practitioners who have developed and setup practices that focus on neurodiversity and neuro divergence. And I'm really looking forward to introducing their work to you. So we're going to be speaking with Dr. Katie Adolphus, Dr. Emma Offord, and Dr. Lola Perez Gavino. And so I'm going to invite you all in now welcome all of you to this episode, where we're talking about changing the narrative on diversity in private practice. So lovely to see you all. I'm really glad the tech is working. And we're keeping our fingers crossed that it's going to carry on working. And, yeah, it's lovely to see your faces. So I'm going to come to across to you first, Katie, if that's alright, for a bit of an intro, and we'll we'll kind of go round. So Katie, tell us a little bit about you and your practice.
Katie Adolphus
Okay. Hi. So I'm a clinical psychologist, and have been for many years, I've been working in the independent sector for 15, approximately 15 years. And over the course of my total career, been working a lot with the neurodivergent community. And so my practice now provides assessments of neuro divergence and autism, ADHD, and I have a team of clinical psychologists speech and language therapists and OT and some coaches, as well to provide assessments and support.
Wendy Kendall
Yeah, fantastic. Thank you for that. So Emma offered Dr. Emma offered over to you a little bit of an intro. Hi.
Emma Offord
Sure. So like Katie, I'm a clinical psychologist, trained in the NHS and worked in the NHS, mainly in physical health services, and moved into private practice and had a very, I guess, broad range of referrals. And over time, decided to niche and sort of working with yourself, develop divergent life, which, similar to Casey works with neurodivergent individuals during assessment, screening, coaching, therapy. And we are in neuro farming practice. We're not as large as yours, Casey. There's really, I'm the Clinical Psychologist part. And then my colleague, Jolene is a trained counsellor, and works in the arts as well. So it's quite a holistic practice in terms of the different we hope you're affirming therapies that we offer.
Wendy Kendall
Yeah. Thanks, Emma, and over to Dr. Lola Prez, Gavino, a little bit of an intro from you, Lola.
Lola Perez Gavino
Hi. Well, yes, I am also a clinical psychologist. And I used to work for the NHS, there was a bit of an overlap between me working in the NHS and private practice for a few years, but now I just work privately, and I run my small clinic, which is just me, really. And the things I do are mainly therapy, and I offer autism assessments as well. And the main, the main things that I do trauma work using EMDR. And working with anxiety and my autism assessments I, I decided to maybe not, I mean, focus, I guess, because I have a lot of experience and an interest in in high masking autism, which is what we normally see in in private practice. I mean, very, very often when people have gone through their, you know, whole lives, thinking that they were different and that there was something about them that was different and and maybe not everybody or on or not no one noticed until until they are adult and I'm very, very interested in in that kind of kind of journey. Yeah, that's yeah.
Wendy Kendall
Yeah, perfect. So I'm really curious about your kind of journey into working in this area in your private practices because I think like so many of us I was in private practice, there's always seems to be a kind of evolution and a path that we take, right. It's not just, it's not some kind of almost like mechanistic decision that is taken, there's always some kind of personal as well as professional path that gets into that gets people into this into, you know, particular area in their private practice. So, I guess, you know, if I, I'm gonna mix it up a little bit if I can come across to you, Emma. Because you mentioned there that you work, for example, in physical health, and then you'd worked in different areas. And then there was a certain path into developing a neuro affirming private practice, which was slight, it's a slightly different take on this area. Right. So what kind of what made that so important to you that you wanted to focus on that in your private practice?
Emma Offord
Yeah, it's quite a long story. So I'll do tissue on it. But when I look back now, although I was working in physical health, I was working in the medically unexplained symptom aspects of physical health for quite a long time, was also working in chronic conditions. But those medically unexplained symptoms were often what I now see in many neurodivergent clients. So I think there was some seed way back then that I didn't quite understand ologists why were they there, these groups of people that weren't being served by the NHS, from a physical health point of view, they were being sent to psychology, and psychiatry, and their physical health symptoms were being seen as purely a kind of psychological process, which is still a biological process, because our head isn't detached from our bodies. So, you know, I sort of began noticing that, and then I started private practice. So like you, Lola, I was doing both for a while. And initially taking any referral that came in trying to sort of work out private practice work. And then I noticed some patterns really, which I started off discussing with you at some point didn't I went around? What what would what you typically through a medical model would call OCD, obsessive compulsive disorder, that type of presentation just kept showing up and showing up. And so I did lots of research. And discovered the neurodiversity paradigm shift where these labels and these diagnoses were coming under a very different lens of neurobiological understanding. There's trauma and contextual and social understandings, but it was creating a different language for understanding what was happening for people. So I just became really hooked on that, because it was moving away from a medical model and looking at people or their differences, but not their disorder and not their illness, it wasn't using that language, it was trying to understand the way that I have always understood mental health. So that really fit for me. And then I guess, the more I, the more I looked into it, the more I looked into looking into this area of neuro divergence, and then I think it just sort of, like you said, that was that evolution, reflecting back on the clients that I've been working with, and why years and years and years of mental health therapy and different diagnoses for them hadn't kind of really helped them. Whereas this understanding was, was really resonating and helping people. So that was really the inspiration for it, or the evolution of it. I mean, there's lots of things that happened since then, but that I guess that's really the beginnings. Yeah. Started divergent life.
Wendy Kendall
Right. And I remember at the time of our conversations around your particular interest in OCD, I remember some of the conversations that I'd had generally with practitioners where people had been showing up in their practices with challenges like that, where they had felt that that was kind of intractable. They, you know, it felt as though there were there was a broader swathe of practitioners who were kind of almost like running into a wall in terms of making breakthroughs with people with that were experiencing those kinds of symptoms. And I remember your absolute kind of fascination for really drilling into what was happening here. And I think it started with looking at second sound protocol and then kind of blossomed from there in a way, and kind of the path evolved at that point.
Emma Offord
So maybe this is some of the physical side of things that I'm also very passionate about the neurobiological. There's one theory called the polyvagal theory, which which very much focuses on the central nervous system. And so in my years of researching neuro divergence, this just became a really important theme. And also like you, Lola, trauma is at the heart of what I do and using a trauma lens, so kind of marry the two together. So yes, the safe and sound protocol is a music technology that speaks to the nervous system, which for some people is a really beautiful therapy, because they don't have to talk all the time, and work things out. They can have, like a safe nervous system experience, through, you know, co regulation with myself or with my colleague, and learn physical skills of regulation, which is that bottom up approach, which again, I think is a very neuro affirming, and developing concept, which I believe, you know, is really helpful to people, not only the sort of more traditional cognitive top down therapies, I think they they work brilliantly for lots of people, but not always, and not. And so I think this is what a lot of people were struggling with, that they were failing therapy and being told that the right insight wasn't the right time. But I think it was the wrong therapy for a lot of them. So yeah, that's also part of this broader picture is what else can we develop? What What are neuro affirming therapies for people that bring this this one to one, you know, or maybe group work? That's kind of, you know, what other things can we do? Yeah, ology and ultimately health, psychology and well being of people.
Wendy Kendall
Yeah, yeah. And, uh, you referred to Lola's work a couple of times, we're going to come across to you, if that's okay, Lola, to also kind of get some sense of that journey for you into developing this private practice and why it was important to you. But one of the things I really remember, picking up on some of Emma's points about different ways of helping people to feel safe, if you like in the nervous system was the amount of creativity you brought into your practice. And I remember, you know, that you develop some really beautiful animations early on and so on. So, yeah, what was what was your kind of? Why was this so important to you to take this, this, you know, slightly different approach in terms of developing your practice?
Lola Perez Gavino
Yeah. I, they are still very important. I wish I could do more. But it's hard work. But I do have a few ideas in progress. But yeah, animations and visual material, and images. And metaphors are things that I use a lot in my, in my work analogies and lots of imagery. And it seems to work, you know, interesting that people think that autistic people and neurodivergent people have no imagination. And it actually I find that, you know, metaphors, analogies, stories, they work so, so well. So very, sort of passionate about, about that about, about stories about the narrative that people you know, sort of the narrative that we carry with us throughout our rescue experiences, and that for neurodivergent people, even if it's with the best intention, but people keep hearing messages about you know, you're not good, there's something wrong with you, you're different and and all those things, you know, we kind of absorb and then they show up in are sometimes in childhood already. But yeah, you know, in my experience, because I've worked with adults, now in adulthood in ways that maybe we don't think were or we don't realise where they are coming from. And I have found that EMDR is a bit like a my guess it's kind of I have found, I am also a CBT therapist, and sometimes I combine both, but I think maybe EMDR because I came a little bit later in my career to EMDR there's so many options, there's so many ways of working with EMDR and bringing in different ideas. And I have found that is providing me with so much so many resources to help to help people. So yeah, and then you were asking me about, yeah, just
Wendy Kendall
in terms of the evolution of your, of your practice, and you know, that journey of, I guess so let me let me think about how to articulate my question more clearly. You know, how did what are what happened that helps you to decide To start to focus much more on supporting neurodiversity, and supporting people with neuro divergence in their, in your practice, or through your practice,
Lola Perez Gavino
always been an interest of mine. And I guess throughout my career, I've been working in places where I've come across neuro divergence a lot. And for some reason, we just seem to work well together. So I tend to have, you know, sort of feedback from people, you know, like, I think a mouse I mentioned about therapies where, you know, sort of, you don't need to talk a lot. So you know, sort of iron have skills and feel comfortable working with other tools that are not necessarily sort of asking people, you know, sort of further thoughts or further experiences. So there are, you know, ways that that where people can feel safe and and I guess, once you start putting a few things out there and showing a little bit of who you are as a therapist, and as a psychologist, you know, because, well, I think now there are more people who are maybe specialising and training and becoming a little bit more confident working with neuro divergence, but a while ago, maybe wasn't so much. So I guess neurodivergent people are looking for, you know, sort of for, for people they feel comfortable with, and they offer things that will work for them. Yeah, yeah, that's my experience.
Wendy Kendall
And you mentioned in your introduction, as well, there was this link with or there was something about working with people who were high masking autism. And, you know, what was happening in your practice that made you think, Ah, this actually needs some attention, I'm going to put some specific attention on this.
Lola Perez Gavino
I think I'm still, you know, in the process of me, you know, I think it's such a big topic. And it's really complex in the sense that, you know, sort of the diagnosis patterns are changing, there is an increment in how many people are diagnosed with some kind of controversy, you know, so who, you know, it should be diagnosed and unknown, and things like that. But I think it all started in one of my jobs, where I kept coming across lots of young people, teenagers, who were different, you know, they, they, they had, they came to comes, which is, you know, so far the team that I was working in, with depression with anxiety, like really vague symptoms, no one knew what was going on. And I started reading about about autism and autism in the, you know, different aspects of autism. And that's where I started to learn a lot about high masking. And notice, I'm just seem to answer, you know, sort of be a possibility in terms of explaining who these people were these these young people and their, what their experience was. And I just became really, really interested in that in that area. And I think in my evolution as someone doing diagnose, doing assessments, has been maybe the change from doing assessments in NHS where the weight is on what the person doing the assessment is, so sees, so sort of, do I see you as someone who is autistic, to me sort of shifts a little bit to what's your experience, you coming here talking to me, and being here with me and telling me about your experience, so sort of, obviously, it's very important, you know, sort of the sort of what someone is observing, and you know, what's going to be used to see if someone meets the criteria, but also the person's, the person's experience, because a lot of people are making efforts to get by? And yeah, and we don't realise that they are. So I remember that, that, you know, sort of discussions with my colleagues, where maybe someone said, but that was a very normal answer, you know, to the, you know, doing an assessment, or I don't think they were artistic. But, you know, maybe I sort of thought about, you know, about it a little bit more in depth, but how is that person experiencing it? Are they making an effort? Are they tired, are they uncomfortable, and doing it in my private practice has allowed me to do the assessments in a way that I hope makes people feel safe, confident, comfortable, and be able to show up a little bit more, you know, telling me what their experiences but maybe, you know, sort of be able to do some stimming or be able to regulate, you know, I've had assessments where people were sitting on the floor, I've had, you know, sort of assessments where people were holding things in their hands, you know, sort of things that will make people feel comfortable. And so I think there is also an experience of quite difficult experience of assessments for some people. Failing that they put, you know, sort of in a situation that is really unnatural for them. So,
Wendy Kendall
yeah, and just to be really clear, For people who don't know, what do you mean by high masking?
Lola Perez Gavino
So high masking and maybe Katie and Emma, you can add anything or you know, if you have any, any better ways of explaining it, but it's, I mean, it's a it's a range of behaviours that everybody uses. So we all use them in to some degree in different situations, like when you go to a job interview, we're generally masking, try to show the best details. But in autism, and in a number of, you know, sort of people, they, they use it more as a strategy to get by, and maybe they rely on masking more, because maybe they don't know naturally how to behave, or they are worried about how they may come across. So masking is not necessarily a bad thing by itself. But in noticing very often because people feel that they have to do it or they don't realise, but they keep doing it all the time. That's when the problem comes. And what I find is that very often people forget who they are. I don't know if you find that that people say I don't even know who I am anymore, because I'm feel like I must masking all the time.
Wendy Kendall
Yeah, yeah. But it's super interesting as well, Lola in the I know that when I've been doing executive coaching, there have been times that I've spoken to people, and I've, I've literally heard them say, they've said, you know, in certain situations, I need to mask who I am. And I'm not. I don't offer neurodiversity coaching, I'm not trained in say, I'm not clinical psychologists. But when I guess the more I've worked alongside folks like you, the more I've started to hear these things happening, and as you said, then, you know, if all of these criteria that were used to let's say, assess someone have come from observing from the outside, and then you've got people who are really highly functional at masking what it looks like from the outside, then that makes sense that actually we need to think about how does it feel from the inside to be doing that? So yeah, thank you for sharing that insight. And Katie, coming over to you. So you were kind of nodding and kind of interesting, because,
Katie Adolphus
like origin story, if you like has got is different, but I resonated with both Emma and dolars story. Yes, I, I started my career at Great Ormond Street Hospital. And for a little bit of my time there, I was involved in a neurodevelopmental assessment clinic. And coincidentally a little bit of my time in unexplained medical symptoms, and with which, how interesting to think or when maybe the seeds are there in that part of the work as well. But I was really taken, I think one of the reasons I'm a psychologist is because I love people's stories. And I was really taken about how, through an assessment, you could begin to tell a different story for a person about about their place in the world about and start stripping some of the negative labels that people collect along the way, and replacing them with more affirming, explaining ways of understanding themselves and retelling their stories in a validating way. This was a very, very long time ago. So the world of neurodiversity and autism was very, still very much entrenched in the deficit model. But I think I still saw that ability to tell tell a story that made an important difference, or a narrative that made an important difference via an excursion into working with youngsters, who were care experienced. I then went back to my last role within the NHS was coordinating support for families in a local borough kind of post diagnosis, post discovery of autism, their children. So my world had been coming increasingly new, you know, full of neuro divergence, and, you know, and so as a family move, we we moved away from London. And that's when I had to start myself up and into independent practice. And I again, I held the doors really wide open thinking, I don't know, I don't know if there's a market here. I don't know what you know how this is going to go. So all comers. And actually the people who walked through the door, so many of them were neurodivergent and in ways that either they were masking or in ways that would never have got over that threshold in the NHS. So it might be that their parents couldn't kind of describe it. Explain the challenges in a way that their GP would go, Okay, I know what's needed here. But as soon as I could open the door and say, we'll just come, and we'll work out from there. Because there isn't a barrier, there isn't a referral threshold, and name. And what we discovered ultimately was that they were neurodivergent. And that was the helpful way of understanding their story. Yes. And so more and more of my clients were neuro divergent, and it became more and more sensible, and more and more exciting for me to go, actually, I don't need to know everything about everything. What I what I really need to do is understand how to be the best therapist, the best psychologist, the best assess, you know, person that does these discovery assessments that I can be for the neurodivergent community. And alongside that, there's neuro divergence in my family. So it was a coming together of my world. Really? Yes. Yeah. That brought me to this point where my practice is specifically for neurodivergent people.
Wendy Kendall
Yeah, you know, there's something that all of you have kind of spoken to and spoken for there that I think is profoundly important for us to kind of get the message out there, which is when there is an area in psychology that is not well understood, not coherent. And then gatekeeping, access to professionals, through people being able to articulate in a certain way, what their needs are, is like setting up people for failure. Right. So when we have a situation, I didn't watch this panorama documentary last week, I've heard people describe what was going on, I've read some newspaper articles about it. But this whole thing about, Oh, is there an you know, an unnecessary explosion in the diagnosis of people who aren't really, you know, then then that kind of what you're saying kind of really speaks to me there. Because you're saying if I'm understanding this correctly, when we're, we have inappropriate filters for what this should look like. And actually what we're doing is being, which is actually more of a scientific way of doing things, which is opening up the conversation about and getting curious about it. First of all, rather than having these pre fit pigeon holes that people need to match before they can receive any support? Am I Am I way off track here? Am I understanding this? What? What's your thoughts on that?
Emma Offord
Um, so one of my thoughts, and I start to get kind of like a fight flight response, when I think about some of these discussions, because
Emma Offord
I haven't watched the panorama. I thought it might sort of be a bit triggering to watch.
Emma Offord
But I think what can get forgotten in all of this, but it's not only incremental change, working a different way, one to one with people and families. It's a movement, it's a social movement. And, you know, it's grassroots, it's from service users, or neurodivergent, self identified. So I've added individuals, it's not just coming from private services or kind of experts, it's coming, who are doing their own research, who are confronted with a system that's down, that's not everybody, but many people. And they're creating this movement. And so I see a lot of the work that I do as part of that movement. And part of using the skills I have now, I guess, the voice that have the platform that you can have as a clinical psychologist, to advocate on behalf of those individuals and families. You know, see a lot of families in crisis, they can't get access, if they are being given access. They're being asked to write a letter justifying their assessment, or they're, they've got a waiting list of two to five years, and they know their child isn't able to access school getting any education, either that's the part that needs to also be investigated and looked at is quite being gatekeeper. The gatekeepers, you know, saying I'm sorry, you're you're too socially You're making too much eye contact for a neurodivergent person and all those stereotypes, which are anecdotal. I have not witnessed that myself, but this is what my clients come to me and tell me. So, you know, I think it's I think it's, it's, it's your it's that transformational change that we're part of your neurodivergent neuro affirming clinician. So if you guys would agree with that.
Katie Adolphus
I think I'm really interested by that. Because I think that there was almost there's been a recent critical mass that's allowed people kind of, I sense a kind of permission giving to say, as a clinician, actually, yes, there are people around me who agree with with me, I'm not alone person saying a thing. And as you say, Emma, there's a huge neurodiversity community, finding their voice, which is a glorious thing. And it feels like that that impetus is really, really grew. So I wonder whether there have been lots of people I know for myself, a lot of the stuff that is being said, Now, in a neuro affirmative way, I was thinking but didn't feel like I had permission to push that boundary professionally, for quite a while. And it's, and it's really freeing to now say, Oh, actually, there's a body of people around us that are on the same page. Yeah. And that makes me feel a degree of hope, even though the systems and structures that we work in. are as they are.
Wendy Kendall
Yeah. Yeah. And Lou, I notice you kind of nodding your way through that as well.
Lola Perez Gavino
I mean, I agree with everything that that has been said, and I'm very aware of, you know, sort of some of the sort of ideas and positions that are out there in terms of, you know, sort of these, you know, people who who have managed to get through life without a diagnosis. And, and, you know, is, are they really, really autistic? And I don't know if it is fortunately or unfortunately, but there are, you know, people wouldn't think of, you know, am I ADHD? Am I autistic? For no reason. So that that's one of the questions for me. So people feel different people struggle, and then they ask the question, like, what, what, why, and then they, they look into neuro divergence, and it could be anything, because it could be dyslexia, it could be, you know, it could be anything that makes you different from from the majority. And it is an explanation, people feel comfortable, people feel normal. So for me that sense, I think if if, you know, the community is brilliant, you know, splitting that there is a community out there and that people belong. And at the moment, you know, the way things are set up, it just seems like, you know, there is a diagnosis, you know, but maybe I don't know, where things are gonna go, you know, what direction are we going to start seeing, you know, sort of different, different, you know, neurodiversity in a different way. And hopefully, there will be a time when people don't even need to, like, at the moment, I feel like people need a diagnosis to get support. I think that's what Emma was saying, isn't it? So hopefully, we get to the point where people say, Well, I cannot work in a room full of people making noise, and you don't need to say I am autistic, to be able to get a space that is appropriate, or, you know, the light bothers me. Now, you have to go with the, you know, sort of say, Look, this is why I need Well, actually, you know, everybody needs a space that works for them or, you know, sort of an ADHD person to be able to get up and move around or, you know, whatever it is that that that that they need without having to sort of feel like you need this label to get the support. But it's complex, isn't it, like, so many layers?
Wendy Kendall
That it, isn't it kind of when you talk about responding to people's needs like that? I mean, goodness me, we're not talking about having to, you know, dismantle the whole world out, you know, what I mean? It seems like what is being asked for, actually, a lot of the time is, in itself, not some kind of huge adjustment, somehow huge departure from what other people have put up with, and yet it gets layered with so much politics because a person is asking for something to help them with something.
Katie Adolphus
I think it's that confusion, isn't it between asking for accommodations so that the world works for you, and people's confusions about equality? Because you're supposed to treat everybody the same, but actually policy and equal is equality of opportunity. And so that might be for Finding different things for different people so that their opportunities are equal. And I think that that's that people get tripped up about that, because there's an assumption that equality means providing the same thing. And it doesn't it means that the outcome has to be the same the outcome in terms of opportunity and availability, for for growth and to reach your potential is equal.
Wendy Kendall
Yeah, yeah. So removing barriers to people growing, you know, as necessary, right?
Lola Perez Gavino
Exactly. What they need to thrive because right and there is this idea that, Oh, you know, you are neurodivergent you cannot have a job, you cannot keep a job, you cannot have a family, you cannot have a relationship. Yes, you can, with the right support with the right understanding in the right environment. And I think that's one of the things I don't know if you Katie and Emma find that but you know, a lot of people who come to see me who don't believe that they are able to or or that have those beliefs around themselves, of how far they can get.
Emma Offord
Yeah, I think that's been the narrative throughout many people's lives, hasn't it of kind in a square peg round hole experience. So have, you need to change that this is Asian, this is the norm, this is the boy uniform, you must have put off, you must eat that I've served you, you know, and fighting against your sensory preferences. You're kind of ways of processing information, like what you were saying, Lola, even, you know, in therapy, we need to change the way that we help people process information. We can't just do it, and then intense eye contact talking about all of the time. Yeah, if that kind of 15 minutes is a bit artificial. Why does it have to be 50 to 60 minutes? Why can't it be something else? But yeah, just shifting. That understanding that it's not an I won't it's I need order to be able to listen, learn, engage, feel safe. Smile, be happy. And I love what you said there, Katie, about inequality. I think that's just so spot on.
Wendy Kendall
Something also, I mean, you know, this is episode 10. No, of this first series. And what I've realised from having these conversations is there's always something that people say that, that really kind of that is like my paradigm shift in my head. And, you know, there's a couple of things that I think you've raised here, one, which is about how important it is for all of us, but all of us to feel as though we are the ones telling our stories, like, it's like our story doesn't have to be and it can be traumatising, when it is defined by and shared by other people. And we're not involved in that somehow we're not asked about it. We don't relate to it. You know, there's something really important there, I think, which is some message around the ownership of our stories. Yeah, and so when it comes to you and your practices, you know, we talk about breaking out of the mould. That's what this kind of podcast is around. Because I think that's, for me, it's something that's really fundamental to the power of private practice, which, which is that it gives us the capability, I feel like it gives us that power in our hands to start shifting some of these the systems where we feel like something needs to be done differently. But obviously, that can feel exposing. So just wondered about whether that's been part of your experience. I think a couple of you have alluded to that, that, you know, feeling as though you're not the only one now feels better than it used to feel. So have you had what have been your experiences about starting to break some of these moulds?
Katie Adolphus
I think that's a really interesting question, Wendy, when when we think about doing assessments, there's a real tension, I think because to ensure that they are not challenged and that they can the outcome can provide access to services or supports that people are eligible for. There's a real tension that we we use the international diagnostic manual those that exist, which are both currently really quite deficit focused in their in their language and their understanding or divergence, whilst wanting to provide an experience for the client, that is affirmative validating, and that they can come away with a sense of being understood and a sense of pride in their identity as a neurodivergent person. And I think that tension is something that within our practice, we routinely touch upon and reconsider and think about in terms of the diagnostic, you know, the tools that we use as part of our assessment, the way we the language that we use in reports. I think that's a tension that's, that's really alive. amongst the community. Yes, autism and ADHD assessors at the moment. Yeah,
Wendy Kendall
yeah. So on the one hand, having to keep one foot in the, you know, the current system, let's say, and with the other foot kind of starting to break out of the mould a little bit, and they're always being attention in on there being a tension in that currently
Katie Adolphus
has, you know, most families that come to me one of their questions is, are your assessments, you know, do local services and schools accept your assessments? So it's pivotal, we find that, that we tread that tightrope and do it well, right? Yeah.
Emma Offord
One way that I try to bridge that gap, because I at that's, I mean, I'll always have the conversation that similar converse with the parents and some person, no, this is going to be medicalized language, or parts of your report. Reason for that. And, you know, and we'll have to put, you know, Autistic Spectrum Disorder, you have to put that diagnostic in there. And that's uncomfortable, really uncomfortable. But I think you can couch that with the trust gap, and you can have that conversation. But I co construct my room with every person I work with, so they get a draft, if there is something they feel they really need to say, in that. So it's not only going to be as medicalised diagnostic report is also going to have their voice in there will also be including other trauma experiences that not being heard, and so that that tip is really useful there as well, because this idea of school trauma is not really understood that, that a lot of innocent neurodivergent individual experiencing trauma, not only in school, in the workplace in another area, so that that's not really part of a traditional autistic HD assessment. So think, yeah, you're you're you're trying to make it as affirming as possible around this medical model, but it's still really uncomfortable.
Wendy Kendall
Yeah, yeah. And just to kind of bring you in Lola there, because I noticed as well, but you're kind of affirming that some of those experiences as well. It's something that you also that tension that you also seen, I was
Lola Perez Gavino
going to say? Yeah, yes, I was going to say that that's probably the area where it feels that it will really felt like breaking the mould, I think in terms of assessments, because they are so different from the sort of the more traditional way that I was used to doing them when I worked in teams. And that, you know, sort of that balance, you know, sort of really being careful checking that you're doing everything that should be done that no one can challenge. Well, they get challenged there, but you know, sort of giving all the information that that it feels a little bit like justifying yourself, you know, sort of making sure that you put all the information that that someone reading the report may say, did they ask about this? Or does this, you know, this is sort of nice compliance, NICE guidelines compliant is so it's there's a lot of work to make it robust enough to you know, sort of feel like it shouldn't be challenged. And but at the same time, they're giving the person the experience that they wanted, and I think that that is one of the things that I find that some of the people who have come for assess, you know, for to have an assessment with me that it was like a process, you know, the opposite to be, but it was something it wasn't just the label, you know, it was like I want someone who understands and I want yeah, validated. Yeah. So I completely agree with what what Katie said, and I'm as well Yeah, but it feels like really, you know, to have an exercise where you have to sort of Really make sure that you take all the boxes.
Wendy Kendall
Yeah, yeah. And at the same time really holding this kind of responsibility and privilege as well I guess of being a person there to start. That is that is affirming someone that is validating them that is helping them to take back the power over their own stories you said Emma about CO creating reports with them and, and so on. So, yeah, I love that because it's such a description of almost like the, the grassroots day to day, what it looks like to challenge and push back on a system within the mental within the mental health sector, right, where people have been traumatised by the system. And on the one hand, holding that experience with empathy so that it's not a re traumatising experience again, and meeting the requirements of the system whilst pushing back on it. I mean, that's such a, you know, an incredible description of the kind of challenges of, of the work that you're doing in your private practices, because part of their reason for being is to challenge the system, as opposed to just in inverted commas being there to support people who have been unseen by or damaged by the system.
Emma Offord
Yeah, I definitely feel on a completely different level, of course, what some of those clients feel, because, you know, you are pushing back against us, you are doing things differently, you are challenging what's being said, changing narratives. Even you even a draft report could be seen as you know, not the right way to do it, you should just be writing the report your expert opinion and delivering it. But, you know, you know, it can feel very anxiety provoking, you can feel like you could be challenged for doing this work, at the same time, putting your heart and soul and even in in it and wanting to someone's got to do the advocacy, haven't they? So, yeah, it's something that I think we as clinicians in these roles and, and deeply empathise with that, the level of disempowerment, that other clients, yeah, that how they feel on a daily basis, you know, facing and challenging the system is, you know, huge, actually, it's an IT, they can feel very hopeless. So there has to other people at different levels within the system, you know, the system to be able to do this, but it's, it's hard. Really,
Wendy Kendall
yeah. And you all, you all know me. So you will know that one of the things I say about people in private practice is, I think, I even have a card that I send out to people as they come on to the programme, which is psychologists in private practice, where they're brave pants every day. And so this whole thing of, you know, what helps you to wear your brave pants every day? You know, is it is it having other practitioners in the practice with you? Is it having these kinds of conversations? What is it that helps you wear those brave pants every day?
Katie Adolphus
That's such a good question. But I would just say, I don't know that. I do, do that manage to do that every day. So I just like to put my hand up and say I sometimes I'm able to do that and other times feel more vulnerable. I think what helps me is being really tuned into autistic voices. Because if I, if I hear that what I'm doing is, is kind of rooted in what autistic voices are saying then that makes me feel good or it gives me a course correction. If not, right.
Emma Offord
I'd agree with that. I think that that's that's where the grounding comes from when ail sort of unsure of yourself or thinking you know, what, what am I colleagues maybe going to think about me or people that I used to work with in the NHS and then you see things like your the controversy that's that's about you know, it's uncomfortable. But then again, when it when you listen to the community Tea, it's all there. And so really, that's what we're doing is we're listening, we're doing our job experience, and the narratives are the people we serve and want to work with, and want to support. So, yeah, that gets me very quickly out of a bit of a head spin of doubt, sometimes not my own doubt, you know, society will come, come back on you.
Wendy Kendall
Yeah. Yeah,
Lola Perez Gavino
I agree with what you said. I think I think that's one of the reasons why private practice really works for me, because I have kind of shaped the work I do, and what I offer to what's aligned with my values, and what I want to be about as a professional and as a psychologist. So I mean, obviously, you know, sort of doing your research and be, you know, sort of hearing listening to the community, to the artistic community, in your direct diversion community in general. feedback from clients, it's just such a luxury to be able to tailor and adapt what you do to what you think and what people tell you that is needed. So, but yeah, I think, you know, sort of going back to that, that tension, isn't it earlier, where you're trying to do your best, but then also, you have to sort of bear in mind what's what, what, what the system or what certain systems are, are about or value. But it's, I don't know, if you If Katie, and Emma has not have noticed that. But I've also noticed, like, in the last couple of years, it's been such an expansion in terms of, you know, hearing about neurodiversity and assessment assessments have changed so much, there's so much more emphasis on the person's experience, and, you know, this new Euro forming way of working, you know, with with the Autistic community, that has been really amazing to be part of it and actually do it, you know, in the way that you believe that is the right way to do it. And the helpful way to do
Wendy Kendall
Yeah, awesome. So I guess coming to kind of thinking about the hopes for the future. If you're going to think about, you know, how you would, what you're hoping will happen in the coming, you know, few years with respect to the changes you'd like to see in the system. And also, just in terms of how you see your own practices developing. Yeah, how, what are your hopes for the future around that? I need to perhaps come to Lola, if that's okay, first, yeah.
Lola Perez Gavino
Very good questions when all of it can make you think a lot? I'm, I'm really curious at the moment, there's so much happening at the moment in terms of, you know, sort of social media, voices, you know, coming, you know, coming up and out. And I'm really, really curious in terms of what's going to happen, how, how we are going to shape the future of neurodiversity on services for neurodivergent people. And as I said, in a way, you know, I sort of, it's really tricky. And I think for me, there is a this balance between sort of validating, like, this is your, you know, this is your group, you know, this is who you are, but then at the same time taking each person by themselves, and not necessarily saying, oh, this person is autistic, so this applies to them, or that applies to them, or they won't benefit from these kinds of therapy, or they will benefit from these kinds of therapies. So actually, maybe, yes, it's a framework. And it's useful to think about neuro neuro divergence, but then at the same time, each person being unique, and thinking about what does this person need? And yeah, so that's part of the process that I am at the moment.
Wendy Kendall
Yeah, I love that. And I think that just sounds like such a profoundly important capability for us to develop within our systems as well, that we don't just have this kind of cookie cutter. Okay, well, you've got that label now. So this is the suite of things that you get or that you don't get, like, like, if our systems could, could have a for an organising framework, and then an individual focus, like everyone's going to benefit from that, right. Absolutely. Emma, how about you for hopes for the future?
Emma Offord
But they're not dissimilar? I'm very curious. I mean, I, I kind of almost sometimes imagine the possibility of kind of re defining of the medical model and In quite a different understanding of this idea of mental health and psychology, and psychiatry, I think there's much more to still learn and incorporate. So, for me, that would be my ultimate goal, my ultimate outcome would be that could be just have another look at that.
Wendy Kendall
keep chipping away at that scientific paradigm.
Emma Offord
More research, you know, using neurodivergent or self identified neurodivergent individuals as part of that research because, you know, that that has been gatekeeper. There's been gatekeepers there. And, and more clinicians, as neurodiverse clinicians, and I think there are men who perhaps don't feel able to say they are as well. So, you know, yeah, more inclusivity in those kind of terms. Yeah, that's, um, I think it's the system change really, for me, schools as well to have schools that are more inclusive and less compliance control LEDs, which I know is very relationally, traumatising for many neurodivergent individuals. So, you know, it's to stop the trauma. Really, and to and to, to look at this with curiosity, not a sin. Like you said earlier, when do you know, people are doing this with good intention as a survival response for for themselves and for their families? Not, you know, looking at the neurodivergent not because they're out to get anything. It portrayed as so. Yeah, yeah.
Wendy Kendall
Awesome. Thank you, Katie, what are your hopes for the future?
Katie Adolphus
Well, are we allowed to change the world in response to this question? I think my hopes for the future are the systems and structures around us. Don't take people as individuals and, and respond accordingly. And when that happens, we can dismantle the idea that neuro divergence is part of a mental health thing. You know, it can come out of the DSM, or the diagnostic manuals can come out of the ICD, or other diagnostic manuals. And I say it that way around, because there's no point in taking it out if actually, that's going to mean that people fall between the gaps. Right, you know, and are further harmed. But, but both of those changes need to be happening. I, I think. And wouldn't it be amazing if if we weren't needed, if we didn't have to have cohorts? conversations about neuro divergence and trauma? Yeah. So my long term hope is that I can retire on needed.
Wendy Kendall
What kind of new job for you? Okay. Fantastic. Well, yeah, I mean, it's been such an amazing conversation to speak with all of you today, because it really brings home how important it is, I think for you know, for in terms of being able to dismantle systems that are harming people, that actually, within our private practices, we all there is a role for us to play within private practice to do that, that it's not and the reason why I think that is really important. And why I make that link to, you know, practices that are actually very purpose driven is because I know even within our own community of psychologists, there can be a sense that, oh, people go into private practice for kind of selfish reasons. And I see exactly the opposite with everybody that I work with, you know, people go into private practice very often because they fundamentally cannot bear to see something happening that is happening every day. And they want to make a difference with that. And by the way, we do need to make practices that that also support nurture practitioners so that you know, we can live that we can live also, you know, happy and effective lives and not be traumatised by our practices as well. But yeah, I I've just I've learned so much from this conversation. I've also learned so much over the the period of time that I've known you guys to just in terms of thinking about the world with a or seeing the world with a different lens as well. And yeah, I'm profoundly grateful to to all for you for this conversation for the for the various conversations that we've had over the, over the years. So thanks very much. Thanks everyone for listening. A really big grateful thank you to Katie Adolphus, Emma Offord, and Lola Perez Gavino. Today, where can we find you? Oh, Katie, where can we find you on social media, on internet?
Katie Adolphus
Social media. I'm very much at the beginning. So we do have a Facebook page, the Adolphus Practice. We've got an Instagram account, that's the Adolphus Practice. But and they are about to be meaningful as pages and accounts to follow, but they are not there yet.
Wendy Kendall
We'll get lots of followers for you. And what's your website address? We'll put it in the show notes.
Katie Adolphus
The Adolphus practice.co.uk
Wendy Kendall
Perfect, Emma, where can we find you?
Emma Offord
At the moment, it's divergent life.co.uk on our website and Instagram is Divergent Lives.
Wendy Kendall
Awesome. Yeah. I love your Instagram account. And Lola.
Lola Perez Gavino
So my, my therapy website is mind made easy.com. And my website for autism assessment is high masking autism assessments.com. Not very original, but very straight to the point. And I am. Yeah, I'm at the beginning of starting, you know, sort of to be a bit more present in social media. I've created an account, which is called artistic flee. But I only have one post so far, but lots of ideas that just need to be
Wendy Kendall
Seen you on LinkedIn as well. So I know. Connect with you on LinkedIn. Yes, yes. Perfect. Thanks so much, everyone. And thanks, everyone for listening. We will see you in next week's episode. Until then, take care and bye.
